Convene and catalyze action to drive change: WRA strategic approach in action
By Deepa Jha, Senior Program Officer, White Ribbon Alliance India
White Ribbon Alliance uses six strategic approaches to create change and achieve our vision that all girls and women will realize their right to quality health and well-being. Deepa Jha, senior program officer with WRA India, explains the strategy “convene and catalyze action to drive change.”
Citizen engagement in public health is not a new concept. For centuries, governments across the world have used a variety of techniques to actively involve citizens in decision making. But the recent design of citizen engagement by WRA India is an important advancement because it ensures that women do not face reprisals and repercussion for speaking out and holding their leaders accountable. This principle is key to White Ribbon Alliance’s global strategic approach of convening citizens, governments and other leaders to catalyze action and drive change.
Understanding the problem
India has some of the best designed policies and programs that are centered on women’s health needs. These include guaranteed free care before, during and after pregnancy and referral and transportation services for the most at-risk women. While certain components of these programs have been successfully deployed, universal implementation has yet to be realized and the operationalization of these programs is proving to be a big challenge.
Hearing directly from people about those challenges is critical in closing that gap. And while women are increasingly coming forward to voice their opinion on issues like health, there are still many women from marginalized communities whose voices remain unheard. Because of these gaps and a lack of accountability at multiple levels, maternal and newborn mortality in India remains unacceptably high, with a pregnancy or childbirth related death occurring every 12 minutes across the country.
Women need a safe and secured platform to voice their concerns about their own health and the Alliance ensures that the anonymity is maintained, while amplifying women’s voices about their health needs. I’m happy to say that in India today, women’s participation is regarded as central to creating sustainable health care policies and strengthening health service delivery. WRA India is committed to providing safe and effective platforms and support for women so they are comfortable and confident in speaking about their health and rights.
Case Study: What Women Want
One of the most recent and exciting examples of WRA’s strategic approach of convening and catalyzing action to drive change is WRA India’s groundbreaking campaign, Hamara Swasthya, Hamari Awaz (What Women Want). They took to clinics, communities and everywhere in between to find out just what it is that women want when it comes to maternal health care. The results were clear: they want to be treated with dignity and respect. Now they’re working to realize that request with policy makers and service providers across the country. Read more about this initiative HERE, which WRA and partners are taking global to drive demand for quality, equity and dignity in reproductive and maternal health for every woman, everywhere.
People-led solutions
WRA India has pioneered an implementation model for social accountability specifically to improve maternal health outcomes. We have employed various tools including public hearings, checklists for facility assessment, citizen reporters, citizen scorecards and low-cost technologies such as Integrated Voice Response System (IVRS) to rate facilities and services received. These tools are a way to gather evidence from women and the community at large so those in power can hear directly about specific challenges faced in accessing and receiving entitlements and services that are meant explicitly for them. This multi-faceted model measures successes and identifies gaps in reproductive, maternal and newborn health program delivery while strengthening capacity, and engaging those responsible for improvements in service delivery.
The findings gathered from various citizen engagement models are collated and shared with policy makers, community and media, for specific action. WRA acts as a catalyst and convener around all these efforts to ensure that the promises made to women are kept. Our two-pronged approach of pushing for government accountability for promises made while keeping our eye on longer term policy advancement, brings quick wins for the most vulnerable while keeping sights set on systemic, sustainable change.
Citizen Engagement Tools Briefly Explained:
· Public Hearings: Public hearings are organized at local levels each with participation of around 1,500–2,000 women health officials, elected leaders, media and community representatives to discuss issues such as good and bad experiences of women, access to and provision of quality services, challenges of referrals, non-availability of promised entitlements, demands for “informal payments”, and more. This leads to local decisions being taken for various cases and commitments for further action to improve maternal health service and care.
· Checklists: Facility level assessments are done through checklists that are used for rapid monitoring of facilities, through quick surveys based on standard protocols and interviews. Gaps and key areas for improvements are identified, which are then discussed with health providers and policy makers for action.
· Citizen reporters: Through citizen reporters, rural communities are engaged to locally-own and manage media production and community-based film making on women’s maternal health gaps. The powerful locally generated films depict the real grassroot situations that women are facing due to lack of quality care.
· Integrated Voice Response System (IVRS): Women were also provided with a low-cost technology based platform on IVRS that are used to educate them on their health entitlements and quality of maternal care, then let them rate the services that they receive at hospitals.
Cross sector partnerships, collaborative networks
Rather than carrying-out isolated interventions, WRA India advocates for the involvement of all stakeholders, across multiple sectors, who are seeking safe motherhood solutions. Partnerships are formed at national, district and community levels to build ownership of problems and their solutions. Collaborative networks are established and recommendations are shared with policy makers.
As our citizen engagement model and the initiatives behind them have become more rooted in civic processes over that last decade, we have witnessed that when women are directly engaged and given the charge of their health, they become less vulnerable and their voices are included in polices and protocols, which accelerates progress at the facility and policy level. Witnessing women demanding their health rights gives huge encouragement to other women to speak up, especially rural women who now have greater access and opportunities to improve the maternal health conditions in their own communities.
It is gratifying to see women who are empowered and understand that they can influence the quality of services they receive and become active participants in their health, not merely passive recipients of services.
White Ribbon Alliance unites citizens to demand the right to a safe birth for every woman, everywhere. We harness the power of local women and men to achieve lasting change. Our approach is working. Subscribe to WRA’s newsletter VOICES and follow us on Facebook and Twitter to keep up to date on White Ribbon Alliance’s global maternal health campaigns.
