Addressing the General and Reproductive Health of Women in Global Supply Chains Supported by: The David and Lucile Packard Foundation October 2002 Table of Contents Introduction ................................................................................................................... 1 Project Methodology.......................................................................................................................2 Report Organization .......................................................................................................................2 Executive summary .......................................................................................................4 Major Findings.................................................................................................................................4 Reproductive Health...................................................................................................................4 Nutrition.......................................................................................................................................5 Self-Esteem ..................................................................................................................................5 General Occupational Health....................................................................................................6 Options for Effective Reproductive Health Programs..............................................................7 China..............................................................................................................................8 Country Summary ...........................................................................................................................8 Country Health Overview..............................................................................................................8 Health Status of Women Workers..........................................................................................10 Projects Profiled ............................................................................................................................11 Meeting Women Workers’ Needs...............................................................................................13 Conclusion......................................................................................................................................15 India............................................................................................................................. 17 Country Summary .........................................................................................................................17 Country Health Overview............................................................................................................17 Health Status of Women Workers..........................................................................................20 Projects Profiled ............................................................................................................................21 Type of Programs......................................................................................................................23 Meeting Women Workers’ Need ................................................................................................24 Conclusion......................................................................................................................................28 Indonesia ..................................................................................................................... 30 Country Summary .........................................................................................................................30 Country Health Situation..............................................................................................................30 Health Status of Women Workers..........................................................................................32 Projects Profiled ............................................................................................................................34 Types of Programs....................................................................................................................34 Meeting Women Worker’s Needs...............................................................................................36 Conclusion......................................................................................................................................40 Mexico..........................................................................................................................42 Country Summary .........................................................................................................................42 Country Health Situation..............................................................................................................42 Health Status of Women Workers..........................................................................................44 Projects Profiled ............................................................................................................................46 Meeting Women Worker’s Needs...............................................................................................48 Conclusion......................................................................................................................................49 Options for effective reproductive health programs ................................................... 51 Resources..................................................................................................................... 69 Global ...............................................................................................................................................53 China ................................................................................................................................................53 India..................................................................................................................................................53 Indonesia ...........................................................................................................................................53 Mexico...............................................................................................................................................53 Other.................................................................................................................................................53 Project Descriptions .................................................................................................... 53 China ................................................................................................................................................53 India..................................................................................................................................................54 Indonesia ...........................................................................................................................................60 Mexico...............................................................................................................................................64 INTRODUCTION “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Women's health involves their emotional, social and physical well-being and is determined by the social, political and economic context of their lives, as well as by biology. Women are affected by many of the same health conditions as men, but women experience them differently. The prevalence among women of poverty and economic dependence, their experience of violence, negative attitudes towards women and girls, racial and other forms of discrimination, the limited power many women have over their sexual and reproductive lives and lack of influence in decision-making are social realities which have an adverse impact on their health.” - United Nations, Beijing Declaration and Platform for Action1 Women comprise a majority of the workforce in labor-intensive manufacturing industries such as apparel, footwear, toys, electronics, food processing and house-wares. They also work extensively in the informal sector, including in agriculture and handicrafts. The working environment in these industries can present health hazards to both male and female workers. Women employees, however, risk greater health consequences because they are often of childbearing age and are regarded with less social status than men, causing them to be less educated and more vulnerable. Consequently, they face unique needs in terms of health education, access and nutrition. This report presents the findings of a project initiated by Business for Social Responsibility (BSR) with the support of the David and Lucile Packard Foundation to improve awareness of the reproductive and general health needs of women workers in the global supply chain. This project presented a unique opportunity to support the promotion of women’s health programs, including reproductive health issues. The project focused on health programs and practices in four countries – China, India, Indonesia and Mexico. Each of these four countries is a major exporter into the global manufacturing economy, with a large concentration