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Paper short abstract:

The polycrisis has deepened health inequities, particularly among marginalized women and tribal communities. Saksham's Sashakt AAA model empowers FLWs, fostering community-driven solutions that improve maternal and child health outcomes through participatory, gender-sensitive approaches.

Paper long abstract:

The polycrisis—characterized by climate change, pandemics, economic instability, and sociopolitical conflicts—has exacerbated health inequities, particularly for marginalized women and tribal communities in regions like Assam, Chhattisgarh, and Odisha. These areas face systemic neglect, limited access to healthcare, and socio-cultural barriers that hinder progress in maternal and child health.

The Saksham project's Sashakt AAA model offers a community-driven, gender sensitive solution to these challenges. By empowering frontline health workers (FLWs) such as ASHAs, ANMs, and ASHA Supervisors, the model strengthens grassroots healthcare systems. Participatory methodologies like Living Labs (5Ds), Visioning exercises and Leadership and Supportive Supervision enhance FLWs’ capacity to co-create locally relevant solutions, ensuring better health outcomes for marginalized populations.

Key interventions in the three states have demonstrated success: in Assam, the MAAdol campaign bridged documentation gaps for Wage Compensation Scheme, benefiting over 5,000 tea garden workers; in Chhattisgarh, improved FLW coordination through agenda driven sector level cluster meetings resulted in a 185% increase in high-risk pregnancy identification; and in Odisha, community advocacy through joint home visits reduced home deliveries by 70% in Kashipur block. These initiatives underscore the power of community-led approaches in transforming health behaviors.

To build resilient and equitable health systems, the Saksham approach advocates for expanded intersectional training for FLWs, strengthening community platforms like VHSNCs and GKSs, integrating climate resilience into health planning, and fostering cross-sectoral partnerships. These strategies align with India’s health and equity goals, supporting SDG 3 (Good Health and Well-being) and SDG 5 (Gender Equality) through inclusive, gender-responsive health systems.