In an ideal situation, strong public health systems must ensure women have access to affordable and high-quality health care, preventive services, and timely treatment, reducing their dependence on costly private care. This is particularly critical in Bihar, where out-of-pocket expenditure on maternal health care averages ₹2,067 in public health facilities, compared with a staggering ₹25,600 in private facilities. This is especially concerning given Bihar’s high levels of multidimensional poverty.

But change is underway in Bihar, where women are at the forefront of seeking health care, no longer content to be passive beneficiaries. The now formidable combination of ASHA, ANM, and anganwadi teams is leading the charge on this.

In a Patna village, an ASHA reminds a pregnant woman to go for her check-up. In Muzaffarpur, another woman talks to families about how family........

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