Spreading awareness regarding health among women under Improving Bihar's Health Outcomes
Improving Bihar's health outcomes


Frontline Health Workers of CARE India's Improving Bihar's Health Outcomes Projects

Bihar has a population of over 110 million, featuring in the list of Indian states with the highest rates of maternal, neonataland 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.

Despite progress and commitments from the Government of Bihar, deep-rooted problems limit their ability to affect lasting change. Persistent barriers include poor quality services, lack of availability and skills of frontline health workers (FLWs) and facility staff, limited accessibility of services by marginalised populations, lack of accurate data, and inadequate public health infrastructure.

To address these challenges in Bihar, CARE India launched the Bihar Technical Support Programme (BTSP) in 2011 with the support of the Bill and Melinda Gates Foundation (BMGF). We are supporting the Health and Social Welfare Departments pf the Government of Bihar to strengthen and improve reproductive, maternal, newborn, child and adolescent health, improve nutrition outcomes, support family health initiatives and services, and helping the government improve immunisation rates and reproductive health services (including family planning).

Working in close collaboration with the state government, the BTSP team is investing in sustainable improvements made through up-scaled initiatives, as well as addressing systematic issues by transforming institutions, organisational structures, enforcing regulations, and streamlining governance.

Know More

Our Work

Read more about the various interventions CARE India is implementing to improve health service delivery and outcomes in Bihar.

Our Innovations

?> Women with child under Improving Bihar's Health Outcomes Project - CARE India

Our Achievements

  • 01

    More than 16,700 babies saved as a result of tracking and management of very low birth weight babies

  • 02

    Introduction of mobile technology to aid FLWs enabled them to visit 88% of mothers at least twice at home during their last trimester of pregnancy

  • 03

    Contraceptive use increased by 10% and this initiative is being scaled up to eight other states in India, beginning with the training of 100,000 FLWs

  • 04

    Over 40,000 FLWs have been engaged in approximately 2,300 health sub-centres, with each centre covering 5,000 people

  • 05

    Bihar’s maternal mortality ratio is now 165 per 100,000 live births (2018) compared to 312 per 100,000 live births in 2005

  • 06

    Infant mortality rate has significantly decreased from 61 per 1,000 live births in 2005 to 38 per 1,000 live births in 2018

  • 07

    Institutional deliveries have increasedby 76% and immunisation coverage has reached 81% of the children due for shots

  • 08

    Implementation of the nurse mentoring programme at 17 under-performing emergency obstetric and newborn care facilities is being scaled up in the entire state


BTSP will continue improving health outcomes in Bihar and focus on providing managerial and leadership support to the Government of Bihar. It will also draw a sharper focus on interventions to strengthen health systems, services at facilities, and community-based interventions. The learnings from BTSP will be elevated and disseminated through the Learning Exchange for Adaptation and Diffusion (LEAD) platform. Driven by our work in Bihar, the LEAD approach will bring together interested CARE offices in South Asia to participate in a regional network and share knowledge on key innovations in programme design and scale.

For more information about CARE India’s work in Bihar, visit careindia.org/bihar