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. To achieve its goals, the foundation has adopted a broad-based family health approach that addresses both supply-and demand-side barriers to increased uptake, coverage, and quality of family health interventions through a synergistic set of four complementary grants. Two of these grants aim to strengthen the supply and delivery of essential family health and infectious disease interventions in the public and private sectors, respectively. One demand-side grant focuses on changing behaviors, social norms, and self-efficacy to support family health through a multichannel communication strategy. The fourth, a community mobilization grant, focuses on strengthening and creating community structures to support the delivery and uptake of family health services. A key component of the Ananya program is the scaling up of successful approaches to the delivery of effective family health and infectious disease interventions. To this end, the Ananya program will focus initially on implementing and assessing the effectiveness of an integrated package of demand-and supply-side approaches to improving family health outcomes in select focus districts (8 districts for all grants, except for the private sector grant, which will focus initially on 12 districts). Based on the findings and lessons learned from these efforts, the program will then promote and facilitate the replication and scale-up of successful strategies by the GoB and other development partners in the remaining 30 (of 38) districts in Bihar. To achieve its scale-up and impact goals, the Ananya program focuses on leveraging and strengthening existing public and private sector delivery platforms, including state and local government health initiatives, such as the National Rural Health Mission (NRHM) and the Bihar Health Sector Reform Project (HSRP) funded by DFID. As part of this effort, the foundation has signed a memorandum of cooperation with …