Tackling maternal and child health in Bihar

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A community health worker using Mobile Kunji

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Bihar's statistics speak for themselves: the northern Indian state's population stands at 104 million – larger than any European country and one third the population of the United States. There are 27 million women of child-bearing age, 18.5 million children under the age of six and 200,000 community health workers looking after them.

Bihar also has 80% of its population living in rural areas and 40% living below the poverty line. The state's newborn and maternal mortality rates are much higher than the all-India level and it has among the lowest uptake of health services in the country. While the Government of Bihar has recently made major strides in improving the state's health infrastructure, awareness of critical family health issues remain low.

The Ananya programme, funded by the Bill & Melinda Gates Foundation, aims to reduce child mortality, improve maternal health and reduce infectious diseases in Bihar.

As a project partner, BBC Media Action has adopted a pioneering approach to improve the demand and uptake of life-saving family health behaviours amongst the population of 104 million.

Reaching this enormous audience through traditional forms of media is difficult. Only 27% of young mothers have access to any traditional media (TV, radio, newspapers or cinema). But add mobile phones to the mix and access goes up dramatically to 90%.

360-degree approach

BBC Media Action has therefore adopted what has been called 'a 360-degree approach' – a combination of face-to-face communication, Information Communication Technology (ICT), mass media and community work – which is being implemented on an unprecedented scale.

These sustainable, scalable, innovative, and multiple channels of communication work together to create a whole that is greater than the sum of its parts.

The multiplatform approach consists of three complementary strands:

Empowering community health workers: Mobile Academy and Mobile Kunji

BBC Media Action has developed two innovative mobile phone services for CHWs: a training course called Mobile Academy, and an on-demand service called Mobile Kunji which is supported by a deck of cards illustrated with life-saving messages.

Taking it to the people: mass media

Humorous and engaging TV adverts about specific family health behaviours such as birth spacing are accompanied by a long-running radio series about critical maternal and child health issues.

Community mobilisation

10,000 street theatre performances and 6000 women's listener clubs will further engage and inform families about critical family health issues.

All these elements focus on the critical 33-month timeline from when a woman becomes pregnant until her child is two years old. The objective is to shift social norms and empower those who lack the information and power to make informed choices about their health.

To implement this project called Shaping Demand and Practices, BBC Media Action leads a consortium that includes Pathfinder International, the GSMA Development Fund and Madison World. This consortium works in close partnership with the government of Bihar at all stages.

For more on this project:

Empowering community health workers through Mobile Academy and Kunji

Improving family health in Bihar through mass media

Mobilising communities to improve family health in Bihar

From the BBC Media Action blog:

Bihar has two i's

A 360 degree approach to communication 

Pilot-itis: What’s the cure? 

Multiple channels of communication will work together to create a whole that is greater than the sum of its individual parts
DonateCharity number 1076235

Project at a glance:

  • The multiplatform project uses mobile phones, face-to-face training and mass media to reduce maternal and infant mortality.
  • Training course Mobile Academy and on-demand health service Mobile Kunji is delivered via mobiles to 200,000 community health workers.
  • TV adverts, a long-running radio programme, 10,000 street theatre performances and 6000 listening clubs reinforce the health messages.

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