Project Summary 

The project seeks the following objectives:

  1. To increase uptake and adherence to IFA supplements among women of reproductive age, including pregnant and lactating women, and adolescents;
  2. To generate implementation knowledge on how to deliver at scale within the government system; and
  3. To reduce gender barriers affecting access and adherence to IFA supplements.

The purpose of the program is to design, test, implement, and evaluate impactful interventions focusing on the key target segments to ensure increased uptake of and adherence to IFA supplements in identified geographies of Bihar and develop recommendations for delivering the strategies at scale.


Working alongside different departments of the state Government of Bihar, the project is applying an implementation science framework to test a set of strategies, initially at a pilot level and then a scalable level. These strategies will aim to increase adherence of IFA supplements among three main groups in rural areas: i) adolescent girls (both in and out of school), ii) pregnant and lactating women, and iii) general women aged 15 to 49 years. A mixed method approach, including Human Centered Design (HCD) and a cluster randomized control trial (CRCT) will be used to design and test a set of strategies. The project will address key implementation research questions to inform feasible and cost-effective strategies to support adherence to and delivery of recommended maternal nutrition interventions.


Bihar Project Process

Proposed Theory of Change