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Improving Care Quality at Private Health Facilities in Northern India


  • Can we improve maternal and infant mortality in Bihar, India?
  • Abt supported Integrated Family Health Initiative Private Sector (IFHI-PS) initiative
  • We developed tools to make IFHI-PS cost-effective and sustainable
The Challenge

Bihar is one of India’s largest and poorest states. Its more than 100 million people have high rates of maternal, neonatal, and infant mortality due to extreme poverty, poor nutrition, and gender and social inequality. Persistent barriers to improvement include: 

  • poor quality and availability of frontline and primary health-center services and staff
  • inaccurate data
  • ineffective program management
  • poor training
  • lack of supervision in health facilities
  • poor public-health infrastructure
  • underdeveloped private sector
The Approach

Under the Integrated Family Health Initiative Private Sector (IFHI-PS) initiative, Abt supported efforts to engage private health-care providers in order to improve the availability and quality of their services. The initiative created a network of 50 private providers. Abt trained the network’s paramedical staff to improve the quality of care provided by family health services via classroom and on-the-job sessions. Abt followed up with supportive supervisory visits and observed births at each facility.

The Results

IFHI-PS developed several tools and manuals such as the Facility Assessment Tool (FAT), Quality Assurance Manual, paramedics staff training module 1 and 2, facility improvement matrix, and assessment checklist. The goal was to make IFHI-PS a cost-effective and sustainable private-sector intervention.