Reproductive and Sexual Health
Integrated Family Health Initiative: Catalysing change for healthy communities
Recent trends in the Infant Mortality Rate (IMR), Maternal Mortality Rate (MMR), nutritional status, immunization and family planning, as highlighted in Figure 1, 2, 3 and 4, indicate that there are substantial gaps in achieving related MDG goals 4 and 5.
Despite recent gains and commitments from the Government of Bihar (GoB) and active leadership of key stakeholders to improve health infrastructure and outcomes, deep-rooted problems limit the government’s ability to affect lasting change. Persistent barriers include poor quality and availability of frontline and primary health center level services and staff, limited access to services by neglected and marginalized populations, lack of accurate data, lack of effective program management, weak training systems, absence of supervision in health facilities, poor functional integration of interventions, inadequate public health infrastructures, and an underdeveloped and unregulated private sector.
With support from the Bill and Melinda Gates Foundation, the Integrated Family Health Initiative (IFHI) program seeks to support the GoB to improve family health outcomes statewide as well as build their leadership and ownership towards these services. Ultimately this is to accelerate the progress toward MDG 4 to reduce child mortality and MDG 5 to improve maternal health. [12 pages] Read More...
Despite recent gains and commitments from the Government of Bihar (GoB) and active leadership of key stakeholders to improve health infrastructure and outcomes, deep-rooted problems limit the government’s ability to affect lasting change. Persistent barriers include poor quality and availability of frontline and primary health center level services and staff, limited access to services by neglected and marginalized populations, lack of accurate data, lack of effective program management, weak training systems, absence of supervision in health facilities, poor functional integration of interventions, inadequate public health infrastructures, and an underdeveloped and unregulated private sector.
With support from the Bill and Melinda Gates Foundation, the Integrated Family Health Initiative (IFHI) program seeks to support the GoB to improve family health outcomes statewide as well as build their leadership and ownership towards these services. Ultimately this is to accelerate the progress toward MDG 4 to reduce child mortality and MDG 5 to improve maternal health. [12 pages] Read More...
Evaluation of the Information and Communication Technology (ICT) Continuum of Care Services (CCS) Intervention in Bihar
The Information and Communication Technology (ICT) Continuum of Care Services (CCS) intervention was conceptualized and implemented by CARE as part of the Ananya program in Bihar.1 The intervention involves the provision of ICT-enabled mobile-phone-based tools for frontline workers (FLWs) that aim to increase the coverage and quality of services that FLWs provide, enhance their communication with beneficiaries, and facilitate supervision (Box 1 summarizes the features of the ICT-CCS tool). [123 pages] Read More...
Measurement, Learning, and Evaluation Framework for the Bihar Initiative
The Family Health Initiative in Bihar, India (referred to in this report as the “Bihar Initiative”) is one of the foundation’s flagship programs. It represents a new approach to investing in global health, with the goal of yielding greater impacts on health outcomes and mortality, and accelerating progress toward Millennium Development Goals 4 and 5. In particular, the Bihar Initiative takes an integrated approach to improving reproductive, maternal, neonatal, and child health by leveraging and bundling services and delivery mechanisms from several of the foundation’s Global Health Strategies to improve uptake and coverage across the continuum of family health care. These strategies include Maternal, Neonatal, and Child Health; Family Planning; Nutrition; Vaccine Delivery; Tuberculosis; Enteric and Diarrheal Diseases; Pneumonia; and Neglected and Other Infectious Diseases. [60 pages] Read More...
Measurement, Learning, and Evaluation for the Ananya Program (Family Health Initiative in Bihar)
In 2010, the Bill & Melinda Gates Foundation launched the Family Health Initiative in Bihar, India (now named “Ananya”, a Sanskrit word meaning “unique” or “unlike others”). The goals of the Ananya program (2010–2015) are to reduce maternal, newborn, and child mortality; malnutrition; fertility; and morbidity from infectious diseases by developing and implementing innovative and integrated health solutions that involve both the public and private sectors. More specifically, the program aims to expand the reach, coverage, and quality of (1) essential primary health and nutrition services for infants, children, and women of reproductive age; and (2) diagnostic and disease-control services for infectious diseases, including pneumonia, diarrhea, tuberculosis, and visceral leishmaniasis. [68 pages] Read More...
Using Supply- and Demand-Side Strategies to Improve Maternal and Child Health in Bihar, India
This report focuses on the findings from our process study of two early Ananya grants: (1) the Integrated Family Health Initiative (IFHI), led by CARE; and (2) Shaping Demand and Practices to Improve Family Health in Bihar (SDP), led by BBC Media Action. We focused on these two grants because their activities had begun earlier than other grants and had had time to take root. Next, we offer additional detail on the interventions, describe the data collection for the study, and summarize key findings. [120 pages] Read More...
Baseline Findings from the Ananya Evaluation
The Ananya program (ananya is a Sanskrit word meaning “unique” or “unlike others”) was created by the Bill & Melinda Gates Foundation (the foundation) to address some of the important family health challenges in Bihar, one of India’s most populous and poorest states. Ananya started as a five-year program (2011–2015) with the long-term goals of reducing maternal, newborn, and child mortality; fertility; and undernutrition rates in Bihar. To achieve these goals, the foundation is funding a synergistic set of complementary grants focused on improving the reach, coverage, and quality of family health services in two main areas: (1) essential reproductive, maternal, newborn, and child health services and (2) diagnosis and treatment of infectious diseases, including pneumonia, diarrhea, tuberculosis, and visceral leishmaniasis. Since its inception, the program has also expanded to include additional interventions that focus on improving sanitation in Bihar and on strengthening the system for health payments, including health-related incentives for households and incentives and payments for frontline health workers. [126 pages] Read More...
ANCP CHIVI WASH Endline Survey Report
Care International in Zimbabwe, in partnership with Chivi Rural District Council (RDC) with funding from Care Australia has been implementing a WASH project termed; “Putting Women and Girls at the center of WASH and Health in Chivi district”. The funding which Care Australia availed to Care Zimbabwe was obtained from the Australian NGO Cooperative programme (ANCP) and other private and charitable organisations including Thank You. The project is hence commonly referred to as the ANCP Chivi WASH Project. The overall goal was to impact two categories of vulnerable women and children namely; (i) Rural and vulnerable girl children between the ages of 10-19 with limited choices and at high risk of early marriage, pregnancies and HIV and AIDS, and (ii) Poor rural women in female headed households unable to fully exercise their rights and residing in areas dependent on agricultural activities. [67 pages] Read More...
Improving Harm Reduction Program in Thailand: An Assessment of the STOP TB and AIDS Through RRTTR (STAR) Program
Thailand continues to experience significant health and social challenges associated with illicit drug use, including injection drug use. Rates of infectious diseases among people who inject drugs (PWID) in Thailand remain high, and access to evidence-based addiction treatments remain low. This is due in part to Thailand’s continued emphasis on drug law enforcement, and the adverse impacts such emphasis has on the delivery of essential healthcare to people who use drugs. At this time, Thailand is also experiencing a growth in non-injection amphetaminetype substance (ATS) use, which has created new challenges. [38 pages] Read More...
Assessment to improve the Harm Reduction Program
Since 2015, Raks Thai Foundation is the PR under the NFM. Under their Stop TB and AIDS through RRTTR (STAR) Programme, the Harm Reduction program is active in 12 provinces, providing 14 dropin centers (DICs), outreach activities, distribution of needles and syringes, information packages and condoms, referral to HIV and STI testing and treatment and other health services and referrals to Methadone maintenance treatment for PWIDs. The service providers are RTF with two DICs, O-Zone with 8 DICs, and Thai Drug Users Network (TDN) with 4 DICs. NSP is only available in the DICs and through outreach of these centers; the number of NSP has been reduced due to the close down of DICs and the termination of partnerships with local pharmacies under the NFM. The number of needles distributed per person per year is 144. According to program data from RTF, the Harm Reduction program is reaching about 7,000-9,000 PWID per year in the 12 provinces or around 16-20% of the national estimate of PWID in need of Harm Reduction services. [29 pages] Read More...
Nepal Earthquake Recovery Response Restoration of Health Facilities with Improved Access to SRMH and WASH Services Baseline Report
The overall objective of this survey was to establish the baseline values on the project indicators as provided in the project logical framework and monitoring and evaluation (M & E) plan. The baseline survey is part of an initial program assessment to inform setting of benchmarks before project intervention that will determine achievements the project’s achievements at the end of the implementation period. The baseline will also provide opportunity to validate design assumptions, updating context information in the target VDCs and inform changes on the design of the project in the logical framework and any necessary alignment on monitoring indicators. Read More...