The booming garment industry in Bangladesh has become a critical location for achieving the Sustainable Development Goals (SDGs), especially those related to health (SDG 3).
Bangladeshi Fashion Boom
The Ready Made Garment (RMG) industry, the mainstay of the Bangladesh economy, accounts for 81% of the country's total export. Bangladesh is the world’s third largest garment producer with more than 3,000 factories, employing around four million workers, of which 85% are women. Most RMG workers are migrants from rural areas, who face multiple barriers to receiving adequate healthcare, and services related to Sexual and Reproductive Health and Rights (SRHR).
Healthcare and SRHR - important for attaining SDG 3
In Bangladesh, the lack of fulfilment, protection and promotion of healthcare and SRHR is a significant factor that undermines human development and is particularly evident through health, social, political and other development indicators. SRHR has a significant impact on mortality and morbidity, population growth, access to education, employment, women empowerment and other related issues.
Realising SDG 3 in Bangladesh’s Fashion Industry
SNV’s work in Bangladesh’s RMG sector is closely linked to multiple targets set in SDG 3. Currently, SNV is implementing three projects in the garment industry all working towards the improved health and wellbeing of garment workers through the provision of universal access to health and sexual and reproductive health care services (Targets 3.8 and 3.7).
We recognise that realising SDG 3 in Bangladesh’s fashion industry requires a systematic approach. We made factory management understand that investing in a workers’ health is not just a social responsibility, but that there are compelling business results that arise from such investment. We believe in designing efficient markets to enable the garment factories to both contribute to and benefit from growth, while investing in their health and well-being.
Having identified the cornerstones to challenges faced by garment workers in accessing healthcare, over the past four years, SNV developed different inclusive business models to make healthcare affordable and available in garment communities. We build the capacity of local organisations, NGOs and private sector, and establish linkages in reaching the untapped market segments in healthcare. Our approach shifts away from traditional awareness and capacity building programmes, and focusses only on the workers within the garment businesses, so they can realise the returns of addressing SRHR issues in their factories. In this way, SNV builds demand and supply mechanisms that support female workers access to convenient, gender-friendly, affordable and quality healthcare services within or near factories. Our work in four factories focuses on four sustained results: inclusive development, systemic change, local ownership, and contextualised solutions.
Inclusive Business for health & well-being
The Working with Women-II (2017-2021) project funded by the Embassy of the Kingdom of the Netherlands, is improving the health and wellbeing of garment workers through Inclusive Business (IB) practices across the RMG value chain.
This project builds upon the pilot phase of the project (2014 -2017) which initially delivered improved and affordable gender-friendly SRHR and health services for more than 30,000 workers. Results from this project were impressive. Fifteen thousand workers subscribed to health insurance schemes while SRHR service accessibility quadrupled from 3,434 workers in 2015, to 22,727 workers in 2017.
The new phase of the project is now involving NGOs, service providers and businesses to set-up self-sustaining structures in the sector that will ensure the continued promotion of accessible and affordable healthcare and SRHR.
This will be achieved through three IB models meticulously designed to respond to the most critical SRHR and health needs of the RMG workers. This includes the need for a safer workplace, smart health financing solutions, proper menstrual hygiene interventions, family planning, information and education, financial risk protection, health coverage, access to quality health-care services, and access to essential medicines.
Universal health coverage is making a difference
SNV technically supports two innovative projects aiming to ensure universal access to health services.
Gonoshasthaya Kendra (GK), a Bangladeshi healthcare service provider, is implementing a Social Health Insurance Scheme, with financial support from Weave our Future (WoF) and the Auchan Foundation – one of the largest retail chains in France. During 2017 – 2021 the project will provide 20,000 RMG workers with pro-poor health insurance schemes, and each beneficiary can avail health care facilities of up to BDT 25,000 (almost € 300) at selected health care centers, by paying an annual premium of only BDT 600 ( € 7). This scheme also offers access to 24-hour hospital services, pharmacy supplies, and ambulance facilities.
Another partnership with the Sphere Association implements a project delivering comprehensive and easily accessible healthcare services for garment workers. The project works in five factories in collaboration with two insurance companies and four local health care providers. Under this initiative, workers have (“cashless”) access to medical consultations, diagnostics services, family planning services and maternal care. The total cost for the health insurance is BDT 575 (€ 6) per worker a year.
Ensuring that garment workers have the right to healthcare and education on sexual and reproductive health rights, empowers them both physically and economically, and enables these workers to have healthy and productive lives.