A three-pronged approach can enable positive breastfeeding outcomes

Optimal Breastfeeding can boost maternal and child health worldwide

According to WHO & UNICEF, over 820,000 lives can be saved annually through optimal breastfeeding. Breastfeeding can significantly improve the health of children and mothers resulting in economic benefits equivalent to USD 300 billion worldwide annually.

The optimal breastfeeding practice recommended by WHO is to initiate breastfeeding within one hour of birth, exclusively breastfeed (EBF) for the first six months, followed by breastfeeding and complementary feeding for a minimum of two years thereafter.

India has not scaled its breastfeeding rates as desired
Research has shown breastfeeding rates have not scaled as desired in India (NFHS 4). While institutional deliveries have increased from 40% in 2005-6 to 78% in 2015-16, breastfeeding initiation in the first hour is still low at 48.5%, with EBF rates for the first six months at 55%. These numbers point to a missed opportunity to enable breastfeeding at birth and sustain those practices effectively thereafter.

In public hospitals, the front-line workers (FLWs), doctors and nurses are expected to provide information and support on breastfeeding. However, inadequate staffing, low awareness and incentivisation for other activities over breastfeeding play a role in why this is not prioritised. In the private sector, where regulation is limited, there is low awareness and limited incentives for doctors and nurses, who are the key caregivers to mothers. Many caregivers encourage mothers struggling with breastfeeding to lean towards formula food.

Why are breastfeeding rates low?
Considering breastfeeding is a natural process, we assume that it comes naturally to every mother. However, issues range from incorrect latching, doubts on milk sufficiency, lip and tongue ties, delayed onset of milk (which require individual counseling) to mastitis and breast abscess (which require medical intervention and sometimes, surgery). Predominantly, lack of timely awareness and sustained support mean that mothers are ill-equipped to address such issues and this can ultimately, lower their confidence to breastfeed.

A three-pronged approach is required to address these barriers:
1. Awareness generation to ensure that families have the right information
• Counselling should start early (during pregnancy) and be extended to the family, especially the primary support system (spouse, mother, siblings, mother-in-law) to ensure a supportive and encouraging environment.
• Ensure adequate and frequent training to all who impart breastfeeding counselling (including frontline workers, doctors and nurses). Training should also be a part of the curriculum for medical and nursing students.

2. Skilled counselling to overcome barriers and enable appropriate behaviour
• Invest in dedicated skilled lactation counsellors for breastfeeding counselling at a public district hospital level. A cost-benefit analysis (EPW ) has shown that it will strengthen the government’s agenda on breastfeeding and promote best practices.
• Invest in sustainable models of skilled counselling in private facilities that focuses on demand creation along with ensuring a pool of trained counsellors.
• Boost private and public partnerships to address availability and quality of care by filling gaps in the public sector through appropriate incentivisation

3. Peer support groups to sustain the behaviour for the desired period
There is strong evidence to show how support groups improve breastfeeding rates. It is important that such groups work with families, as they play a significant role in busting myths and stigmas and stopping mothers from abandoning breastfeeding. . We need to:
• Institutionalise and sustain peer and mother support groups in the public sector by working closely with frontline workers and communities
• Strengthen and replicate successful existing peer networks and use them to accelerate breastfeeding outcomes in the private sector through enabling the right partnerships

It is critical these strategies all work in tandem to achieve favourable outcomes.

Finally, it is the choice of the mother
In India, we see a gap between intent and implementation. Strengthening policy, enabling working parents, increased funding and rigorous monitoring are critical enablers in reducing these gaps. In addition, catalysing the private sector to focus on innovation and demand-led models to increase breastfeeding rates are important, especially as the private sector starts to play a larger role in healthcare.

The choice to breastfeed lies with the mother. What the ecosystem should ensure is that her choice is backed by the right information and the necessary emotional and medical support throughout her breastfeeding journey.

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An edited version of this article was published in BW Wellbeing World to mark World Breastfeeding Week.

Talk to us: impact@sattva.co.in

PRALAY CHAKRABARTI

Pralay is a Principal with Sattva’s Transformation Advisory and Portfolio Services. He has 15+ years of management consulting and corporate strategy experience across multiple sectors. He has led multi-country complex transformation initiatives. These have been across impacting organisation strategy, process, people, and culture that needed strategy formulation and deep change management expertise.

Pralay holds an MBA from Indian Institute of Management, Kozhikode.

Digital Solutions for Women-Owned Enterprises

Digital Solutions for Women-Owned Enterprises

Background

A decline in rural jobs, the one-sided burden of unpaid care work, along with other structural and underlying issues, such as unequal pay structures, have compounded the decreasing female labour force participation of India—56.1% of working women in India were self-employed as of 2014. There are 8.1 million Indian women-owned enterprises as per the 6th EC, making up 13.7% of enterprises in India. Only 20% of these report their Gross Value Added (GVA) as over INR 5,000 per month compared to 73% of men-owned enterprises.

There are multiple different approaches that have been used to promote and address the variety of barriers faced by women-owned enterprises, ranging from programmes driving financial inclusion to the provision of skilling initiatives. Of the plethora of different approaches to solving for these barriers, e-commerce and digital solutions offer a new and potentially scalable pathway to potentially solve for some of these issues and generate market linkages for these women-owned enterprises. Digital solutions are only just beginning to be explored in India and could provide a scalable means of linking women to markets and job opportunities. The effect size of such interventions (both in India and internationally) could extend beyond market connections and livelihood linkages, to providing layered social empowerment outcomes.

Sattva_Woman-market-india

Sattva organised a roundtable to understand this potential through three lenses — the viability of e-commerce as a solution, the enablers it provided that could solve for specific barriers, and the feasibility of implementing such a solution at scale. ‘Digital Solutions for Women-Owned Enterprises’ takes forward the insights from the roundtable to better understand the potential of e-commerce in growing women entrepreneurship.

Key Findings

1. The high potential of B2B e-commerce
The B2B customer segment of e-commerce offers high potential for women-owned enterprises to access markets and scale as it helps producers procure bulk amounts of raw materials at a lower cost, and have larger order sizes and more predictable revenue.

2. Three B2C sectors with opportunity
Three sectors in B2C e-commerce provide maximum potential for integration of women-owned enterprises. These are:

  • Sale and manufacture of apparel and home furnishing
  • Retail sale of food and beverages
  • Hyperlocal services like hairdressing and beauty services, or repair and alteration of clothing

3. E-commerce enables enterprises in multiple ways
E-commerce platforms can enable enterprises to access larger markets, understand market dynamics and tailor their products/services, get easier access to credit and other inputs, and improve their technical and business skills.

4. There are five key enablers that need to be provided or developed in order to ready women for integration into e-commerce

  • Willingness to participate in e-commerce
  • Functional and technical skills
  • Access to and usage of mobiles and technology
  • Market intelligence and business support
  • Access to working capital and inputs

5. Similarly, there are five enablers required to achieve readiness at an ecosystem level

  • Developing infrastructure in partnership with telecom providers
  • Creating a favourable policy and regulation environment
  • Adding a gender lens for e-commerce platforms
  • Reducing entry barriers on e-commerce platforms
  • Facilitating technological access for women (by developing familial and community support)

The full report can be accessed below.
Digital Solutions for Women-Owned Enterprises – Full Report

Our research shows that even though the e-commerce sector in India is experiencing major growth, the effects of e-commerce growth have been concentrated amongst a few of the larger vertical and horizontal players, with the bottom of the pyramid not yet having any real benefits.

There are a few industries that show high promise for women entrepreneurs to integrate with e-commerce value chains, such as; restaurants/online food delivery, groceries, and the manufacture of textiles and home furnishings. Additionally, the operational models of e-commerce platforms provide a host of enablers that address the constraints faced by women entrepreneurs and women-owned enterprises, building a solid market case for the potential of incorporating women into these value chains. However, in order to truly incorporate women into these value chains, there is a need for mentorship, hand-holding support, financial and digital literacy and technical guidance to be provided. Further, there is also a need for infrastructure to be strengthened, a supportive environment to be developed (by addressing normative and social constraints as well as by enterprises providing support). Favourable government policies towards e-commerce growth, like we’ve seen in other countries such as China, and enabling its decentralized access are also necessary for these women entrepreneurs to thrive in parallel with the rapidly growing e-commerce space.

Would you like to partner with us to further the conversation around the potential of e-commerce in growing women entrepreneurship? Write in to knowledge@sattva.co.in.

Shambhavi Srivastava

Shambhavi is a Senior Research Manager at Sattva and brings in 8 years of experience in research and public policy projects in the sectors of rural livelihoods, women’s economic empowerment and financial inclusion. Shambhavi brings with her strong expertise in quantitative and qualitative research methods using mixed-method approaches, statistical tools and experience with leading outreach and dissemination activities on the field and in the ecosystem. She has served as a Principal Investigator (PI) on numerous gender, public health, financial inclusion and rural livelihood projects.

Prior to Sattva, Shambhavi worked as Research Manager for Institute of Financial Management and Research (IFMR LEAD), India where she served as the PI and programme lead for policy projects in the Financial Inclusion vertical on multi-stakeholder projects in collaboration with partners such as DFID, Access Assist, SIDBI, Ministry of Finance and the University of Munich.

Shambhavi holds a Master of Arts degree in Cultural and Social Geography from the University of British Columbia, Canada, a Master of Arts Degree in International Relations and Political Science from Jawaharlal Nehru University, India and a Bachelors in Political Science from Lady Shriram Delhi University, India.

More than Money

Elderly self-help groups in rural areas provide more than just financial security.

National Bank for Agriculture and Rural Development (NABARD) in India defines Self Help Groups (SHGs) as “small economical homogenous affinity groups of rural poor, voluntarily formed to save and mutually contribute to a common fund to be lent to its members as per group decision.” The loans that the rural poor can avail of is utilized in a number of ways, including generation of income through entrepreneurial pursuits.

Earning a living, however, is not the sole reserve of under-60-year olds. Given their vulnerabilities, elderly people in villages need it just as much. In the last two decades, HelpAge India has pioneered the creation of Elder Self-Help Groups or ESHGs in rural India to provide livelihood support to the elderly. The success of this model has led to its adoption by the Ministry of Rural Development for the National Rural Livelihoods Mission in India, for 5,543 ESHGs, impacting 67,014 elders across 12 states in India. The ESHG members may save as low as an amount as INR 30 (USD 0.42) per month per person, and then pool their resources to inter-lend within their group of 10-20 people, eventually moving on to larger loans through financial linkages with banks. They may then individually or collectively engage in income generating activities, such as taking on the project of cooking the midday meal for children in the village school.

While ESHGs have potent financial impact on the lives of the aged, there are also some lesserknown social aspects that are harder to quantify and may often be empirical in nature. However, there is no denying the positive impact they have on the personal psyche and relationships of seniors.

Sattva_Insights_MoreThanMoney_AditiChatterjee

Increased inter-generational bonding
Travels into rural West Bengal brought us in touch with 10 such ESHGs, including a few 80-year-olds who walked into the ESHG meeting bent over crude walking sticks. They were too old to earn the INR 1 (less than 2 US cents) a day that they had to contribute to the collective savings fund. They proudly announced though, that their grandchildren gave them INR 1 a day from their own daily “pocket-money” of INR 5 so that the grandparents could be a part of the ESHGs. Though anecdotal in this instance, ESHGs have been known to increase intergenerational bonding within the family due to similar circumstances.

Improved status within the family
Old age is sometimes associated with familial neglect. However, ESHG members often enjoy improved status within their families. One of the reasons for this is that they are able to contribute to the family income through their own earnings via the ESHG. Even in the absence of such earnings, the elderly nominate family members who will be the recipient of their ESHG savings and the interest it accrues upon their demise. Having an inheritance to leave behind therefore also contributes to their improved social standing within the family.

Antidote to loneliness
Even with improved social status in the family, loneliness is a real concern for the aged. Amidst their own work and household chores, family members may have little time to spare to engage with the elderly folks in the house.

However, village elders who had become ESHG members said that they had organized outings to picnic spots and religious sites as a group – something they had never tried before. Others mentioned that when ill-health hampered their mobility, the whole group congregated close to their house for the weekly meetings so that they could be a part of it. Interestingly, the elderly having their own social circle led to decreased stress for the care-givers in the family too, and therefore often resulted in more harmonious family relationships.

Broadened horizons and collective action
Among the most remarkable effects of the ESHGs however, is the impact of exchange tours to other ESHGs. Not only does this expose members to wonders they had never experienced in their own lives (like travelling by train for the first time, or seeing running water flowing out of a tap), it also gets them acquainted with best practices of other groups. There have been reports of groups who almost doubled their contribution to the savings fund to provide small stipends for more destitute members. Dolon Mukherjee, a Ph.D. scholar in gerontology and a HelpAge India veteran, commented that ESHGs who had met such groups came back to their own villages and started to save INR 2 instead of INR 1 per month. The reason? To set up a parallel avenue of pensions for members of their ESHGs who did not have access to state pensions and social security benefits.

Elder Self-Help Groups have, therefore, not just helped the elderly financially, but also given them a new lease on their social and personal lives in their twilight years.
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This article was originally published in Impact Magazine and can be accessed here.

You can find more Insights from Sattva here.

To talk to us for collaborations or partnerships, you can write to us: impact@sattva.co.in

Finclusion: Empowering Women Through Digital Finance

Did you know that poor women account for 1.1 billion of the world’s unbanked adults, or most of the financially excluded?

Financial inclusion needs to bridge gender gaps for it to become truly inclusive, and India has a long way to go in this respect.

In order for digital finance to reach rural women sustainably, there is a need to bring together stakeholders from policy, government, businesses, digital financial solution providers, community-based organisations, and funders, to discuss pathways to collaboration for sustained outcomes.

To achieve this, L&T Financial Services and Sattva have taken a bold first step in focusing their efforts on digital financial inclusion of women in rural India through the conception of Finclusion: Empowering Women Through Digital Finance – a participatory dialogue on learnings, gaps and potential to harness digital financial inclusion for rural women in India.

The summit will take place on 1st February, 2019 from 9am to 2pm in New Delhi.

In an effort to establish knowledge sharing and thought leadership in this largely untapped ecosystem, Finclusion will bring together some of the most eminent thought leaders in the space, including Shri Krishnan Dharmarajan of Centre for Digital Financial Inclusion and Renana Jhabvala of SEWA Bharat among others.
With discussions on topics of great contemporary significance like “Partnerships in effective delivery of financial inclusion” among panellists like Prabhat Labh, CEO of Grameen Foundation and P. Satish, Executive Director of Sa-Dhan, the national-level platform hopes to facilitate vibrant discussions between stakeholders across the board, and ultimately, enable sharing of best practices, solutions and partnerships around women empowerment through digital finance.

Finclusion: Empowering Women Through Digital Finance is an event you won’t want to miss, especially if you wish to leave a lasting impact in the digital financial inclusion space.

To participate in our event, write to aashika.ravi@sattva.co.in.

Rahul Shah

Rahul is part the Consulting Services team in Mumbai, with experience working on organisational development with both small and large NGOs, CSR design and implementation, development impact bonds, fundraising and impact assessment.

His diverse experience in the development sector has evolved from his time working at the grassroots level in Ahmedabad, India, to community organising in his hometown of Washington, DC, consulting with social organisations across domains and managing multi-year development projects. Prior to joining Sattva, Rahul worked with TechnoServe India where he managed a CSR funded accelerator programme for women-led social enterprises and NGOs, and a USAID funded project transferring frugal agricultural innovations from India to Africa. In addition to his development sector work, he has five years of progressive experience in corporate finance with industry leading, Fortune 500 corporations in the United States.

Rahul has an MBA and an MS Finance from the University of Maryland’s Smith School of Business and an Executive Certificate in Non-Profit Management from Georgetown University.

Bobbymon George

Bobbymon heads Assessments in Sattva and is based in our Bangalore office.

He has delivered evaluation assignments across sectors and with key CSR accounts such as ABG, JPMorgan, ACC, Philips, L&T Infotech, L&T Financial Services, Dell and Fidelity. He comes with over 13 years of experience in the development sector, across programme design, implementation and Monitoring and Evaluation. He has led Programme Delivery, Curriculum Development, setting up Monitoring & Evaluation frame works and tools in non-profits.

He is also a master facilitator/trainer in Life Skills.

Suhas Urs

Suhas is part of our Consulting Services team in Mumbai, designing and implementing programmes for CSR clients.

Before joining Sattva he was a Gandhi Fellow, where he worked with 5 Government Schools across Surat, Gujarat in the School Transformation Program and carried out focused skill based interventions with the teachers to help improve the student learning levels. At Sattva he has worked with a key CSR client of Sattva in designing and implementing a flagship programme. He has also worked with non-profits in designing the organisational strategy for fundraising.

Suhas has a Bachelor’s degree in Computer Science Engineering from Sai Vidya Institute of Technology, Bangalore.

Mohana Rajan

Mohana Rajan is part of the Consulting Services team in Mumbai.

Prior to Sattva she has worked in the corporate as well as development sectors and as a Legislative Assistant to Mr. Jyotiraditya Scindia. She has worked with Foundations, Philanthropists, Corporate CSR and Non-profits in the areas of skill development, healthcare and children with special needs. She is passionate about gender equality and is keen to look into innovative models that can emulate corporate success in the development sector.

Mohana is a mechanical engineer from NITK Surathkal and a graduate of IIM Bangalore.