Improving primary health care delivery in Bihar, India: Learning from piloting and statewide scale-up of Ananya

Darmstadt GL, Pepper KT, Ward VC, et al. 2020. Journal of Global Health. 10:2. 19pp. DOI: 10.7189/jogh.10.021001.

In 2010, the Bill and Melinda Gates Foundation (BMGF) partnered with the Government of Bihar (GoB), India to launch the Ananya program to improve reproductive, maternal, newborn and child health and nutrition (RMNCHN) outcomes. The program sought to address supply- and demand-side barriers to the adoption, coverage, quality, equity and health impact of select RMNCHN interventions. Approaches included strengthening frontline worker service delivery; social and behavior change communications; layering of health, nutrition and sanitation into women’s self help groups (SHGs); and quality improvement in maternal and newborn care at primary health care facilities. Ananya program interventions were piloted in approximately 28 million population in eight innovation districts from 2011- 2013, and then beginning in 2014, were scaled up by the GoB across the rest of the state’s population of 104 million. A Bihar Technical Support Program provided techno-managerial support to governmental Health as well as Integrated Child Development Services, and the JEEViKA Technical Support Program supported health layering and scale-up of the GoB’s SHG program.