“Only if the mother is healthy, the baby can be”: Understanding maternal health through Indian low-caste and tribal women’s perspectives
Date
2026
Authors
Ottsen, Patricha Jeppe
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Abstract
Background: India has made substantial progress in reducing maternal mortality in recent decades. However, these collective gains obscure persistent inequities, as low-caste and tribal women continue to experience disproportionate barriers to maternal health and wellbeing. While community-based initiatives are increasingly promoted, a gap remains between low-caste and tribal women’s own priorities for maternal health and those reflected in widely implemented programs based on the World Health Organisation’s (WHO) definition of maternal health. This study seeks to address this gap by examining low-caste and tribal women’s understanding of maternal health, ultimately nuancing and contextualising WHO’s framework. Methods: Guided by an intersectionality-informed life course approach, a framework synthesis review of scholarly literature was conducted, informed by a community consultation in Kherwara, Rajasthan, India. Results were validated with the same community to refine and contextualise findings. Results: Maternal health is understood by low-caste and tribal women in India as encompassing the health of the mother and baby, and to an extent, other family members. Women in this context understand maternal health as holistic, relational, and collectively governed. According to this study, maternal health is a continuum that begins with marriage and extends through pregnancy, childbirth, breastfeeding, and beyond, as women often have multiple children and later transition into caregiving roles as sisters, friends, and grandmothers. These women also identified food security along with respectful, inclusive, and accessible health services as central to achieving maternal well-being. Discussion/Conclusion: There is a disconnect between low-caste and tribal women’s conceptualisation of maternal health and existing healthcare and supports available to them. Centring low-caste and tribal women’s articulated priorities is essential to designing equitable maternal health systems that support maternal well-being.
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Keywords
Maternal Health, Sexual and Reproductive Health, Community-based, Framework Synthesis, Participatory Research, Culturally safe health services