Feminised Frontline Governance in Public Health Services: A Mixed-Methods Study of PMMVY Implementation in North-Eastern Rajasthan

Abstract

This study examines the role of frontline women workers in mediating the implementation of the Pradhan Mantri Matru Vandana Yojana (PMMVY) in four districts of North-Eastern Rajasthan. It addresses gaps in existing scholarship that overlook everyday implementation practices, gendered frontline labour, and the links between maternal welfare, early childhood support, and inclusive developmental opportunities. Using a qualitative-dominant mixed-methods design, the study conducted thematic analysis of 15 interviews with ASHA and Anganwadi workers and triangulated the findings with descriptive statistics from questionnaires administered to 300 beneficiaries. Three themes emerged: labour-mediated governance of health services, feminisation of frontline care labour, and structural and digital barriers in policy implementation. Drawing on feminist political economy, street-level governance, and intersectionality, the study shows that PMMVY implementation depends on continuous, adaptive, and labour-intensive practices by frontline workers who manage gender expectations, technological requirements, documentation demands, and administrative bottlenecks. The study further argues that Anganwadi-based welfare interactions have relevance for special and inclusive education because maternal nutrition, early childhood monitoring, documentation support, and frontline counselling shape the conditions through which children from marginalised households access early learning and developmental services. The findings recommend formal recognition, social security, digital support, context-sensitive administrative flexibility, and stronger convergence between health, ICDS, and inclusive early childhood systems, thereby offering policy-relevant insights into gendered governance, welfare access, and the early welfare conditions that may support educational inclusion in India.