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Maternal Mortality in India
USAID and its partner organizations implemented the development impact Utkrisht bond in February 2018. Many believe this is an innovative and cost-effective solution to end preventable maternal and child deaths in India.

The Utkrisht bond is targeted to assist the State of Rajasthan, where 80,000 babies die annually from inadequate medical care. But proponents hope the model can be used throughout India, which accounts for 20 percent of maternal and child deaths globally.

The development impact bond was announced in November of 2017 by USAID Administrator Mark Green at the Global Entrepreneurship Summit in India. It is expected to provide 600,000 women with improved healthcare access and potentially save 10,000 moms and newborns.

The bond works as a public-private partnership. Investors grant providers of maternal care with upfront capital. Then, outcome funders pay back the investors their principal plus a return if pre-agreed metrics are achieved. The investor, in this case, is the UBS Optimus Foundation, which has committed about $3 million. The organization works with philanthropists to bring sustainable benefits to vulnerable children.

Up to 440 private health facilities will then be operated with assistance from Population Services International (PSI) and the Hindustan Latex Family Planning Promotion Trust (HLFPPT), which also are co-investors providing 20 percent of the required capital. PSI is a global health nonprofit and the HLFPPT is an Indian nonprofit that works with maternal care.

In order to maximize success, private facilities are the focus of the Utkrisht bond. They host more than 25 percent of institutional deliveries in Rajasthan and are used by women of all socioeconomic backgrounds, yet little has been done to improve their quality of care.

USAID and Merck for Mothers, a nonprofit with the goal to end maternal mortality, have each committed up to $4.5 million that will be paid if the heath facilities meet accreditation standards. This is a highly cost-effective method to save lives according to World Health Organization standards, which is particularly exciting to USAID.

“The pay for success approach ensures appropriate stewardship of U.S. taxpayer dollars, while unlocking both private capital and government resources for health,” USAID states.

While this is the first development impact bond targeted toward health, the future of the Utkrisht bond looks promising. If it is successful, more initiatives can be implemented that involve private-public cooperation and effective use of taxpayer money to save the lives of many women and children around the world.

– Sean Newhouse

Photo: Flickr

How Foreign Aid Has Advanced Education in IndiaIndia, located in South Asia, has a population of 1.2 billion people and is on its way to becoming the world’s most populous nation by 2030. However, the country still struggles with providing its growing population with access to quality healthcare, potable water, education and clean energy. The education sector in India, in particular, requires special attention, since so much of the nation’s personal and national development is based upon it.

India, being a developing nation, has struggled in this area for a very long time. For instance, even in the late 1980s, between 30 and 40 million children of primary school age were out of school. Foreign aid to India, as a result, proves to be an effective investment in this arena, and there are many ways foreign aid has advanced education in India.

One of the ways foreign aid has advanced education in India is by initiating projects that focus on improving the sector from its core. For instance, one of the three major goals of USAID’s Global Education Strategy is “improved reading skills for 100 million children in primary grades.” Focus on the children in primary grades is essential, as so much of a country’s future depends on it. For instance, according to the World Bank, “an increase of one standard deviation in student reading and math scores is associated with an increase of two percentage points in annual gross domestic product (GDP) per capita growth.”

In order to advance this target, USAID supports 10 initiatives in the country and partners with the government of India to “identify, support and scale early grade reading innovations developed in India.” Additionally, USAID focuses on improving the capacity of educators to improve pedagogy and teaching.

For instance, the Teacher Innovation in Practice program works to positively impact the teaching practices of 14,657 teachers to improve early grade reading outcomes of more than 564,000 primary school children in the states of Delhi and Uttar Pradesh in India. By developing teachers’ mindsets, building an enabling environment and improving pedagogical skills and knowledge, the main goal of this program is to reignite teacher motivation to drive better student learning outcomes.

Other initiatives focus on improving the literacy rate in the country, which was as low as 19.3 percent shortly after independence in 1951. USAID, in partnership with Tata Trusts and the Center for microFinance, is leading an initiative called the Nurturing Early Literacy Project that aims to “shift the prevalent rote-based pedagogy in India to one that views the child as an active learner.”

The project incorporates different approaches, including in-class sessions for teachers and equitable access to libraries for children, both in schools and communities. The aim of this project is to improve the reading skills of more than 90,000 primary school children in the states of Rajasthan, Maharashtra and Karnataka.

India reportedly spends a mere 3 percent of its GDP on education, making foreign aid geared towards development in the educational sector crucial. Foreign aid has advanced education in India significantly over the years. For instance, the literacy rate increased to 65.4 percent in 2001, and currently sits at 74.04 percent.

Hopefully, with continued support from foreign investments, India will be able to develop its education sector, thereby potentially boosting its economy and reducing poverty.

– Mehruba Chowdhury

Photo: Flickr

US-Backed Health Programs in India Reduce Risk of Disease
India has a population of approximately 1.3 billion, making it the second-highest populated country in the world. With the exception of the Himalayan foothills and deserts in the northwest, a majority of the country sustains a very high population density that straddles the country’s river valleys. Due to its population density and sanitation conditions, Indian citizens face a high risk of infectious disease with the most common being bacterial diarrhea, hepatitis A & E and typhoid fever.

Public Health Programs

Because of the risk and occurrence of infectious diseases, public health programs in India continue to work with the United States Agency for International Development (USAID) as well as many other U.S backed organizations to decrease the risk of a disease pandemic.

Historically, U.S. public health programs in India foster positive health outcomes. For instance, because of World Health Organization (WHO) and Center for Disease Control (CDC) treatments in the 1990s and early 2000s, India is now polio-free.

In the early and mid-2000s, CDC and USAID programs identified the monsoon seasonality of influenza and shifted their recommendations to vaccinate before India’s monsoons occur, greatly benefiting civilian populations. Between 2009-2015, U.S. backed public health programs in India even developed 65 HIV reference laboratories certified under the CDC training programs, therefore increasing the access to effective testing and treatment programs.

Emerging Pandemic Threats Program

More recently, the United States developed USAID’s Emerging Pandemic Threats Program (EPT), a global health initiative that works in countries that are most vulnerable to the outbreaks of pandemics. This branch of USAID launched in February 2014 and maintains a growing partnership with over 50 nations, international organizations and non-governmental stakeholders to ensure that the country reduces the risk of infectious disease threats.

EPT in India

The Emerging Pandemic Threats Program in India strengthens the subcontinent’s capacity to detect threats of infectious disease through an early intervention approach. USAID works alongside WHO to fight antimicrobial resistance (AMR), which is defined as virus and bacteria’s ability to become resistant to already known and utilized antibiotic treatments.

Antimicrobial Resistance

Antimicrobial resistance occurs due to natural genetic changes viruses and bacteria undergo when they are initially exposed to an antibiotic. AMR is complicating the fight against the spread of tuberculosis, HIV and malaria, by making some current treatments ineffective.

EPT programs in India combat AMR by conducting targeted surveillance of key wildlife and livestock species, as well as those who handle the animals to identify harmful bacterias and viruses and develop new treatments against them.

Also, EPT programs in India collaborate with WHO to identify unknown harmful viruses in nature and better understand its biological characteristics. Through early monitoring of viruses and bacterias, public health professionals can more quickly develop working vaccines as well as preventative community health preparations to lower risk factors in India’s vulnerable populations.

Public Health Programs in India

EPT programs in India also work closely with the Food and Agriculture Organization of the United Nations (FAO) and the World Organization for Animal Health (OIE), encouraging a multi-sectoral response system to food safety hazards and educating farmers and food preparers of sanitary food and livestock keeping practices.

While India’s population density makes public health efforts difficult to perfect, U.S. efforts, as well as United Nations efforts, are working hard to decrease the risk of infectious disease and limit pandemic potential within the country.

– Danny Levy

Photo: Flickr