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Slum community groups use negotiation skills, knowledge, to improve access to
services and entitlements: A demand side approach to better
governanceJanuary 25-27, 2016
www.facebook.com/uhrcindia/www.uhrc.in
January 25-27, 2016Urban Thinkers Campus on Health and Wellbeing
Convened by United Nations University IIGH,Kuching, Malaysia
Agarwal Siddharth, Verma Shabnam, Verma Neeraj, Agarwal Kabir, Sharma M.R., Sharma C.B
Urban Health Resource Centre, India
Presentation Outline• Glimpses of low access to services, deprivation from our urbanizing
planet• Demand-side approaches towards more accountable urban
governance and inclusion based on program experience across > 410,000 urban disadvantaged population1. Trained slum women’s groups and Cluster Teams2. Increasing Access to Proof of Address and Picture ID3. Gender empowerment enhances caring capacity of woman and family4. Pull Outreach health service in migrant and other deprived
neighbourhoods5. Gentle, tactful Demand-side Negotiation through Collective Community
Petitions6. Youth-children groups emerging as ‘Force Gen-next’ 7. Demonstrate uses of spatial Neighborhood and City Mapping
• Inter-sectoral-Coordination for Bringing Multi-sectoral Efficiencies for Improved Health and Well-being
• Improvements in Access to Services in Slums, Informal Settlements
Glimpses of an Urbanizing World
Competing for water Washing utensils on railway track - Kolkata
Rolling incense sticks to support family income- IndoreAn iron-smith’s daughter on Kolkata pavement
Children on a temporary “bridge” across a drain-Jakarta
Competing for water railway track - Kolkata
Physical Living Environment of Urban poor
Slum at the edge of large Wading through a large drain for daily transit- Indore Water enters low-plinth house after heavy rain: Slum at the edge of large drain – risk of floodsfor daily transit- Indore
Child filling water -DelhiCommunity toilet- pig; hard to keep clean Mosquito breeding in collected water - Indore
house after heavy rain: climate change
Living Conditions of Urban Disadvantaged
The urban disadvantaged, including women contribute cheap labour towards GDPConstruction site, brick-kiln workers, labourersChild-bearing migrant-girls faced particular risks.
Ignited slum community groups engage as active citi-zens,
negotiate collaboratively for negotiate collaboratively for equity and access to contribute
to better urban governance
Trained, empowered slum women’s groups and cluster-level teams of slum women’s groups gives stronger voice and greater negotiation power
Demand-side Approach to better urban governance # 1Cluster Teams of Women’s Groups, Indore and Agra
Slum women’s health groups (Mahila Arogya Samitis) mandated in Govt. of India’s National Urban Health Mission to strengthen demand for health services.
Demand-side Approach to better urban governance # 2Increase Access to Govt. Address Proof and Picture ID
During Apr 2013 – Mar 2015: 20,000 persons benefited from Govt. proof of address and Picture ID
Demand-side Approach to better urban governance # 3Women’s empowerment for enhanced caring capacity of woman, family, improved social support
• Slum women’s groups gradually contribute to a positive gender equation at family and society levels, provide social support to needy families• Women’s enhanced access to resources and greater capacity to take timely care of themselves, children, and capacity to take timely care of themselves, children, and the family helps the family and community• Reduce number of alcohol
vending, gambling joints• Promote savings, girls’ educationThere are over 125 million women among urban vulnerable in India
Demand-side Approach to better urban governance # 4Pull Regular Outreach Health Services by Government and Private Providers in Migrant, other Deprived clusters
Registration of beneficiaries -identifying left-outs and drop-outs
Linkage with the Auxiliary Nurse-Midwife for vaccine administration
Information and community motivation –women arrive for immunization day
Linkage with Doctor for ailments, Ante-natal check-up
Urban Health Extension Worker, Community Volunteer in Ethiopia, Urban Accredited Social Health Activist, ANM in India mandated to identify vulnerable pockets, improve Service access, infection prevention, promote healthy behaviours
Demand-side Approach to better urban governance # 5Gentle, tractful Negotiation through Collective PetitionsWritten requests to officers of Municipal Authorities, Nutrition Dept, Electricity Dept.
Petition
Response of Civic AuthorityDisadvantaged communities actively participate in governance, collaborate for equity, justice, access: maintain paper trail, persevere with tact (including tea + biscuits, polite thank you) to achieve “Right to the City”.
Demand-side Approach to better urban governance # 6Youth-children groups emerging as ‘Force Gen-next’With continual mentoring, motivation Youth-children groups in slums improve their own lives; also contribute to their communities in tangible ways. More vigour and joy to ‘ignite the senses”.
Promoting Hygiene, Hand-washing Youth requests to civic authorities for streets,
garbage cleaning, family-income certificatesThere are 150 million youth 15-32 yr, 125 million 10-24 yr in urban India
Slum Women’s groups in slums use hand-drawn maps to a) Ensure that no family is left out from lists used for housing, sewage
system, toilets, entitlements; b) Track access to health services e.g. Immunization and ANC,
delivery, other health and nutrition services, c) Help identifying recent migrants for linkage to services,
entitlements
Demand-side Approach to better urban governance # 7aDemonstrate uses of Spatial Neighborhood Mapping
1
Demand-side Approach to better urban governance # 7bSpatial City MappingHelps make the invisible visibleLocation of Listed, Unlisted Slums in Agra
Slum Number Population Listed 215 538322Unlisted 178 303251Total 393 841573Agra City Spatial mapping can help socially sensitive planning, inclusion of small pockets, seasonal,
recent migrant clusters
Dept. Women Child Dev.
ICDS, LADLI,Others
Health DeptANC, Immunization
Maternity Benefit Scheme,Other services
PoliticiansLend support for
Multi-Sectoral Community Groups’ Efforts in Smart City
Roads, drains,water., toilet, tenure,
housing
Cluster team of Women’s Groups
Collector’s OfficeSocial Assistance ProgramsOld Age & Widow Pension
Food Subsidy Cards: BPL, APL Cards
Labor DeptDomestic worker
registration
Lend support for applications
housingCity Govt/JNNURM
Picture ID, proof of
Residence, Certificate of
residence
UHRC Indore/Agra
Glimpses of Improved Access to Services in Slums, Informal Settlements
Group member HH Non Gp member HH Non-InterventionHH
Availing Healthcare in Govt. facility
31% 15% 9%
Self-efficacious Slum Women’s Groups Improve Health care, Knowledge including non-group member families
Knowledge of FP/birth spacing method
59% 61% 14%
1. Availing healthcare in Govt. facility was thrice as high among group member families than non-intervention slums; twice as high as compared to non group-member families2. Knowledge of Family Planning methods was four times higher among program slums than non-intervention slums
Self-efficacious Slum Women’s Groups Improve Living Environment including Non Group Member Families
Group member HH Non Gp member HH Non-InterventionHH
Toilet in House 60% 58% 30%
AppropriateDisposal of Garbage
59% 61% 14%
1. Having toilet in house was twice as high among intervention slums as compared to non-intervention slums.2. Appropriate household garbage disposal was four times higher among intervention slums than non-intervention slum families.
Improved access to Toilets, Sewer, Paved Streets
During 2013-2015: 60,000 slum population benefited from sewage system
Struggle for water Water tank erected
Improved Water Supply
During Apr. 13- Mar. 15: 120,000 slum population in Agra and Indore slums benefitted from improved water supply
During 2013-2015: 40,000 slum population benefited (Agra + Indore) from electricity connections
Slum Women’s, Children-Youth Groups community requests to civic authorities over 5 years bring bridge over large drain, Indore2013-2015:Determined women’s, children-youth group members continued to submit written applications to civic authorities and represented in person.
Women’s group members at Dist. Public hearing20112010
2015More permanent, taller bridge is builtAugust2012 October2012
Bridge over Large Drain Benefits 1,20,000 population
1. Trust less formally educated to analyse challenges, evolve & implement solutions with support2. Appreciation, motivation, sustained mentoring and training builds collective confidence, negotiation skills among urban vulnerable communities to work towards overcoming exclusions, vulnerabilities 3. Simple 'indicators' can assess challenges & improvements e.g. i) proportion of households in neighborhood having toilet, ii)
Lessons for Policy, Action Research, Sustained Efforts
proportion of households in neighborhood having toilet, ii) proportion of families with money-lender debt, iii) proportion of families with habitual alcoholics, gamblers, iv) number of community petitions, reminders per year to civic authorities for services (water supply, cleaning drains, sewage system, paving of streets) 4. What keeps them motivated: Recognition from the community, and at public platforms, enhanced self-esteem, opportunity to be co-opted as Govt. outreach worker through training, outreach work [email protected]
Let us Build Human Capability, Expertise, Ignite Action & Engagement, Collaborative efforts and Resilience of
Urban Excluded, Deprived Citi-zens, and to bounce forward, prevent their to bounce forward, prevent their
learning to survive in impoverishmentLet us translate words into real action towards inclusive, socially just cities.