Core Project in Bihar

CROWN Core Projects are independent research projects engaged in the collaborative. Each Core Project focuses on increasing adherence to maternal micronutrient supplements among women of reproductive age. As members of the collaborative, Core Projects collaborate with each other by sharing knowledge, resources, and findings across the project lifespan.

Our Project in Bihar Placeholder
Our Project in Bihar

Women’s health

  • Maternal mortality ratio (per 100,000 live births): 145 deaths1
  • Anemia prevalence (women of reproductive age): 53%1
  • Anemia prevalence (pregnant women): 50%1
  • Anemia prevalence (non-pregnant women): 53%1
  • 4+ ANC visits during pregnancy: 58%2
  • Receipt of iron tablets or syrup (among those with 4+ ANC visits): 78%3

Child health

  • Under-five mortality rate (per 1,000 live births): 33 deaths2
  • Child stunting (<2SD from the median height-for-age): 31%2
  • Child wasting (<2SD from the median weight-for-height): 17%2


The project is being led by Project Concern International (PCI) which has been working in India for the last three decades in the fields of Maternal and Child Health and Nutrition, Women’s Economic Empowerment, Gender Transformative Action and Social and Environmental Protection. The IFA Adherence Project is supported by Bill & Melinda Gates Foundation and Centre for Social and Behavior Change (CSBC) of Ashoka University, a center dedicated to expanding and sharing knowledge and underscoring behavioral science’s role in building public policies that directly impact society. For this project, PCI is collaborating with FinalMile – a behavioral solutions design agency, Friday & Theo – a creative communications agency, and Athena Infonomics – an impact evaluation agency.

Country Indicators

India is grappling with high levels of anemia among the general population. The fifth round of India’s National Family Health Survey (NFHS-5) found that more than half (57%) of women and a quarter (25%)  of men aged 15-49 years are anemic in India. Anemia levels are even higher among children aged 6-59 months with two in three children being anemic – 29% have mild, 36 % moderate and 2% have severe anemia levels. The survey also found that anemia levels among all three groups have gone up since the fourth round five years ago.

The overall prevalence of anemia is consistently high in almost all of the subgroups of women — among breastfeeding women it is 61%, among pregnant women it is 52% and among women who are neither pregnant nor breastfeeding, the prevalence is 57%. Indian Government has started several programs to address anemia among women, adolescent girls and boys, and young children below 5 years of age.


1. World Bank. World development indicators [Internet]. 2019 [cited 2022 Mar 29]. Available from: 

2. UNICEF. Country profiles: India [Internet]. 2020 [cited 2022 Mar 29]. Available from: 

3. ICF. The DHS program STATcompiler [Internet]. 2019 [cited 2022 Mar 29]. Available from: 

4. Photo courtesy of: The Reduction in Anemia through Normative Innovations (RANI) Project.

5. NFHS-5, Govt. of India, IIPS, 2022.