Participation for Local Action

Implementation research with indigenous communities in southern India for local action on improving maternal health services

The main goal of the study was to facilitate contextualisation of the safe maternal health services of the National Health Mission in areas with indigenous population in Chamarajanagar district of Karnataka with the aim of improving access to services for this population. We attempted to fulfil this goal by interacting with various stakeholders from district to the community level in order to achieve a more inclusive and locally adapted implementation of safe maternal health services.


The overall study design employed is participatory action research (PAR) that brought together the community representatives, local NGO and researchers. Through the cycle of PAR, the community representatives went on a self-reflection journey to map the status of women in the community in accessing safe maternal health services, and identify issues or gaps that influenced access with possible reasons for them. With repeated discussions and workshops, the community researchers shared their analysis and offered possible community-led solutions that could help address these issues. A couple of solutions were taken up by the PAR team, and are currently being operationalised. Meanwhile a team of public health researchers is developing a theory-driven concept note about the implementation strategy taken on by the PAR team to understand and possibly explain their efforts and outcomes. In the coming months, the PAR team will implement the community-led solutions in Chamarajanagar district, which will be documented and monitored by a three-member team on a quarterly basis.

Dec 2014 - Sep 2016 (22 months)

Study Outputs

The key output the study aims to deliver is locally customised solution/intervention to help improve implementation of safe maternal health services for women of tribal communities in Chamarajanagar district. The intervention is currently being developed by the PAR team and will be operationalised in September 2016.

In terms of written outputs, an interim report was released earlier this year as a mid-term deliverable to initiate documentation of project processes. A report of the community-led analysis of their status to accessing maternal health services, and a report on the maternal health services available for women of tribal communities in the district are in progress.

A photo-story and an organised session about the community-led analysis were part of the 3rd national conference on bringing evidence into public health policy in July 2016 at Bangalore. Videos from this session will soon be available for viewing. The team will also be participating in the upcoming fourth global health symposium at Vancouver, Canada via an e-poster and by participation in an organised session. The series of photo-stories developed during the study is also accepted to be on display during the global symposium.

Study Team

Dr. Tanya Seshadri

Principal Investigator
Vivekananda Girijana Kalyana Kendra & The Malki Initiative

Dr. Prashanth. N. S (co-principal investigator, Institute of Public Health, Bengaluru)

Dr. C Madegowda (Zilla Girijana Budakattu Anhivrudhhi Sangha, Chamarajanagar)

Dr. Vishweswariah (District Reproductive and Child Health Officer, Chamarajanagar)

Dr. S M Sadhana (Karnataka Health Systems Resource Centre, Bengaluru)

Dr. Giridhara Babu (Indian Institute of Public Health, Hyderabad-Bengaluru)

Dr. Arima Mishra (Azim Premji University, Bengaluru)

Dr. Bruno Marchal (Institute of Tropical Medicine, Antwerp)

Supported by

Under the Decision Maker-led Implementation Research Platform