I know I am not powerless. I am powerful. And I will no longer be silent.

SUTRA’s initial engagement with health was rooted in direct service delivery, addressing the glaring gaps in public healthcare in remote, rural regions. Dispensaries were established in under-served areas, and traditional birth attendants (dais) were trained in hygiene and safe delivery practices to improve maternal outcomes.

In parallel, women were encouraged to rediscover and share their knowledge of local herbs and home remedies, fostering self-reliance in primary care. This approach honoured traditional wisdom while grounding it in safe, community-based healthcare.

By the 1980s, SUTRA’s understanding of women’s health had evolved into a rights-based framework. This shift gave rise to the groundbreaking resource “Stree Shareer ki Pehchaan”—a series of eight illustrated booklets covering the woman’s body across her life cycle. These booklets, developed collaboratively with women from Mahila Mandals, continue to serve as a vital tool for training health workers and demystifying women’s health.

In 1996, during a gathering of elected Panchayati Raj representatives, concerns were raised about the declining number of girl children in districts like Kangra, Una, Bilaspur, and Mandi. This marked the beginning of a bold and sustained campaign by SUTRA on the issue of the falling sex ratio in Himachal Pradesh.

Despite initial resistance from the state government, SUTRA’s fieldworkers took the conversation to the grassroots—gathering birth registration data from panchayats, publicly displaying annual sex ratios outside offices, and collecting district-level data from sub-centres and hospitals. The facts were grim—and could no longer be ignored.

SUTRA’s campaign gained strength through community-led initiatives such as the formation of Kanya Bachao Samitis, street plays, local meetings, and continuous coordination with public health departments. These efforts transformed the issue into a widely recognized public concern.

In addition to advocacy, SUTRA worked to build awareness about the National Rural Health Mission (NRHM) at the panchayat level, ensuring that elected representatives and communities understood their roles in improving health outcomes. Field staff monitored public institutions such as anganwadis and government health centres to bridge service gaps in reproductive health.

A nuanced challenge emerged around the issue of abortion. While SUTRA campaigned vigorously against sex-selective abortions, it remained equally committed to defending a woman’s right to safe and legal abortion. This balance—between protecting unborn girls and upholding bodily autonomy—has remained central to SUTRA’s rights-based approach.

As Himachal Pradesh rapidly transitioned into an emerging economy in the late 1980s—with cash crops, horticulture, and privatization reshaping rural life—new gendered vulnerabilities emerged. On one hand, the mean age of marriage for girls rose to 22.2 years (Family Welfare Statistics 2011); on the other, dowry expenses increased, child sex ratios declined, and gendered health indicators worsened.

Despite material progress, reproductive health declined. Women faced high rates of anaemia (43% among reproductive-age women, NFHS-III), the unchecked use of over-the-counter abortion pills, early and often unsafe sterilization procedures, and a rise in RTI/STI symptoms due to poor sexual health education.

In this complex landscape, SUTRA continues to work at the intersection of community health, gender rights, and governance—empowering women not just to seek care, but to demand rights, make informed choices, and build health justice from the ground up.

 In May 2012, SUTRA launched the initiative “Ensuring Reproductive Rights for Women in Himachal Pradesh”, grounded in the belief that reproductive health and rights are not merely service issues—but matters of governance and justice.

The project set out to demonstrate that, with the right support and awareness, Gram Panchayats can take meaningful responsibility for fulfilling the reproductive rights of women, in line with the International Conference on Population and Development (ICPD), 1994.

At the heart of this approach is the creation of an enabling environment through community mobilisation. A local collective known as the Kanya Bachao Samiti (KBS) was formed—comprising members of Mahila Mandals, the Ekal Nari Shakti Sangathan, Self Help Groups, as well as front-line workers from the ICDS and Health Departments, including anganwadi workers and ANMs.

These Samitis serve as both knowledge hubs and action groups. They are trained to understand all aspects of reproductive health, disseminate critical information, challenge gender-based discrimination, and promote community-led monitoring of local health facilities. They also support the formation of Mahila Gram Sabhas, giving women a structured and influential voice in local governance.

The vision is to gradually shift the ownership of the ICPD framework from state authorities to the village-level institutions—making Gram Panchayats the custodians of reproductive justice.

Currently, the project is active in 300 Gram Panchayats across 10 development blocks, nine of which are culturally and geographically diverse. It spans five districts of Himachal Pradesh—Una, Solan, Mandi, Kangra, and Sirmaur—and reaches a population of approximately 6.9 lakh people, nearly 48% of whom are women.

 The core activities of the project revolve around information dissemination, awareness-building, and capacity enhancement during regular monthly meetings and trainings of the Kanya Bachao Samitis (KBS). Beyond raising awareness, a strong emphasis is placed on nurturing a deep sense of ownership and collective responsibility within the groups.

These spaces foster open dialogue, experience sharing, and joint decision-making, empowering members to evolve as local changemakers. As trust and confidence grow within the KBS, the groups actively support Gram Panchayats in implementing their resolutions, particularly through the convergence of ICDS and health services at the grassroots level.

Over the past years, this steady groundwork has led to a visible shift—from initial sensitization to tangible community-led actions. The KBS groups are now stepping forward with independent initiatives, demonstrating the potential of collective action in advancing reproductive rights and gender equity.