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Changing Health Behavior

HERproject raises awareness and promotes behavior change through simple improvements to in-factory health services, and demonstrates the business value such as reduced absenteeism and turnover, and higher productivity.

Case Study Information

Country	Pakistan
Company	Levi Strauss & Co.
Partner	Aga Khan University

83%

Knowledge of the importance of tetanus toxoid immunization during pregnancy increased from 30 to 83 percent

Project

In focus groups in one factory in Karachi, Pakistan, female factory workers shared that they were missing up to three days of work a month during their menstrual cycles. Women reported monthly pain, infections, and embarrassment due to a lack of knowledge about proper hygiene and limited access to sanitary napkins. Nearly three-quarters of women interviewed also reported that they had never seen a condom and they expressed extremely limited knowledge of sexually transmitted infections and prevention. For example, though most had heard of AIDS, not a single woman knew about HIV or how the virus was transmitted.

Health Impacts

In addition to feminine hygiene, peer educators also raised sensitive issues like family planning and sexually transmitted diseases. To make discussions more culturally acceptable, these topics were framed as “preparing for married life.”

The method was effective, and workers began asking for contraceptives. Global partner, ESD, provided AKU technical assistance on making family planning services available at the factory. To meet the demand, AKU worked with the local government and Marie Stopes International to enroll the nurse in a certification program to dispense contraception. The Population Welfare Department, government of Sindh, donated family-planning products, including condoms, oral contraceptive pills, injections, and intrauterine devices to the factory.

Business Impacts

The health awareness and behavior changes in the factory have also had positive business impacts. Because of changes specific to menstrual health, women reported a 25 percent reduction in poor concentration in work, 28 percent less absenteeism related to menstruation, and 33 percent less difficulty in meeting production targets.

Overall, reported absenteeism was 11 percent lower, with a 24 percent reduction in the mean number of days absent. Women who reported taking the maximum number of allowable days off was reduced by 46 percent. Initial ROI analysis has confirmed that women in the factory worked an average of 2.5 more hours per month during the project period, representing an additional 615 days of work per year.

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