Innovations

Quality Improvement Approach at Public Healthcare Facilities

The launch of quality improvement (QI) approach in eight districts of Bihar and later scaled to all 38 districts within the state, as a solution to improve the quality of services at public health facilities.

  • Tackling several tangible and intangible elements of high-quality care by upgrading the infrastructure and equipment.
  • Improving staff morale, sharpening clinical skills, and updating a range of standard operating procedures, systems, and processes.
  • Bringing positive changes to public health facilities, which contributed to an increase in the attendance in outpatient departments and delivery loads in these facilities.
  • Increasing availability of supplies and equipment in facilities, including functional autoclaves, pregnancy testing kits, and intrauterine contraceptive devices.
  • Improving the emergency response and critical care skills of nurses and ANMs, through the nurse mentoring programme – AMANAT, in close collaboration with the Government of Bihar.
  • Increasing the practice of evidence-based interventions, including an improvement in the active management of third stage of labour and delayed clamping of the umbilical cord.

Team-Based Goals and Incentives

CARE partnered with the Government of Bihar to plan and facilitate training sessions for Front Line Workers (FLW) at health sub centers and enhancing public healthcare services.

  • Strengthening the link between the community and the primary healthcare system.
  • Providing ongoing training and supportive supervision to FLWs.
  • Increasing cooperation and coordination between ASHAs and AWWs.
  • Reviewing and planning the actions of FLWs based on the needs of the community, identified through data collected during home visits.
  • Implementing the Team-Based Goals and Incentives (TBGI) innovation to leverage the power of incentives, teamwork, and goal setting to improve their motivation and job performance.

Digital Scale to Measure the Weight of Newborn Babies

The Government of Bihar, in partnership with CARE, is innovating to identify, track and care for the newborns having very low birth weight. A key part of this innovation is the use of a simple and affordable tool—a digital scale—that is increasing the ANM’s accuracy in measuring the weight of newborns, immediately after birth.

  • Establishing accurate weights to help ANMs, ASHAs, and AWWs to give low birth weight babies the special care they need during the first critical weeks of their lives.
  • Coordinating with all the FLWs in the family’s community to ensure that they schedule follow up visits and receive counsel on these life-saving topics.

Scientific Temper in Children to Solve Real Life Problems through STEM Programming

CARE India through its STEM programming is focused on building scientific inquiry in children by helping them explore the pertinent issues in their communities.

  • Mentoring children to use different scientific tools for exploration.
  • Guiding students to conduct small research, where they explore questions from their immediate context, adopt scientific inquiry methods in devising answers and validate answers by trying them.
  • Facilitating learning opportunities where children start being observant of their immediate environment, investigate, explore, and seek answers.

Supplementary Early Grader Reading Materials in Indigenous Tribal Languages

Building a strong sense of identity and comfort to read in one’s mother tongue for children in marginalised communities —

  • Developing reading resources that enhance language development.
  • Creating supplementary reading materials in underserved languages for early graders in two states.
  • Activating involvement from local community members and teachers.

Tool to Track the Development of Young Children

CARE India devised a simple development milestone tracker that captures all-round development (cognitive, language, social, emotional, creative, and physical) of the child. The tracker can be used by the caregiver with ease and allows identifying any early development delay amongst children.

Organic Linkage between Community and School using Multi-Pronged Approach

In the intervention districts, one of the key issues is lack of parental engagement in school processes, especially fathers. Fathers remain busy in livelihood activities and migrate as well, while mothers are not allowed to go to schools as women’s presence in public places is not appreciated by some religious leaders. CARE India aims to reform this.

  • Starting dialogue with religious leaders and fathers of girls on value of parental engagement in schools.
  • Utilising a multi- pronged approach of meetings with mothers and fathers in the community and community seminars in schools.
  • Regularising parent teacher meetings to discuss the achievements and challenges of girls.

District Resource Group (DRG) on Gender, Equity and Safety and Security to Support Teachers

CARE India charted out the role and responsivity of DRG in the training of nodal teachers at schools in revitalising school-based leadership platforms to promote girls’ leadership.

  • Ensuring sustained support to teachers on the issues of leadership beyond project life.
  • Creating district resource groups who were capacitated on approaches of gender and equity.
  • Building a comprehensive understanding of the safety and security of children, especially girls.

Nutrition Gender Toolkit

CARE India has adopted the Social Behaviour Change Communication (SBCC) approach that focuses on empowering women as leaders for household and community nutrition security.

  • Strengthening their nutrition decisions within the household.
  • Empowering women’s collectives to promote a nutrifood system.
  • Developing a Nutrition-Gender Tool Kit (NGTK) to ensure a gender transformative change among women at the centre of behavior change communication.
  • Ensuring sustainable nutrition outcomes with gender equity and equality-based decision making and intervention.

Community Nursery Unit

Initiative for supporting Homestead Kitchen Garden (HKG), a potential source of nourishment that ensures a year-round supply of seasonal vegetables and fruits.

  • Supplementing the nutrition requirement of small-holder family members.
  • Addressing the critical issue of timely supply of good quality seedlings at an optimal price as per the requirement and choice with the SHG managed Community Nursery Unit (CNU).
  • Raising of select seasonal vegetables and saplings of perennial trees by the SHG following the recommended package of practices.
  • Promoting community participation with technical support from the project.

Sustainable Household Energy (SHE) Schools

SHE Schools function as learning cohorts of Self-Help Groups and as grounds for practice-based capacity building of women on clean energy and ICS options.

  • Adoption of clean energy practices, thereby improving health outcomes, clean household air and empowered women.
  • Providing a space for gender dialogues between women and their spouses from FDHs and other influential community members.
  • Admitting membership of around 20-25 women coming from two SHGs in the same village.

Establishment of Community Based Early Warning System (CBEWS) to Reduce the Risk of Disasters

To avoid any delay in early warning information reaching the communities in disaster-prone areas, CARE India developed a community based early warning system in 10 villages of Idukki district.

  • Undertaking discussions with Hazard Analyst and District Emergency Operation Centre
  • Increasing the participation and building the capacity of vulnerable groups
  • Formation of task forces at the community level and training them on risk identification, monitoring, and communication of warnings
  • Providing task forces with necessary tool kits like megaphones, whistles, flags, and torches
  • Organising mock drills to test the capacity of community-based early warning systems
  • System warning to reach every household across villages
  • Allowing people to take timely action to protect their lives and property
  • Developing and disseminating knowledge through wall paintings in the villages

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