Bihar

Health

Outline India worked with Mathematica Policy Research, which is the MEL partner for Packard Foundation’s and Pathfinder International’s Population and Reproductive Health (PRH) program based in Bihar.

The Sashakt program implemented at the pilot phase by Pathfinder International aimed to meet the specific needs of unmarried and married Mahadalit adolescents (aged 15 -19 years) in improving their long-term Sexual and Reproductive Health (SRH) outcomes. Since few programmes have focused on the marginalized population, a key aim of the Sashakt programme is to assess which approaches are most effective for this population. The program will support the government’s rollout of the Rashtriya Kishor Swasthya Karyakram (RKSK) program by providing program-monitoring as well as training support to block and district officials.

Our impact evaluation sought to gauge the knowledge, attitudes and practices toward healthy timing and spacing of pregnancy, demand for and uptake of contraceptive services and family planning, access to contraceptive and maternal health services, and sexual health and counseling services provided for both married and unmarried adolescents in Mahadalit communities. Moreover, since the project is initiated in collaboration with the State Health Society, Bihar Mahadalit Vikas Mission, and focused on reaching out to Mahadalit population through training delivered by Accredited Social Health Activists (ASHAs) and Vikas Mitras, our evaluation sought to investigate existing government capacity to deliver and sustain quality SRH services and behaviour change programming for Mahadalit adolescents through a mixed-method approach, combining surveys with in-depth interviews and focus group discussions with a sample size involving 1200 adolescents and other relevant stakeholders such as ASHAs, ANMs, School headmasters and programme officials.

Given, the sensitive nature of the topic, a major component of the study was dedicated to thorough tool review, pre-testing and translation to the local language and dialect to ensure appropriateness and relevance, followed by obtaining all necessary ethical approvals from an Institutional Review Board (IRB) prior to data collection. Outline India also developed training manuals and conducted intensive field training on survey tools and research ethics to ensure data is collected in an accurate and ethical manner. Upon, completion of fieldwork we provided the client with transcriptions of all interviews and focus group discussions, in addition to the submission of an in-depth field report detailing the field movement and data monitoring plan and recommendations for program implementation.