Inclusive Health of Women: Building a case for corporate engagement with Sexual and Reproductive Health

The COVID-19 pandemic challenged the planning capacity, efficiency, effectiveness, and preparedness of the global public health systems. With increased socio-economic insecurities in low and middle-income countries, progress on the Sustainable Development Goals (SDGs), was stalled. The United Nations has forecasted a $2.5 trillion annual financial deficit to fulfil the SDGs, which has been compounded by the pandemic. Given that we are in an era of transnational governance, where companies, civil society, international organisations, and governments play interconnected roles in standard-setting, supervision, and enforcement of welfare policies and programs it is the responsibility of all the stakeholders in the health ecosystem, including the private sector, to collaborate and strategize how best we can do our part if we are to make progress on our shared goals and targets. This view is reflected in Goal 17 (Partnership for the Goals) of Sustainable Development Goals (SDGs), which aims “to mobilise, redirect and unlock the transformative power of trillions of dollars of private resources”.

In 2013, India became the first country in the world to make Corporate Social Responsibility (CSR) mandatory for eligible corporations in India. In doing so, it acknowledged industry as a key change agent and recognized the critical need for utilizing the skills and resources of the corporate sector. Through 2014-2021 CSR spending has been a crucial enabler of development services. Education and health were the highest recipients of support, these being the basic needs of most India’s underserved populations.

The COVID 19 pandemic however reshaped the CSR agendas in India. The pandemic set in motion an interesting trend – while there was a greater overall focus on health for all, women’s health was subordinated due to the immediacy and urgency of the COVID-19 crisis. 

Source: CRISIL CSR Yearbook 2021

One of the most severely affected areas of health, during the pandemic was and continues to be in the domain of Sexual and Reproductive Health, and Family Planning. For instance, access to contraception and reproductive healthcare has been greatly hampered while several countries were under a state of lockdown, due to very low mobility of people and services. The lockdown also had a disproportionately negative impact on women, due to its gendered manifestations. As per the UNFPA report, in 2020 the COVID-19 pandemic prevented 12 million women from accessing contraceptives, leading to 1.4 million unwanted pregnancies. In addition, COVID-19 related school closures and economic poverty have led to more sexual abuse, early child marriages and early pregnancies.

While India with its oldest family planning programme in the world has made progress, several gaps remain. Therefore womens’ health must be located in an intersectional analytical framework, which acknowledges women’s different experiences and identities. For instance, women, transgender and gender non-binary folks who are subjected to racism, ableism, and other forms of marginalization, discrimination, gender-based violence, sexual abuse and socio-economic exploitation have been exposed to such instances at a greater intensity, which has been further aggravated due to the COVID-19 pandemic.

In addition, globalisation has considerably influenced the nature of relationship and shared responsibilities present between business and society whilst the gender composition of such workplaces has witnessed a significant shift. Women currently make up a significant proportion, if not the majority, of the workforce in several industries. Therefore, there is a need to adopt standards and practices, in alignment with the changing gender composition in the workplace.  These changes necessitate inclusive Occupational Safety and Health (OSH) and other industry initiatives can help attain SDGs 3 (healthy lives and well-being for everyone) and 5 (gender equality and empowerment).

Sexual and reproductive health, and family planning is a cross-sectoral investment which impacts all the 17 goals of the SDGs, directly or indirectly. A collaborative and alliance-based approach can prove to be fruitful when the key stakeholders invest directly in fields such as education, reducing child marriages, sexual and reproductive health, and family planning, using an intersectional lens, as these sectors have a multiplier impact resulting in greater economic and social returns.

Sexual and Reproductive Health and Family Planning is an opportunity for India Inc. to ensure systems change and make a lasting difference at the grassroots. Some potential areas of engagement are offered below,

  • The National Family Health Survey 5 reported several gains for women’s health in India. However, some gaps remain. The need for family planning has declined among married women (15-49 years) across all states and Union territories except Meghalaya. This unmet need can be key to improving the maternal mortality record of India as well as to ensure child health. Further, according to the latest National Family Health Survey-5 (2019-2021) only 9.5% men used condoms but 37.9% of women underwent sterilisation. While the fertility rates have reduced in India, access to contraceptives and modern family planning methods remain patchy and were mostly virtual in the Covid 19 phase. It is key to a variety of development goals and is an opportunity for corporations to diversify their CSR agenda through comprehensive programmes on women’s health and engage with men as partners in change.
  • ESG provides a sustainable and long-term strategy to leverage opportunities and invest in behavioural change among the large number of youth employees across the supply chain. In addition, engagement with ESG ensures competitive advantage for both donors and recipients. The mandatory reporting format of Securities and Exchanges Board of India (SEBI)’s Business Responsibility and Sustainability Reporting (BRSR) requires corporates to report on 9 different sustainability parameters. The immediately relevant principles for the SRH and (Family Planning) FP sector include:
    • PRINCIPLE 3 Businesses should respect and promote the well-being of all employees, including those in their value chains
    • PRINCIPLE 5 Businesses should respect and promote human rights
    • PRINCIPLE 8 Businesses should promote inclusive growth and equitable development
  • Adopting an alliance model presents an opportunity to bring together resources and knowledge of different stakeholders.  India’s Condom Alliance established by SHOPS Plus in 2019 and Samhita’s REVIVE Women@Work coalition may be considered as an innovative model that is actively engaging with multiple stakeholders with a focused agenda and messaging that resonates with all stakeholders. The Condom Alliance, is a collaboration of market leaders such as DKT India, HLL Lifecare Limited, Janani, Population Health Services India (PHSI), PSI India Private Limited, Reckitt Benckiser, Raymond Group, TTK Healthcare Ltd, undertakes campaigns like ‘Break The Wall’, ‘The Birds & Bees Talk’ and ‘ConSenSuality’ aimed to remove the mindset barriers while delivering adequate and effective sexual education to Indian youth. The REVIVE Women@Work a $15 million blended finance platform, supported by United States Agency for International Development (USAID), Michael & Susan Dell Foundation (MSDF), Omidyar Network India, British High Commission New Delhi and United Nations Development Programme (UNDP) continues to support the revival, resilience and growth of India’s informal economy.

As a way forward, Samhita-Population Foundation of India proposes the Stakeholder Alliance Creation for Collaborative Impact (SACCI), a multi-stakeholder alliance of policy makers and practitioners, private sector, civil society organizations, and institutional funders in furthering the significance of autonomy, freedom and choice for women and young girls, whilst ensuring better, affordable, and quality healthcare services for the citizens through various milestone policies.