Reducing child mortality in Bihar through improved hand washing

Country

India – South Asia

To prevent childhood illness and mortality in Bihar, India through handwashing with soap.

$7,700,000 Multi-Year Grant Value

Partners

Evaluators

London School of Hygiene and Tropical Medicine

By reaching nine million school children, and their families, the grant aims to help reduce the incidence of diarrhoea and pneumonia by more than 10% by 2018.

Out of 3.6 million neonatal deaths that occur each year, more than 99% are in low or middle-income countries. 86% of these deaths are due to a combination of infections, premature delivery and complications during childbirth. The World Health Organization has recommended hand washing with clean water and soap both before and after handling the newborn child during the postnatal period in order to prevent infections.

If you want to know more about the huge impact hand washing with soap can have, watch this video by Lifebuoy.

The backbone of this programme is the activity of an army of trained health promoters who visit schools four times in a 21-day period to engage with students. The health promoters use fun and engaging materials with super heroes, exciting stories and interactive demonstrations to drive home the message of handwashing with soap at five critical times of the day.

The video below follows the story of just one of these amazing health promoters.

The students’ mothers are also targeted through a series of mothers meetings. These meetings use specially-designed materials and activities to achieve sustainable behaviour change.

Impact

The school-based programme was piloted in 2014 in Begusarai and Khagaria districts of the Indian state of Bihar to test the feasibility of the operational model. Over a period of four months (October 2014- January 2015), the pilot reached 170,291 students from 597 schools and demonstrated that the model is viable.

Programme implementation started in full swing at the end of February 2015. Intensive training was rolled out to ensure that that 112 field teams were delivering the message correctly and clearly. During the first six weeks of activity, 37,650 students were reached.

After April 2015, field operations were severely disrupted by a teachers' strike which closed all public schools in the state for so long that all the field teams had to be re-trained. The strike was followed by further school closures due to the nearby Nepal earthquake, and early summer school holidays (April and May). State elections forced a renewed suspension of activities in October 2015. In addition to these events, the project team faced challenges recruiting adequate number of high-quality field promoters in the field – critical to ensuring sustained behaviour change among children and mothers.

As a result of all of these challenges, the programme closed the third quarter of 2015 severely behind its targets, reaching a cumulative total of just 560,000 children against a planned total of 2.1 million.