The day after arriving in New Delhi, I went with five other members of the evaluation team to the USAID Mission in the US Embassy where we were welcomed by the Deputy Director Health Officer and staff. Following my presentation of the final evaluation findings, a discussion of the accomplishments of the project occurred. We were commended on a well-done evaluation and a project that scaled-up to all 1,297 villages in a district of 1 million people using community mobilization and district-level advocacy with public health officials for sustainable improvements in maternal child health.
The following day, EFICOR invited about 100 key people to a ‘Presentation of the Best Practices of the Parivartan Child Survival Project.’ Attending were officials from the National Rural Health Mission and the USAID Mission, along with representatives from NGOs and others involved in health projects. After introductions (which included flowers), I shared the results of the final evaluation. During the project:
• 28 of 33 key indicators in the areas of maternal newborn care (MNC), nutrition, immunizations, and infectious diseases saw statistically significant improvement (p ≤ 0.05).
• Government health facilities in the district improved in staffing, lab and malaria services, and provision of antenatal, delivery and child care.
• The organizational capacity and viability of village health committees expanded to impact maternal child health care at the village level.
The Parivartan project promoted maternal child health in the Sahibganj by building community capacity at the village level. They empowered 250 village health committees and mobilized villages for village health and nutrition days, improved MCH knowledge and practices with household timed counseling, and overcame cultural and religious barriers with targeted behavior change communication (BCC) strategies informed by barrier analysis. In addition, Parivartan provided training and support to 4,147 village citizens to promote MCH, including 1,233 CHWs called Sahiyas and 1,548 Anganwadi workers responsible for growth monitoring and nutrition counseling. The project also strengthened the local health systems through participating in planning and advocacy at the district level, supporting improved access to institutional deliveries, and strengthening the capacity of the local health sub-center to provide MNC and immunizations.
Several best practices from the project that were scaled-up at district andor state levels included Saas Bahu Pati Sammelian, a village-wide behavior change communication program developed to address the resistance of mothers-in-law and husbands to MNC, and the upgrading of health sub-centers to institutional delivery points.
One of the constraints that the project identified were the “stock outs” of essential drugs in the health centers and sub-centers. At the end of my presentation the Minister of Health attending the dissemination asked for specific information concerning these so that he could address them. Our hope is that the evaluation will have additional beneficial effects on delivery of drugs in the future.