#45 Workers-led delivery of Healthcare and Social Protection

In this episode, we resume the building block of our social protection solar system on the topic of delivery and provision of social protection. In this second episode of the series, we will turn to India, to understand how informal workers organizations can play an important role to improve access to their members by facilitating the last mile delivery of services or benefits. The Self-Employed Women’s Association, SEWA, set up in India their so-called Shakti Kendras, or SSKs. I talked to Susan Thomas, the National Coordinator of Health and Childcare programmes at the Lok Swas-thya SEWA Trust (LSST), to learn more about this worker-led initiative. Susan explained how the Shakti Kendras operates, how they help informal workers to access social protection in India, how digital tools are being integrated in their work, as well as the next steps of the Shakti Kendras. *** Learn more: -BLOG: Bridges to Better Lives: SEWA’s Community Health Workers (October 05, 2019), by Annie Devenish, Laura Alfers https://www.wiego.org/blog/bridges-better-lives-sewas-community-health-workers/ -We are the bridge’: an implementation research study of SEWA Shakti Kendras to improve community engagement in publicly funded health insurance in Gujarat, India (2022), by Susan Thomas, Sharmada Sivaram, Zubin Shroff, Ajay Mahal, Sapna Desai https://gh.bmj.com/content/7/Suppl_6/e008888 -BLOG: In India, One-stop Shops Increase Access to Healthcare, Nutrition and Social Security Services for Working Poor (May 15, 2017), by Laura Alfers https://www.wiego.org/blog/india-one-stop-shops-increase-access-healthcare-nutrition-and-social-security-services-working/ *Our theme music is Focus from AA Aalto (Creative Commons)

In this episode we take a pause from the discussion around delivery and provision of social protection benefits and take a fresh look at the challenges to finance social protection in a time of very deep transformations in the world of work. Among these changes, we have increasing automation, swift advances in artificial intelligence and the emergence of forms of capital-labour relations through the mediation of platforms. These multiple processes have triggered an intense discussion about how social protection systems should be or could be financed – and by whom. It was within this ongoing debate that Luca Pelerano and Florian Juergens-Grant have recently published an op-ed at Project Syndicate. In this article, they analysed some of these challenges and, most importantly, advanced some possible innovative alternatives to address them. Luca and Florian will be our guests in this special episode. Luca Pelerano is a social protection specialist and works at the Social Protection Department of the International Labour Organization (ILO) and he has more than 15 years of experience in policy reform. Florian is the Global Social Protection Advisor at WIEGO, and his work focuses mainly on the issues regarding the financing of social protection for informal workers, the impacts of social protection programmes on labour markets, workers and their families; as well as the design of inclusive social insurance systems. *** Learn more Future-Proofing Social Protection, by Luca Pelerano and Florian Juergens-Grant - https://www.project-syndicate.org/commentary/how-to-ensure-sustainable-financing-social-insurance-by-florian-juergens-grant-and-luca-pellerano-2025-03s

In this episode, we start a new building block of our social protection solar system with the first part of the topic on delivery and provision of social protection. We will be looking at the innovations in the delivery of services and cash grants, focusing on informal workers and on the role that informal workers organizations might have in improving access to these workers by facilitating the last mile delivery of services or benefits. To open this block, we will turn to Africa and look into three cases of provision of child care services. First, we go to South Africa, to talk to Richard Dobson about the pop-up child care facility in the Warwick Junction market, in Durban. Richard is an architect and co-founder of the NGO Asiye eTafuleni. Next, we move to Accra, in Ghana, to talk to Dorcas Ansah, WIEGO’s Accra Focal city coordinator. We discussed the guidelines for implementing child care facilities in the Ghanaian capital markets and the plans for expanding the initiative. We finish our tour in Rwanda, where the market vendors association SITRIECY is also implementing child care facilities in the Kigali markets. We talked to SITRIECY’s secretary-general and StreetNet International treasurer Jeanette Nyiramassengesho. She explained their approach to combine provision of child care for informal workers’ children in markets with the creation of a community savings group. *** Learn more - WIEGO: Child Care in Markets: An E-Book https://www.wiego.org/research-library-publications/child-care-in-markets/ - Working in Warwick: Including Street Traders in Urban Plans https://www.wiego.org/research-library-publications/working-warwick-including-street-traders-urban-plans/ - WIEGO - Child Care in Markets project: https://www.wiego.org/project/child-care-markets/ - Guidelines and Standards for Day-Care Centres in and around Markets in Ghana, by Susan Sabaa, Dela Quarshie-Twum https://www.wiego.org/advocacy-worker-education-resources/guidelines-and-standards-day-care-centres-and-around-markets-ghana/ - Webinar: https://www.youtube.com/watch?v=wn9niHLL8vI - About Asiye eTafuleni https://aet.org.za/about-asiye-etafuleni/our-story/

In the fourth and last episode of the governance building block we dive into the discussion of social dialogue and social protection for informal workers. But what does social dialogue actually mean? How can in be used as a tool to improve social protection schemes to better include informal workers? What are the aspects we should look at when analysing these spaces and what are the main barriers workers in the informal employment face to access them? To help us understand these questions we invited two guests. First, we are going to talk to Jane Barrett, who will set the stage and introduce us to the main aspects of social dialogue, the power dynamics and how these spaces should work. Jane is the former Organization and Representation programme director at WIEGO. She has extensive experience in collective bargaining, membership recruitment and organizing, trade union membership and leadership education, research and policy advocacy. In the second part of the episode we talk to Aura Sevilla, who will talk about the concrete social dialogue experiences in Southeast Asia. Aura is the Southeast Asia focal point of the Social Protection programme at WIEGO. She has been working in a study report analysing six countries in the region: Brunei, Cambodia, Indonesia, Myanmar, the Philippines, and Thailand. *Our theme music is Focus from AA Aalto (Creative Commons) References Informal workers and dialogue for social protection, Social Protection Responses to COVID-19 #3, by Annie Devenish and Cyrus Afshar https://www.wiego.org/social-protection-responses-covid-19/ Social Dialogue for the Transition from the Informal to the Formal Economy, by Global Deal https://www.wiego.org/research-library-publications/social-dialogue-transition-informal-formal-economy/

In the third episode of the governance building block we move on to the discussion of legal frameworks and social protection. How can legal provisions of participation, access to information, transparency and equality be leveraged to include those workers into social protection systems? What are the main legal frameworks? How does administrative justice work for this end and how it can be used a tool for informal workers in their advocacy efforts? To help us understand these questions we invited Pamhidzai Bamu. Pamhi holds a masters and a PhD in Labour Law from the University of Cape Town. She is currently the President of the African Labour Law Society. She has consulted for the International Labour Organisation and the Southern African Development Community on various projects. She is currently the Africa Coordinator of WIEGO’s Law Programme. *** References Social Protection for Self-Employed Informal Workers in Sub-Saharan Africa: A rights-based assessment of the impact of the COVID-19 crisis https://www.wiego.org/publications/social-protection-self-employed-informal-workers-sub-saharan-africa-rights-based R202 - Social Protection Floors Recommendation, 2012 (No. 202) https://normlex.ilo.org/dyn/normlex/en/f?p=NORMLEXPUB:12100:0::NO::P12100_INSTRUMENT_ID:3065524 C189 - Domestic Workers Convention, 2011 (No. 189) https://normlex.ilo.org/dyn/normlex/en/f?p=NORMLEXPUB:12100:0::NO::P12100_ILO_CODE:C189 African Charter on Human and Peoples' Rights https://au.int/en/treaties/african-charter-human-and-peoples-rights *Our theme music is Focus from AA Aalto (Creative Commons)

In the second episode of the governance building block we continue to discuss the issues surrounding digitization and social protection. This time, we take a political economy perspective to understand the interests, ideas, actors and policy implications of digitization. To help us understand this complex issue, we invited again Ruth Castel-Branco, Ruth is a Senior Researcher at the Southern Centre for Inequality Studies at the University of Witwatersrand. Her research is focused on the casualization of labour, worker organizing and the redistributive role of the state. She has studied the case of Mozambique, and shared some of her findings with us in this talk. References Improvising an E-state: The Struggle for Cash Transfer Digitalization in Mozambique, by Ruth Castel-Branco. Available at: https://onlinelibrary.wiley.com/doi/abs/10.1111/dech.12665

In this episode, we start a new building block of our social protection solar system with the first episode on the topic of governance. We have invited two guests to lay the groundwork for this block, to help us understand social protection governance, as well as the new concerns and potentials brought by digitization. We start with Tony Roberts. Tony is a researcher based at the Institute of Development Studies on the campus of the University of Sussex in the UK. He has worked on the use of digital technologies in social justice organisations since 1988. As a founder of the African Digital Rights Network his research focuses on the human rights implications of introducing digital technologies. He will share some of the findings of his report on digitization and social protection. On the second part, we talked to Gbenga Sesan. Gbenga is the Executive Director of Paradigm Initiative, a non-profit organisation that works with digitization and data protection rights in Africa. He will bring some concrete cases of how digitization affects informal workers.

In the third episode of the registration block we travel to Latin America to take a regional overview of this issue regarding domestic workers. To learn the challenges these workers face to be registered, the positive experiences, as well as the opportunities and limitations digital technology tools offer in this task, among other issues revolving around registration for domestic workers in Latin America, we invited Adriana Paz. Adriana is currently Secretary General of the International Domestic Workers’ Federation (IDWF). Previously, she served as Latin America Coordinator for more than six years, also at IDWF. References IDWF and WIEGO. Imagining Social Security for Domestic Workers. Available at: https://www.wiego.org/publications/imagining-social-security-domestic-workers ILO, UNWomen and OISS. Acceso de las personas trabajadoras domésticas remuneradas a la seguridad social en Iberoamérica. Available at: https://www.ilo.org/americas/publicaciones/WCMS_861167/lang--es/index.htm

In episode five of the systems’ mapping, building blocks approach, we continue to explore the topic of registration. This time, we look closely at the Cambodian IDPoor programme, to understand to what extent a government-led effort to improve how beneficiaries of social assistance and social protection schemes are effectively accounted for – and what are the gaps, challenges and merits of this new registration drive. To understand the Cambodian case, we invited Bunly Than. Bunly is the lead of the Inclusive and shock-responsive social protection system project at Oxfam Cambodia. *Our theme music is Focus from AA Aalto (Creative Commons) References WIEGO Resource Document #30 (2023). Home-Based Workers’ Access to Social Protection: Lessons Learned from the IDPoor Programme in Cambodia. Available at: https://www.wiego.org/publications/home-based-workers-access-social-protection-lessons-learned-idpoor-programme-cambodia Government of Cambodia (2021). Performance Assessment of the Cash Transfer Program for Poor and Vulnerable Households during COVID-19. Available at: https://nspc.gov.kh/Images/GiZ_CT_Policy%20Brief_20210602_Design_Draft_2021_06_02_17_46_02.pdf

And we start the year with the first episode of the second building block of our new season, in which we will discuss the issue of registration. How is digital technology helping to include informal workers into social protection schemes or how is it creating new barriers for these people to access protection? What are the risks and opportunities? What is the role of informal workers organisations in building more inclusive registration systems? These are some of the questions we will try to answer by looking at some cases of programmes and policies countries are implementing to expand their social protection systems to include informal workers. We start this new block with the case of the Social Relief of Distress Grant in South Africa. When the COVID-19 pandemic hit the country, the government expanded the SRD to reduce the impact of income loss, targeting a much broader population than the ordinary social assistance programmes were covering. The second new aspect is that this policy was that it heavily relied on digital means to register new beneficiaries. To understand how the implementation of the SRD was rolled out, how digital forms of registration contributed or hindered access of informal workers to the grant, we talked to Hoodah Fayker. Hoodah holds a Law degree from the University of the Western Cape, and she is the National Advocacy Manager for the veteran human rights organisation Black Sash, which advocates for the right to social protection in South Africa. *Our theme music is Focus from AA Aalto (Creative Commons) References A Digital Bridge to Social Support https://www.project-syndicate.org/commentary/social-programs-for-informal-workers-must-bridge-digital-divide-by-laura-alfers-2021-06?barrier=accesspaylog R350 Covid grant is too little and excludes too many, research report finds https://www.groundup.org.za/article/r350-covid-grant-too-little-and-excludes-too-many-research-report-finds/ Social Protection in a Time of Covid: Lessons for Basic Income Support https://socialprotection.org/discover/publications/social-protection-time-covid-lessons-basic-income-support Black Sash report reveals extent of issues experienced by Social Relief of Distress grant recipients https://www.dailymaverick.co.za/article/2022-05-17-black-sash-report-reveals-extent-of-issues-experienced-by-social-relief-of-distress-grant-recipients/ SOCIAL PROTECTION IN A TIME OF COVID: LESSON FOR BASIC INCOME SUPPORT https://www.blacksash.org.za/social-protection-in-a-time-of-covid-lesson-for-basic-income-support/ The Social Relief of Distress Grant: how it stimulated local economies https://www.econ3x3.org/article/social-relief-distress-grant-how-it-stimulated-local-economies COVID-19 Crisis and the Informal Economy: Informal Workers in Durban, South Africa https://www.wiego.org/publications/covid-19-crisis-and-informal-economy-informal-workers-durban-south-africa