Aug 2015 – Aug 2020

Facilitating Learning & Action with Women’s Groups



India – South Asia

To improve care seeking and adoption of healthy practices during pregnancy through women’s groups in Jharkhand.

$7,252,826 Grant Value

$711,342 evaluation budget


Other funders

  • Government of Jharkhand -

  • Government of India

Prompt care during pregnancy, clean birth practices, keeping the newborn warm, and delaying the first bath are some of the practices that can make or break the chances of a baby surviving. And yet, these same practices happen far too seldom in many countries around the world.

Changing behaviours, however, is extremely difficult to do, especially among poor and marginalised women who not only lack the knowledge, but also the agency to act or demand quality care. 

A new, simple, low-tech method - participatory learning and action through women’s groups – has been proven in trial settings in rural India to promote healthy behaviours during the critical period of pregnancy and childbirth, as well as reducing newborn deaths by one third. 

Participatory women’s groups offer a structured problem solving approach, where women are supported to collectively discuss the barriers to better health, identify solutions, and mobilise the community for change.

The investment will support the scale up of participatory learning and action to all rural villages in Jharkhand state. 

The overall aim is to enable the public health system to take on the proven approach, empowering women to adopt lifesaving behaviours for themselves and their babies. 

Government community health workers - accredited social health activists (ASHAs) - will be trained to facilitate group meetings, and take women through the problem solving cycle. 

Over the life of the investment, 50,000 women’s groups will be formed, across a population of 25 million.

Programme funds will support Ekjut, the local NGO that has pioneered the approach, to embed the intervention within the state’s health system. By the third year of the investment, scale up costs will be picked up by state government. 

Based on the experience in Jharkhand, Ekjut will encourage the Government of India to roll out participatory learning and action through women’s groups to other states. 


By helping to scale the approach to all rural areas in the Indian state of Jharkhand, this investment will aim to directly avert 10,280 newborn deaths and 1,054 maternal deaths among the poorest and most vulnerable communities. 

The investment will also hopefully prevent many more mother and child deaths in other states, as participatory women’s groups are rolled out in other states in India. 

Since inception, the initiative has been successful in establishing six learning sites in six blocks across five regions. National Health Mission state and district teams have been mobilised to take ownership, and the Government of Jharkhand has committed budgetary allocation (up to $3.8 million) under the National Health Mission for the  incentives and participatory learning action cycles (PLA) module development on maternal and newborn health. The Federal government has recommended scale-up of the PLA approach using the community health workers (ASHA’s) platform to ten states in India.