Improving Treatment For Child Health

Care India initiative for Child Healthcare in Bihar

The primary purpose of the project was to learn how improved quality of community and low-level facility management can lead to decreased pneumonia and diarrhea cases fatality rate at the block level in Bihar.

The project covers Samastipur district located in central Bihar, constituted by 20 blocks, and is one among the eight innovation districts under the Ananya program. It has a strong private sector, and is flanked by three teaching hospitals (Darbhanga, Muzaffarpur, Patna), which are potential key elements in any eventual state-wide referral network, and also important clinical resource bases.

In this district, CARE India uses a combination of delivery channels established under CARE India’s Integrated Family Health Initiative (IFHI) in Bihar to engage the public sector, and an expanded capacity to engage private sector providers through a contracted agency, to methodically deliver standard community level and facility level clinical interventions for the timely diagnosis and management of childhood diarrheas and pneumonias, including the management of life-threatening complications.

The proposed approach is built primarily on the accumulated experience of CARE IFHI project of how the public and private health sectors are organized in Bihar and what it takes to influence their ways of working. The approach of strengthening community level and facility level services including the component of strong supervision and attention to supplies are integral to the larger work of IFHI project. The positioning of the Technical Support Unit at the state and district levels, and the fact that addressing child mortality, and specifically the strengthening of diarrhoea and pneumonia services are a stated priority of the state government, will help both, provide the necessary political will and contribute to sustainability.