Abstract
Swasti, an International Health Resource Centre was established in 2002 in India. The objective was to enhance the health and well-being of communities, particularly the marginalized. Swasti’s main focus lies in the areas of primary health, sexual and reproductive health including HIV, communicable and non-communicable diseases, water, sanitation and hygiene and gender based violence. The organization, during the last decade has grown in leaps and bounds reaching out to the most affected communities through policy influence and grassroots level intervention reach. Swasti has an agile, passionate and multi-disciplinary team, who deliver in diverse situations across the development spectrum while integrating community needs, programs and policies. The organization’s focus is on quality support to deliver cutting edge, sustainable solutions. Swasti has a global approach and works with many development partners across many countries. So far it has been involved in over 200 engagements in over 20 countries with partners ranging from Government Departments, Bilateral and Multilateral Donors, Foundations, INGOs, FBOs, CBOs etc. With many awards and recognitions to its credit, Swasti also contributes to policy and is a part of many global platforms for advocacy.
Keywords: Advocacy, global health, HIV, organization, reproductive health
Objectives and approach
Swasti was established as a not for profit society in 2002 with a vision to enhance the well being of marginalized communities. The society was set up by a group of committed professionals who envisioned an organization that would make a difference in the social and management aspects of public health. To achieve its goal of reaching out to the marginalized, Swasti operates through its various areas of expertise such as health systems strengthening, market based solutions, e-health, work place interventions and social protection for the marginalized. The main thematic areas of Swasti’s work include:
Primary health, Sexual and reproductive health including HIV, Communicable and non-communicable diseases, Water, sanitation and hygiene and Gender based violence.
Swasti also addresses issues of health workforce within broader public health reforms.
At Swasti there is realization that health and well-being is best addressed when all three aspects – behaviors, systems and social determinants – are addressed together. This stems from the fact that challenges to well being are not limited only to health and hence the need to address the key enablers in an integrated manner. The focus is on achieving outcomes with scale and high quality.
The communities that benefit through Swasti’s endeavors in public health include vulnerable children and adolescents, marginalized rural and urban communities; HIV infected and affected populations, migrant and mobile populations and women in factory settings. Strong partnerships that have been built over the last decade have helped Swasti bridge civil society, government and the corporates.
Strong, committed and a focused pool of Human Resources is another strong aspect that has helped Swasti make its presence felt internationally. In the course of the last decade, Swasti has been able to build cooperation and provide technical support to various organizations in different parts of the world across different sectors – Universities, NGOs, international institutions and organizations – and has engaged governments and the private sector for various purposes.
At Swasti the focus is on implementing projects that involve organizations and communities at the grassroots level, thus ensuring sustainable outcomes. This coupled with innovative thinking and creativity helps Swasti raise the bar in terms of results with each new effort.
Key strategies
The need to improve health outcomes for the communities that Swasti works with is an integral component of Swasti’s Strategic Plan which spans across a broad spectrum right from ideating models, partnering globally with organizations to become an active voice in advocacy and policy shaping. The three major strategies that are a part of Swasti’s various efforts include the following:
Innovative models for impact
This strategy aims to design and demonstrate effective, innovative, replicable and sustainable program models that help address complex public health challenges. This strategy ideates, incubates, validates and productizes models and advocates and supports scale up. It has helped to successfully design, test and validate 5 intervention models and has initiated steps for replication and scale up.
Partnership for results
This strategy looks at working closely with development partners to understand what they aspire to achieve through partnership with Swasti and their challenges to provide timely, need based quality support to achieve the envisioned outcomes for the partners. Swasti provides support in a number of areas such as strategic planning, programme design, advisory and mentoring support, resource mobilization, strengthening management systems, institutional and individual capacity building, review and evaluation, impact assessment, research and documentation. The last 5 years has seen the Partnership for Results team at Swasti involve in more than 200 engagements through technical support in about 20 countries.
Knowledge management and policy shaping
This strategy focuses on Swasti to be a knowledge leader in niche areas, while contributing to public health knowledge and policies. Swasti has had the privilege of being part of several strategic international public health advocacy alliances such as the Global Health Workforce Alliance (GHWA), Asia Pacific Alliance for Sexual and Reproductive Health and Rights, Global Partnership for Maternal and New Born Child Health (PMNCH). Swasti is also party to the Global Civil Society pledge “A Promise Renewed” committing to Child Survival Call to Action 2012.
Major projects and publications
To know how Swasti works as an organization can be best explained through the strategic focus and successful projects that have been implemented so far. Listed here are some of the major engagements and accomplishments of Swasti over the last decade.
Empowering women in sex work
Swasti has been implementing “Pragati”, a comprehensive empowerment programme for women in sex work since 2004. This programme is funded by the Bill and Melinda Gates Foundation (BMGF) in partnership with the Karnataka Health Promotion Trust (KHPT) and SwathiMahilaSangha, a community based organization for women in sex work. It is a comprehensive HIV intervention programme that not only looks at the health aspects of women in sex work but also provides intense support through various components of the project such as prevention of HIV and STIs, condom promotion, financial assistance through Microfinance Schemes, Community Crisis Response, Alcohol De-addiction and Stigma Reduction. Swasti also helped the SwathiMahilaSangha to perfect the system of Community Elections to choose its leaders. Swasti has brought together various organizations of sex workers under one platform called “Network for Women’s Equity and Equality” in India. About 8 community based organizations form part of this network providing voices to over 35,000 women in sex work. Pragati has the distinction of being recognized as the largest street based sex work intervention model for prevention of HIV in Asia.
Improving evidence for programming
Swasti has been instrumental in mapping key populations affected by HIV and AIDS in rural and urban India. This mapping covered 16,985 villages and 729 towns across 19 states/provinces. This unique mapping strategy has been replicated in Pakistan, Sri Lanka and Afghanistan. Unique and innovative approaches towards research, programming and policy shaping have also been achieved over the last decade. Some prominent examples include estimation of children affected by AIDS, measure of vulnerability of young people at risk to HIV, burden of disease and the like. Swasti has also helped improve the Tsunami Relief Program by building evidence in partnership with Oxfam.
Strengthening human resources for health
Swasti is playing a key role in assisting national and state governments in India to develop and implement human resource policies, strategies and good practices. This is a three-year program, which is being implemented in partnership with the Public Health Foundation of India with support from the European Commission. The aim is to strengthen a functional Human Resource Management System within the state health departments.
Centre of excellence for market based solutions in health
Swasti established the Centre of Excellence (CoE) in 2011 to promote effective and sustainable market-based solutions for health to address the public health needs of the Base of Pyramid (BoP) households in India. Initially partly funded by USAID, CoE is now supported by partners CMS (www.cms-india.org) and Vrutti (www.vrutti.org). CoE currently partners with Access Health and is the India Hub for the Center for Health Market Innovations. The CoE provides advisory and consulting support to its clients and helps to generate new models by brainstorming new ideas. It also disseminates knowledge of lessons learnt and facilitates partnerships and networks between organizations and promotes cross learning to improve the efficiency and effectiveness of organizations.
Improving quality of programming
Swasti contributed to improving quality of programming through its various policy and programme guidelines. Some examples are HIV and migrant framework and policy for India and Nepal; Standard Operating guidelines for HIV Targeted Interventions; Monitoring and Evaluation Guidelines for several partners, and M&E guidelines for Civil Society strengthening for Global Fund.
Comprehensive rural HIV Intervention Programme
Spandana, a comprehensive rural HIV Prevention Programme was implemented by Swasti in 210 rural villages in Karnataka. This programme used a village link worker strategy to provide information on HIV and general sexual health to rural communities and link them to HIV prevention, care and support services as well as general health services.
Leveraging Funds for Reproductive Health and Family Planning in India
Swasti has the honor of being the South Asia partner for the Euroleverage project that was implemented globally by the German Foundation for World Population (DSW). Funded by the Bill and Melinda Gates Foundation, the project aimed to advocate and leverage funds for reproductive health and family planning.
Integrated Water Resource Management (IWRM) Project
EU funded Integrated Water Resource Management Project titled “People and Panchayat-led Equitable Water Governance in three Agro-Ecological Zones in India” is being implemented by Swasti along with Vrutti in India. With a goal of improved health and livelihoods, the project seeks to establish and demonstrate a people and Panchayat led equitable water governance model.
Action against stigma and discrimination
Through South Asia Regional Development Market Place, Swasti provided technical and management support to networks of sex workers in India in conceptualizing and implementing innovative campaigns. This project has also been documented as a best practice.
Juvenile Diabetic Support Group
Swasti has been instrumental in setting up the Juvenile Diabetic Support Group in Bangalore, India. This support group brings together families with children affected by Juvenile diabetes.
In terms of publications Swasti has had about 62 publications that include papers, articles, manuals, think pieces and approach notes for the various programmes that are implemented by Swasti.
Structure and funding
Swasti’s organizational structure is quite unique. Swasti was established as a not-for-profit organization. Swasti has maintained a high degree of governance, public accountability and financial management practices by having its structures and policies in place. Swasti is governed by a Swasti Board which provides the overall insight, advice and recommendations on the future direction of the organization. The Board has seven members who are versatile and highly committed professionals who give their best inputs to the organization at all times. The Board Members of Swasti are Mr. Nandlal Narayan (Chairman), Ms. Siddhi Mankad (Secretary), Mr. R. Mohan (Treasurer). The other esteemed members of the Board include Mr. JVR Prasad Rao, Mr. N. Shiv Kumar, Mr. N. Raghunathan, Mr. P. Rajarethinam, Mr. M.R.C. Ravi, Dr. Revathi Narayanan, Mr PRN Murthy and Dr. Jacob John.
The organization has a President and Chief Executive Officer in Mr. N.Shiv Kumar who reports to the Swasti Board. He is responsible for setting policies, strategies and steering the organization. He is accountable to the Board for implementation of the Strategic Plan and ensuring the organization adheres to established policies and systems.
The organization has a Strategy to Results Team (S2R) which reports to the President and Chief Executive Officer. The S2R team monitors and reflects on the organization’s progress towards achieving its goals as per its strategic plan and achieving the outcomes for the communities that it works with. The S2R currently comprises of 3 Senior Most Directors of Swasti and is presided over by President and CEO.
The Accountability and Transparency Committee is a subcommittee of the Swasti board. It consists of three members and is responsible for ensuring that Swasti is transparent and accountable to all its clients, partners, staff and the communities that it works with.
In terms of funding, Swasti has two main streams of funding. Funding is obtained through competitive grants as well as revenue generated through various consulting assignments by providing technical support. Some of the grants are self-funded and funds are also obtained through market-based models. Swasti has been successful in the last decade in diverting funding to successfully implement models and projects that have immensely benefitted the communities that Swasti has worked with. Swasti, through its technical support has helped to raise funds not only for itself but also for countries and other development partners that it has worked with within India and overseas. Over the last decade Swasti has successfully evolved a business model that is able to sustain its work of reaching out to the most marginalized communities by improving intervention design, management systems and capacities.