Shriya Palekar: Public Health Business Management
Mid-Year Public Progress Report
Shriya Palekar with a Bachelors in Economics and History from Cornell University is paired with Chaitanya in rural Pune district. Shriya’s interest in economic development is being put to good use as she develops a health insurance program from rural women.
Chaitanya came into existence when two pioneering women sought to make it possible for a woman in rural Maharashtra to stand on her own two feet. The founders spent years educating the women of isolated villages on the benefits of organizing themselves into self-help groups (SHGs), in which they cultivated an understanding of finances, pooled their savings and gained access to microloans. Chaitanya’s contribution to Indian development has been tremendous; it goes beyond the successful federation of a far-reaching SHG network and is seen in the transformation of a woman’s mentality from resigned acceptance of her plight to aspiration for advancement for herself and her daughters. What is most breathtaking is that while Chaitanya provides social services to women, its key role is as an SHG promoter and facilitator, providing them with capacity and support to provide social services to themselves.
I arrived at Chaitanya with the mission of creating a viable community-based health micro-insurance to the SHG network. The current Indian rural public health system is plagued with shortcomings: doctors are tardy or absent during office hours or they do not provide appropriate treatment, the quality of infrastructure is poor, and people often have much trouble accessing public facilities given poor transportation infrastructure. The result is that rural families often seek care at private facilities which they cannot afford. Micro-insurance promises access to quality health care and protection from the escalating costs of care.
I was drawn to Khed by a simple project description of an informal arrangement between SHG women and local doctors. In actuality, micro-insurance requires very formal arrangements to ensure that members are well informed, and receive services on schedule, and that health providers deliver quality services. The part of this project in which I take the greatest pride is the health and insurance education it provides to people who have not previously had the opportunity to learn how to prevent illness by simple lifestyle practices such as washing one’s hands with soap. While the financial benefits of insurance will percolate through the community over time, the ethics instilled through education will have immediate effects and the potential for a lifelong impact. Furthermore, an understanding of the value of insurance – of investing in preparation for future risks – can change the course of a person’s life.
Six months after the arrival of our team of three fellows to Khed block, the design of the insurance scheme is underway in partnership with an NGO in Pune City that will provide the technical expertise. Project design has come after an onslaught of research and community surveys to determine people’s needs, expectations, and lifestyles. Conducting the surveys provided me with a unique opportunity to explore women’s lifestyles beyond superficial appearances: I lived with an SHG leader and probed the women of her village for personal information about their health, income, education, and even their reproductive practices. We were then able to construct a holistic picture of life in rural Maharashtra from individual, personal glimpses into people’s lives. The design of the product has its roots in this understanding of the community.
In my role promoting health and insurance education, I have the privilege of working directly with people in the villages. True to Chaitanya’s founding philosophy of promoting self-help, the education campaign is being run by the villagers themselves. How is that possible? My teammate and I recruit local youth in each village to perform a street play and spur discourse on the value of insurance. These young adults run the health insurance dialogue and drum up enthusiasm for health promotion in their own villages. They give advice about the best way to gather crowds, gain people’s interest, and incorporate local village customs into our performances. Thus, the momentum and energy requisite for the success of the micro-insurance scheme will come from within the village.
The effect of the project is visible, even before its launch, in the dialogue it has spurred in local communities who are watching their most promising students rehearse for the play and discuss the value of insurance. In the months ahead I will be focusing on discovering a way to make this burgeoning enthusiasm sustainable, so that the micro-insurance scheme is something people own, use, and improve upon with a momentum based entirely in the villages. While I arrived at Chaitanya with a mission to create a smooth functioning community-based health micro-insurance for the SHG women, my evolved objective is to mobilize women to take action to improve their health care situation.
Reflecting on the past six months’ evolution, I am conscious that my biggest achievement in my time focused on women’s empowerment is to begin to learn how to be a strong woman myself. The amazing women I meet have instilled in me a belief that anything is possible as long as I stand up for myself and pursue my passions rather than the course of action others may prescribe for me. I have learned to never hear anyone tell me that I “shouldn’t,” or worse, that I “can’t.” I have learned to meet challenges by taking a deep breath and pausing to think of the women of Khed block, who aspired to better lifestyles, united against alcoholism, and stood strong in the face of domestic violence. If their challenges were not insurmountable, why should mine be?
Shriya Palekar, August 2009 Indicorps Fellow