Bihar is the third-largest state in India, with a population of over 110 million. Despite recent gains, Bihar has some of the country’s highest rates of maternal, neonatal, and infant mortality, as well as a high prevalence of malnutrition, stunted growth, and high fertility rates. Extreme poverty, gender and social inequality, low literacy rates, and early marriage further compound Bihar’s poor health outcomes.
The Bihar Technical Support Program is a partnership between CARE, the Bill & Melinda Gates Foundation and the Government of Bihar, focused on reducing rates of maternal, newborn, and child mortality and malnutrition, and of improving immunization rates and reproductive health services statewide. The program covers all 534 blocks in 38 districts of Bihar and involves at least 400 public sector hospitals and 200,000 frontline workers. Through this partnership, CARE has contributed to significant improvements in the health system.
Today, CARE and the government continue to invest in sustaining improvements made through scale-up as well as addressing systematic issues by transforming institutions, organizational structure, regulations, and governance.
The Bihar Technical Support Program is working to reduce rates of maternal, newborn, and child mortality and malnutrition, and to improve immunization rates and the quality of reproductive health services statewide
Since 2011, CARE and the Government of Bihar have made great strides in testing and implementing innovations to improve health outcomes and strengthen the health system.
The Bihar Technical Support Program has also contributed to state-level impact in the areas of maternal and infant mortality:
Improvements made to the health system have also increased use. In 2005, public health facilities had a client load of 39 people per facility per month. In 2018, that figure was about 10,000 people per facility per month.
Frontline health workers form the backbone of the public health system in India, like they do in many low-income countries. With long distances between health centers, poor road conditions, and limited transportation options, people living in rural and remote areas of Bihar have little access to facility-based health services. Frontline workers work hard and walk miles each day to provide in-home counseling, health and hygiene education along with basic maternal, newborn and child health and nutrition services to families in need. Properly trained, supported, and valued, they have the potential to save millions of lives.
Manju is an ASHA – a frontline health worker working in Bihar. She goes door-to-door, walking miles each day, to provide counseling and basic health services to people in rural communities who would otherwise have no access to care.
CARE is working as an integrated unit within the Government of Bihar to strengthen community- and state-level systems to accelerate progress toward maternal and child health goals and to promote sustainability. CARE has successfully tested and scaled health innovations across the entire state.
Through a powerful 10-year partnership in Bihar, India, positive maternal and child health outcomes were achieved via working with frontline health workers, especially women. See the impact a decade partnership can lead to in this flagship report.
Read MoreA program brief on the Bihar Technical Support Program, which CARE began in Bihar, India, in 2011 with funding from the Bill & Melinda Gates Foundation.
Read MoreInnovation brief covering the incremental learning approach, in which CARE partnered with the Government of Bihar to plan and facilitate training sessions for frontline health workers at health subcenters.
Read MoreUsing team-based goals and incentives to leverage the power of incentives, teamwork, and goal-setting to improve the motivation and job performance of frontline health workers.
Read MoreThis approach tackles several elements of high quality care by upgrading infrastructure and equipment, improving staff morale, sharpening clinical skills, and updating a range of standards at primary health centers.
Read MoreUsing mobile nurse mentoring teams to unlock the potential of nursing staff in public facilities.
Read MoreInnovating to identify, track, and care for very low birth weight newborns to ensure newborns survive and thrive.
Read MoreUsing digital job aids to transform health systems and improve the lives and work of frontline health workers in India.
Read MoreCatalyzing multi-level change in the Bihar, India healthcare system through the Technical Support Unit Model.
Read MoreInnovating and leveraging digital tools and platforms to make data-driven decisions to achieve Bihar’s health goals.
Read MoreA program brief on the weak newborn tracking model implemented and evaluated in the Bihar Technical Support Program.
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