A health worker excels - GK paramedics digitally empowered

Hi, I’m Sharmin, a 19-year-old with a big dream: to become a nurse and help people in need. Recently, I got accepted into the GK training program, which has been an incredible experience.

In 2023, International Women’s Day focused on “DigitALL: Innovation and Technology for Gender Equality”, and inspired by this, GK encouraged paramedics like me to learn computer skills alongside our regular training. I had never used a computer before—my older brother was the only one in our family who had one. But I quickly realized that knowing how to use Word and Excel is essential for any job nowadays.

Excel fascinated me. It’s like magic—it can calculate percentages and analyze data. Now, armed with this knowledge, I feel more confident during our door-to-door visits in rural villages. As a paramedic, I can provide health information effectively and be a first responder when needed.

This training is just the beginning, but I’m hopeful. The blend of healthcare and technology empowers me to serve my community better. Together, we can make a difference—one step at a time.

When a gender reveal isn't a good thing - testimony from a GK traditional birth attendee in Bangladesh

Halima, 57 years: "I received Traditional Birth Attenders (TBA) training from Gonoshasthay Kendra (GK) and began working in my village. In Bangladesh, maternity care often occurs at home due to stigma around women going to hospitals. As a TBA, I provide health advice to pregnant women and support them during follow-up visits with GK paramedics and I also bring them to our sub-centers for ultrasound scans. Unfortunately, I sometimes encounter uncomfortable situations where families try to know the fetus’s gender. This can be dangerous: if it’s a boy, often the family is very happy and the mother praised and taken care of. However, if it’s turns out to be a girl, families can be unhappy and can blame the mother, neglect her or even lead to physical and mental abuse them.

To prevent this, in 2020, the Bangladesh High Court issued a rule to prevent gender-based discrimination against unborn children. GK not only abides this but to contribute addressing this serious issue, has incorporated gender awareness into our midwifery training. Through workshops, we educate elders and family members that woman are not responsible for a baby’s gender and that daughters are just as much of a blessing as sons. Within our role of traditional birth attendees, we can help eliminate discrimination and contribute to dismantling societal stigma.

Since my gender awareness training, I’ve actively promoted change within many  families and villages and have been proud to witness this."

From toiling the soil to leading the union - CFTUI, India

Marisa Naresh, 38 years, born in the village of RAJAM in Andhra Pradesh: "My family survived on a mere 3 acres of agricultural land, toiling under the sun. We were laborers, our livelihood tied to the earth.

As a young man, I looked up to Mr. N. Satyanarayana—the towering figure behind the District Agricultural Union. At 17, I stepped into the world of union activities. Our affiliation with CFTUI in 2007 opened doors. Thematic knowledge, organizing skills, and public speaking—these became my tools.

Through WSM-supported activities, I learned about labour standards, participated in sectoral conferences, several basic and advanced training which boosted my knowledge on labour rights.  I now lead struggles, especially concerning MGNREGA wages. The ageing leaders pass the torch to me, and I’ve become a role model for youth in the agricultural sector."

Strength in numbers: some results of partners in India during 2023

Labour rights: 639.813 people, of which 64% women and 37% younger than 35 years, were reached through actions focussing on ensuring existing labour rights or developing new labour standards: 

• 536.302 workers (64% women and 37% youth) were made more aware of their labour rights through campaigning and outreach. 
• The partner organizations have organized 71.081 workers, of which 97% women and 30% youth. 
• 33.049 people, of which 94% women and 34% youth received basic training, while 4.859 workers and union leaders (90% women and 43% youth) received advanced training. 
• 14.107 workers, of which 95% women and 24% youth, benefitted from some kind of individualized support or advice from the partner organizations. 

Over 150.000 people (46% women and 39% youth) were mobilized at grassroots level (ex. demonstrations, petitions…) for advocacy and to meet policy makers.

Social security: 93.904 people, of which 61% women and 33% younger than 35 years, were reached through actions focussing on giving access to better social security.  58.168 people were reached through awareness raising activities (60% women and 25% men), while 13.681 received basic training (97% women and 24% youth) and 728 people received advanced training (45% women and 16% youth). The partner organizations gave legal assistance and support to some 21.082 workers (99% women and 36% youth) and reached out to 245 policy makers.

Healthcare: overall, 9.539 people were reached during actions to improve awareness on health practices and how to use native medical practices and medicines.

Network: In 2023, all WSM partner organisations jointly organised and participated in 9 State and national level events focusing on ensuring and including health insurance (ESI) for informal workers in the Social Protection Scheme and inclusion of Domestic workers in Informal Sector. A total of 4950 workers (37% women, 18% under 35 years old) actively participated in these mobilization efforts.

The collective efforts of WSM partner organizations have paved the way for getting attention by the authorities for the inclusion of social protection and the health insurance ESI for informal workers and recognise domestic workers contribution for economic development of the country and include them under informal sector. By advocating for health insurance coverage and the inclusion of domestic workers, they have voiced critical issues to the State Government.

India context in 2023: women, health and agriculture

Women’s Right 

The Women’s Reservation Act, 2023 (also known as the Nari Shakti Vandan Adhiniyam) is a historic step towards gender equality in Indian politics. It reserves one-third of all seats in the Lok Sabha, State legislative assemblies, and the Legislative Assembly of the National Capital Territory of Delhi for women. This includes seats reserved for Scheduled Castes (SCs) and Scheduled Tribes (STs) as well. The proposed legislation aims to continue this reservation for 15 years.

Health Policies

The Pradhan Mantri Jan Arogya Yojana (PMJAY) is a significant component of the Ayushman Bharat initiative launched by the Government of India. A flagship scheme aimed at achieving Universal Health Coverage (UHC) in India. It moves away from a fragmented approach to health service delivery and focuses on comprehensive, need-based healthcare. It provides cashless and paperless health insurance for secondary and tertiary care across public and private empanelled hospitals in India. PM-JAY is a crucial step toward ensuring affordable and accessible healthcare for millions of Indians, reducing out-of-pocket expenses and improving health outcomes.

New policies in Agricultural Sector

The new agriculture policy of the Indian Government aimed to promote growth in the Indian economy by focusing on increasing agricultural productivity, encouraging the adoption of modern agricultural practices, and promoting value addition in the agricultural value chain.

Fading flowers? No, facing the world! AREDS, India, 2023

I’m Shanmuga, an 17-year-old girl who’s been through quite a journey. Life wasn’t all rainbows and sunshine for me. Irregular periods, loss of appetite, tiredness, hair falling out like autumn leaves, and a constant feeling of fatigue. Yep, that was my life. Anaemia had me in its grip, and it wasn’t letting go. But that wasn’t the worst part. Every time I saw another girl my age, I felt like a drooping flower next to a glowing bloom. My self-esteem? Well, it was buried somewhere deep, along with my energy.

Here enters the AREDS Health Team. They didn’t just throw medical jargon at me; they built a bridge of trust. Slowly, I spilled my worries—the irregular cycles, the hair loss, the whole shebang. And guess what? They didn’t judge. Instead, they handed me a lifeline. “Shanmuga,” they said, “meet your new best friends: bitter gourd, beetroot, turkey berry, pomegranate, dates, gooseberry, curry leaf, and jaggery.” Iron-rich foods became my daily companions. I chomped down on them like a hungry squirrel. And you know what? It worked! Six months of commitment, and my body thanked me. My menstrual cycle decided to play nice, anxiety took a vacation, and my hair even stopped its escape act.

Now, I’m not saying I turned into a superhero overnight. But I did feel lighter—physically and mentally. No more hiding in the shadows. I could face the world, chat with friends and neighbours. Plus, my parents didn’t need to mortgage the house for doctor visits. Bonus!

So here I am, an 17-year-old with a renewed spirit. Anaemia? It’s still there, but it’s no longer the boss of me. I’ve got my iron-packed squad, and we’re rocking this health thing. If you see a girl with a spring in her step, that’s probably me. And hey, if you’re dealing with your own struggles, remember: You’re not alone. There’s always a way to bloom, even in the toughest soil.

Strength in numbers - Achieved by partners in Indonesia in 2023

 Labour rights: More than 90.070 workers, of which 43% women and 25% younger than 35 years old, benefitted from activities pursuing more awareness, a better understanding and knowledge of the regulation on the wage structure and scale, on the Job Creation Law and its impact on workers, on how to negotiate CBA’s and MoU’s, on how to prevent and deal with gender-based violence at the shop floor. In several companies CBA proposals were drafted or agreements were concluded and signed. 

Social security: 62.469 people, of which 30% women and 11% younger than 35 years, were reached through actions focussing on giving access to better social security. 

INSP!R Indonesia mobilised 1766 of its members (81% women, 41 under 35 y/o) to advocate during the drafting of two new regulations regarding health and SP for migrant workers, as well as on adaptive social protection and other social protection issues. INSP!R Indonesia also raised the awareness of 5.140 people on these matters through leaflets and videos (accessible to people with disabilities).

Since 2023 was an election year, INSP!R Indonesia analysed the positions of the various candidates on social protection and submitted policy recommendations to 19 policy makers.

Indonesian context in 2023 related to social protection and INSP!R network issues

At the end of December 2022, President Joko Widodo issued an emergency regulation on Job Creation to replace the Omnibus Law, with the reason of addressing global recession risks in 2023 and for attracting more foreign investment at the expense of workers’ rights. The Indonesian Unions rejected the new regulation as some provisions in the regulation have given governors discretionary power to determine the minimum wage, affect outsourcing, severance pay, recruitment of foreign workers and criminal sanctions against employers which will impact workers.

Seeing the shrinking of democratic space in the region, many trade unions and civil society organizations are trying to defend and reclaim their democratic space. 

A new Health Law came into force in Indonesia on 8 August 2023. The new law (Law No.17 of 2023 on Health) (Health Law) holds monumental implications for the development and transformation of Indonesia's health care system. The Health Bill not only potentially deprives people of their health rights but also threatens public safety.

WSM was able to initiate and facilitate the creation of a new platform: the Global Union Indonesia Network, to unite the affiliates of the International Trade Union Confederation and Global Federations in Asia with National Trade Unions centres in Indonesia as one of the best practice of building unity. The platform has been successfully placing the controversial Indonesia’ Law on Job Creation on the short list of cases of non-compliance for the ILO Convention nr. 98 on Freedom of association and the right to collective bargaining. The report of the ILO Committee on the Application of Standards concluded that the Job Creation Law is in non-compliance with the ILO C.98 and therefore the ILO CAS recommended the government of Indonesia to reform the Labor Law with focus on the Job Creation Law by having a proper and a time-bound dialogue with the most representative unions in Indonesia. As a lesson learned: with openness and cooperation, we are able to unite in one platform the majority of national trade union centres, including some of the labour NGOs and solidarity support organizations.

Wheels in motion: the Belgian ambassador visits an Indonesian tyre factory

The Belgian Ambassador in Jakarta and the DGD went to Elang Perdana Tyre Industry and its local union affiliated to LOMENIK federation, part of WSM's partner KSBSI.

This company is currently in its 8th Collective Bargaining Agreement (CBA) and has a zero-tolerance policy for gender harassment. They’ve established a wage structure and other measures for worker well-being. As part of the supply chain exporting to Europe, they follow relevant HRDD legislation. Most workers are permanent, and good working conditions result from constructive social dialogue.

The company, founded in 1997 with new Indonesian management in 2003, is gradually expanding. Despite pandemic challenges, they export 70% of their production to 85 countries while adhering to quality standards. The Trade union, with 1,600 members (only 8 women) out of 1,900 workers (70 women), focuses on welfare, occupational health and safety (OHS), and social security (SS). They compete with Chinese manufacturers, which limits their offerings.

An OHS committee ensures safety, with a program of 1,000 accident-free days and locally available ambulances. Training has improved knowledge and practices. Legal assistance was provided during a dismissal case. In future CBA negotiations, they aim for better allowances. However, since the 2017 government regulation on wage scales, salary negotiations at the company level are restricted. They hope for legal amendments to allow negotiation flexibility.

A blind woman gets new inspiring insights - INSP!R Indonesia 2023

Rina is 47, from Indonesia and a member of the Indonesian Association of Women with Disabilities (HWDI), member of INSP!R Indonesia:
 “As someone with a disability, INSP!R Indonesia has given me new insights. Before, I mostly talked to other disabled people. But with INSP!R Indonesia, I learned that many organizations discuss disability issues, especially social security rights. I work in a hotel and know about social security, but many of my disabled friends don’t. Some can’t hear or speak, and few go to school. 

I hope INSP!R Indonesia can create schools for people with disabilities. Education is essential not only for disabled kids but also for their parents to understand its importance. With support, people with disabilities can be independent.”

My Journey as a Home Worker: Empowerment, Challenges, and Triumphs - Nepal 2023

My name is Laxmi Pradhan Shrestha, and I am a 44-year-old woman residing in Naikap in Kathmandu. As an active member of the Nepal Home Workers Union, affiliated with the Nepal Trade Union Congress (NTUC), my life has been a tapestry of struggles, growth, and resilience.

The Struggle for Workers’ Rights

When I first joined the home worker’s union, I was an ordinary woman from a regular family. Like many others, the income I earned through my work was barely enough to support my family. But being part of the union opened my eyes to the rights of workers. I realized that we deserved better—better wages, better working conditions, and better opportunities.

Balancing Union Work and Family

As I actively participated in various union activities—May Day rallies, meetings, and conferences—I faced a delicate balancing act. While I fought for workers’ rights, tensions arose at home. My in-laws, who lived with me, closely monitored my household affairs whenever I was away for union work. Conflicts ensued, but I persevered.

Skill Development and Income Generation

The union provided training on income generation and skill development. I seized this opportunity, eager to enhance my small-scale business. From knitting sweaters to making caps, spinning yarn, creating garlands, and preparing pickles at home, I honed my skills. Gradually, appreciation flowed in, and local shops started buying my products. I even sold my handmade items in Kathmandu’s bustling Asan area.

 A Positive Shift in My Life

With improved skills and growing confidence, my income began to rise. No longer solely dependent on my in-laws, I could better support my children’s education and maintain our health. Life took a positive turn. Recently, at the World Social Forum (WSF), our union supported me in setting up a stall to sell our products, providing additional income.

Navigating the Pandemic and engagement in Social Protection schemes

The COVID-19 pandemic posed challenges, but I adapted. My business weathered the storm, and I remained self-employed. The Nepalese government’s initiatives for social security among self-employed women like me give hope. We’ve expressed our desire to local government offices, advocating for our inclusion in these programs. Security and protection are essential for our well-being.

Looking Ahead

As I reflect on my journey, I am content. Yet, I look ahead with determination. The path to empowerment is ongoing. I dream of a future where self-employed women like me receive the support they deserve. Let us weave a stronger fabric of resilience, unity, and progress.

Context of 2023 related to social protection and INSP!R Nepal

Nepal's contribution-based social security scheme has been expanded to include workers in the informal economy, migrant and the self-employed. Previously, only workers in the formal sector and migrant workers were permitted to participate in the plan. Administered by the Social Security Fund, the plan covers eight of the nine branches of social security grouped around four key schemes: Medical care, health and maternity benefits scheme; accidental and disability protection scheme; dependent family protection scheme; and old age protection scheme. According to the Social Security Fund, 420,000 workers from the formal sector and 280,000 migrant workers have already enrolled in the contribution-based scheme. Nearly a million Nepalis left the country, including students, in 2023 to look for a better future abroad. The increased number of labour migrants has led to an increase in remittance inflow. But this growing remittance trend should no longer be considered a blessing. It reflects not only the failure of the country to provide for its people but also the waning hopes of the progressive youth. The drop in student numbers has alarmed not only colleges but the education sector as a whole.

Impact of climate change – Nepal’s climate vulnerabilities emerge from a combination of fragile mountainous topography and ecosystems, highly variable monsoon-driven hydrology, unplanned settlements, and a lack of resilient infrastructure. The unusual weather conditions deviating significantly from the reasonably expected is a strong indication of the effects of climate change in Nepal, and globally. A government report shows that 2023 was one of the worst years in Nepal for the environment with more than 5,500 incidents of forest fires. The United Nations Secretary-General’s visit to Nepal and his appeals to the global community for urgent action to protect the mountains and glaciers helped to draw global attention to the catastrophic consequences of climate change for which the country is not responsible. Nepal’s representation in the COP28 meeting and commitments of the government to deal with the impacts of climate change can be also taken as positive developments.

Pathfinder country for the new Global Accelerator for Jobs and Social Protection: to assist with the COVID 19 recovery, the UN launched a Global Accelerator, and Nepal is one of the Pathfinder countries where it will be initiated, which should involve civil society. To create decent jobs, expanding social protection and promote pathways for just transitions, the Global Accelerator will support the Nepali government with national strategies and policies; financing and enhanced multilateral cooperation.

Strength in numbers: achievements by the Nepali partners in 2023

Labour rights: In total over 80.000 people, of which 32% women and 16% under 35 years, were reached by services from the Nepali partners to promote labour standards.

NTUC reached 73.645 (30% women and 11% younger than 35 years) and GEFONT ensured 6.436 workers (50% women and 67% younger than 35 years) became more aware of their rights though campaigns and public outreach. Empowering young workers, GEFONT also organised 14 one day trainings for 1516 new members (657 female and 1351 under 35 years) in all 7 Nepali provinces.

Social Security: nearly 57.906 workers (46% women and 64% under 35 years) were reached by the services of the trade unions to ensure coverage of workers in the contributory Social Security Fund.

Vocational training: 72 people received vocational skill training on tailoring and embroidery, and self-employment from NTUC.

INSP!R Network
Advocacy: Over 99 policy makers were met , CSOs and trade union members showed their public support for 11 policy documents and position papers, as well as one research on the Integrated Social Protection framework. 

INSP!R Nepal and its CSOs and trade unions members contributed to two key regulations being passed:

1. New Social Security working procedures were passed to cover self-employed, informal and migrant workers.

2. Integrated Social Protection Framework: developed by the National Planning Commission, which tackles Shock Responsive Social Protection aspects, determines provincial and local level roles in social protection and ensures more harmony among the schemes and ministries involved. During the drafting, WSM partners were actively involved and beginning 2024, the Framework was endorsed by the Nepali Cabinet of Minsters.

Learning: In 2023, 471 CSOs and trade union leaders were trained to promote social protection, including through steering committee meetings.

Youth not leaders of tomorrow, but of today - GEFONT, Nepal 2023

“I have always been an activist and was part of the student union. When I joined KFC in Kathmandu, I looked to join the union, where most were very senior leaders, quite old. In the beginning this was difficult, because I felt so inexperienced but now I can say I am not only a member, but also a leader. We should not be considered the leaders of tomorrow, but already today.” 

Neel Kashi, Hotel Sector union 

Neel Kashi is a young worker and was not confident to speak in public. After his studies he joined KFC Hotel in Kathmandu. When he was in college, he was engaged in students' union work and very interested to learn about the union work in the hotel sector. He witnessed for instance a woman worker at KFC having issues with her working hours, was supported by the union, which negotiated for her. But since the union leaders were quite seniors, Neel was shy and lacked confidence. 

Neel participated in different campaigns from the union and also attended a training on labour rights and collective bargaining. He went to demonstrate in May Day Rallies and also different youth events organized by GEFONT. 

By his active participation in these different events, he started to understand the importance of unions in the workplace and and his confidence level went up. Now, he holds a leadership position in the hotel union and contributes to organising more young workers to join the union.