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Our wellbeing, our voice: strengthening access to healthcare amongst vulnerable groups at the grassroots

  • Amount funded: £31,000
  • Year: 2022
  • Duration: 21 months
  • Locations: India
  • Grant stream: Open grants call

LGBTQI communities and sex workers in Shimoga District in the State of Karnataka face challenges accessing healthcare due to identity-based stigma and discrimination despite efforts to strengthen these vulnerable communities.

Project partners
Best Practices Foundation
Karnataka Sex Workers' Union (KSWU)
Prakruthi Samudaya Seva Samusthe
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How we are helping

The project will strengthen the capacities of marginalised and vulnerable communities at the grassroots levels, including LGBTQI communities and sex workers, to advocate for improved access to healthcare services and enhanced inclusion in healthcare policies and processes.

About the project

LGBTQI communities and sex workers in South India face multiple barriers accessing healthcare services including identity-based stigma, discrimination and ignorance surrounding their unique healthcare needs. Health outcomes are worsened by social determinants—lack of societal and familial acceptance, precarious livelihood conditions and compromised educational status—exacerbated by the Covid-19 pandemic.

Measures for social inclusion of transgender individuals are outlined in Karnataka’s State Transgender Policy in 2017 and further reinforced in the Transgender Persons (Protection of Rights) Act of 2019.

Project partner Best Practices Foundation has identified a decline in the overall wellbeing of these communities in Karnataka since the Covid-19 pandemic. A needs assessment on sexual and reproductive health has highlighted the extent and nature of barriers experienced in accessing healthcare services due to underlying stigma, including denial of abortion services, lack of access to gender-affirmative processes, lack of affordable and non-judgmental mental health services.

In this project Best Practices Foundation will build on the outcomes of these recent initiatives; working with three partners to contribute to improving health service delivery and enhancing access to comprehensive healthcare for LGBTQI communities and sex workers in Shimoga district. The project will also contribute to strengthening government responses to the Covid-19 health pandemic at the local level and complement implementation of Karnataka’s State Transgender Policy.

This will be achieved through:

1) Capacity building and community district committee creation

  • Training 60 people (30 sex worker and 30 LGBTQI community members) on healthcare, patient rights and accountability within the public healthcare system
  • Forming a district committee within Shimoga district (comprising four women sex workers and four LGBTQI community members)
  • Conducting intensive training on community health, leadership and advocacy with eight members of the district committee for three days

2) Partnership and accountability building

  • Facilitating a consultation meeting with 60 community members conducted by the district committee members on health issues, patient violations/grievances, entitlements, advocacy ideas, visiting the primary community health centres
  • Conducting four sensitisation sessions with staff at the primary community health centres and local health department
  • Designing an advocacy campaign calling for higher accountability within the healthcare system for community health needs

3) Resource and evidence generation

  • Producing six audio-visual resources on various topics related to community health produced for knowledge building of community members
  • Disseminating the findings of situational analysis with the primary community health centres, health department and other civil society organisations

Improved knowledge and attitude about healthcare services among sex worker and LGBTQI communities in Shimoga district is expected as a result of this project, enabling a greater sense of agency and confidence to access these services and increased grassroots advocacy surrounding the inequities faced. District committee advocacy efforts are expected to result in improved accountability and responsiveness of the healthcare system towards the needs of sex worker and LGBTQI communities in Shimoga district.

Project Partners
Best Practices Foundation

Best Practices Foundation (BPF) works to improve the quality of life for poor and marginalised communities through participatory approaches. It is involved in documenting best practices across various thematic areas of work including institutional strengthening, livelihood, HIV, gender equality and gender-based violence. In partnership with Solidarity Foundation, BPF have worked in four Southern Indian states focusing on institutional strengthening of gender and sexual minorities (LGBTQI communities) including sex worker CBOs and supported fellows from the community to grow as leaders.


Sangama is a sexual minorities, sex workers and people living with HIV human rights organisation for individuals oppressed due to their sexual preference. Sangama has a particular focus on the concerns of sexuality minorities from poor and/or non-English speaking backgrounds and sexuality minority sex workers, who otherwise have little to no access to information and resources. Sangama aims to bring sexuality, sexual preference and gender identity into the realm of public discourse and link it to gender, human rights development and other social movements.

Karnataka Sex Workers' Union (KSWU)

The Karnataka Sex Workers’ Union is a trade union of women, men and transgender sex workers who advocate for the rights of all sex workers. Their work includes: (i) assisting in the resolution of disputes of sex workers in work, (ii) assisting sex workers and their dependents with all facilities for educational, cultural, social, political and economic development, and (iii) cooperating with the efforts of the government, local bodies, and public institutions for the improvement of the lives of sex workers.

Prakruthi Samudaya Seva Samusthe

Prakruthi Abhivruddhi Seva Samusthe is a registered organisation working on a rights-based approach among marginalised communities on issues of health, education and community development. The organisation has a focus on women empowerment through gender sensitisation, revival of indigenous culture, child rights and climate change.

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