Innovation + Systems Strengthening in Bihar

Our Team-Based Goals and Incentives team from our Cohort 1 alums are part of a broader team dedicated to scaling innovation with the government of Bihar, India. In his annual letter, the Gates Foundation Director of the India Country Office highlight’s CARE’s work in Bihar, addressing the real-world challenges of making innovation effective in the midst of fragile and broken systems.  Way to go team!

The public health system in Bihar consists of hundreds of thousands of health workers, from doctors and auxiliary nurse midwives in primary health facilities to ASHA and Anganwadi workers who provide basic advice and care to women in communities. We began by helping the government test new techniques and technologies to improve the quality of these providers’ services in eight pilot districts. For example, to help frontline workers advise women about healthy practices like breastfeeding, we developed next-generation teaching aids based on digital technology. In facilities, we established a nurse-mentoring program that has, among other successes, doubled the number of nurses who wash their hands and wear gloves before and during procedures.

Though these interventions have led to successful outcomes, a careful review of the data revealed that by themselves they were unlikely to have enough impact on maternal, newborn, and child survival, which was the ultimate goal of the work. Therefore, the Government of Bihar, our foundation, and our grantee CARE India agreed to expand these investments in innovative methods and tools that solve specific problems to more districts and to augment them with investments in basic best practices that strengthen the underlying health system in general.

The partners are now working to bolster everything about Bihar’s health system, from budgeting and procurement to management practices and data collection. This two-pronged approach that layers technical solutions on top of a stronger health delivery platform promises to help Bihar meet its goals while generating lessons that will benefit other partners, especially other state governments interested in investing in the health and the human capital potential of their people.”

Read the full letter here

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