The Self-Employed Women’s Association, SEWA, is a national union of over 18 lakh women workers of the informal economy in 14 states of India. SEWA and the SEWA movement began in Ahmedabad, Gujarat, in 1972. It was founded by Ela Bhatt, a lawyer and labour organiser who began her work with head-loaders and streetvendors, all informal workers, in Ahmedabad. As she organised them into their own union and cooperatives, like SEWA bank, an urban cooperative bank, SEWA members also expressed their need for primary health care. Hence, she and other early SEWA pioneers organised ‘Know Your Body’ training programmes for women workers, health check-ups and referral care in case of serious illnesses. This then gave rise to a comprehensive primary health care programme implemented by a team of Arogya Sevikas and Dais, all local, front-line health workers.

Once 50 such health workers were trained and actively working at the grassroots, SEWA promoted a health cooperative–Lok Swasthya SEWA Mandli—the first of its kind in Gujarat and perhaps, in India. Today Lok Swasthya Mandli is a financially viable cooperative with 2000 share-holders. It is generating surpluses which it then manages according to its bye-laws, approved by the cooperative department of the state government of Gujarat. It has been growing and generating more surplus over the 25 years of its existence. Hence, the board of the cooperative decided to register a trust, Lok Swashtya SEWA Trust, to undertake welfare-oriented activities like health education and awareness and child care, to mention a few, which are non-revenue generating. The idea was to contribute some of the cooperative’s surplus for these charitable and welfare activities.

Hence Lok Swasthya SEWA Trust was registered in 2005 as a charitable trust with 6 permanent trustees and five rotating ones, all women, and several themselves informal workers from different trades, communities and geographies. Every year, one third of our rotating trustees are replaced, allowing other women to exercise fresh leadership. We hold quarterly meetings where trustees learn about all activities undertaken and examine all financial statements. This information is shared with all staff and grassroots level workers, thereby inculcating a culture of transparency and accountability. The Chairperson of LSST is always a woman from the informal sector, hence recognising their leadership and centrality to all that we do and have accomplished. In addition to our grassroots action, we bring the issues of women workers directly to the attention of policy-makers and legislators at district, state, regional, national and global levels, and in their own voices.

To achieve our vision of empowering women, we understand and take up women’s felt needs and demands from the grassroots level. With the information gained from such experiences, we liaise and coordinate with local, state and national level government functionaries and institutions. As a result we work closely with local governance committee such as panchayats and their sarpanch, Village Health, Sanitation and Nutrition Committees, Municipal Corporations among others to ensure proper implementation and outreach. In this manner we work in a service-cum-rights-based approach and the community forms the bedrock for all our activities, a modus operandi that throws up new avenues for constructive local action at community level and appropriate changes at the policy level. Following in Gandhi’s footsteps we work towards decentralising control, strengthening decision making by women and placing resources, dissemination of information, planning, implementation and monitoring in their hands.

Fund-raising in the Lok Swasthya Sewa Trust (LSST) is done such that it supports activities which will become sustainable over time. Hence, we prefer investment approaches to funding, and look for strategic partnerships in this direction. We partner with donors who share our approach and view on long-term sustainability. LSST has supported three cooperatives to become sustainable and fully self-financed after the initial investments. Of course, this took several years, during which we needed finance to cover costs and build up sustainable activities and organisations. One such recent example is the Megha Adivasi Mahila Cooperative of tribal women farmers who are now selling their produce directly to whole-sellers. It is already sustainable.

In the last ten years LSST has grown to include livelihood security, insurance, health and child care, capacity-building and cooperative development in its portfolio of activities. In 2010, LSST obtained Foreign Contribution Regulation Act (FCRA) registration and now has a number of international donors like the Packard Foundation, Rockefeller Foundation and GIZ (Deutsche Gesellschaftfur Internationale Zusammenarbeit) as partners. In addition, we have partnered with several UN agencies like the UNDP and WHO. We have also partnered with the Ministry of External Affairs, Government of India, to provide services and share its experiences in five countries in Africa: South Africa, Tanzania, Ethiopia, Ghana and Senegal. In sum, our manner of working combines building a grassroots movement of women workers alongside policy action at various levels for lasting and effective social change.