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TBI Blogs: Mumbai’s Swasthya Sevika Programme Has Trained over 600 Nursing Assistants Across 38 Batches

A unique skill-development and training programme in Mumbai is empowering women from underprivileged and difficult circumstances to take charge of their lives as nursing assistants. Rahul Thekdi explores further.

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Even though the mercury levels rise to a new high of 39°C in Mumbai, the 25 women in the ‘Swasthya Sevika’ classroom, who seemed to have negotiated extraordinary life circumstances, are completely focused on listening to their instructor. Sitting in the first row is 20-year-old Geeta Bali (name changed), a divorcee and single mother of a 2-year-old boy. Having gotten married at an early age, her life took a turn for the worse when her husband became abusive. Geeta decided to divorce her husband and seek a fresh start.

Sitting next to Geeta is Pragati More (name changed), aged 22. A school dropout, Pragati’s formal education ended at the age of 13 as she had to look after her younger siblings and an ailing mother. Until recently, Pragati’s day would start with her doing the household chores, and end with getting beaten by her alcoholic father.

The stories of the remaining 23 women are not very different either.

All the women (who are in the age group of 18 to 35) in the classroom have negotiated equal or worse life challenges. What binds all of them together is the Swasthya Sevika or Nurse-aide programme, a vocational course run by Mumbai-based non-profit organisation, SNEHA (Society for Nutrition, Education and Health Action).

The programme seeks to provide economic opportunities for out-of-school adolescent girls, while fulfilling an existing need in the health system – to train a cadre of staff known as nurse-aides or nursing assistants. The eight-month course, supported by Tech Mahindra Foundation, places a strong emphasis on practical training and aims to train adolescent girls to function as assistants in private hospitals, nursing and maternity homes.

The programme’s twin objectives are to empower marginalized girls and women and equip them with skills that will enable them to enjoy financial freedom, and to create a cadre of quality healthcare professionals in urban areas. To date, 38 batches have successfully completed the course, training more than 600 Swasthya Sevikas.

Nurse-aide programme

SNEHA conducts this programme, completely free-of-cost, in two centres, in Santacruz and Kurla. There are tie-ups with private hospitals and nursing homes spread across Mumbai to facilitate internship and job placements for the students on completion of the course.

“Students in this course typically hail from low-income groups, and they typically latch on to this opportunity to be productive members of society. Many of our students have had turbulent lives, so this is their chance to break free from the vicious cycle of poverty,” observes Ujwala Bapat, Program Coordinator of the Nurse-Aide programme. “Teachers are very helpful. In a short span of just a month, I feel that I have learned a lot. I’m now eagerly looking forward to the internship. My family, too, is very happy with my progress,” says Komal Pal, one of the students.

The selection process involves an assessment of basic communication skills through a reading and writing test. For on-boarding, the candidate needs to fill in a form, declaring her willingness to participate in the programme, along with her family’s consent. After admission, a counsellor talks to every student to help her complete the course in a time-bound manner.

“Through the counselling session, we understand the family background of the candidate, and problems that might hinder her learning in the session. Once we assess the candidate, we offer one-on-one counselling sessions that stretch throughout the period of the course to help the candidate optimally,” says Swati Gupta, a volunteer counsellor attached to SNEHA.

The syllabus

The syllabus equips students to train as well-equipped nursing-aide professionals by offering a holistic blend of skills and knowledge training, in addition to soft-skills trainings, such as basic computer education, and communication. SNEHA also brings medical practitioners working in different specialisations for experience-sharing sessions with the students on a monthly basis. In addition, there are regular knowledge sessions on sexuality, gender issues, work ethics, and emotional intelligence, so that students can benefit, both professionally as well as personally.

“The nurse-aide programme is more than just a vocational training course. It is practically a personality development course. We also emphasize on working, both individually and in the classroom, to build resilience and mental toughness among students,” says Ujwala, adding that monthly written tests and exams help in assessment.

Challenges

Mangala Kajjar, a teacher in the Nurse-aide programme, shares that since many of the women are school dropouts, there is a problem of low grasping levels, and difficulties in understanding complex topics. “To make it easier for students to understand, we have translated most of the course material to Hindi.”

A major challenge in the course is that there is a tendency of students dropping-out in the middle of the course. “A majority of the cases are due to personal reasons, rather than students finding the course academically tough,” states Mangala. To alleviate this, the Nurse-aide programme engages with the student’s family – whether parents, husband, or in-laws – and offers counselling to the family members too, on a needs-basis.

“We rigorously follow-up with each student during classroom sessions, the internship period, and until they graduate, and in some cases even after they graduate,” says Ujwala. SNEHA’s Out-patient department health clinic and crisis centre also support the girls’ physical and mental health. If there is a need, students also get access to legal and police systems, for free.

“We try to create a platform for the girls to exhibit varied talents. We organise cultural shows, events, and celebrations,” says Ujwala. She adds that sensitization training for workplace sexual harassment and exposure visits to hospitals are part of the course.

Impact

SNEHA has followed up with previous cohorts of the nurse-aide programme and attempted to create an active alumni network. 70 % of the former students work as nursing-assistant professionals in various hospitals and health set-ups. Ujwala also talks about the drastic transformation of the girls in the eight-month period. “They involve into confident and independent women,” she states.

A trained woman stepping into the shoes of an employed professional has greater impact than just monetary or personal development.

“We have typically seen that the girl’s empowerment gives her family confidence too, also providing the economic benefits of employment. This in turn creates a multiplier effect in her community,” Ujwala says. A testimony to this is Noor Shaikh (name changed) who graduated from the course two years ago.

A timid girl, with little self-confidence initially, has today turned into a strong and independent woman. After completing the course, Noor has continued to work at the nursing home where she had interned. She now earns a monthly salary of ₹10,000, helping not only her family, but also supporting her younger brother’s education. Typically, these are families living in the most marginalised areas in Mumbai. Such a boost is life-changing for them, and likely to have an inter-generational effect.

For the nurse-aide programme delivery team, it is the students and their soaring spirits who keep them going. “They come to class every morning with a smile, irrespective of the difficulties they face. We strive very hard to ensure that we give the best towards empowering every one of these girls. Not only are we helping them become economically independent, we are creating change agents for society,” says Ujwala.

To learn more about SNEHA and to donate, please visit the website.

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Society for Nutrition, Education and Health Action (SNEHA) is a Mumbai-based, secular non-profit that works on preventive and promotive healthcare among children and women in vulnerable communities.