Empowering women in rural Bihar: A mixed methods cluster-randomized controlled trial of a large-scale participatory learning and action programme

Participatory learning and action programmes have been shown to improve maternal and neonatal health outcomes. Implemented through women's self-help groups, these programmes aim to empower women to solve community problems. However, evidence on their impact on women's empowerment is limited. We used a mixed methods cluster-randomized controlled trial to evaluate the impact of a large-scale participatory learning and action programme called Gram Varta on indicators of women's empowerment in rural Bihar. The programme was implemented by state-supported agencies in women's self-help groups and aimed to improve women's and children's health and nutrition by empowering them. Using data collected from more than 3000 women in 68 village clusters, we estimated the community-level intention-to-treat effect of Gram Varta. Qualitative data was used to understand the setting and prevalent norms, processes of change, and barriers to programme success. Our findings suggest that Gram Varta did not improve women's empowerment. The qualitative data identifies several barriers, including irregularities in programme delivery, entrenched caste discrimination, and strong patriarchal norms. In the setting of this study, a strongly patriarchal context with stifling caste dynamics, challenges to women's empowerment are deeply rooted and difficult to address. The participatory approach of Gram Varta implemented at scale through women's self-help groups was not sufficient to overcome barriers to women's empowerment.