Country Context
India has an extensive but poorly managed and equipped public health system. 75 percent of health care spending is the expensive private sector. Cost constraints and concern for their family’s needs above their own mean most women seek advice and care only for serious conditions.
Family planning awareness is reasonably widespread because of a soft two-child limit encouraged and publicized by the government. Basic problems with malnutrition, poor personal hygiene, and reproductive health present the most serious threats to women’s health in India.
Unmet Health Needs of Female Factory Workers in India
- Reproductive tract infections
- Lack of adequate personal hygiene
- Irregular or painful menstruation
- Lack of awareness of HIV/AIDS transmission and prevention
- Pre- and post-natal care
- Poor nutrition
Perspective
Sridevi Kalavakolanu, ResponsibleBiz.com, BSR consultant, HERproject
At the BSR Annual Conference in October 2007, Sridevi shared her concerns about women’s health in India.
Context: South India Factories Dominated by Female Workers
Most women workers in factories in South India are in their early to mid-twenties, and many are the first generation in their families to leave home and seek employment. Most have very little schooling, usually 10 years, with older workers having as little as 5 years of schooling. They are for the most part untrained and when they begin working in factories, often begin in the ‘Helper’ category and pick up skills on the job. Very few factories offer comprehensive training programs for new workers.
Demographics
With regards to working conditions, about 10 percent of factories can be said to be excellent, 80 percent are average, and about 10 percent provide extremely poor conditions.
Workers typically work until the age of 45 and then retire. Workers generally get married in their early to mid-twenties and usually have two or three children.
Female workers typically live at home, and dormitories are not commonly provided in India. Workers often do not have time to take care of themselves or their health as their days are filled with long commutes, work and taking care of their families when at home.
India advocates a “two-child” family planning policy which is not a legally mandated limit. Very few women use contraception and the most common method of those that do is an IUD Device. Most women opt for permanent contraception through a tubectomy operation after the birth of their second child.
Existing Factory Health Programs and Services
Most factories only provide very basic diagnostic and referral health programs. Factories with more than 500 employees are required by law to have full-time trained medical staff ” most factories of this size have nurses and very few have doctors.
Health facilities tend to be extremely basic. For example, few factories even have refrigeration facilities for storing injections. As a result, only the most basic treatments can be taken care of onsite.
Workers are covered by the Employee State Insurance (ESI) service, based on contributions from the employer and employee. However, ESI clinics and hospitals are very poorly equipped and staffed.
Most workers tend to use private hospitals for emergencies, which are very expensive. India has one of the highest levels of private spending on health — 75 percent, with only 25 percent of total spending on health carried out by the government.
Health Challenges Facing Female Factory Workers
In health education, there is very little available to women beyond the two child family planning program.
Typically women only seek medical care and go to hospital at the time of child-birth. Most lack knowledge about basic rights and required provisions for women such as the right to move to seated or less strenuous work during pregnancy, maternity leave, child care facilities, nursing breaks etc.
Nutrition is another serious problem — women workers rarely have time for breakfast before leaving for work and tend to take long breaks between meals. Their diet comprises mostly rice with few sources of vitamins and protein such as green vegetables.
Gastritis and upper respiratory tract infections are common. Cases of dehydration are also common and often lead to dizziness — some factories reportedly do not allow workers to drink water as this threatens productivity.
India also has the second highest rate of new TB cases in the world at 168 cases per 100,000 people, and this is reflected in a number of cases in factories as well.
Women typically have poor personal hygiene; for example during menstruation few women use sanitary napkins. There is subsequently a high incidence of reproductive tract infections among factory workers.
Awareness of HIV/AIDS is reasonably well-spread as an STD, but other methods of transmission are not widely known. Prevention methods are also not well known.