Sector Wide Approach to Strengthening Health ( SWASTH )

Bihar Technical Assistance Support Team (BTAST)
Government of Bihar initiative supported by Department for International Development, UK


BTAST releases DLSS data at cross-sectoral knowledge sharing workshop

Patna: Bihar Technical Assistance Support Team (BTAST) released the key findings of District Level SWASTH Survey (DLSS) at a cross-sectoral knowledge sharing workshop held in Patna today. The findings of DLSS survey show that Bihar has made progress in achieving key development indicators on health, nutrition and water, sanitation and hygiene (HNWASH).

Through DLSS, BTAST also monitored the progress of nine high priority districts supported under Sector Wide Approach to Strengthening Health (SWASTH) programme of the Government of Bihar, which is supported by the Department for International Development (DFID). The results of the survey in these nine districts show how SWASTH interventions have catalysed a change leading to appreciable progress in the areas of HNWASH.

DLSS covered 77,748 households across 38 districts of the state. If compared to NFHS – IV, the sample size of DLSS is more than double.

This survey captured information on the status of selected indicators at the state and district level, focussed on the socio-economic-demographic status of the population; knowledge, practices and perceptions of women, unmarried adolescent girls and male decision makers of the households on maternal and child healthcare and services; maternal mortality; and violence against women.

The survey also covered information on enabling environment for health and hygiene, access to drinking water, use of toilet facilities and services provided by health and Integrated Child Development Services (ICDS) facilities and utilisation of the services offered under Village Health Sanitation & Nutrition Day (VHSND) by the target groups. The nutrition status of children under 5 years of age was also measured through anthropometric methods.

The key findings of DLSS show reduction in Bihar’s Crude Birth Rate to 24.8 per thousand in 2015-2016 from 27.8 per thousand as per the Census of 2011. Infant Mortality Rate (IMR) and Under-Five Mortality Rate (U5MR) is estimated 47.8 and 58 per thousand live births respectively and there is a slight reduction as compared to Annual Health Survey 2012-2013.

The state’s progress on health indicators reveals that Ante Natal Check ups increased by 23 per cent (from 59 per cent in 2007 – 2008 to 82 per cent in 2015-2016). According to DLSS, institutional deliveries increased to 69 per cent, which were 28 per cent in 2007-2008 (DLHS-3). The institutional deliveries increased by 40 per cent in rural areas and 25 per cent in urban areas.

The nutritional status of children under 5 years was measured in DLSS. Data reveals that the number of underweight children reduced by 10 per cent (from 55 per cent to 45 per cent) and wasting reduced by 9 per cent (from 33 per cent to 24 per cent) if DLSS (2015-2016) findings are compared with NFHS-3 (2005-2006).

A comparison between the results of DLHS-3 and DLSS shows that 51 per cent children aged 0-23 month olds were breastfed immediately/ within one hour of birth, which was 38 per cent in 2007 – 2008. Similarly, colostrum feeding to newborns increased to 85 per cent from existing 69 per cent recorded during DLHS-3 In 2007 – 2008.

The results from WASH sector show that 97 per cent households have improved drinking water in Bihar. In urban areas 30 per cent households have access to toilet facility. However, the situation is poorer in the rural areas, where only 20 per cent households are using improved toilet facility.

The DLSS data can be used for state level planning and evidence-based decision-making by development partners and the government. The data was shared at the BTAST’s cross-sectoral knowledge sharing workshop, where representatives from various government departments.