A new cadre of grassroots women health leaders in Bihar
SATHI is working in collaboration with Jan Jagran Shakti Sangathan (JJSS) to empower rural communities in Bihar on health and nutrition rights through their joint project, SAHAR (Strengthening Access to Healthcare and Raising Awareness on Health Rights).
The program has trained and equipped a group of women, many from underprivileged and underserved communities in Bihar, with the skills to navigate healthcare systems and challenge inequities. This new, burgeoning cadre of grassroots health advocates are called Swasthya Sathis.
Alongside three coordinators, twenty Swasthya Sathis were trained in reproductive health, maternal and child care, menstrual hygiene, TB and HIV awareness, and scientific approaches to health. SAHAR has also held four workshops, and an exposure visit to Jan Chetna Manch, Bokaro – which was the first time many of the Swasthya Sathis traveled in a bus, away from their hometowns. The Swasthya Sathis also visited health centers, anganwadis, and public hospitals, where they learned how health services function and how to engage with the right officials.
Swasthya Sathis – now community health leaders
These women now spearhead outreach in their local communities, organizing village meetings to promote public hygiene and proper nutrition practices, and to discourage superstition. No longer relegated to the sidelines, these women, many from Dalit and working class backgrounds, now use their voices with confidence, and even take part in public celebrations like Independence Day.
They also advocate for patients, helping them file grievances, and demand better implementation of health schemes by the local authorities. They know how to hold the health systems accountable, and have started to file written complaints about the denial of services and unsafe water.
Standing up for their rights – testimonies of change
In rural Bihar, ambulance drivers or hospital staff regularly demand bribes in exchange for health services that should be free for all. This was especially the case during deliveries, when women patients were at their most vulnerable. Many Swasthya Saathis are now boldly refusing to pay or give bribes, challenging the corruption which has been long normalized in rural public healthcare.
Even small examples are signifiers of a larger change. At Khervanna village, patients at the primary health centre were being overcharged for case papers – Rs. 10 for a paper that cost only Rs. 5. When Swasthya Sathi Munni Devi raised this issue at a women’s meeting, she and ten women from Ramghat Panchayat visited the PHC to demand answers. Confronted by officials who justified the excess charge as “travel expenses,” the women stood united and insisted on accountability. Their persistence worked—the centre now follows the official ₹5 rate, a small but powerful example of collective action.
The movement still faces significant challenges. Most obvious are the issues at the policy and institutional levels regarding public health, which have slowed down the delivery of critical services and the redressal of problems. Social and economic conditions, such as low literacy, entrenched gender hierarchies, and the prevalence of superstitions have also hindered collective change. Women still face resistance when questioning those in power or when trying to discredit quackery and unscientific practices. The Swasthya Sathis need continued support, material and otherwise, in order to sustain their momentum and motivation. Despite these barriers, their collective courage and scientific temper have begun to steadily reshape rural health accountability in Bihar.