Even though Maharashtra is among the more developed states in India, the benefits of this growth are unevenly distributed. Some regions, especially those with a predominantly tribal population, are underdeveloped.

In Nandurbar district, where Bhils and Pawaras make up 70 per cent of the population, the majority lives below the poverty line. Shahada block has a large number of landless adivasi labourers, and livelihood security and health outcomes are the worst-affected here.

Meanwhile, a significant change is currently underway in 35 villages, essayed by a dedicated army of barefoot auditors, or Gram Arogya Sakhas, who are motivating women to eat better, get their pre- and post-natal check-ups on time, opt for institutional delivery and immunise their children. This empowered and socially responsible force is part of a maternal health intervention undertaken by Janarth Adivasi Vikas Sansthan (JAVS), a local non-governmental organisation, and Oxfam India, under the DFID-supported Global Poverty Action Fund initiative.

Among those handpicked to be a barefoot auditor is Jagu Pahar, the 43-year-old former sarpanch (village head) of Vagharda, 25km from Shahada, who firmly believes that healthy mothers and children can ensure a better future for his community.

Preeti Bohidar, a project officer at Oxfam’s Raipur office, says maternal health is a key challenge in rural areas where poverty is stark and resources are scarce.

Although the National Health Mission has introduced several schemes to improve the situation, there is a glaring lack of awareness, especially among women, about their basic rights and entitlements, she adds. In Nandurbar, the barefoot auditors have been filling the information gaps since 2012.

What exactly does a barefoot auditor do?

“S/he forms a crucial link between the community, the NGO and various government departments. Their main task is to spread awareness on the schemes and facilities available to pregnant and lactating women, and push the community to involve itself in meeting the health needs of its girls and women. Each project village has one barefoot auditor, who is passionate, outspoken and someone the locals look up to. Most are at least semi-literate,” says Ranjana Kanhere, Executive Director, Janarth.

Pahar learnt the ropes at training sessions conducted in 2013 by Dr Mohan Deshpande of the Pune-based Arogya Bhan.

“We were informed about our rights, the schemes we are entitled to and how a government hospital functions. The sessions enabled me to identify five children who were suffering from malnutrition. I was able to make sure they got vital treatment and followed up with the Primary Health Centre [PHC] at Shahada as well,” he says.

Since he became Vagharda’s barefoot auditor in 2013, the village has had no maternal deaths or deliveries at home. “Using illustrations I explain concepts to people. I make a note of the number of pregnant women in the village and talk to them about eating right and taking the necessary precautions. I even ensure that they get the diet and monetary incentives they are entitled to under different government schemes,” Pahar says.

In the neighbouring hamlet of Bhute, women no longer hesitate to ask for health-related advice. They turn to the 55-year-old barefoot auditor Manga Thackeray who, together with his niece Bharati Udaysi, a local Janarth activist, has been motivating people in his village to stand up for their rights.

Initially he did face stiff resistance to his “new-age ideas about childbirth”. Tribal elders often insist on following certain traditional customs that could easily prove detrimental to the wellbeing of both the mother and child. “Take the practice of not eating enough during pregnancy simply because they don’t want the baby to grow too big. They fear that delivery will be extremely painful. I had to sit with them and clarify why that was not good for them or their infants,” says Thackeray.

There was a similar resistance to immunisation. Says Udaysi, “My uncle, I, and our Accredited Social Health Activist (ASHA) have had to make several home visits to convince them.”

Their efforts have borne fruit, as is apparent from the huge trust Thackeray and Udaysi now enjoy in the community.

Laxmi Barade, a shy tribal woman from Bhute, says, “I know more about sanitation and nutrition thanks to Mangaji. I have realised the importance of consuming leafy vegetables. They give us iron supplements to build immunity and for the growth of the child. Most women in our village suffer from malnutrition and anaemia as our staple diet is chillies and bhakri (flat unleavened bread).”

Thackeray, a sugarcane and cotton farmer, is happy at this healthy turnaround. “The awareness levels are so high that if anyone sees a villager being ignored at the PHC, they step up and voice their concern to the doctor in-charge. Personally, the training changed my outlook. I don’t fear anyone anymore, as I know our rights… even approaching the Collector does not appear daunting anymore,” he signs off with a wide smile.

Dilnaz Boga, Women’s Feature Service

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