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Research Projects/Studies Completed Year-2008-2009

National health services performance

Agency:Ministry of Public Health, Afghanistan and the World Bank

Project Team:S.D.Gupta, Dhirendra Kumar, Binay Kumar, Anubhav Agrawal, Manish Kumar and Dushyant Mishra

The Johns Hopkins University Bloomberg School of Public Health (JHU) and the IIHMR were awarded a contract by the Ministry of Public Health, Islamic Republic of Afghanistan to provide Monitoring and Technical Support to the Ministry of Public Health from April 1, 2008 to January 31, 2009.

The objectives of the project were: a) to provide an independent assessment of how NGOs and the MoPH are doing in improving the delivery of the basic package of health services (BPHS); b) to strengthen the capacity of the MoPH to evaluate service delivery so that they will be able to do it themselves in the future. IIHMR and JHU have completed successfully the following activities to support Ministry of Public Health, Islamic Republic of Afghanistan.

  • Conducted four rounds of National Health Services Performance Assessment at the national level and developed a Balanced Scorecard for the health sector in Afghanistan.
  • Provided the Ministry of Public Health with Community Feedback on the health services.
  • Developed a framework for monitoring and evaluation of the Essential Package of Health Services and other hospital services.
  • Conducted two rounds of the National Hospital Performance Assessment, focusing on delivery of the Essential Package of Health Services and other hospital services.
  • Conducted a household survey in 2006 in order to provide estimates of priority health indicators for rural Afghanistan and to describe case seeking practices and health expenditure patterns across rural Afghanistan.
  • Conducted a Capacity Building and Learning Needs Assessment in close partnership with MOPH's General Directorate for Human Resources.
  • Conducted an assessment of the quality of drugs provided through Basic Package of Health Services (BPHS) facilities in each province and in private pharmacies in five major urban centers of Afghanistan.
  • Designed and analyzed the health module for the 2007 National Risk and Vulnerability Assessment (NRVA).
  • Provided GCMU, senior managers of MoPH, concerned NGOs and donors with user-friendly results of the analyses from all of the above assessments.
  • Trained and advised MoPH provincial and central level staff in the collection, analysis, reporting and dissemination of the data from the assessments so that they can take increasing responsibility for monitoring and analysis of information
  • Helped develop capacity of the ministerial staff and Afghan Public Health Institute (APHI) to undertake research and health services performance assessment.

Short training on research methods for reproductive health organized in collaboration with Afghan Public Health Institute

Agency:Ministry of Public Health, Afghanistan and the World Bank

Project Team:Dhirendra Kumar, Binay Kumar

Afghan Public Health Institute (APHI) with technical support from IIHMR conducted three rounds of 10-days training programs at Kabul. The financial and technical support was received from Reproductive Health Division, WHO, Geneva. About 25 medical officers mostly female doctors from various provincial hospitals of Nanagarhar, Balk, Heart and Kabul participated in the training. Training sessions included various topics on research methodology, sample design, sample size, data management, analysis report writing and reproductive health. The participants were encouraged to develop a research protocol for funding from WHO.

Mid-term review of health sector development initiative (HSDI), West Bengal

Agency:DFID (India), New Delhi

Project Team:Barun Kanjilal, L P Singh, Sneha Singh, Swadhin Mondal, Arnab Mandal

Health Sector Development Initiative (HSDI), a five-year reform programme, was launched in August, 2005 in West Bengal by the Department of Health and Family Welfare, Government of West Bengal with the support from DFID (India). The broad objective of this initiative was to support and operationalize the state's health sector strategy developed in 2003 (HSS, 2004-13). IIHMR was selected through a national bidding process to carry out the mid- term review of HSDI in the state. The overall objective of the Mid-term Review (MTR) was to review the progress undertaken under HSDI/HSS in seven milestone areas (strategic and policy framework, health coverage priorities, organizations and management systems, Health financing, access and demand, private sector and asset & supply management) and suggest measures to strengthen and sustain the reform process on the basis of secondary data including various reports, studies, database, and documents related to HSDI, in-depth consultations with multiple stakeholders at all levels of health care system, and field trips to three districts. The review spelt out the potential strengths and weakness of the initiative and provided the key stakeholders with a set of recommendations to strengthen the process.

Capacity assessment study of NGO partner's on Plan India's country programme framework (CPF) for health

Agency:PLAN International, New Delhi

Project Team:L.P. Singh, Nutan Jain, Saumya Verma, Preeti Bajaj

The study aims at critically analyzing health and survival challenges that threaten the lives of children and women in the project areas of the Plan and its partners' involvement, contribution and support towards realizing the Plan's health objectives. The specific objectives are: a) to identify and map health challenges and opportunity to work for achieving optimal health in the project areas; b) to assess and report partners' (health department) current capacity and future needs of the project both in terms of technical and managerial sectors; c) to explore opportunities to coordinate with the government services in the project areas to supplement their efforts and developing synergies; d) to explore possibilities and opportunities for linkages / partnerships with the key stakeholders; e) to identify professional institutions in India (national and regional level) with whom the Plan's partners can have linkages for learning, sharing and networking as long-term partnership; and f) to make suggestions for further improvement of the projects, coordination and capacity building needs and their redressal.

Study of cardio vascular disease related life Agency

Agency:ICMR, New Delhi

Project Team:S.D. Gupta, Neetu Purohit, Surabhi Arora, Mittu Muthu Varghese

Cardiovascular disease is a major cause of morbidity and mortality in the world today and will become the leading cause of death and disability worldwide by 2020. India is undergoing a rapid health transition associated with a rising burden of cardiovascular diseases. In India, WHO and its collaborators such as ICMR and IC Health are in the process of surveillance studies identifying non- communicable diseases risk factors in the population in which cardiac diseases play a part. As part of this activity ICMR entrusted IIHMR with the task of understanding a study on cardiovascular diseases and related life

A community survey in five states for understating the community dynamics for success of community based projects

Agency: Micro Insurance Academy, New Delhi

Project Team:Santosh Kumar, Arindam Das, N.D. Sharma, S.P. Chattopadhyay, Nilesh Wavare, Khatirbur Rahaman, Rohit Jain, Manoj Soni

The aim of the survey was to understand the underlying processes of 'community dynamics' that drives 'success' in each case, and gather how those features can be incorporated while providing community micro- insurance. A household survey was conducted in six districts, namely Churu (Rajasthan), Pithoragarh (Uttrakhand), Jhobua (Madhya Pradesh), Wardha (Maharashtra), Ganjam (Orrisa) and Sundergarh (Orissa). Case studies were also conducted on collective action in different domains. The key domains included as water management, agriculture, education, livelihood, health etc

PEHLI PEHCHAN: Mobilizing deprived section of society for universal birth registration in Rajasthan

Agency:PLAN International/ Plan India, New Delhi

Project Team:Nutan Jain, Suchitra Godara, Rajpal Singh Yadav

The initiatives for mobilizing Civil Society for Universalizing Birth Registration in Rajasthan from January 2006 have resulted in increased awareness of the importance of birth registration. As per the Mid-term Evaluation report (2008) one of the challenges mentioned is that registration services in rural areas need to be strengthened. To reach the most vulnerable children in rural areas the focus must be on the registration of domiciliary births, on low performing districts, blocks and villages. The focus must be given to children from socially excluded communities like Nuts, Bhils, and Banjara s who live on the margins of the society. The potential birth registration of a child should influence or should be influenced by different events that occur from the child's birth until the age of five. Early childhood services may provide an access point for registration, and the likelihood that the child is registered might be related to institutional delivery, vaccination, supplementary nutrition, and early childhood education.

After successful implementation of the birth registration initiatives in eight districts of Rajasthan, the Plan India has decided to continue working on the project activities in eight districts (Bhilwara, Bikaner, Churu, Jhunjhunu, Jodhpur, Karauli, Nagaur, and Pali) of Rajasthan focusing on the most deprived section of the society. The objectives are as follows: a) to analyze birth registration situation among the communities of deprived section of society; b) to create awareness of birth registration among the communities of deprived sections of society; c) to facilitate birth registration of all the children born during the project/ reference period among the communities of deprived section of society; and d) to facilitate birth registration of all the children aged below 10 years of the communities of deprived section s of society.

Assessment of health and education programme interventions supported by Lakshmi and Usha Mittal Foundation in Rajgarh block of Churu

Agency:Lakshmi and Usha Mittal Foundation

Project Team:Neetu Purohit, Nilesh wavre, Preeti Bajaj

The study was carried out to assess the interventions in the field of health and education by Lakshmi and Usha Mittal Foundation (LUMF). The specific objectives of are as follows: 1) to assess the level of awareness of the community with regard to the activities carried out in the field of health and education; 2) To assess the interventions carried out in the project area to improve the health status; 3) to evaluate the interventions carried out the education field to improve the educational level; 4) to review the aptness and utility of the scholarships and other assistance being provided to needy students; 5) to compare the project driven services with the government run services; and 6) to make recommendation for improving the services. The study findings indicated an impressive status of the health and education indicators on which LUMF was working.

Data quality assessment of MIS implemented at the network of PLHIVs

Agency:Population Foundation of India

Project TeamNeetu Purohit, Sunita Nigam, Vidhya Bhushan Tripathi, Nilesh Wavare

The Global Fund and Population Foundation of India (PFI) have signed a grant agreement to implement the project 'Promoting Access to Care and Treatment (PACT)' programme in eight highly vulnerable states: Uttar Pradesh, Madhya Pradesh, Rajasthan, Gujarat, Bihar, Chhattisgarh, West Bengal and Orissa. This program offers care and support services to People Living with HIV/AIDS (PLHIV). PFI, being the principal recipient, disburses the allocated fund to sub-recipients i.e. INP+, HLFPPT and CBCI to implement the programme in their respective geographical areas. With a view to monitoring the programme, PFI had developed an MIS for the networks functioning in the selected states and districts. MIS audit was conceived to use it as a mechanism for assessing the quality of programme data and assist sub-recipients to improve quality of their reporting. Specifically, MIS audit was carried out to meet the following objectives: 1) to check the reliability of the data recorded in the reports with regard to their accuracy and consistency; and 2) to check the validity of the clients by verifying the authenticity of the enrolled PLHAs.

State project implementation plan for ICDS IV, Rajasthan

Agency: UNICEF, Rajasthan

Project Team:Neetu Purohit, Preety Sharma, Manish Kumar

The major objectives of the assignment were to critically review and analyze the performance of ICDS III and to identify and prioritize the programme implementation to be addressed in ICDS IV for Government of Rajasthan. The State Project Implementation Plan for ICDS IV was prepared using logical framework approach in consultation with UNICEF and Department of Women and Child Development. ICDS IV aims at accelerating action in a 'Mission Mode' to improve the nutritional and health status of children 0-6 yrs and women, by providing a package of six services comprising of supplementary nutrition, early childhood education (pre-school education), nutrition and health education, immunization, health check-up, and referral services to the children below six years and pregnant women and lactating mothers

District level household survey -3 (DLHS-3): Rajasthan, Punjab and Chandigarh under RCH Programme

Agency:Ministry of Health and Family Welfare, Government of India/IIPS, Mumbai

Project Team (Punjab and Chandigarh):J.P. Singh, N.D.Sharma, Khatibur Rahman Arif, Vidya Bhushan Tripathi, Richa Pandey, Aparna Vaidya, Rohit Jain, Mukesh Gehalot

The district level household survey under reproductive and child health programme was designed to provide information on population, reproductive and child health, immunization, family planning, reproductive tract infection/ sexually transmitted infections, human immuno deficiency virus/acquired immunodeficiency syndrome and women's health status. The survey involved interviewing a randomly selected group of ever-married women who were between 15 and 49 years of age and unmarried women who were between 15 and 24 years of age. IIPS was the nodal agency to design and co-ordinated this large-scale demographic and health survey. IIHMR was identified as the regional agency for Rajasthan and Punjab & Chandigarh for conducting the survey, which included mapping and house-listing of selected areas, administering the questionnaires and gathering information from government health facilities and households. The field work and data collection has been completed. Data analysis and preparation of fact sheet is under progress for Punjab and Chandigarh. The fact sheet has been submitted to IIPS for final approval.

Assessing the role of NGO partners in UNICEF assisted project - Gramshakti and behaviour change communication in Tonk district

Agency:UNICEF, Rajasthan

Project Team:Neetu Purohit, Vidhya Bhushan Tripati, Nilesh Wavare

To improve the quality of life of women and children of Tonk district in Rajasthan, UNICEF, in partnership with the government, the NGOs and the like-minded institutions, is on its way to carry forward the reform processes cross cutting all sectors and initiating an action oriented programming through proactive participation of the rural communities. The Gramshakti project has ended and Behaviour Change Communication project is being implemented by almost the same NGOs which implemented Gramshakti project from 2005 onwards. The study was conducted with the following objectives: 1) to undertake desk review with respect to the studies conducted on the subject and in the field area in the past; 2) to assess the status of the key indicators among the target community; 3) to explore the extent to which behaviour change could occur among the beneficiaries; 4) to assess the effectiveness of the NGOs with respect to the desired performance; and 5) to make recommendations on the future course of action in supporting BCC partnerships.

Measuring patient satisfaction at public health facilities in Madhya Pradesh: a research study under quality assurance project

Agency:Directorate of Health Services, Government of Madhya Pradesh

Project Team:P.R. Sodani, Rajeev Kamal Kumar, Jayati Srivastava, Manoj Soni

The objective of the study was to measure patient satisfaction at public health facilities in the State for improving the quality of health care services. In all, eight districts were selected, one from each division of Madhya Pradesh. From each district, a sample of public health institutions was selected to measure the patient satisfaction. In total, 1121 patients were interviewed including 561 outdoor patients, 280 indoor patients and 280 patients utilized investigative facilities. In-depth interviews of hospital administrators and service providers were also conducted. A detailed report has been submitted to the Government of Madhya Pradesh to use the study findings in improving the quality of service at public health facilities.

The study showed that quality of health services in public hospitals was poor and the level of patient's satisfaction was also low mainly because of poor public health infrastructure, lack of skilled human resources, weak communication among staff as well as with patients. The patients were also not much satisfied with the in-door and investigation/diagnostic services provided at the public health institutions. The major recommendations of the study to improve patients' satisfaction at public health facilities were as follows:

  • Improving the infrastructure including building and other basic amenities
  • Improving skilled manpower in the public health facilities
  • Proper equipment and furniture in the health facilities in adequate number
  • Improving the quality of OPD, IPD and investigating services
  • Capacity building of MOIC/hospital superintendents
  • BCC training to the medical and para-medical staff
  • Reducing the work load from technical and nursing staff
  • Internal quality measurement mechanism for taking care of the hospital performance and patient satisfaction at regular intervals.

Technical Support Unit for Rajasthan State AIDS Control Society (RSACS)


Project TeamAlok Mathur, N.K. Godhara, Pritam Pal, Suresh Tehliani, Sunita Nigam, Hemant Mishra, Anil Bahuguna, Ashuthosh Sharma, Rohit Jain, Mukesh Gehalot

For effective implementation of National AIDS Control Programme in the State of Rajasthan, UNFPA and NACO have entrusted IHMR with the task of providing technical support to the Rajasthan AIDS Control Society. For this purpose, a well-equipped Technical Support Unit has been established at IHMR. It is providing support to Rajasthan State AIDS Control Society. The key areas for technical support include targeted interventions, capacity building, promoting public-private partnership, and strategic management.

Under strategic management, the TSU has developed the Annual Action Plan for 2008-09 for the State. Now the plans for high priority districts will be prepared with the district authorities. A strategic paper for involving two private hospitals in priority district for starting ICTC services is underway.

The technical support unit is preparing modules and training manual for different personnel working in and with RSACS for HIV prevention, care and support. A training calendar for the year 2008-09 for RSACS has been developed by TSU. One of the important tasks of TSU is to monitor the quality of the training.

Independent assessment of NGOs working in the RNTCP

AgencyCentral TB Division, MoHFW, Government of India

Project Team:L P Singh, Nutan Jain, Preeti Bajaj and Aparna Vaidya

The objectives of the study were: a) to assess the overall capacity and contribution of NGO to overall performance of RNTCP to establish relevance of the NGOs involvement to the mandate of TB control program at the district level; b) to study the scheme components under the program, its planning, implementation, monitoring, evaluation and efficacy; c) to review organizational structures of NGOs involved for RNTCP; d) to assess staffing (both technical and managerial) pattern in the NGO in line with prescribed procedure and norms; and also to assess requirements for efficient and effective project implementation; e) to assess competency and performance of the staff involved under RNTCP against the given roles and responsibilities at the NGO level; f) to review the management information system (recording and reporting mechanisms) as per RNTCP guidelines; g) to assess the utilization of program funds and fund management at the NGO; h) to evaluate coordination mechanism with the district program cell; and i) to recommend suitable changes in the program strategy, if necessary. Four states, namely Andhra Pradesh, Jharkhand, Rajasthan and Uttar Pradesh were covered under the study. The consultations were conducted with the Central TB Division, State TB Office and District TB Offices and a group of selected NGOs working with the Central TB Division.

All the NGOs visited during the assessment were working in relatively poor areas and stated that their mission was to serve the poorest strata of the society. It was observed that the documentation of the planning was almost non- existent. The DTOs are technical persons by training and they give higher weightage to the clinical component. The monitoring was perhaps the strongest part of the RNTCP and it worked really well. The strong point of the community awareness was in the form of informal contacts with the community and home visits. This was claimed to be a successful model and was reportedly working well. The fund flow and its utilization also varied from state to state. In some states there was considerable delay in the release of funds to the NGOs whereas in others it was promptly released. There was good coordination between the NGOs and DTC.

Review and revision of medical manual of Madhya Pradesh

Agency:Directorate of Health Services, Government of Madhya Pradesh

Project Team:P.R. Sodani, G. S. Sachdeva, Laxman Sharma

The existing medical manual of the state had been reviewed and a report was submitted to the state government. After reviewing the existing medical manual of the state, in- depth consultations were carried out with the policy makers and state level officials on various issues pertaining to the existing medical manual and scope for improvement. In addition, the manuals of other states were also reviewed. The draft of the revised medical manual was presented and submitted to the Government of Madhya Pradesh for final approval.

Sharpening strategies: a situation analysis of targeted intervention for home based sex workers in Pali district, Rajasthan

Agency:Rajasthan State AIDS Control Society, Government of Rajasthan

Project Team: Alok Mathur, Hemant Mishra, Sunita Nigam, Ashutosh Sharma

For systematizing and sharpening the strategies of the existing Target Interventions of the Rajasthan state a situational analysis of home based sex workers in Pali District was carried out by TSU, IIHMR for effective HIV prevention planning. The report has been shared with Rajasthan State AIDS Control Society. This will help RSACS to develop and implement appropriate and context specific strategies for risk reduction, vulnerability reduction and in the district. The report also suggested how the NGO currently working with targeted population should roll out after developing a community based organization.

Baseline survey of PAHEL, Bihar

Agency:CEDPA India, New Delhi

Project Team:L P Singh, Nutan Jain, Manish Kumar, Preeti Bajaj, Manoj Soni

CEDPA India intended to pilot a community based women's leadership program in the two blocks, namely Punpun and Masaurhi of Patna, Bihar, with the financial support from the David and Lucile Packard Foundation. The agency intended to initiate a two-year project on sexual and reproductive health (SRH) services with two major objectives: a) to build the capacity of women Panchayat representatives at the district, block, panchayat and village levels to change them as agents in advocating, supervising and monitoring community health initiatives, especially those focusing on SRH services for young women and young couples, thereby responding to the demand for quality youth-friendly SRH services; and b) to strengthen the SRH services delivered by health providers at the government run health facilities by enhancing their capacity and making them youth friendly.

IIHMR was entrusted with the task of carrying out a baseline survey for the project. The focus was on the existing basic knowledge on SRH services among various stakeholders. The respondents included 500 youth men and women, 100 women Panchayat representatives, and about 50 heath service providers at sub-centres, additional PHC and block-PHC levels. Along with knowledge assessment of stakeholders and their present involvement on SRH issues, the Institute also conducted facility assessment of all the government-run medical facilities in both the blocks and the training need assessment of health workers and doctors working in those facilities.

Reviewing and Redesigning of Village and Sub-Health Center Level Records

Agency: Directorate of Health Services, Government of Madhya Pradesh

Project Team:Suresh Joshi, Santosh Kumar, Hemant Mishra, Parthasarthi Datta

To strengthen maintenance of sub-center level health records and registers in Madhya Pradesh, IIHMR worked closely with the Department of Public Health and Family Welfare, Government of Madhya Pradesh. Guna district of Madhya Pradesh was selected for piloting the project. The overall objective of the pilot study was to review all records and reports generated under various programmes at different levels in consultation with different stakeholders to design the requisite records and report formats, which ensured ease of data capture and its use by the concerned functionaries.

Based on the findings of the record review, IIHMR designeda "Daily Service Diary" with supportive reporting format and a "Village Register". A three-tier training programme was designed and implemented for the district officers, supervisors and health workers. Sufficient numbers of logistics were provided to the health workers for four months through the Block Medical Officer. To build the capacity of the health workers regarding new tools, monitoring and supervisions were made for three consecutive months.

Aakash Ganga : Roof top rain water harvesting

Agency:World Bank's Development Marketplace and RANA

Project Team:Goutam Sadhu

The objectives of the Aakash Ganga project are to develop rainwater harvesting structure in an economically viable, self-sustainable manner with a community ownership and to develop a system to use the overflows of rooftop rainwater harvesting structure which would meet the drinking water need as well as generate income for O&M. The institute has been identified as a nodal agency for implementing through various NGOs partners.

The scheme has been implemented in 3 villages of Churu and Jhunjhunu districts. 118 households' tanks and 4 village tanks have been constructed in which community and local donors contribute around 30-50% of the construction cost.

The major outcome of the project are as follows: a) It offers a reliable alternative in absence of ground water and surface water. Typical water storage capacity 10 liters/ person/day or 300,000 ' 400,000 Ft3 per village; b) It modernizes the quotidian ingenuity and centuries-old traditions to ensure cultural and social sustainability; c) It builds public-private-community partnership in which community the contribute 30-40% in construction cost. Local governments contribute 100,000 Ft2 land for revenue generation; d) It weans people away from the 'free water' entitlement mindset; e) It ensures flow of capital, management and technology through a two-tier social enterprise structure; f) It frees up girls and women from the daily chore of fetching water to pursue education and to be productive members of society.

The extension of the project to 70 villages is under active consideration by Government of Rajasthan.

Mapping of health facilities in Madhya Pradesh

Agency:Directorate of Health Services, Government of Madhya Pradesh

Project Team:P.R. Sodani, Rajeev Kamal Kumar, Laxman Sharma, G. S. Sachdev, D. S. Surybanshi, Abha Richhariya, Uma Shankar Shukla, Aparna Vaidya, Rohit Jain and Manoj Soni

The major objective of the study was to conduct mapping of public and private health facilities in all the 48 districts of Madhya Pradesh. This was perhaps the first of its kind in the state which provides a comprehensive picture of public and private health facilities in the districts and contains vital information on location, operational timings, type and ownership pattern, availability of services, physical infrastructure, wards and beds, diagnostic services, major equipment, human resources, level of utilization of basic services and structure of fees and charges. The present database would be very useful for effective micro planning and better implementation of national health programmes. It would also help in assessing availability of services, duplication or overlapping between the public and private facilities, identifying the underserved areas to quantify the level of additional investment required and relocating of existing facilities for achieving better efficiency. The information would also facilitate public-private partnerships (PPP) in implementing various health programmes for better health outcomes. The district level reports of all the districts have been submitted to the Government of Madhya Pradesh.

Baseline survey for Sure Start project in Uttar Pradesh

Agency:PATH India, New Delhi

Project Team: R.S. Goyal, N.K. Sharma, S.P. Chattopadhyay, N.D. Sharma, Surbhi Saxena, Rajeev Kamal Kumar, Swati Roy, Janisar Akhtar, Manoj Soni

In order to improve the maternal and newborn health (MNH) in rural Uttar Pradesh, PATH India had undertaken the study namely Sure Start. The objective of the study was to carry out the baseline evaluation of MNH to develop an understanding of the ground situation as well as to evolve benchmark to assess outcome of interventions. Both quantitative as well as qualitative data were collected under the project. A total of 14000 eligible women in the reproductive age groups were interviewed from 700 villages in seven districts of eastern part of Uttar Pradesh. The information sought from them were on socio-economic characteristics, pre-natal, natal, and post-natal care practices, awareness and participation in socio-economic development activities in the villages. The qualitative data were collected from the different stakeholders, such as community health providers, community leaders, NGOs functionaries etc.

The project was successfully completed in the year 2008-2009. The final report of all the seven districts, namely Balrampur, Basti, Gorakhpur, Hardoi, Rae Bareli, Jaunpur, and Kanpur Dehat and the combined report for the state of Uttar Pradesh were prepared and submitted to the PATH India, New Delhi.

End Stage Renal Disease (ESRD) is a life threatening condition which is closely associated with diabetes and heart disease. Due to high and rising prevalence of these diseases in India, incidences of renal failure are on rise. It is estimated that in India more than 100,000 persons suffer from ESRD each year. There is a general lack of awareness of the disease, its treatment options, inadequate access to care and, above all, affordability in the society. Direct costs of HD and PD are easily available, but currently there are no studies in India that have analyzed the direct and indirect costs of the two therapies over the lifetime of individuals. The unit costs of each method, as well as the personal costs are important pieces of information, not only for patients, but also for policymakers, both in and outside the government who can make a difference to the current treatment-seeking scenario of ESRD

Preparation of district action plans under NRHM for Rajasthan

Agency:Department of Medical, Health and Family Welfare, Government of Rajasthan

Project Team:P.R. Sodani, Laxman Sharma, N. D. Sharma, Hemant Mishra, Santosh Kumar Sharma, Jayati Srivastava, Manoj Soni

IIHMR provided technical assistance in developing District Action Plans under NRHM to Government of Rajasthan. The District Action Plans had been prepared in consultation with the district health mission and district health society for a period of five years from 2007-08 to 2011-12. The process involved stakeholders consultations at block level, and village consultations, facility survey for need identification was carried out and priorities were decided in consultation with the district health society. The District Action Plans were reviewed and approved by the respective district health mission and district health society. The revised and modified plans have been submitted to respective district health mission and district health society and are in the process of getting final approval. The Institute prepared prototypes and then prepared plans for Bundi, Kota, Tonk, Sawai Madhopur and Karauli districts.

Assessment of sex ratio of 0-6 years children in Alwar, Jaisalmer, Jhunjhunu, Pali and Ganganagar districts of Rajasthan

Agency:Government of Rajasthan, SIHFW

Project Team:N.K. Sharma, M.K. Rehman, Abha Richariya, Vidhya Bhushan, Rohit Jain and Manoj Soni

The objectives of the present study were : 1) to assess the sex ratio of 0-6 years age group and compare it with the reported figures in Census 2001; birth registration figures; and data available with the Department of Health and Family Welfare; 2) to explore the reasons for declining/ increasing sex ratio among 0-6 years age group; 3) to enlist organizations registered for a genetic counseling center/ genetic laboratory/genetic clinic/ ultrasound clinic/ imaging center; 4) to assess knowledge of PCPNDT Act; attitude towards use of pre-natal diagnostic techniques for detection and determination of sex; practices prevailing in the community, service providers and other appropriate authorities; 5) to find out the reasons of preference of male child; and 6) to assess impact of adverse sex ratio on socio - cultural conditions of the community. The selection of districts was done purposively on the basis of the difference in increase and decrease in sex ratio during the previous decade.

The study covered various stakeholders like community, medical officers, health workers, district and state level officials to explore the reasons for the decline/increase in sex ratio among 0-6 years children, their knowledge of PCPNDT Act, views on the sex ratio imbalance in the society, responsibility of the misuse of technique, suggestions to removing the individual and social barriers which deny the right of birth to a girl, etc.