Despite the presence of numerous centrally sponsored schemes in health, nutrition, sanitation, education, and livelihood, rural blocks, such as Sewapuri in Uttar Pradesh, struggled with fragmented service delivery, low convergence among departments, and limited community outreach. These gaps led to inefficient resource utilization, poor awareness of entitlements, and limited access to quality services, undermining efforts to improve basic health and welfare outcomes in the region. Recognizing this, NITI Aayog and the Ministry of Rural Development identified the Sewapuri block for piloting a gram panchayat-level saturation model intended to demonstrate how coordinated governance and community-level convergence could address these challenges sustainably.
MSC was commissioned to support the Varanasi district administration in operationalizing the Sewapuri Vikas Abhiyan (SeVA). This involved:
- Establishing a full-time program support unit (PSU) with development professionals to drive implementation and convergence.
- Designing strategic sectoral plans for health, education, nutrition, sanitation, and financial inclusion with detailed action frameworks.
- Developing a monitoring, evaluation, and learning (MEL) framework to regularly track and report on 138 defined KPIs.
- Providing capacity-building and advisory support to government departments and ecosystem partners.
- Facilitating community outreach and behavior change communication, including training 2,000 community volunteers.
MSC collaborated with NITI Aayog’s ecosystem partners, which include the Piramal Foundation, UNICEF, and the Gates Foundation’s partners, such as JHPIEGO, IHAT, PCI, ID Insight, and WaterAid. The integrated efforts led to:
- Saturation of development interventions across all 87gram panchayats, reaching over 240,000 residents.
- Achievement of 100% of targeted KPIs. A critical achievement was screening 95% of the eligible population (aged 30 and above) for diabetes and hypertension at health and wellness centers, with follow-ups at public health centers (PHCs).
- Enhanced service delivery through better coordination across 13 central and state ministries.
- A replicable model of convergence that contributed to the scale-up of the initiative under the Aspirational Blocks Programme across 500 blocks in India.
The project was commissioned by the Gates Foundation (formerly BMGF) in collaboration with NITI Aayog, with MSC serving as a technical and strategic partner to the Varanasi district administration.
The Pradhan Mantri Jan Arogya Yojana (PM-JAY) is the world’s largest health insurance program, which provides USD 6,723 (INR 500,000) per family annually for secondary and tertiary care hospitalization. Government and private hospitals are empaneled under the PM-JAY to offer medical treatments, procedures, and surgeries. However, several systemic and operational bottlenecks led to dissatisfaction among empaneled health care providers (EHCPs), which led them to lose confidence in the program and opt out of the program.
MSC provided technical assistance to the National Health Authority (NHA), the central body responsible for the PM-JAY’s governance. We conducted a study across the states of Bihar, Haryana, and Madhya Pradesh to assess the challenges healthcare providers face in the delivery of services under this program. The study mapped the payment process to hospitals and identified key bottlenecks that affected payment timelines. MSC developed recommendations to optimize the claims process, enhance technology platforms, and strengthen human resource capacity while ensuring alignment with government policies.
A key focus was digital transformation and resource optimization to streamline claims processing for EHCPs and governance agencies. Additionally, MSC proposed digital incentives for the EHCP health workforce to improve engagement.
The study provided practical insights to improve efficiency, transparency, and trust in the PM-JAY’s implementation. MSC’s work addressed payment delays and administrative inefficiencies to restore confidence among healthcare providers, ensure their continued participation in the PM-JAY, and strengthen India’s healthcare delivery system.
The Gates Foundation commissioned the project.
The Government of Bihar intended to increase routine consumption of aquatic food among pregnant and lactating women, adolescent girls, and children under five years. The efforts sought to improve nutrition outcomes, especially around women and children, through dietary habits, cultural practices, and changing perceptions that hinder fish consumption.
MSC has been actively collaborating with women’s self-help groups (SHGs) in Bihar. Therefore, as an extension, the government sought MSC’s technical support to elevate nutritional literacy and build awareness of the benefits of fish consumption among groups involved in fish farming or allied activities. We executed targeted social and behavior change communication (SBCC) initiatives. We led awareness campaigns with women and children in Bihar, which emphasized the safe consumption of fish, particularly for children under five years. This involved a multifaceted approach that included mass media interventions and localized cooking demonstrations to reinforce the importance of incorporating fish into daily diets for improved health outcomes.
Our SBCC efforts enhanced the nutritional status of the target audience. It promoted regular consumption of nutrient-rich aquatic food, addressed deficiencies, and improved overall health outcomes. This ensured long-term health benefits for the community.
Indonesia’s blue food economy can drive sustainable development and improve nutrition outcomes. Small-scale fisheries play a crucial role in food security, yet their impact is limited due to inefficient value chains, restricted market access, and low awareness of fish’s nutritional benefits. Women in this sector face systemic barriers, while environmental degradation, climate change, and food loss further threaten sustainability and public health.
MSC conducted an assessment across four provinces to analyze the contributions of small-scale fisheries to nutrition, food security, and public health. Through consultations with fisherfolk, policymakers, and processors, MSC identified key barriers and developed recommendations for creating more nutrition sensitive supply chains of blue food. To increase the uptake of nutritious blue food varieties, MSC recommended the integration of blue food into school meal programs, maternal health initiatives, and social assistance programs, such as Bantuan Pangan Non-Tunai (BPNT). We also emphasized the potential of fortified fish products to enhance nutritional value.
MSC explored strategies to reduce food loss and waste to strengthen the blue food value chain while promoting gender inclusion. A policy roadmap was developed to align blue food with Indonesia’s sustainable development and nutrition strategies. The roadmap focused on sustainable fisheries management, nutrition security, and equitable participation of small-scale fishers. We identified scalable models from other countries that Indonesia can adapt to promote sustainable fisheries, improve nutrition outcomes, and ensure inclusive growth.
The findings help strengthen Indonesia’s fisheries sector while they improve access to affordable, high-quality nutrition for vulnerable communities.
The Indonesian Ministry of National Development Planning, the Economic Research Institute for ASEAN and East Asia, Stanford University – Center for Ocean Solutions, and Surveyor Indonesia supported this initiative.
60% of India’s population suffers from anemia and micronutrient deficiencies, which undermines national health and productivity. To address this emergency, the Government of India sought to blend approximately 40 million tons of regular rice with fortified rice kernels (FRK) per year to enhance the nutritional value of rice distributed through public welfare programs. Fortified rice, enriched with essential micronutrients, such as iron and vitamin B12, helps combat anemia.
MSC supported the Department of Food and Public Distribution from the pilot phase in 2020 to full-scale implementation by March 2024. MSC provided strategic guidance, developed an implementation roadmap, and engaged with all states and union territories to ensure a smooth rollout. Through technical support, MSC enabled real-time monitoring to track progress effectively.
MSC conducted landscape studies in Andhra Pradesh, Bihar, Punjab, and Uttar Pradesh to assess and strengthen the supply chain of fortified rice. These insights led to the development of a digital solution to improve transparency and efficiency in fortified rice supply chain management and quality control, which was piloted with the Government of Andhra Pradesh before wider implementation. MSC also organized learning workshops in Varanasi and Vijayawada to foster collaboration. These workshops brought together state governments and stakeholders to exchange experiences and best practices.
The program significantly improved nutritional outcomes for 800 million beneficiaries. It directly benefited more than 500 million women and children by providing fortified rice through schools (PM POSHAN), Anganwadi centers, and fair price shops. It helped 16 states and union territories establish a sustainable fortification roadmap. The initiative also supported an estimated INR 20 billion capital investment for fortified rice kernel manufacturing, blending units, and laboratory infrastructure. It also created more than 50,000 jobs within the fortification ecosystem, which boosted economic sustainability.
The Gates Foundation funded the project.
The integration of fortified foods into India’s food security programs is a complex challenge that requires coordination across government departments, optimized supply chains, and alignment with private sector stakeholders. However, despite the importance of food fortification, several barriers exist in both the public and private sectors. Therefore, advocacy and policy support are crucial in building a strong, fortified food ecosystem.
MSC worked closely with the Department of Food and Public Distribution to secure key stakeholders’ commitments to include fortified staples in India’s social safety net programs. MSC established a collaborative platform to improve coordination between central and state governments. We organized regional learning workshops that facilitated knowledge exchange among food fortification stakeholders. We also developed knowledge briefs that provided insights into the current status of food fortification in India and its future opportunities. Additionally, MSC supported the formulation of quality standards and standard operating procedures (SOPs) for fortified rice processing and distribution.
MSC’s efforts helped shape government policies and quality standards for fortified rice processing and distribution. The project accelerated the rollout of the rice fortification program, which benefited 800 million people through the distribution of fortified rice. More than 200 stakeholders actively participated in the learning workshops, which led to stronger policy commitments. The intervention also helped resolve challenges within the food fortification ecosystem.
The Gates Foundation funded this project to support the Government of India’s goal to improve nutrition through large-scale food fortification.
