Chanthy has been a nurse at a garment factory for over eight years. During her long career at the factory, Chanthy has seen a multitude of workers go through her infirmary seeking advice and help.
After 5 years of successful partnership under the GSK Frontline Health Worker Programme building the capacity of frontline health workers in rural southern Cambodia, GSK and CARE Cambodia launched a new project in 2016, focusing on young, female garment factories in urban Phnom Penh. About 80% of the 700,000 garment and footwear factory workers in Cambodia are women. Many are young, female migrants in the 18-30 age group with low levels of education. At least half of these are sexually active and about one third already have children while less than a third of those who are sexually active use contraception, pointing to the importance of holistically addressing sexual, reproductive, and maternal health. In addition, poor nutrition is cited as a key contributing factor to the “fainting spells” in Cambodian factories.
The CARE-GSK project, called Healthy Women, Healthy Workplace, seeks to improve the sexual, reproductive, maternal health and nutrition status of this marginalised group.
The project focuses on both supply and demand-side barriers to good health. On the supply side, this means improving the quality and accessibility of care at urban health centres and infirmaries for young workers and on the demand side this means influencing the attitudes and behaviours of the workers themselves as well as supporting factory management to improve the factory environment.
The design challenge
The question that emerged was how to have real, lasting impact on attitudes and behaviours?
For sexual and reproductive health, CARE could begin engagement right away, implementing the evidence-based, award-winning Chat! Contraception, an innovative package that includes activity-oriented sessions, video dramas, and a mobile quiz app, which complement each other and empower workers to make healthy decisions about sex, contraception and abortion. A solution was still needed for issues of maternal health and nutrition, however.
CARE formed a partnership with design thinking experts from the international NGO, iDE, and the marketing and communications firm, Melon Rouge, to approach the challenge. To do this, the team customised a human-centred design (HCD) approach targeting maternal health, nutrition, and hygiene.
Photo credits: Erika Pineros