Women’s Community Groups Connect Urban Areas to Primary Health Care Services in India

Thirteen women gather at a local Anganwadi Centre for their monthly Mahila Arogya Samiti meeting on a bustling Tuesday evening.

Story and photos by Rebecca Chase

Accredited Social Health Activist (ASHA) Mrs. Geeta Devi started the Mahila Arogya Samiti (MAS) community meeting by reviewing last month’s action plan and discussing the group’s progress toward its goals. She then led the women in discussing the problems they are seeing in their urban slum community. Water shortages and water sanitation were at the top of this month’s agenda.

While the group’s members were retrieving water, shopping for needed items at the market, talking to their neighbors and peers, and washing clothes, they heard that other women and households were experiencing the same water shortage. The shortage forced them to walk miles to get water from the nearest water source. And, when local water was available, it was unsanitary and potentially contaminated, which can lead to waterborne diseases.

These women, a united force representing their local community of 100-150 households, are volunteering their time to discuss locally led solutions to mitigate the problem. After 30 minutes of spirited discussion, they decided to come together on Sunday at the Anganwadi Centre to visit the Ward Parshad (ward counsel), Ms. Shehnaz Perween, from the hamlet Sarai Sattar Khan, and ask for immediate intervention from the government.

The elected MAS secretary, Seema, a 19-year-old adolescent eager to improve conditions in her community, noted the next steps they will need to take. “The issue will be raised with the local authority and, if they fail to resolve it, will be put before the higher authority. Everyone’s engagement and support will be required,” she said. The meetings end with the MAS slogan, Akele ham haar jatein hain aur milkar paar jatein hain (Together we can and we will).

Devi comments that, “the MAS committee has an added advantage of providing women a platform to speak for their concerns and helping me and ANMs (Auxiliary Nurse Midwives) connect with families through outreach services. This has benefited urban areas with a diverse population and limited human resources to reach everyone.”

In 2013, the Government of India launched the National Urban Health Mission (NUHM) to improve and strengthen primary health care services in urban areas of cities and towns. In October 2018, MAS groups were formed to utilize community volunteers to reach urban slum settlements vulnerable to health issues, environmental hazards, disasters, and food insecurity. The MAS groups increase the uptake of government health services by creating awareness in their communities of health issues and quickly referring community members to the appropriate service provider.

MAS helps neighborhoods take ownership of their health concerns by supporting women as they bridge the gap between people’s needs and service delivery. In February 2023, JSI trained ASHAs and MAS groups on various aspects of health and hygiene promotion. We also assisted with training and the creation of the Mahila Arogya Samiti Flipchart (see above) and the Handbook for Mahila Arogya Samiti: Urban Mobilization for Routine Immunization. Our continued support through these activities has enhanced local capacity and awareness of critical aspects of immunization services; nutrition; water, sanitation, and hygiene; newborn health; gender; and social determinants in urban slums of Darbhanga, Bihar, India. As Seema points out, “We are an extended family, and people reach out to us, and we link them with the related service providers.”

We practice different religions, have different cultural practices, and also have differences in opinion, but there is a commonality, and that is we all speak, and if we don’t speak, no one speaks for us.” – Seema