India: How one woman’s traumatic birth experience inspired her to help other mothers

Manju gave birth to her third child on the side of the road, one mile from the nearest health facilities. She was bleeding heavily, but with no access to ambulance service and with winter roads nearly impassable, it took her nearly four hours to get to the hospital.

Manju knew, as soon as she and her baby were safe, that she never wanted any other woman to go through what she had experienced.

Bihar, Manju’s home, is one of India’s poorest and largest states, with a population of over 110 million. Almost 90 percent of the state is rural, which means access to necessary infrastructure and resources is very limited. Despite recent gains, Bihar has some of the country’s highest rates of maternal, neonatal, and infant mortality, as well as a high prevalence of malnutrition, stunted growth, and high fertility rates. CARE is working with partners to reduce rates of maternal, newborn, and child mortality and malnutrition, and on improving immunization rates and reproductive health services statewide.


Through this project, Manju decided to become an accredited social health activist. These are frontline health workers trained to connect their villages, which are often rural or otherwise disadvantaged, to Bihar’s rejuvenating healthcare system.

Frontline health workers form the backbone of the public health system in India, like they do in many low-income countries. She is well known in the community.

“I give the mothers information that benefits them, which is why the mothers trust me.”

Dressed in her official blue-trimmed saree, Manju visits dozens of families every day, walking to her appointments to counsel expectant and new mothers. With long distances between health centres, poor road conditions, and limited transportation options, people living in rural and remote areas of Bihar have little access to facility-based health services.

Health workers like Manju work hard to provide in-home counseling; health and hygiene education; and basic maternal, newborn, and child health and nutrition services to families in need. They have the potential to save millions of lives.

“I don’t want anyone to suffer the same sadness I did,” says Manju.