BOOK EXTRACT

How the Election Commission got more women to vote

In his new book, 'An Undocumented Wonder: The Great Indian Election', former chief election commissioner SY Quraishi details how the organisation has increased voter turnout by reaching out to the last voters: nomadic communities, the differently abled, the homeless and the transgendered. Here, he details how the Election Commission ensured that more women turn out to vote.

India suffers from one of the lowest sex ratios among the South Asian countries. Provisional figures in the 2011 Census of India put the sex ratio of the country at 940, the highest since 1971. But among the ten most populous countries of the world, only China is behind us with a sex ratio of 926. Similarly, the female literacy rate was 65.14 per cent in 2011 as compared to a male literacy rate of 82.14 per cent. With this background and awareness about the socio-economic-political milieu, several steps were taken by the Commission to ensure that eligible women are not left out from attaining their right to register and exercising their right to vote.

There is a very comprehensive system of statistical analysis in place in the Commission to ensure that no citizen of eighteen years age is left out of the electoral rolls. It calculates the gender ratio, the elector–population ratio and the age cohort of voters as against the population figures given by Census, which are projected on an yearly basis with the help of the decadal growth rate. This kind of broad strategy then forms the basis for developing a polling station-wise strategy for positive intervention by the electoral registration officer of each assembly constituency to ensure that not one eligible voter is left out. An analysis of the gender ratio is one of the main focus areas in this strategy, which has been scrupulously followed since 2006.

It was felt in the middle of the last decade that due to the social structure of Indian society, which is still somewhat restrictive for women, some radical efforts needed to be made. Consequently, the system of appointing Booth Level Officers (BLOs) was devised and recently, the Commission has initiated the system of annual house to house verification of voters with the help of the BLOs. A BLO is a government or semi-government functionary (like a school teacher or patwari (revenue official)) who is designated to work within the geographical limits of a single polling station area for the purpose of voter registration, roll verification and awareness building about electoral processes. This is an additional responsibility and in lieu of these functions, they receive a small honorarium. Out of the 824,000 BLOs in the country, a substantial number are women and that has been a major contributory factor in an enhanced registration of women voters...

A concern that is taken into account while publishing photographs on the electoral rolls is the socio-cultural gender related sensitivities in the country. It is mandatory to give hard copies of these rolls to recognized political parties during every revision at the draft level, as well as of the final publication. These rolls are also shared with various government departments, academics and researchers and civil society groups, if they so require. However, it is the policy of the Commission to share the soft copy of the rolls without photographs of the voters keeping in view cultural sensitivity about women. It was felt that a soft copy of women’s photos could be subjected to abuse like morphing. The printed copy with a small postage stamp size photo was considered good enough for identification. With regard to non-inclusion of women in electoral rolls on account of shifting of residence due to marriage, a number of FAQs were designed to address the issue of electoral rolls of newly married women in their spousal families.

Female Participation in the Voting Process

Several steps have been taken to encourage and facilitate women’s participation on polling day. For one, there are separate queues for men and women. To make it faster for women, in the Uttar Pradesh elections in 2012, it was decided to allow two women in the queue to proceed for every one man. This worked wonders as their queues moved very fast and the women were able to return quickly, which motivated others to go and vote. This has been made a nationwide practice. There is invariably one female polling staff member to take care of the sensibilities of female voters who, for example, may not like to have a male polling staff member applying indelible ink on their fingers or they may prefer to be identified by a female staff member. All-women polling stations are set up with only women staff members in areas with purdahnasheen (veiled) voters. Women police forces are also deployed with a view to encouraging female voter turnouts.

 Pre-election Survey

Since 2010, when a voter education division was set up, a system of a Knowledge, Attitude, Behaviour and Practices (KABP) survey has been taken up as a mandatory pre-election activity that has revealed several reasons why female turnout is lower than that of males. In fact, KABP has emerged as an important election management tool to assess voter perceptions about physical and psychological barriers amongst various voter segments. The surveys have empowered election managers in addressing various issues that the voters face. The knowledge and insights gained from these surveys have also led to the fulfilment of service gaps hitherto unknown.

An analysis of gender-disaggregated data in the electoral rolls indicated a considerable gender gap, much below the national population ratio. The survey highlighted areas where interventions were required. Concern for personal security (as women feared that polling booths attract anti-social elements), dependence on the approval of family elders, especially men, and lack of adequate toilet facilities were some of the factors that kept many women away from voting. Consequently, a communication targeted at family elders to break their resistance to women of the family participating in polls and messages allaying fears on security were included in the overall communication campaign.

The innovations continue, for example, in the Bihar state assembly elections in November 2010, the strategy included motivation through generating awareness by having a popular local female icon, Sharada Sinha, as the face and voice of the campaign. The focus of the strategy was twofold—provide a safe and secure environment for voting to women and motivate women to come out and cast their votes as a sign of their empowerment. Areas with relatively greater gender gaps were identified for increased ECI intervention; this worked. As a result, female voters at 54.85 per cent outnumbered male voters at 50.77 per cent—a clear lead of eight per hundred.

An extract from An Undocumented Wonder: The Great Indian Election by SY Quraishi, published by Rainlight Rupa; pp 416; Rs 795.


We welcome your comments at letters@scroll.in.
Sponsored Content BY 

What hospitals can do to drive entrepreneurship and enhance patient experience

Hospitals can perform better by partnering with entrepreneurs and encouraging a culture of intrapreneurship focused on customer centricity.

At the Emory University Hospital in Atlanta, visitors don’t have to worry about navigating their way across the complex hospital premises. All they need to do is download wayfinding tools from the installed digital signage onto their smartphone and get step by step directions. Other hospitals have digital signage in surgical waiting rooms that share surgery updates with the anxious families waiting outside, or offer general information to visitors in waiting rooms. Many others use digital registration tools to reduce check-in time or have Smart TVs in patient rooms that serve educational and anxiety alleviating content.

Most of these tech enabled solutions have emerged as hospitals look for better ways to enhance patient experience – one of the top criteria in evaluating hospital performance. Patient experience accounts for 25% of a hospital’s Value-Based Purchasing (VBP) score as per the US government’s Centres for Medicare and Mediaid Services (CMS) programme. As a Mckinsey report says, hospitals need to break down a patient’s journey into various aspects, clinical and non-clinical, and seek ways of improving every touch point in the journey. As hospitals also need to focus on delivering quality healthcare, they are increasingly collaborating with entrepreneurs who offer such patient centric solutions or encouraging innovative intrapreneurship within the organization.

At the Hospital Leadership Summit hosted by Abbott, some of the speakers from diverse industry backgrounds brought up the role of entrepreneurship in order to deliver on patient experience.

Getting the best from collaborations

Speakers such as Dr Naresh Trehan, Chairman and Managing Director - Medanta Hospitals, and Meena Ganesh, CEO and MD - Portea Medical, who spoke at the panel discussion on “Are we fit for the world of new consumers?”, highlighted the importance of collaborating with entrepreneurs to fill the gaps in the patient experience eco system. As Dr Trehan says, “As healthcare service providers we are too steeped in our own work. So even though we may realize there are gaps in customer experience delivery, we don’t want to get distracted from our core job, which is healthcare delivery. We would rather leave the job of filling those gaps to an outsider who can do it well.”

Meena Ganesh shares a similar view when she says that entrepreneurs offer an outsider’s fresh perspective on the existing gaps in healthcare. They are therefore better equipped to offer disruptive technology solutions that put the customer right at the center. Her own venture, Portea Medical, was born out of a need in the hitherto unaddressed area of patient experience – quality home care.

There are enough examples of hospitals that have gained significantly by partnering with or investing in such ventures. For example, the Children’s Medical Centre in Dallas actively invests in tech startups to offer better care to its patients. One such startup produces sensors smaller than a grain of sand, that can be embedded in pills to alert caregivers if a medication has been taken or not. Another app delivers care givers at customers’ door step for check-ups. Providence St Joseph’s Health, that has medical centres across the U.S., has invested in a range of startups that address different patient needs – from patient feedback and wearable monitoring devices to remote video interpretation and surgical blood loss monitoring. UNC Hospital in North Carolina uses a change management platform developed by a startup in order to improve patient experience at its Emergency and Dermatology departments. The platform essentially comes with a friendly and non-intrusive way to gather patient feedback.

When intrapreneurship can lead to patient centric innovation

Hospitals can also encourage a culture of intrapreneurship within the organization. According to Meena Ganesh, this would mean building a ‘listening organization’ because as she says, listening and being open to new ideas leads to innovation. Santosh Desai, MD& CEO - Future Brands Ltd, who was also part of the panel discussion, feels that most innovations are a result of looking at “large cultural shifts, outside the frame of narrow business”. So hospitals will need to encourage enterprising professionals in the organization to observe behavior trends as part of the ideation process. Also, as Dr Ram Narain, Executive Director, Kokilaben Dhirubhai Ambani Hospital, points out, they will need to tell the employees who have the potential to drive innovative initiatives, “Do not fail, but if you fail, we still back you.” Innovative companies such as Google actively follow this practice, allowing employees to pick projects they are passionate about and work on them to deliver fresh solutions.

Realizing the need to encourage new ideas among employees to enhance patient experience, many healthcare enterprises are instituting innovative strategies. Henry Ford System, for example, began a system of rewarding great employee ideas. One internal contest was around clinical applications for wearable technology. The incentive was particularly attractive – a cash prize of $ 10,000 to the winners. Not surprisingly, the employees came up with some very innovative ideas that included: a system to record mobility of acute care patients through wearable trackers, health reminder system for elderly patients and mobile game interface with activity trackers to encourage children towards exercising. The employees admitted later that the exercise was so interesting that they would have participated in it even without a cash prize incentive.

Another example is Penn Medicine in Philadelphia which launched an ‘innovation tournament’ across the organization as part of its efforts to improve patient care. Participants worked with professors from Wharton Business School to prepare for the ideas challenge. More than 1,750 ideas were submitted by 1,400 participants, out of which 10 were selected. The focus was on getting ideas around the front end and some of the submitted ideas included:

  • Check-out management: Exclusive waiting rooms with TV, Internet and other facilities for patients waiting to be discharged so as to reduce space congestion and make their waiting time more comfortable.
  • Space for emotional privacy: An exclusive and friendly space for individuals and families to mourn the loss of dear ones in private.
  • Online patient organizer: A web based app that helps first time patients prepare better for their appointment by providing check lists for documents, medicines, etc to be carried and giving information regarding the hospital navigation, the consulting doctor etc.
  • Help for non-English speakers: Iconography cards to help non-English speaking patients express themselves and seek help in case of emergencies or other situations.

As Arlen Meyers, MD, President and CEO of the Society of Physician Entrepreneurs, says in a report, although many good ideas come from the front line, physicians must also be encouraged to think innovatively about patient experience. An academic study also builds a strong case to encourage intrapreneurship among nurses. Given they comprise a large part of the front-line staff for healthcare delivery, nurses should also be given the freedom to create and design innovative systems for improving patient experience.

According to a Harvard Business Review article quoted in a university study, employees who have the potential to be intrapreneurs, show some marked characteristics. These include a sense of ownership, perseverance, emotional intelligence and the ability to look at the big picture along with the desire, and ideas, to improve it. But trust and support of the management is essential to bringing out and taking the ideas forward.

Creating an environment conducive to innovation is the first step to bringing about innovation-driven outcomes. These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott, which is among the top 100 global innovator companies, is working with hospitals and healthcare professionals to improve the quality of health services.

To read more content on best practices for hospital leaders, visit Abbott’s Bringing Health to Life portal here.

This article was produced on behalf of Abbott by the Scroll.in marketing team and not by the Scroll.in editorial staff.