Slum community groups use negotiation skills, knowledge, to improve access to services and entitlements: A demand side approach to better governance

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.

[email protected]