Improving primary health care delivery in Bihar, India: Learning from piloting and statewide scale-up of Ananya
Gary L. Darmstadt, Kevin T Pepper, Victoria Ward, Sridhar Srikantiah, Tanmay Mahapatra, Usha Kiran Tarigopula, Debarshi Bhattacharya, Laili Irani, Janine Schooley, Indrajit Chaudhuri, Priyanka Dutt, Padmapriya Sastry, Radharani Mitra, Sara Chamberlain, Sophia Monaghan, Priya Nanda, Yamini Atmavilas, Niranjan Saggurti, Evan Borkum, Anu Rangarajan, Kala M. Mehta, Safa Abdalla, Jess Wilhelm, Yingjie Weng, Suzan L. Carmichael, Hina Raheel, Jason Bentley, Wolfgang Munar, Andreea A. Creanga, Shamik Trehan, Dilys Walker, Hemant Shah
Abstract
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 selfhelp 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