Specialist Services in the Indian Rural Public Health System for Maternal and Child Healthcare – A Study of Four States
The present study attempts to examine the role of specialist services in rural public health system of India in the areas of maternal and child healthcare. The study uses primary data collected through a survey of doctors and paramedical staff working at public health facilities regarding availability and quality of the specialist services in gynaecology, paediatrics and anaesthesia.
The out-of-pocket expenditure is quite high in Punjab. Hence, a rapid review of health facilities was undertaken to suggest remedial measures.[from abstract]
The Post-Graduate Diploma in Public Health Management, launched by the Govt. of India under the aegis of the National Rural Health Mission in 2008, aims to enhance the managerial capabilities of public health professionals to improve the public health system. The Govt. of India invested enormous resources into this programme and requested an evaluation to understand the current processes, assess the graduates’work performance and identify areas for improvement. [from abstract]
Inadequate, inequitable distribution of the medical workforce remains a challenge across the globe, and India is no exception. Odisha, a state in India faces a major shortage of doctors particularly in rural and remote areas. In order to address this challenge, it is essential to understand medical students’ career plans, specialization preferences, choices of job location and sector, and views on working in rural and remote areas.
Need For Competency Based Healthcare Management Education In India: Concerns, Challenges And Way Ahead
The paper explores the possibility of conceptualization and introduction of standardized competency based healthcare management education in India. The impression about competency based education in field of healthcare is limited to medical and nursing education. Concentrated efforts are required to develop the same concept in the field of healthcare management as well. [from abstract]
Blindness and visual impairment continues to be a major public health problem in India. Availability and easy access to primary eye care services is essential for elimination of avoidable blindness. In the current situation, an integrated health care system with primary eye care promoted by government of India is apparently the best answer. This model is both cost effective and practical for the prevention and control of blindness among the underprivileged population. [from abstract]
Building Locally Relevant Models for Universal Health Coverage and its Implications for Health Information Systems: Some Reflections from India
This paper speaks to this agenda, and describes an ongoing pilot study from the state of Punjab in India with a focus on the implications of UHC models on HIS. Five key implications on HIS are identified: Expanding basket of services; Population basing of services; Ensuring continuity of care; Resource allocation choices; Monitoring financial protection and costs of care. [from abstract]
It is hoped that this background paper supported by the interactive discussions at the convention will help all of us including the People’s Council of Education to initiate a strong countervailing process and movement which will stimulate a re-thinking in the direction content and relevance of health sciences education in the country making it more relevant to people’s needs and health for All. [from introduction]
With India’s low life expectancy largely reflecting deaths from preventable diseases, the most significant gains in health would come from population-wide preventive measures. Access to public health care services varies substantially, resulting in many people turning to private-sector providers who mainly serve those who can pay. [from abstract]
India faces enormous challenge in human resources for health care delivery system. Geographical misdistribution and urban-rural health worker deficit impedes the progress towards achieving Millennium Development Goals. Many rural Indians receive health care from unqualified providers. Rational distribution and retention of qualified providers in rural and remote areas is a daunting task for the government. Little attention is paid in public medical institutions for the real health needs of the community. [from abstract]
Development of a Smartphone-Enabled Hypertension and Diabetes Management Package to Facilitate Evidence-Based Care Delivery in Primary Healthcare Facilities in India: A Formative Research to Inform Intervention Design
Hypertension and diabetes have become a major public health challenge in India. This research work aims to develop a feasible and scalable intervention for hypertension and diabetes, tailored to primary care settings in India. [from abstract]
Factors Affecting the Performance of Community Health Workers in India: a Multi-Stakeholder Perspective
Community health workers (CHWs) form a vital link between the community and the health department in several countries. In India, since 2005 this role is largely being played by Accredited Social Health Activists (ASHAs), who are village-level female workers. Though ASHAs primarily work for the health department, in a model being tested in Rajasthan they support two government departments. Focusing on the ASHA in this new role as a link worker between two departments, this paper examines factors associated with her work performance from a multi-stakeholder perspective. [from abstract]
A comprehensive health care services requires effective human resource (HR) management policy to ensure organizational success. Government is primarily concerned with the size of the workforce rather than the contemporary HR practices. This resulted into lack of attention to HR management in health sector. [from abstract]
Progress, Challenges and Opportunities for HIV Prevention and Control Among High Risk Groups: A Public Health Perspective
There are various socio-cultural issues/obstacles in prevention of HIV-AIDS in high risk group for e.g., gender inequality, power inequalities and male dominance; condom use believed to be in conflict with the cultural importance for procreation; poverty, illiteracy, increase in migrant population and unemployment; poor knowledge and awareness of reproductive and sexual health and sexuality; emergence of new urban sub-culture and physical or mental abuse at a young age.
Does Involvement of Local NGOs Enhance Public Service Delivery?: Cautionary Evidence From A Malaria-Prevention Evaluation in India
The study observed the impact of an experimental supportive intervention to India’s malaria control program by location on the individual level. There are various possible reasons that account for the observed divergence across districts. [from abstract]
Qualified and motivated human resource (HR) is essential for a qualitative and robust health care delivery. Understanding the constraints and difficulties of health managers is essential for effective and efficient management of health care services. The present study is aimed at understanding the various constraints and difficulties of human resource management (HRM) in the public health sector. [from abstract]
India faces critical human resources shortages for key cadres such as doctors, specialists, nurses, and midwives. Other key challenges include suboptimal deployment of staff exacerbated by a skewed urban-rural distribution, gaps in certain specialties, and inefficient use of staff due to poor rationalization of tasks. Lack of comprehensive, reliable, and up-to-date data and an absence of commonly agreed definitions and analytical tools make the task of managing the health workforce more difficult.
Community-based monitoring and planning (CBMP) of health services in Maharashtra state, India represents an innovative participatory approach to improving accountability and healthcare delivery. This paper examines the successes and challenges of this process, discussing lessons learned and the potential for generalizing such initiatives to other sectors and regions. Maharashtra’s experiment could inform ‘communitization’ of health services in diverse contexts, as an alternative to
privatization and as a means to enhancing the ‘publicness’ of health services. [from summary]
There is an evolving need for better utilization of ICT resources which are direct, cost effective, time-saving, and highly persuasive in pursuit of quality healthcare delivery. Therefore this research proposes a ten-layer ICT model converging advanced Mobile and Internet interventions, to disseminate health messages for patients suffering from fatal diseases. Using breast cancer as an instance, a communication strategy is exemplified using the ten-layer model.
Advancing the Application of Systems Thinking in Health: A Realist Evaluation of a Capacity Building Programme for District Managers in Tumkur, India
Health systems interventions, such as capacity-building of health workers, are implemented across districts in order to improve performance of healthcare organisations. However, such interventions often work in some settings and not in others. Local health systems could be visualised as complex adaptive systems that respond variously to inputs of capacity building interventions, depending on their local conditions and several individual, institutional, and environmental factors.
Balancing Authority, Deference and Trust Across the Public–Private Divide in Health Care: Tuberculosis Health Visitors in Western Maharashtra, India
While concepts such as ‘partnership’ are central to the terminology of private–public mix (PPM), little attention has been paid to how social relations are negotiated among the diverse actors responsible for implementing these inter-sectoral arrangements. India’s Revised National Tuberculosis Control Programme (RNTCP) has used intermediary agents to facilitate the involvement of private providers in the expansion of Directly Observed Therapy, Short-Course (DOTS).
Universal health coverage (UHC) is the means to provide accessible and appropriate health services to all citizens without financial hardships. India, an emerging economy with demographic window of opportunity has been facing dual burden of diseases in midst of multiple transitions. Health situation in the country despite quantum improvements in recent past has enormous challenges with urban-rural and interstate differentials. Successful national programs exists, but lack ability to provide and sustain UHC.[from abstract]
Capacity Building of Institutions in the Health Sector: Review of Experiences in Uttar Pradesh, Uttarakhand and Jharkhand.
This report documents the efforts and contributions made by USAID through the Innovations in Family Planning Services (IFPS) Project towards capacity building and strengthening of public and private institutions in the health sector
in India. The report highlights the support rendered at the national level and in three Indian states: Uttar
Pradesh, Uttarakhand, and Jharkhand. [from introduction]
Rural households in India rely extensively on informal biomedical providers, who lack valid medical qualifications. Their numbers far exceed those of formal providers. Our study reports on the education, knowledge, practices and relationships of informal providers (IPs) in two very different districts: Tehri Garhwal in Uttarakhand (north) and Guntur in Andhra Pradesh (south). [from abstract]
In 2005, India embarked on the National Rural Health Mission, an extraordinary effort to strengthen the health systems. However, coverage of priority interventions remains insufficient, and the content and quality of existing interventions are suboptimum.
This paper describes and analyzes Andhra Pradesh’s Aarogyasri scheme [in India], which covers against the costs of around 900 high-cost procedures delivered in secondary and tertiary hospitals. Using a new household survey, the authors find that 80 percent of families are eligible, equal to about 68 million people, and 85 percent of these families know they are covered; only one-quarter, however, know that the benefit package is limited. [adapted from abstract]
Does Involvement of Local NGOs Enhance Public Service Delivery? Cautionary Evidence from a Malaria-Prevention Evaluation in India
Using data from an experimental supportive intervention to India’s malaria control program, this paper studies the impact of leveraging local non-state capacity to promote mosquito net usage and recommended fever care-seeking patterns. The supportive activities were conducted simultaneously by three nongovernmental organizations in two endemic districts in the state of Orissa. The study finds that program impact varied significantly by location. [from abstract]
Strengthening Malaria Service Delivery Through Supportive Supervision and Community Mobilization in an Endemic Indian Setting: An Evaluation of Nested Delivery
This paper tests the effectiveness of two service delivery models designed to promote recommended behaviors, including prompt treatment seeking for febrile illness, in Odisha India. The tested modules include supportive supervision of community health workers and community mobilization promoting appropriate health seeking. [from abstract]
Our study highlights the importance of supply-side barriers to health services utilization. To meet the Millennium Development Goal of reducing maternal mortality, policymakers should make additional investment in improving the availability of infrastructure. [from abstract]
Mobile Phones for Real-time Nutrition Surveillance: Approaches, Challenges and Opportunities for Data Presentation and Dissemination
The aim of this report is to review and discuss approaches, opportunities and challenges in the aggregation, presentation and dissemination of data collected in a mobile phone-based nutrition surveillance system. [from introduction]