Bishops’ Appeal supported this Christian Aid health and education project that aims to improve the health and nutrition of mothers and new-borns from socially excluded groups in Bihar, India.


Bihar is home to 15% of India’s poorest people. Nearly half of the children under five years old are underweight and 7% of them are classified as having Severe Acute Malnutrition (SAM). The Maternal Mortality Ratio is 219 deaths per 100,000 resulting in 8,000 maternal deaths every year. Only 3.3% of women had full antenatal care. Socially excluded groups are marginalised, poor and often have low levels of education: these, along with other cultural factors often limit their access to healthcare.

This project aims to empower communities to access health services and change behaviours by the following activities:

  • Establishing Women’s Groups – trained facilitators will teach women in the groups about their rights and entitlements, how to access them and how to educate their community on health issues.
  • Strengthening Village Health, Sanitation and Nutrition Committees (VHSNCs) – these committees increase the demand for and improve the quality of services, as well as holding the Government to account for health service provision.
  • Promoting a Participatory Learning and Action (PLA) Approach – Women’s Groups will invite non-group members, including adolescent girls, pregnant women, mothers and fathers to participate in learning, planning, implementing and evaluations activities.
  • Community based monitoring – processes will be developed to assess the services in each village and ensure each village knows what they are entitled to.
  • Evidence-based advocacy – data on maternal and infant deaths will be collected and the analysis will allow an understanding of patterns of factors responsible, so they can be highlighted at relevant forums.

The project is a continuation of work that has been happening since 2012, during which time 22,561 women were supported to give birth in an institution, 209,314 women received full benefits (ante-natal and post-natal care) and 351,181 children received their full entitlements to nutrition.