CARE received funding from the Bill & Melinda Gates Foundation to begin work with the Health and Social Welfare Departments of Bihar state in 2011, aiming to help them achieve their goals of reducing rates of maternal, newborn, and child mortality and malnutrition, and of improving immunization rates and reproductive health service quality. Many innovative solutions have come out of this work that are increasing access to high quality health services in Bihar. In fact, the BTSP team has intentionally created a culture of innovation, with the goal of promoting lasting change and building to impact at scale. (Stakeholders shared how this was accomplished at a World Affairs Council panel discussion, which you can watch here).
In 2014, CARE established a team of over 600 public health data coordinators, analysts, researchers, research managers, and epidemiologists to look at indicators and projections pertaining to reproductive/maternal/newborn/child health as well as child nutrition, family planning, and kala-azar (a sandfly-borne parasitic disease also known as visceral leishmaniasis). The members of this Concurrent Measurement and Learning (CML) unit analyze the effectiveness and utilization of services and work to identify gaps and unmet needs, allowing the state government and other relevant stakeholders to make adjustments and improvements as needed. (Learn more about the CML team’s work on CARE’s Failing Forward podcast).
The emergence of the novel coronavirus and resulting COVID-19 pandemic in late 2019 shook health systems all over the world, threatening to increase the vulnerability of poor and marginalized communities and requiring urgent and significant changes to normal ways of working. CARE quickly moved to procure essential supplies such as N-95 masks for government health personnel and personal protective equipment (PPE) to frontline health workers in Bihar, and to provide the necessary information so health workers and facility managers could adapt their services to slow the spread of the virus. Seeing that gender-based violence was increasing due to pandemic-related control measures, we worked with government staff to train them to provide GBV response services, prioritizing safety planning and psychological first aid. (Read more about how CARE is supporting the Government of Bihar’s COVID-19 response here).
As we look ahead to the next decade of population health challenges, we recognize there will always be a need for resilient, innovative, gender-sensitive, and adaptive health systems. What we have learned through BTSP’s work will be critical in guiding us to design and implement more effective health system strengthening programmes in 2021 and beyond.