July 24, 2024

Since the beginning of July, I have joined a new project under the umbrella of Samagra-Haqdarshak. Funded by USAID and implemented by PSI, the project Samagra (2020-2025) aims to create an urban health ecosystem in India that is responsive, affordable, and equitable, and which provides quality preventive, promotive, and curative primary health care for the urban poor, particularly to women, girls, and other vulnerable populations. The project focuses on family planning (FP), maternal and child health (MCH), and tuberculosis (TB) services and envisages to create a total market for comprehensive, consumer empowered primary health care.

Haqdarshak is a social enterprise that trains women as last-mile support agents (Haqdarshikas) to provide application support services for government schemes to communities members for a fee. That fee then becomes income for the Haqdarshika. On average, Haqdarshikas earn a monthly income of Rs. 3,300 for 70-75 hours of work. From 2021-2023, PSI partnered with Haqdarshak and Haqdarshikas were employed in Delhi and Indore urban slums to deliver key health-based entitlements like the Samagra ID, eShram, ABHA ID and PMJAY. Over 200,000 citizens were served, access to entitlements improved, institutional partnerships fostered, and last-mile delivery into the government health system integrated.

CSBC joined the project as an evaluation partner, to understand the behavioral determinants of successful Harqdarshikas. To do this, we are applying the COM-B framework for behavior in addition to the Self Determination Theory to measure types of motivation.

The COM-B model for behavior change, developed by Susan Michie and a group of psychology faculty at University College London, is a comprehensive framework that identifies three essential conditions for behaviour to occur — Capability (C), Opportunity (O), and Motivation (M). These can collectively drive — or impede — Behavior (B).

Self Determination Theory is a psychological framework that emphasizes the importance of human motivation and personality. The theory suggests that people have innate psychological needs that, when satisfied, lead to optimal functioning, growth, and well-being. It defines two types of

These psychological frameworks have formed the structure of a long interview questionnaire, which we intend to complete with a sample of 200+ Haqdarshikas from across the spectrum of performance. We then intend to run an OLS regression of all the variables collected against performance, to identify the behavioral determinants of success in the role.

While I won’t get to see the project through during my summer internship (which ends in two weeks — how quickly the time flies!) this has been a very meaningful project to work on, and is a fantastic example of where psychology meets development!