Smart Card Initiative
The Smart Card Initiative in Karnataka, India seeks to bring a sense of inclusion and self-worth to sex workers, while motivating better health care practices among them. As part of this programme, sex workers are being rewarded with cash incentives in the form of a "smart card" enabling them to accumulate points to be redeemed for discounts or gifts. The only condition for keeping the card valid is that the cardholder must report at least once every 3 months to a clinic set up by the Karnataka Health Promotion Trust (KHPT), where she undergoes a thorough health check-up for any symptoms of sexually transmitted infections (STIs) such as HIV/AIDS. Developed by KHPT in association with Ashodaya Mahila Samanwaya Samithi (AMSS) - an organisation of sex workers from Mysore and Mandya districts - and with funding from the Bill and Melinda Gates Foundation's India AIDS Initiative, the pilot initiative will initially involve 500 sex workers.
Communication Strategies
This programme uses a reward scheme to build the self-esteem of sex workers and to encourage them to take care of their bodies by addressing their vulnerability to STIs.
The project relies on the participation of private companies and a new technology firm. Five business establishments which include two restaurants, two garment shops and a provision store are taking part in the pilot programme. They offer cash incentives to sex workers bearing the smart cards; with every purchase, points are added and the accumulated points can be redeemed for discounts or gifts when they make purchases at a later date. The sex workers can also present these cards at restaurants or at the store where they buy their provisions. Small hand-held computers, Simputers, at participating business establishments will read the smart cards. (Pennant Consulting Services Pvt. Ltd. prepared the software for the initiative.) While the vendors can record and read their transactions on these cards, they will have no access to the health data stored on them. The health data can only be entered and accessed at the clinic, using the main computer. The system is designed in such a way that the Simputers will not read cards that have not been updated at the clinic in the last 3 months.
Organisers stress that regular health check-ups and timely treatment are essential to counter the risk of STI in the sex work profession; financial incentives provided through the smart card are meant to facilitate that health-seeking behaviour. With sex workers having to support their families with their earnings and needing to spend a substantial amount on transportation, refreshments, and personal grooming and appearance, getting a discount on their purchases and bills is meant to serve as a meaningful incentive to attend health clinics for regular check-ups. As one sex worker explains, "It is not uncommon for us to buy as many as three new saris a month. Being smartly dressed is an integral part of our work." However, considering that sex workers face stigma and discrimination due to their line of work, the smart card is meant so serve as more than just a cash incentive; the strategy involves stimulating a sense of self-worth, independence, and inclusion: "These days, everyone carries a credit, insurance or other cards, so why not us?"
The project relies on the participation of private companies and a new technology firm. Five business establishments which include two restaurants, two garment shops and a provision store are taking part in the pilot programme. They offer cash incentives to sex workers bearing the smart cards; with every purchase, points are added and the accumulated points can be redeemed for discounts or gifts when they make purchases at a later date. The sex workers can also present these cards at restaurants or at the store where they buy their provisions. Small hand-held computers, Simputers, at participating business establishments will read the smart cards. (Pennant Consulting Services Pvt. Ltd. prepared the software for the initiative.) While the vendors can record and read their transactions on these cards, they will have no access to the health data stored on them. The health data can only be entered and accessed at the clinic, using the main computer. The system is designed in such a way that the Simputers will not read cards that have not been updated at the clinic in the last 3 months.
Organisers stress that regular health check-ups and timely treatment are essential to counter the risk of STI in the sex work profession; financial incentives provided through the smart card are meant to facilitate that health-seeking behaviour. With sex workers having to support their families with their earnings and needing to spend a substantial amount on transportation, refreshments, and personal grooming and appearance, getting a discount on their purchases and bills is meant to serve as a meaningful incentive to attend health clinics for regular check-ups. As one sex worker explains, "It is not uncommon for us to buy as many as three new saris a month. Being smartly dressed is an integral part of our work." However, considering that sex workers face stigma and discrimination due to their line of work, the smart card is meant so serve as more than just a cash incentive; the strategy involves stimulating a sense of self-worth, independence, and inclusion: "These days, everyone carries a credit, insurance or other cards, so why not us?"
Development Issues
Sexual Health, Economic Development.
Key Points
The smart card is one tool being used in AMSS's larger goal of fostering sex workers' effort to gain respect and be recognised as equals. "We are excited at the prospect of getting the smart card. It is not so much about the discount, but as much about the feeling that I am as privileged as any other person in society," says one sex worker. Launched in 2004, AMSS works to help sex workers assess their own lives more objectively and in some cases come to terms with the choices they were forced to make. "We used to constantly feel guilty and worthless because we felt we were doing something wrong. Since we became part of the self-organisation, we realise that we had responded to many compulsions and realities in our lives. Most of these were not of our making and therefore we now feel that we are workers like anyone else, pursuing a livelihood like anyone else." Having suffered neglect, abuse, exploitation, harassment and even violence from either close family members, clients, middlemen, law enforcement officers or the general public, they say, "Most of us did not enter this profession voluntarily. Our circumstances and those around us forced us to, why should people question what we do to survive?"
Partners
Karnataka Health Promotion Trust (KHPT), Ashodaya Mahila Samanwaya Samithi (AMSS), Pennant Consulting Services Pvt. Ltd. - with funding from the Bill and Melinda Gates Foundation's India AIDS Initiative.
Sources
The Smart Card Way to Self-esteem for Sex Workers, by Veena Krishnamoorthy, The Hindu, April 6 2006 - forwarded to the AIDS Beyond Borders listserv on April 18 2006 (click here for the archives).
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