Health

USAID works to improve the health of vulnerable populations in India by applying innovative health-system solutions to address some of India’s most pressing health challenges.

While many effective health solutions exist, new interventions must be identified, developed, and scaled up. India is a proven laboratory for health innovations and provides a unique setting for USAID to develop and scale up innovations for global impact.

USAID in India helps build the capacity of national- and state-level institutions and demonstrates high-impact best practices in the areas of: family planning and reproductive health; maternal, newborn and child health; and global disease threats including HIV/AIDS, polio and tuberculosis.

USAID supports evidence-based programs and technical assistance in coordination with the Government of India’s flagship health programs, including the National Rural Health Mission, the National AIDS Control Program, the Revised National TB Control Program and the Pulse Polio Program.

In line with President Obama’s Global Health Initiative and Government of India priorities, USAID envisions that its technical cooperation, coupled with government and private sector resources, will continue to help improve the health system and increase access to quality health care.

Evidence-based decision making for policies and programs

The 2005-2006 National Family Health Survey, coordinated by USAID in partnership with the Government of India and other donors, drew the attention of policymakers to poor nutrition and immunization levels in certain areas of India. Data from the survey were used for the formulation of India’s Eleventh Five-Year Plan; to monitor progress of the Government of India’s Reproductive and Child Health program; to accelerate universalization of the Integrated Child Development Services Scheme; and to help introduce the National Urban Health Mission.

HIV/AIDS

USAID implements HIV/AIDS prevention, care and treatment as part of the President’s Emergency Plan for AIDS Relief (PEPFAR).  PEPFAR efforts in India include HIV prevention in high-prevalence states and among high-risk groups; work to ease the suffering of children affected by or infected with the disease; care and support to those affected and involvement with the private sector to help stem the spread of HIV/AIDS on a broader scale.

Initiatives developed through USAID programs have contributed to the current National AIDS Control Program, and include the development of a policy addressing HIV/AIDS orphans, behavior change communication campaigns, a link worker scheme and many others.

USAID has invested in many large-scale and innovative projects in the high-prevalence states of India: 

• As part of Project Connect, USAID pioneered the first private-sector health insurance for people living with HIV.  
• As part of Samastha, a comprehensive HIV/AIDS project, USAID enhanced rural outreach and HIV care and support services and built capacities across non-governmental and governmental institutions to reach a rural population of more than 300,000 high-risk and vulnerable people.  
• The Avert Project in Maharashtra scaled-up targeted interventions in all the districts for the most at-risk populations.  It also improved the quality of health services and increased the rate of consistent use of condoms in the state.  
• In Tamil Nadu, USAID has supported HIV/AIDS activities since 1995 as part of the AIDS Prevention and Control Project (APAC).  A recent independent evaluation of APAC showed declines in HIV and syphilis prevalence in the general population and in most-at-risk populations. It also recorded an increase in demand for health services and improved overall behavioral indicators in all the 32 districts of Tamil Nadu.

Family Planning

USAID’s Innovations in Family Planning Services  Program, one of USAID’s largest family planning projects in the world, worked in the north Indian states of Uttar Pradesh, Uttarakhand and Jharkhand to help state and national government increase access to and use of integrated reproductive health and family planning services, particularly in poor and underserved communities. 

As a result:

• The use of and access to family planning methods increased more in Uttar Pradesh than in most states not receiving USAID support. 
• Use of modern contraception increased nearly twice as fast from 1992 to 2005 in areas where USAID projects were active than where USAID was not active.

Capitalizing on the Government of India’s momentum to revitalize use of long-term contraceptive spacing methods, specifically the Intra Uterine Device (IUD), in 2006 USAID supported initial master training and revision of the Government of India IUD guidelines for twelve states.

USAID provided support for institutional strengthening, helped design and implement new demonstration programs for eventual scale up, and provided support for communication activities at both the national and state levels.

As a result:

• This initiative was scaled-up nationwide, with recent data indicating an increase in the number of trained providers for the IUD and the number of institutions providing IUD insertions.

Tuberculosis

High-level technical expertise from USAID is bolstering the Government of India’s National Tuberculosis Control Program.

Assistance focuses on priorities such as:

• Sustaining and improving the quality of Directly Observed Therapy-Short Course for Tuberculosis, a globally recognized strategy for TB control;
• Expanding services for diagnosis and treatment of multi-drug resistant TB; and
• Strengthening linkages between TB and HIV/AIDS services and control activities.  

USAID’s help has resulted in:

• Greater detection of TB in HIV counseling and testing centers in high HIV-prevalence states; and
• Strengthened state reference laboratories.

At present, USAID is supporting pioneering innovative research to test new diagnostics and treatment regimens to reduce the time taken for diagnosis and treatment and also to improve adherence. The program has a special focus on Multi-Drug Resistant tuberculosis (MDR TB).

Private sector involvement for improved public health outcomes

Recognizing that most Indians overwhelmingly use the private sector as their primary source for health care services, USAID prioritizes public-private partnerships (PPPs) as a major theme across the entire health portfolio.

USAID support has helped define the strategic framework for PPPs for the $8.5 billion national Reproductive Child Health-2 Program and has demonstrated that a variety of partnerships with the commercial sector are effective development tools.