Local bodies, global goals: ASHA, ANM, and AWW as agents of Planetary Health in India’s tribal regions

The following abstract is part of the collection for the Planetary Health Annual Meeting 2025.

ABSTRACT

Planetary health, which emphasizes the interconnection between human health and environmental systems, requires localized, culturally sensitive, and gender-responsive strategies to be effectively operationalized. In tribal regions of Telangana, the frontline health workforce, comprising ASHA (Accredited Social Health Activist), ANM (Auxiliary Nurse Midwife), and Anganwadi Workers (AWW), forms the critical interface between state-led nutrition programs such as Poshan Abhiyan and indigenous communities. This study examines how these women negotiate their roles within the socio-cultural landscape of tribal areas to implement nutrition and health interventions that are ecologically and socially grounded. Using qualitative methods, including semi-structured interviews, field observations, and participatory rural appraisal tools across six tribal-dominated blocks, the paper captures the lived experiences of these frontline workers and the communities they serve. Findings reveal that these workers act as cultural mediators who adapt state mandates to local contexts—promoting indigenous food knowledge, initiating community-based nutri-gardens, and creating awareness around maternal and child health through participatory tools. Their work strengthens community engagement, promotes food diversity, and fosters ecologically aligned dietary practices. However, they face systemic barriers such as irregular incentives, limited training in environmental health, and gendered undervaluation of their labor. The study interprets these findings through a feminist and participatory lens, arguing that recognizing and investing in the agency of female frontline workers is essential not only for the success of Poshan Abhiyan but also for advancing planetary health in culturally diverse and ecologically sensitive regions. Their work exemplifies how gendered grassroots labor is central to sustainable health futures.