Research Projects/Studies Completed Year-2004-2005
Diagnostic Studies of SMS Hospital
Agency:Funding Agency: IIHMR
Project Team:Project Team: S.K. Puri, Santosh Sharma, Shibu John and Students of Ist Year PGDHM
The diagnostic studies of SMS Hospital, Jaipur, a 1575 - bedded super-specialty hospital, were undertaken at the request of the team constituted by the Rajasthan High Court to find out the reasons of the mal-administration of the hospital. Eleven teams were constituted which were attached to all the important departments of the hospital. The objectives of the studies were:
- To study the organisation structure and infrastructure
- To study the functioning of the hospital
- To pinpoint the problems and bottlenecks
- To make recommendations
A report is being submitted to the Rajasthan High Court team making detailed recommendations, which would definitely improve the functioning of the hospital.
Training Needs Assessment with the Focus on Preparing Staff Development and Learning Plan for World Health Organisation- SEARO
Agency:World Health Organisation
Project Team:Vinod K. Arora, S.D.Gupta and Nutan P. Jain
Attainment of the highest possible level of health for everyone was the key objective of the World Health Organisation, and in order to achieve this objective the South East Asia Regional Office directed and coordinated the activities and programmes in member countries of this region. The WHO-SEARO assisted the governments in strengthening health services. Capacity building is a continuous process and is essential as the technology is developing fast. It is not only technology but also organisational challenges that need to be addressed. Systems and practices get outdated soon due to new developments in technology, including technical, managerial and behavioural practices. One of the most important functions of the organisation was to develop technical and managerial competencies. People not only perform technical and managerial roles but they also have to deal with various problems in the day-to-day life of the organisation. They have to deal with conflicts, problems of cooperation, commitment, teamwork, and such related matters. The proposed training needs assessment aimed to identify training needs of the various categories of employees and develop a work plan for WHO-SEARO staff (covering staff at the regional office as well as country offices) development and learning activities. The specific objectives were:
- To review the job responsibilities of all categories and all levels of human resources (managerial, supervisory, technical and administrative/support)
- To conduct a rapid assessment of training needs of the WHO-SEARO officials in relation to managerial, supervisory, technical and process competencies
- To prepare a draft staff development and training plan
Building Local Leadership in Reproductive Health (with a special focus on convergence of Panchayati Raj Institutions and Self Help Groups)
Agency: International Council on Management of Population Programmes (ICOMP), Kuala Lumpur, Malaysia
Project Team:S.D.Gupta and Nutan P. Jain
society role in making wider availability, accessibility and affordability of reproductive health services. A team of three persons including a CSO representative from the national reproductive health agency, one senior government official in the reproductive health sector and one academician/ researcher were trained in and exposed to the critical issues of civil society roles and responsibilities, mechanisms on its collaboration with the government on the basis of partnership in creating quality of life for the constituents they serve, and the best management practices that have increased synergy in achieving the highest standard of reproductive health services. The objectives of the project were:
- To develop a training module for strengthening leadership skills of CSOs (SHG, NGO, and PRI representatives) in Reproductive Health
- To assess the impact and document the learning systematically and disseminate this information among key stakeholders working on relevant projects/ programmes
A Pilot Study of Tobacco Use Patterns in India: The Social and Cultural Context
Agency: Wake Forest University, School of Medicine, USA
Project Team: L.P.Singh, S.D.Gupta, Nutan P. Jain, Shuchi Kaushik and Soma Mitra
The health implications of increasing tobacco use among the youth and women - particularly women in the reproductive age - are of considerable concern in a country with high level of poverty and under-nutrition. Thus, effective tobacco control efforts are urgently needed. However, any discussion of tobacco control must account for the social and cultural meaning of tobacco in Indian culture. The objective of the study was to document knowledge, attitudes and use patterns with regard to tobacco among a demographically diverse population (men, women, youths from rural and urban areas) in India to develop a survey instrument to conduct a household survey in a larger study.
Evolving Strategies for Designing Programme Intervention in Truckers' Halt Points
Project Team:N. Ravichandran, Anju Bala and Swati S. Roy
The study was commissioned by TCIF-BMGF in Phase - II states where National Highways 2-9 passed by. The purpose of the study was to evolve strategies to design programme interventions in 34 potential halt-points in the northern, western and eastern regions of India where TCIF-BMGF project could begin the intervention. The specific objectives were:
- To identify the 45 topmost potential halt-points (from which 34 halt-points will be selected for project interventions) in the northern, western and eastern regions of India
- To assess the availability and coverage of existing highway programmes in the selected halt-points, which will serve as an excellent tool for rational staffing and planning new interventions for operationalisation
- To generate the database related to sexual networking and truckers' villages in the selected halt-points, which will serve as the base for planning interventions
- To collect the baseline data related to the behavioural change aspects of truckers and sex workers
- To examine the possibility of involving secondary stakeholders, such as transport companies, brokers/agents, and associations of truckers/owners, in the TCIF-BMGF project
- The present study uses participatory techniques to collect information from primary stakeholders, such as truckers and commercial sex workers, and secondary stakeholders, like truckers' associations and trucking industries.
A Study of Infant Mortality in Rajgarh Block of Churu District
Agency:Bhoruka Charitable Trust
Project Team: Anoop Khanna and N.K.Sharma
The study is being carried out in Rajgarh block, where Integrated Child Development Services (ICDS) project is being implemented by Bhoruka Charitable Trust, which provides services for children, and pregnant and lactating mothers through 220 Anganwari centres covering around 170 villages of the project area. The study aims at estimating the current level of infant mortality in the project area and examining the factors associated with infant and maternal mortality. The study is based on a sample survey covering around 5000 households to identify all births and infant and maternal deaths, which have occurred in the sample households. The study also examines the current disease patterns and nutritional deficiencies among the infants.
Concurrent Social Assessment under ICDS - III Project
Agency:Department of Women and Child Development, Government of Rajasthan
Project Team:Ch. Satish Kumar, Neetu Purohit, N.D. Sharma, Basant K Singh, Devesh Sahu, Vikas Dwivedi, V. Vineeth Kumar, R. Swarna Sai Menon, Boby Thomas, S. Bala Murgan, Bijoe A.P, Mejo Jose and Arvind Singhal
The major objective of the project was to provide necessary inputs for the improvement of the performance of ICDS programme by assessing community perception and involvement.
Social assessment was being conducted to ensure that socially and economically disadvantaged people get benefit from the project, particularly in terms of nutrition, health and pre-school education.
The specific objectives of the study were:
- To assess community knowledge and perception regarding ICDS project activities
- To determine the role of community in augmenting the AWC activities and that of women in pre-school activities
- To study the role of the Gram Panchayat in maintaining and running the AWCs
- To study the utilisation level of the ICDS services by lactating and expectant women
- To assess the extent of antenatal care of pregnant women, breastfeeding, initiation of supplementary foods and participation in the ICDS activities by lactating women
- To assess the knowledge of adolescent girls about family life education and participation in the ICDS activities
The Concurrent Social Assessment focussed on identifying community needs, perceptions, practices, preferences, utilisation, participation and problems currently being experienced with the ICDS Project.
Reproductive and Sexual Health Education of Adolescents
Agency:Indian Council of Medical Research
Project Team:R.S. Goyal
A task force multi-centric study was being carried out in Delhi, Jaipur, Kolkata, Lucknow, Pune and Thiruvanathapuram. The broad objective of the study was to develop a feasible model for providing reproductive and sexual health education to school-going adolescents in different parts of India.
The specific objectives were:
- To undertake pre intervention study of adolescents, parents, and teachers regarding the reproductive and sexual health issues and education programmes to set up benchmarks for intervention impact
- To develop a reproductive and sexual health education module for school going adolescents
- To provide reproductive and sexual health education to adolescents in selected urban and rural schools in different parts of India
- To evaluate the impact of educational intervention on adolescents' awareness, knowledge, attitude, change and sexual practices
Reproductive Health Strategic Assessment Project in Rajasthan
Agency: WHO / ICOMP
Project Team:Sudhir Kumar and Kshitij Sharma
A strategic assessment of RCH services in Rajasthan was conducted to find out how new technologies can be introduced within a quality of care and reproductive health framework keeping in view the perspectives of all stakeholders. The strategy was based on a conceptual framework that considers users' needs and perspectives, available technologies and the capabilities of the service delivery system as well as their interactions in the broader context of health, socio-cultural, political and resource settings. The findings of the study would be used in developing a Project Implementation Plan for RCH Phase II in Rajasthan.
District Level Household Survey for Reproductive and Child Health Project Round II Phase -2 (Region # 7)
Agency:Ministry of Health and Family Welfare, Government of India and World Bank
Project Team:Ch. Satish Kumar, N.D. Sharma, Sunita Nigam, Basant K Singh, Devesh Sahu, V. Vineeth Kumar, Boby Thomas, S. Bala Murgan, Bijoe A.P, Mejo Jose, Arvind Singhal and R. Swarna Sai Menon
To monitor the progress of the Reproductive and Child Health intervention, a rapid household survey was planned for each district in the country in two phases every alternate year. As a part of this, during the year 1998-99, all the 30 districts in Rajasthan were covered. The findings of the survey throw light on the status of the fertility, mortality, antenatal, postnatal, essential neonatal care, breast feeding, immunisation and awareness of RTIs, STIs and HIV/AIDS. The new dimension added in this round of survey was the weighing of the children below six years and collection of blood samples from the children below six years, adolescent girls (10-19 years) and pregnant women to assess their nutritional status and anaemia. The second phase of the household survey has been initiated in 16 districts in Rajasthan.
District Level Household Survey, Phase II of Round 2 Under RCH Project, Region 8 (Haryana and Punjab)
Agency: Ministry of Health and Family Welfare, Government of India and World Bank
Project Team:Dhirendra Kumar, J.P Singh, J.B.Singh, Laxman S. Sharma, James E.J and Ubeda Sultana
The information collected in the previous round of the the district level household survey was found quite useful to planners, implementers and policy-makers to implement the RCH project. Realising the utility and importance of the district level information on various RCH indicators, the Ministry of Health and Family Welfare, Government of India decided to undertake the second round of DLHS by covering the remaining 50 percent districts in Phase II in the country. DLHS Phase II of Round 2 collected district level data other than service statistics on the accessibility and utilisation of RCH services. DLHS in the second round covered the information on the nutritional aspects of adolescents and pregnant mothers. The information on the weight of children up to the age of 6 years as well as the prevalence of anaemia in adolescent girls and pregnant mothers was collected. Trained personnel in the field took the blood samples of these target groups. Salt testing from each household was also conducted to assess the iodine level. As many as 18 districts of Haryana and Punjab will be covered in Phase II.
Programme Implementation Plan for RCH Phase II for Rajasthan State
Agency:Department of Medical and Health, Government of Rajasthan
Project Team:Dhirendra Kumar, Rohini Jinsiwale and Shamly Austin
The IIHMR was the nodal agency for the preparation of a Project Implementation Plan (PIP) for RCH Phase II. The first draft of the Plan has been completed and shared with the Government of Rajasthan. The PIP was based on a Log Frame Approach. Various stakeholders, namely the Department of Health and Family Welfare, Department of Women and Child Development, panchayati raj, non-government organisations and development partners (UNICEF, UNIFPA, CARE, European Commission, World Bank) were involved in the consultation process.
Marginal Budgeting for Bottlenecks ' Phase II
Project Team:Ch.Satish Kumar, Dhirendra Kumar, L. P. Singh, Vikas Dwivedi, Basant K Singh, Rahul Bhawsar, Nand Kishore Sharma and Shuchi Kaushik
The mainstay of Marginal Budgeting for Bottleneck (MBB) was to identify country/state specific 'implementation constraints' of the health system and estimate the 'marginal costs' to overcome them. MBB used existing information available for selected tracer interventions to identify the 'bottlenecks', the weakest links in the chain of conditions, and debate various options to address them.
Rajasthan State had formally agreed to adopt the MBB tool to develop marginal budgeting for RCH - II Project. The State Government had formed a core group to identify the interventions and to come out with a marginal budget. In a series of state level workshops the core group had identified a set of interventions at three different levels i.e. family level, outreach level and institutional level. To measure the impact of the interventions, indicators had been developed along with tracer interventions at five levels i.e. availability, accessibility, utilisation, adequate coverage and effective coverage. Data collecting and budgeting were in process in RCH 2 design. However, in order to test the validity of the tool, the second phase of MBB had been initiated with a large sample size to provide district level estimates.
Social Assessment under Health and Nutrition Project, Karnataka Health Systems Development Project
Agency: Karnataka Health Systems Development Project, Karnataka
Project Team:Ch.Satish Kumar, G. V. Nagaraj, S. Nirmala, V. Vineeth Kumar and R. Swarna Sai Menon
A social assessment had been undertaken to improve the health outcomes of the population with special focus on the poor, the tribal, SCs/STs and adolescents. The state government had designed a project with the support of and financial grant from the World Bank to strengthen the primary health care and public health services. The project needed to ensure that it addresses the issues of social inclusion - especially of the poor, tribal and adolescents. The proposed social assessment contributed to the project preparation and design.
The major objectives of the study were to develop a strategy and action plan to improve the health outcomes in the poor and disadvantaged including the SCs/STs, tribal population and adolescent population within the poor districts and to develop a participation strategy for key stakeholders, including beneficiaries, civil societies (NGOs, CBOs, voluntary organisations, and profit providers), and the people in providing and formulating health policies and implementing and monitoring health sector reforms and quality and accessibility of health services.
Baseline / Endline Survey for UNFPA Supported Integrated Population and Development Projects (Phase-II) in Rajasthan and Madhya Pradesh
Agency:UNFPA, New Delhi
Project Team:S.D. Gupta, LP Singh, Anoop Khanna, Nutan P.Jain, P.C. Dash, N.K. Sharma, Rahul Bhavsar, Rohini Jinsiwale, Shamly Austin, Hemant Mishra, Neeraj Mishra, Soma Mitra, Khsitij Sharma and Vaibahv Saroha
In India, UNFPA support began in 1974 on the basis of a five-year programme cycle. The last programme cycle (Country Programme V: 1997-2002) had been completed. A major component of Country Programme (CP) 5 was a set of integrated Population and Development projects in 30 districts and 5 urban corporations spread across six states of the country. CP 6 had been designed to consolidate gains made during CP 5 as well as support interventions in new programme areas e.g. adolescent sexual and reproductive health (ASRH) and life skills, and violence against women and gender. Two blocks in each of the districts have special programme components.
In the light of the result-based management focus in the UNFPA programming, it was important to measure the achievements of the defined programme results. Thus, it was proposed that end line and baseline surveys be conducted for the project districts. Baseline data for CP 6 obtained through surveys served as the starting point for measuring or demonstrating changes in the situation and the performance of the programme.
Similarly, endline surveys were conducted for the project sites to assess the achievements of the programme objectives established for CP 5. The rapid household surveys conducted for the project districts during 1998-99 provided baseline estimates for key programme indicators as relevant to CP 5.It was proposed to commission surveys with the following objectives:
- To assess the achievements of the objectives for the IPD projects during CP 5
- To provide baseline estimate for CP 6
- To provide valid estimates on the outcomes and deliverable output variables so as to describe the situation prior to the proposed CP 6 programme
- To provide useful information for refining programme strategic interventions and activities
Sustainability of Non-profit Organizational Forms in the Era of Globalisation
Project Team:N. Ravichandran, Ajit Kumar Jain and Sathyapriya
The debate over non-profit organisations and their proper role in the liberalisation era continues, periodically grabbing public attention for sustainability, tax exemption etc. However, as the non-profit sector grows in size and in commercial activities, it is becoming indistinguishable from the private sector. The competition between the non-profit sector and the private sector is made even more complex by the fact that the non-profit sector is undertaking activities that have previously been the domain of profit firms and that private firms are expanding into traditionally non-profit arena. To what extent this occurs is important for public policy, since the justification for subsidies, donations and tax exemptions to non-profit organisations hinges on their being different from private firms. On the other hand, the increase in commercial activities in the non-profit sector raises the question of whether non-profit organisations are merely â€˜for profit' in disguise. Attention to non-profit organisations' growing commercial activities is necessary because it highlights both the difference between what society expects from non-profit organisations and private firms, and the similarity in the financial constraints that they face. Looking at all these issues, there is a need to demonstrate the enormous complexity of attempts to answer the question, and the equally great importance of doing so looking at sustainability measures. The study uses the normative approach with qualitative techniques.