© The Gujarat Mahila Housing SEWA Trust
The living conditions of slum dwellers in Ahmedabad, India, have changed with new infrastructure projects, opportunities for employment and more social empowerment. Ultimately this has improved people’s health, and reduced their expenditure on medicines. This is how a social determinants of health approach works in action. Bijal Bhatt from Mahila Housing Self Employed Women’s Association (SEWA) Trust tells us more.
Partivartan, meaning ‘transformation’, is the objective of an ongoing programme in the city of Ahmedabad, in Gujurat, India. It started in 1995 in the slum of Sanjaynagar where 181 households were upgraded. Ahmedabad Parivartan (also known as the Slum Networking Project) brings basic infrastructure services, including water and sanitation in an affordable way to the slums and chawls, or tenements, of the city. Led by Ahmedabad Municipal Corporation (AMC) the project motivates communities, non-government organisations and the private sector to work together in a unique partnership.
The slums are vast with 129,000 informal settlements and 1,383 chawls in the city. Around 300,000 families, or 40 per cent of the city’s population, live there. Many of them have little or no access to basic urban services. The slum networking project is based on the premise that services should only be provided when there is a clear demand for them. The community should be the main driving force. The project works by offering a range of services with realistic ‘price-tags’ attached, enabling communities to make informed choices about the size and nature of the investments to be made. The project is available to any slum wishing to participate and services are fully connected to existing city networks. Parivartan has considerably improved the lives of over 50,000 people in 47 slums so far.
Parivartan provides services at the local level which connect to the city level and include: roads and paving; water supplies to individual households; underground sewer links for individual households; street lighting; landscaping and solid waste management; toilet blocks to individual houses; and storm water drainage arrangements. At the same time finance is provided from both the community level and the city. This means Parivartan can deliver services where the demand is greatest and promotes the management of services at the lowest possible level. It means communities can make choices about technology, contracting and management arrangements. Participating communities form associations or community based organisations to manage their projects at the community level.
Mahila Housing SEWA Trust (MHT) is a non-government organisation set up in 1994 in response to demand from the community of poor, self employed women in Ahmedabad, for specialised housing-related services. MHT has completed nearly 40 projects under Parivartan, in partnership with the municipal corporation.
“Slum upgradation is poverty allieviation. For a poor family their home is a productive asset. It is their workplace. Hence, if their home and it’s environ are upgraded and secured, it is a major contribution to their employment. It has also been observed in SEWA’s activities in the slums that inputs in such programmes as health have a limited impact, if given without adequate basic amenities in the house and infrastructure within the slum locality,” said Ms Mirai Chatternee, Co-ordinator of Social Security of SEWA.
© The Gujarat Mahila Housing SEWA Trust
The development of infrastructure and the provision of basic amenities have a very decisive influence not only on health, education and income, but also the social life of the urban poor and their empowerment. The provision of basic infrastructures in Parivartan inside the slum locality has changed the life of slum dwellers in many ways. There are better water and sewer connections, toilets, paving and lighted streets. In addition school attendance has increase, there is less illiteracy and more employment opportunities. In terms of health, the incidence of illness has gone down to seven per cent, from 17per cent and the monthly health expenditure per house has gone down to 87 rupees, from 121 rupees. The number of daily baths has gone up to 98 per cent, from 66per cent.
This effort to improve people’s lives is multi-faceted and is a good example of the impact that a social determinants of health approach can have. Infrastructure, employment, education and social empowerment are all tackled and improvements in all these areas lead to better health for slum-dwellers.
Bijal Bhatt
Co-ordinator, Mahila SEWA Housing Trust
Contact: mahilahsg@gmail.com
www.sewahousing.org
Filed under: social determinants of health
