Dr Anand Bang
Dr. Anand Bang is a medical doctor and public health expert deeply involved in advancing tribal & community health. He works with the Society for Education, Action & Research in Community Health (SEARCH), a nonprofit organization in the Gadchiroli district of Maharashtra, founded by his parents, the esteemed public health leaders Dr. Rani and Dr. Abhay Bang. In addition to his work at SEARCH, Dr. Anand Bang is a trusted public health advisor to the Tata Trusts and the Government of Maharashtra on developmental issues such as water, sanitation, and livelihoods, helping shape strategic initiatives to improve the well-being of underserved communities.
CAPI interviewed Dr. Anand Bang in Oct 2024 to learn about SEARCH’s pioneering work in community health, specifically to understand India’s maternal and child health philanthropy landscape.
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CAPI: Dr. Bang, thank you for joining us today. Can you share how SEARCH has historically used local research to address health challenges and fill critical healthcare gaps in rural India
Dr. Anand Bang: Sure, my parents, Dr. Rani and Dr. Abhay Bang founded SEARCH in 1986 and were deeply influenced by the Gandhian principles of social service. They believed public health interventions must begin by understanding the unique challenges and realities of the communities they serve. At the time, much of India’s health data came from urban hospitals or international studies, which failed to reflect rural realities. This data gap left rural populations underserved by policies and programs that didn’t meet their needs.
When they started working in Gadchiroli, which is one of the most marginalized and predominantly tribal regions in Maharashtra, as doctors and public health researchers, they began by systematically collecting data on every childbirth and infant death in the district. Their estimates revealed an infant mortality rate (IMR) of 121 per 1,000 live births. Determined to address this, they undertook extensive field research, identifying pneumonia as the leading cause of infant deaths. A low-cost intervention was developed to train semi-literate rural women to diagnose pneumonia using a simple breath counter, administer oral antibiotics, and ensure early referrals to hospitals for treatment. This was the first study of its kind from a developing economy. The approach decreased the IMR from 121 to 80 within two years of the intervention. This model was replicated in seventy-seven other countries.
Progress, however, stagnated at a certain point, with child mortality being caused by other preventable causes. A significant portion of child deaths occurred during the neonatal period, which refers to the first 28 days of life.[1] Realizing the need for deeper analysis, they conducted a detailed study. They found other preventable causes of child deaths, such as sepsis, birth asphyxia, low birth weight, and hypothermia at the neonatal stage. These findings guided them to develop the low-cost primary home-based newborn and childcare (HBNC) model, empowering health volunteers to deliver life-saving care at home. Interventions included keeping newborns warm, promoting exclusive breastfeeding, managing infections with antibiotics, and ensuring hygiene during and after childbirth.
The impact has been profound. By 2003, the IMR in the intervention villages dropped to 30 per 1,000 live births; as of 2023, it is as low as 18-20. Their work demonstrated that simple, community-driven care could save thousands of lives in resource-limited settings. The intervention became a national policy delivered through Accredited Social Health Activist (ASHA) workers across India. A detailed study on the intervention was published in the Lancet, and the model gained global recognition as an effective and scalable solution for reducing newborn mortality in low—and middle-income countries. It has since been adopted in eighty other countries. Today, SEARCH continues to work on reproductive and child health and expands its approach to other critical community health concerns.
CAPI: What key areas should India focus on to improve maternal and child health outcomes?
Dr. Anand Bang: India has significantly reduced maternal mortality to 150 per 100,000 live births. However, significant challenges persist, particularly in underserved regions such as tribal or rural areas and urban slums. One critical gap is the lack of emergency obstetric care in these pockets. Strengthening emergency services, improving surgical facilities, and ensuring comprehensive healthcare setups are essential to bridging disparities.
At the same time, quality of institutional care is crucial with improved access to skilled professionals. Progress has been made in reducing asphyxia.[2] due to hospital deliveries and the incidence of sepsis[3] are also decreasing. In contrast, institutional deliveries have also led to an increase in caesarean sections, often accompanied by challenges like hospital-based infections, poor quality of delivery, and even corruption.
Maternal morbidity is another critical area requiring attention. Chronic conditions such as secondary postpartum hemorrhage, pelvic pain, urinary tract infections, postpartum fever, puerperal sepsis, and breastfeeding challenges (e.g., mastitis, breast abscess) significantly impact a mother’s quality of life after delivery. Mental health conditions, including postpartum insomnia, depression, and psychosis, also pose severe risks to maternal well-being. Addressing these issues through comprehensive postnatal care, integration of mental health support, and structured training programs for community health workers is essential. Additionally, preterm births and low birth weight remain significant challenges that need to be addressed.
Despite the significant reduction in infant mortality rates (IMR) and neonatal mortality rates (NMR) over the past twenty years in India, high mortality rates persist in tribal areas and urban slums. Supportive care for these newborns must be prioritized until they catch up in growth. Reliable data collection, targeted interventions, training of community health workers, and robust health services in underserved geographies are vital to sustaining India’s public health outcomes.
CAPI: What are the biggest challenges in scaling successful public health models like the one developed by SEARCH across diverse geographies in India?
Dr. Anand Bang: Scaling public health models like our Home-Based Newborn and Child Care requires quite a few considerations. Scaling isn’t just about replicating a model; it’s about adapting to new contexts while retaining what works.
The foremost is building a structured and continuous training system for community health workers (CHWs). High-quality training, supported by regular supervision and skill updates, is essential to maintaining program effectiveness during expansion. Supportive supervision for community health workers must ensure they feel equipped and confident to carry out their tasks effectively. At present, we need to understand how AI can enable and improve the training of community health workers.
A related issue is the need for performance-based incentive systems to motivate CHWs and ensure accountability. Without these systems, the quality and consistency of service delivery can be compromised, particularly when scaling across diverse geographies.
There is also resistance to delegating critical tasks to CHWs. Medical professionals may hesitate to entrust responsibilities such as diagnosing pneumonia or administering antibiotics. However, empowering CHWs through proper training and trust-building is essential for scaling such models. Medical experts need to understand the power of delegation and the critical role CHWs can play in bridging healthcare gaps in underserved regions.
Another consideration is ensuring the availability of essential medical supplies such as antibiotics, thermometers, and mucus aspirators. Reliable supply chains and strong coordination with healthcare systems are necessary, especially in remote rural and tribal areas. These regions often face socio-economic barriers, including poor infrastructure and lack of emergency transport, which limit interventions.
While reducing mortality[4] remains vital, addressing maternal morbidity ensures that women not only survive childbirth but also live healthy, productive lives afterward. Chronic conditions like postpartum hemorrhage, pelvic pain, infections, and mental health challenges such as depression directly impact a mother’s well-being and her ability to care for her child. Scaled models must integrate high-quality care into postnatal health services, ensuring that maternal morbidity is systematically addressed. Prioritizing the quality of care in these interventions will create a more sustainable and impactful public health framework that benefits both mothers and children.
Finally, we need robust data systems and technology for health to connect local efforts with state and national health systems. Reliable data enables better monitoring, evaluation, and course correction.
CAPI: How does SEARCH sustain its work, particularly with respect to funding and long-term support?
Dr. Anand Bang: SEARCH’s work has been sustained through a combination of international funding, government support, CSR, and, more recently, increased engagement with Indian philanthropists and UHNIs. One of our earliest supporters was the Indian Council of Medical Research (ICMR), which gave us a large grant in the 1980s. Over the years, international foundations like the Ford Foundation, the MacArthur Foundation, the German organization Misereor, the Gates Foundation, and an unconditional grant from MacKenzie Scott enabled us to innovate and expand our interventions. Indian high-net-worth individuals (HNIs) and institutional donors are also beginning to play a larger role in supporting organizations like SEARCH.
Many CSR donors often focus on project-specific funding, which can inadvertently overlook critical areas such as research, advocacy, and core organizational capacity building. These foundational investments are vital for driving long-term impact, enhancing organizational resilience, and ensuring the sustainability of development efforts. By addressing these gaps, CSR donors can amplify the systemic change their contributions aim to achieve.
Simplifying CSR compliance processes—focusing on meaningful outcome indicators and streamlining auditing requirements—can empower donors to engage more effectively. This approach not only reduces administrative burdens but also enables CSR initiatives to align with developmental goals, creating a more strategic and impactful funding ecosystem.
CAPI: What role can domestic donors play in improving maternal and child health in India?
Dr. Anand Bang: Donors should focus on the most vulnerable communities, as I mentioned before, tribal areas and urban slums are examples of the same, supporting proven and successful models. For philanthropy to be truly effective, it must be strategic and long-term. Public health outcomes, especially maternal and child health, require sustained efforts over many years. Donors who are patient and consistent in support enable non-profits to refine and adapt their interventions while addressing the evolving needs of their communities.
One critical recommendation is that donors invest in core organizational capacity alongside specific programs. Often overlooked, this includes funding for infrastructure, technology, training systems, data collection, research, and advocacy efforts—all essential for a non-profit’s long-term sustainability. For instance, the MacArthur Foundation’s nearly two decades of flexible funding allowed SEARCH to strengthen its operational capacity, improve its data systems, and effectively scale the Home-Based Newborn and Child Care model.
Philanthropists should also champion comprehensive healthcare approaches. Scaling successful programs is essential, but donors should also consider broadening the scope of the programs to address interconnected issues like low birth weight, maternal nutrition, postpartum morbidities, along with access to care. Integrated solutions that tackle multiple aspects of maternal and child health have a far greater impact than focusing on isolated challenges.
Another recommendation would be to support advocacy and research, as donors can help bring successful models to the attention of policymakers and influence other donors. Donors could prioritize investments in knowledge creation, supporting research, data collection, and the development of best practices. These efforts enhance the evidence base for impactful interventions and empower organizations with insights to adapt, innovate, and drive systemic change. However, it is also crucial for donors to resist the urge for “innovation for the sake of innovation.” While innovation is necessary, the focus should be on scaling and strengthening solutions that have already demonstrated success. Proven models can potentially drive impact when implemented effectively and tailored to local contexts. Constantly seeking new innovations without fully utilizing existing ones can dilute resources and slow progress.
A strength donors can bring is actively facilitating partnerships by converging diverse partners with complementary skills and expertise. Collaborative efforts can help address complex challenges more effectively, leveraging the strengths of various stakeholders for greater impact and enabling scale.
Finally, meaningful engagement is critical. Donors who visit the field understand the cultural and socio-economic context and build relationships with implementers and communities to gain deeper insights into the challenges and opportunities. Domestic philanthropy in India should go beyond funding to forge strategic partnerships, advocate for change, and provide mentorship.
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[1] Neonatal mortality refers to deaths within the first 28 days of life, often caused by childbirth complications, preterm birth, or preventable infections such as sepsis, diarrhea, or pneumonia. Infant mortality is the deaths of children under one year, typically resulting from infections, malnutrition, and inadequate postnatal care. Meanwhile, under-five mortality is deaths of children under the age of five, reflecting systemic issues like lack of healthcare access, malnutrition, and poor sanitation.
[2] A condition where a baby does not receive enough oxygen before, during, or immediately after birth, potentially leading to brain damage or death.
[3] A life-threatening condition caused by a severe infection that triggers an extreme immune response, occurring in mothers during pregnancy or postpartum and in newborns after birth.
[4] In the context here, mortality refers to maternal mortality, which is caused by pregnancy or childbirth complications, conditions such as postpartum hemorrhage, pre-eclampsia, infections, unsafe abortion, or pre-existing health issues that worsen in pregnancy. A majority of these maternal deaths are preventable through timely access to quality obstetric care during and post-pregnancy.