Helping women access health care - the Women's Health Fund
This entry has been selected as a finalist in the
Innovations for Health: Solutions that Cross Borders competition.
The revolving Women's Health Fund provides women with ready access to cash funds for accessing health care whenever they need it.
About Your Organization
Rural Women's Social Education Centre
Country where this project is creating social impact
Is your organization a
Non‐profit/NGO/citizen sector organization
How long has your organization been operating?
More than 5 years
Has the organization received awards or honors? Please tell us about them
References - Please provide two references with a two-sentence biography, email address, and phone number for each
Renu Khanna - Renu is a feminist with special interest in women's health issues. She is a part of several national level networks including CommonHealth and People's Health Movement.
Phone: +91 9427054006
Padmini Swaminathan - Padmini is an economist with special interest in Women's development and labour issues. She is a Retired Professor of Madras Institute of Development Studies.
Phone: +91 9444018484
The information you provide here will be used to fill in any parts of your profile that have been left blank, such as interests, organization information, and website. No contact information will be made public. Please uncheck here if you do not want this to happen..
Select the stage that best applies to your solution
Growth (your pilot is up and running, and starting to expand)
How long have you been in operation?
Operating for 1‐5 years
Which of the following best describes the barrier(s) your innovation addresses? Choose up to two
The Need: What problem are you trying to solve?
Expenditure on health care is one of the major causes of indebtedness in rural India. Given existing gender hierarchies, households often prioritize meagre resources on more valued members of the family - male children, male head of the household and male members. While several attempts have been made through innovative financing mechanisms to support households in accessing health care, only a very small number of these have focused on improving access to care of the most marginalized person in the household - the woman. In spite of the fact that women have a high burden of disease, women are less likely to seek appropriate and early care for disease. Women also internalize their subordinate status and often suffer illnesses, especially of the reproductive organs, in silence.
The Solution: What is your solution? Be specific!
To improve rural women's access to health care through providing them with financial resources for the same, we created a revolving Women's Health Fund. This Fund is operated through already existent self help groups and held in a separate bank account in the group's name. Women members of the group borrow from this Fund at very low interest rates for health care and pay back in installments. This provides women with ready access to cash funds that is under their control and can be used for accessing health care whenever they need it. This prevents them from falling into high interest debts to meet health care expenses or worse still, not access health care at all for lack of funds. Women could also seek care for reproductive illnesses - they otherwise do not disclose these to male heads of households who control funds as they feel shameful about it. This also provides women increased standing in their families and communities as they have financial resources under their control.
The Model: Walk us through a specific example of how your solution makes a difference; include your primary activities
To each of ten chosen self help groups, RUWSEC provided an initial small sum as the Women's Health Fund. The group added a small contribution to this and this amount was put in a separate bank account in the group's name and was designated to be the Women's Health Fund. The members of the group could then borrow money from this Fund whenever a need for health care arose - the amount was to be repaid in a maximum of 4 installments at a low interest rate of 1% every month. Women could access health care using this amount from any provider of their choice - public or private. A cap on the maximum amount that could be borrowed was laid so everyone had access to the Fund, group members were asked to prioritize health care needs when more than one person needed the fund and a small amount was held in cash by the president of the group for emergency needs.
Over the last 5 years, funds have been borrowed from the Health Fund for treatment of more than 1000 illness episodes by women in the 10 self help groups in the programme. These illnesses have been of a varied range - from common illnesses like viral infections to surgeries, tuberculosis, reproductive infections and also in emergencies like accidents, suicidal poisoning and snakebites.
Women have innovated with the modalities of functioning with the Fund - they have functioned democratically within the group to prioritize health care needs of different women, arranged for emergency funds when necessary, ensured repayment of the loan and maintained records of all of this.
The Marketplace: Who are your peers and competitors? Identify others also working to address the needs you are and what differentiates you from them. What challenges could these players pose to your success or growth?
The self help group (SHG) movement is strong in Tamil Nadu. The mainstream SHG funds are often used for health care - but this is usually for large amounts and has now moved to being beyond the control of women themselves. While our Fund is operated through SHGs, by being prioritized for illnesses specific to women, it provides greater access to women to health care.
Health insurance is another financing mechanism being explored recently in rural India. However, this is usually for large, in patient expenses in large, recognized facilities. Poor rural women often need cash for outpatient care in small facilities or indirect expenses in public facilities. By providing them a financial resource for this and giving them choice of facility, our Fund fulfills this large gap in their needs.
This Entry is about (Issues)
Founding Story: We want to hear about your "Aha!" moment. Share the story of where and when the founder(s) saw this solution's potential to change the world.
RUWSEC has worked with rural women on health issues for over 3 decades. Our work has been to raise women's awareness on health and change their health seeking behaviour, work with the health system to improve quality of care and make it more sensitive to women's needs and provide services through a small clinic offering women sensitive care.
Throughout, we have found that finances are a major roadblock to women to seek health care. We have seen several women who have postponed seeking health care or waited till illnesses could no longer be borne. A past research study by us on women living with prolapse uterus documents their inability to seek timely medical help. We have also seen that prevalent patriarchal values in society preclude women from using even meagre resources available to them.
This led us to look at alternative models of financing that would put control of resources in women's hands and adapt existing models into the Women's Health Fund.
Please describe the goal of your initiative; outline what you are trying to achieve
RUWSEC has worked from the beginning with the conviction that for women to become agents of social change addressing other issues of oppression, they had to start by dealing with, and transforming, their lack of control over their bodies, and the sense of powerlessness that this led to. The organization's strategy, which has evolved over several years, aims to bring changes in four areas: women’s ‘being,’ women’s ‘consciousness,’ women’s health-seeking behaviour, and the health care system’s commitment and ability to meet women’s health needs.
The Women's Health Fund hopes to change women's "being" and their health seeking behaviour and thus give them more control over resources in order to gain more control over their bodies, health and lives.
What has been the impact of your solution to date?
On analysis of data for three years, the amount borrowed was used to treat the woman's own illness in 57% of the total borrowings. These illnesses have been of a varied range and varied amounts of money have been borrowed by women depending on the type of illness. Pregnancy, delivery, abortion and other reproductive morbidities constituted 14% of the illnesses for which the amount was borrowed. The amount was used to treat illnesses of women in the reproductive age group in 74% of the borrowings. Treatment was sought from government facilities for 70% of the illness episodes. Repayment has also sometimes been in many more than the originally stipulated 4 instalments but there have been very few defaulters.
Women have generally welcomed this initiative - they have reported a decrease in reliance on alternative means of raising money, either at high interest or through mortgaging/sales of assets. The low interest rate and the flexible repayment option have also been welcomed.
What is your projected impact over the next five years?
Over the next five years, we expect the Women's Health Fund to increase women's access to health care, especially for reproductive illnesses: increase women's ability to make decisions and act on issues related to their own bodies and health: increase women's standing in society by increase in control of financial resources; and increase women's voice on issues related to their health and their lives.
What barriers might hinder the success of your project? How do you plan to overcome them?
We mainly see two barriers:
Use of funds to access irrational medical care. We are already seeing some evidence of this. We plan to address this by having specific sessions with women on rational care. A larger campaign in the community on the dangers of irrational care is also planned and in a start up phase. We also plan to work with health care providers towards promoting more ethical, evidence based care.
Existing patriarchal system undermining women's control of the Fund. This will be addressed by our larger work with women on gender and changing their "consciousness". RUWSEC's existing work with men, women, adolescent boys and girls in the community on the interface between gender and reproductive health and rights will also contribute towards this.
Winning entries present a strong plan for how they will achieve and track growth. Identify your six-month milestone for growing your impact
Upscale the Women's Health Fund to ten more groups and start a documentation and costing component.
Identify three major tasks you will have to complete to reach your six-month milestone
Provide ten more groups with the Women's Health Fund
Hold sessions with women on gender and health and start a community based campaign on rational care.
Start rigorous process documentation and work out components of costing the programme
Now think bigger! Identify your 12-month impact milestone
Have more self help groups asking for and starting the Women's Health Fund
Identify three major tasks you will have to complete to reach your 12-month milestone
Start the Women's Health Fund for at least ten more groups
Evaluation of the model and a detailed costing
Develop a group of grassroots women aware of the model and spreading the message horizontally.
Tell us about your partnerships
We partner with women through our grassroots contact and the self help movement. We also partner with some young men in the community who help us work with men on issues of gender and health. We also partner at present with our donors who have helped us set up the Fund. We hope to partner in the future with health care providers in providing better quality care.
Are you currently targeting other specific populations, locations, or markets for your innovation? If so, where and why?
We are presently moving beyond an initial exploratory phase to establishing the model in the rural community that we already work in.
What type of operating environment and internal organizational factors make your innovation successful?
The very grassroots led nature of our organization helps us understand the needs of women and address and adapt our solutions to their needs.
Please elaborate on any needs or offers you have mentioned above and/or suggest categories of support that aren't specified within the list
RUWSEC has an experience over thirty years of working with marginalized women on health issues. Women centred research has been one of our strengths. Much of our work has also been documented by us. We would be willing to share insights gained from these with others who want such information.
|70 weeks ago Kristin Jerger said: Also, Subhasri, do you already know about the project described in the entry, "Health and Microfinance - A Winning Combination for Poor ... about this Competition Entry. - read more >|
|70 weeks ago Kristin Jerger said: First of all, thank you for your entry. Your work is beautiful! It makes so much sense to me. I have 2 questions for you (please ... about this Competition Entry. - read more >|
|75 weeks ago subhasri balakrishnan updated this Competition Entry.|
|75 weeks ago subhasri balakrishnan submitted this idea.|