The health situation of women is abysmal, and the general knowledge about women’s health is very low. SARTHI realizes the need for empowerment in women’s health, and has therefore initiated a women centered health model with a number of programs. The model for women’s health uses a self-help approach. The concept of self-help puts the “self” in the centre, i.e. the patient. It challenges the concepts associated with the female body such as shame and pollution, and encourages the women to explore and gain control over their bodies. The approach also aims at breaking down the hierarchies between the female patient and the (male) doctor. By relocating the health care to the villages and training traditional dais, Arogya Sakhis, local healers and village volunteers, the village women do not feel intimidated. The model has a holistic approach where the patient is empowered, and is based on traditional local herbal medicines.

Due to the fact that there was always inadequate medical staff at the primary health centers located in remote villages, non-availability of medicine supplies, long distance and tough terrain, SARTHI has initiated a program of training dais (traditional birth attendants). The main purpose has been to promote a local cadre of health functionaries to achieve safe motherhood practices. This is in line with the self-help health approach, as the patients do not have compromise on their comfort and convenience to get medical care. To increase the skill of traditional dais, this training module was chalked out keeping in mind that most of the trainees (90%) were illiterate rural women who had never been away from their homes for long stretches of times. During the training the dais learn to conduct safe deliveries, immunization of children, nutritional advice, pre & postnatal care, the importance of tetanus vaccine and medical check up for pregnant women, signs of risky pregnancy and deliveries, and situations in which the pregnant women should be referred to a doctor/ hospital for delivery etc. To this day altogether 200 dais have been trained.

The fact that women are not comfortable talking about their health problems has made SARTHI initiate a program to train Arogya Sakhi (Barefoot gynecological), to motivate rural and illiterate woman to work with locals who do not reveal their problems to doctors, health workers or family members even when they suffer from hard ailments that causes disability, other physical maladjustment or even early death. The Arogya Sakhis makes the women feel comfortable and not ashamed or intimidated by their bodies. Examination is done on the floor not on bed like in the PHCs, as village women are not used to lying on beds and thereby feel uncomfortable. Measurements are taken to break down hierarchies between the women and the examiner. The Arogya Sakhis teach the women how to do self-examination, and how to treat their problems themselves with local herbs, according to the self-help approach. Gradually village women have started sharing more of their gynecological problems with the Arogya Sakhi and asking advice for better treatment. 60 Arogya Sakhis are actively providing their services and herbal medicines to the gynecological patients. Together with the traditional dais, there is now a strong cadre of health providers to the village women.

SARTHI are also training village health workers, whose job is to identify those patients who are in need emergency treatment in off-hours of PHCs and private clinics. The primary objectives of the village health volunteers are to promote the practices of primary health care in preventive, primitive and curative aspects and to provide health education. SARTHI has identified 104 village volunteers from 60 different villages and provided training on health and education. The dais and Arogya Sakhis have changed the way women perceive themselves and their health. Women are no longer afraid to seek help for their maladies, or talk about their problems. Furthermore, they are not forced to travel long distances to endure humiliating examinations at PHCs. Slowly women are becoming aware of their own health, and they start to listen to their bodies. The next step is for the women to take control over their reproductive health. For this the health workers are invaluable.