One of many MAS groups that meets in Bihar.
Community accountability is the cornerstone of public health. When individuals are empowered to monitor and influence health services, they become active stakeholders in their own well-being. The Mahila Arogya Samiti (MAS) women’s groups in India serves as a powerful vehicle for communities to take ownership of health initiatives, ensuring that health providers respond to local needs.
Recognizing this, The Challenge Initiative (TCI) developed an innovative approach to revive MAS groups,in Bihar. In collaboration with urban primary health centers (UPHCs) and under the leadership of city health authorities, TCI launched the “Know Your Facility” campaign.
Through outreach camps and community engagement activities, the initiative introduced MAS members and their families to the range of services available at UPHCs. By offering firsthand experiences of government-provided healthcare, the campaign equipped MAS members with the knowledge and confidence to become health advocates within their communities. Special camps at UPHCs played a crucial role in this initiative, with Accredited Social Health Activists (ASHAs) mobilizing MAS members and encouraging facility visits. These visits familiarized women and their families with available health services, including family planning options.
By raising awareness about government-provided healthcare, MAS members were empowered to leverage their collective influence, promote community awareness, and drive positive change within families. Many expressed gratitude for the experience, as this was their first opportunity to engage directly with UPHC staff. Their confidence in accessing healthcare services grew, strengthening their role as community health ambassadors.
With TCI’s support, MAS in Bihar has become a catalyst for community health and women’s empowerment across seven intervention cities – Patna, Gaya, Bhagalpur, Begusarai, Munger, Rohtas, and West Champaran. This initiative has significantly enhanced community participation in health-related decision-making and empowered women to take on leadership roles. For instance, one MAS member recently assisted a pregnant woman in reaching the nearest health facility for delivery using untied MAS funds. This decisive action reflects the effective coaching provided by TCI, which has trained MAS members to prioritize urgent health issues such as maternal health and family planning. Members have also been trained in decision-making, identifying key health priorities – including heat wave preparedness, diarrhea prevention, nutrition, healthy habits, and communicable disease control – and advocating for necessary services.
One of many MAS groups that meets in Bihar.
To ensure accountability and transparency, MAS groups receive printed registers to document meeting minutes and track fund utilization. Between April and November 2024, over 75% of MAS members underwent health check-ups at their assigned facilities, underscoring the growing awareness and engagement fostered by these initiatives.
A key success has been strengthening MAS governance. When an inactive secretary was identified, members democratically nominated a new leader, demonstrating their commitment to effective leadership and accountability. Beyond regular community meetings, the state government now conducts monthly online sessions with district health officials and development partners to discuss MAS strategies. These meetings provide ongoing training, reinforce community accountability, and address practical challenges such as funding for refreshments and materials. The MAS initiative in Bihar has emerged as a model for community-led health transformation.
Recognizing its impact, the government is now scaling it up across 22 additional non-TCI-supported cities. As part of this expansion, health cards have been developed for all MAS members in these cities. Once printed and distributed, these cards are expected to enhance healthcare access and improve overall well-being. This initiative stands as a powerful testament to the impact of women-led decision-making and community accountability in achieving sustainable health outcomes. By strengthening local leadership and fostering greater engagement, MAS continues to drive lasting change in Bihar’s public health landscape.
