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In India, maternal health has always been an issue of great concern. Maternal health indicators vary based on rural-urban distribution patterns, rich and poor socio-economic status and level of education and availability of health services in different states. Uttar Pradesh (U.P) and Bihar are the least performing states in the health front, according to a NITI Aayog report. Bihar is home to millions of people living on or below the poverty line. Maternal and child mortality rates are higher than the national average.
Under the Bihar Technical Support Programme (BTSP) implemented by CARE India, we have been providing direct technical assistance to frontline workers, sustainable change is required in improving public health leadership and managerial skills, sharpening focus on outcomes, gaining the ability to use data and be driven by evidence and strengthened internal accountability, and strengthening core systems within our programmes to provide an enabling environment for effective implementation of different health sector interventions.
The mandate during 2010-13 was to engage with Government of Bihar’s (GoB’s) healthcare and Anganwadi programmes to improve the coverage of a range of interventions in maternal health, in eight districts. This was done by using creative yet replicable ways of improving frontline worker performance, sharply defined intervention priorities, better tools and job aids, skill building, and improving last-mile supervision. The technical assistance plans were scaled up in the next phase, with work commencing in 2014, spread across all 38 districts of Bihar.
We are helping GoB build robust internal mechanisms for ongoing mentoring and quality assurance initiatives, including intra-natal and post-natal care, care of acutely sick older children, and the full range of family planning procedures and services.
It focuses on clinical outcomes with oversight mechanisms, robust clinical documentation, ongoing clinical skilling/mentoring and efficient management of available human resources, infrastructure and supplies.
Overall decline in PPH ending with adverse outcomes, with hospitals registering a decline by 47%
Women in rural Bihar report that they have received at least one antenatal check-up, with nearly half of them receiving at least three check-ups
Women in rural Bihar received a blood test, 38% had a urine test done and 60% had blood pressure measured, at least once