Background: Cancer remains a major public health challenge in India, with limited awareness, delayed detection, and inadequate access to cancer screening services, particularly in rural communities. This implementation research project aimed to strengthen cancer health education and early detection pathways across three Indian states—Tamil Nadu, Kerala, and Rajasthan—through targeted capacity-building interventions among community-level health facilitators.
Objective : To evaluate the effectiveness of a Swasthya Mitra led cancer awareness program through improving knowledge on common cancers (Oral, breast and cervical cancer) amongst the rural communities in the interventional blocks of Rajasthan.  
Methodology: This implementation study was conducted in the selected rural communities of Rajasthan over a period of six months. The intervention included capacity building of community-level facilitators (Swasthya Mitras) through power-point based interactive sessions on red flag signs of common cancers (Oral, breast and cervical cancer), supported by flipcharts and pamphlets. Self-administered questionnaires were developed for assessment of baseline and post-training surveys, focused group discussions (self-help group members) and in-depth-interviews (Swasthya Mitras) on recognition of red flag signs and navigation to healthcare facility.
 
Results: A mixed-methods approach was used for evaluation. The intervention was implemented amongst the targeted self-help groups using a structured, context-specific approach across the four interventional blocks of Rajasthan (Girwa, Gogunda, Sarada and Kankroli). Total of 15 Swasthya Mitras (self-help group leaders), were trained as the primary facilitators who conducted around 1,103 meetings over 278-targeted self-help groups (SHG groups) which covers around 6,500-8,000 SHG members and about 94 symptomatic patients were referred to the healthcare facilities by the swasthya mitras out of which, 6 were diagnosed with cancer. This Implementation research resulted in raised awareness for cancer early detection, enhanced capacity to detect suspected cancer cases, strengthened community mobilization and referral.
Conclusion: The Swasthya Mitra-led cancer awareness program has played an important role in improving knowledge on common cancers-oral, breast and cervical, lowering fear and overcoming the silence about cancer, particularly among rural women’s who face many social and cultural restrictions. Overall, the study highlights that integrating SHGs into health education programs can enhance outreach, improve health literacy, and promote positive health behaviours in resource-limited settings.