Karnataka State Reforms and Development Project (KHSRDP) Health Facility Survey 2011
Research Team:Dr.Fehmida Visnegarwala, Dr.Veena R, Dr.GV Nagaraj, Dr.Vinay Tripathi, Dr.Srinath V, Dr.Varun Sharma
IHMR Bangalore has shouldered the responsibility of completing the field level work Health Facility Survey in 18 Districts in Karnataka as part of KSHDRP/ICRA project. IHMR successfully completed evaluation of 18 districts’ health care facilities in Karnataka state and the report has been forwarded for the same. This survey comprises both pubic (sub centers, PHCs, CHCs, taluka level hospitals and district hospitals) and private (private nursing homes, hospitals and clinics) health care facilities. IHMR, Bangalore has co-developed the instruments, the manual for the field survey, developed the material for training for the field workers, completed the study and will have substantial inputs in the report writing as well. This study is expected to capture gaps in terms of both availability and functionality of health delivery system and help in formulating a targeted action plan. This field level study will be instrumental for future planning for the KSHDRP projects.
Total Management of Primary Health Care and RCH under PPP in Karnataka– An End line Evaluation
Agency: Population Foundation of India (PFI)
Research Team: Dr. Vinay Tripathi, Dr. Fehmida Visnegarwala, Dr. G.V. Nagaraj, Dr. Varun Sharma, Dr. Veena R, Dr. Srinath V , Dr.Rajeshwari, Dr. Ramya
The project “Total Management of Essential RCH & Primary Health Care through Public–Private Partnership” is a Public-Private Partnership (PPP) initiative, which was implemented in six districts of Karnataka, namely, Bellary, Bagalkot, Raichur, Bidar, Gulbarga, and Bijapur by the Karuna Trust from May 2006. The Population Foundation of India (PFI) supported this project. The project covered 1, 87,904 spread across 159 villages of seven taluks of 6 districts through seven PHCs. IHMR-B carried out the endline evaluation of the project to assess the outcome and impact of the project among the targeted population in 6 districts of Karnataka.
A Study on Knowledge, Attitude and Behavior Intention Change of the Participants of One Life Experience (OLE) towards People
Agency:World Vision India, Chennai
Research Team:Dr.Fehmida Visnegarwala, Mr.Varun Sharma, Dr. Priya Thomas, Mr.Srinath Reddy
OLE is a story telling tool on the real life stories of CLHIV, to create knowledge, awareness about HIV, and an initiative to change attitude & behavior intentions towards PLHIV, statistical sign of OLE tool was evaluated with the help of pre and post OLE tool exposure self administered questionnaire by respondents. 336 respondents participated in study based on the data collected attitude index & knowledge index pre and post OLE exposure was constructed. Statistically which shows that knowledge index score and attitude index score significantly increased post OLE exposure. Hence a good imitative to sensitize the messes about HIV issue and has potential to be scaled up.
Short Programme Review of Child Health in Karnataka
Agency:WHO, India Office
Research Team:Dr.Fehmida Visnegarwala, Dr G V Nagaraj, Dr Usha Manjunath, Dr Vinay Tripathi, Dr Bhavana Naik, Dr Veena R
We at IHMR Bangalore achieved a landmark in the maternal and child health in Karnataka by organizing and conducting a workshop as per a globally utilized package for 'Short Program Review' of Child Health Program (SPR-CH) sponsored by the WHO. The SPR_CH signifies the spirit of team work, inter-sectoral coordination and in-depth data driven processes to achieve the larger goals of Millennium Development. The 3-day workshop brought together 50 maternal and child health stake-holders including: the Government of Karnataka, state program officers and managers, district health officers, Government of India officials, officials from developmental partners such as WHO, UNICEF, prominent academicians, NGOs and researchers from the state. The pre-workshop data population for SPR-CH was done by IHMR-Bangalore. SPR-CH was held in February 2011 in IHMR-Bangalore. SPR-CH adopted a systematic participatory approach consisting of 7 sequential steps completed in three consecutive days unlike earlier workshops in Rajasthan and Bihar. The Workshop was a grand success as it helped the participants review available data using multiple methods and decide how well the programs have implemented child health interventions; and based on these findings, they defined the main problems for further analysis, and identify feasible solutions and decide on next steps to include these solutions in the program for this and coming year’s Program Implementation Plan (PIP). This was a ground breaking and momentous contribution of IHMR, Bangalore’s to child health in Karnataka. Moreover, learning and experience sharing from SPR-CH for Karnataka would also help benchmark the process for other states in India.
JSS Hospital Manpower Planning
Agency:JSS Hospital, Mysore
Research Team: Dr.KSS Rao, Dr. Fehmida Visnegarwala, Dr.Bhavana Naik, Dr.Ravi, Dr.Veena
Manpower is one of the most important resources utilized in an organization to achieve its objectives. In most of the hospitals, manpower consumes about 50 – 60% of its budget. Therefore, it is of paramount importance that the manpower is utilized optimally. IHMR-Bangalore assessed existing manpower and its efficiency in the currently functioning 1150 bedded JSS hospital in Mysore through a series of interaction and work assessment. IHMR team comprising of experts in the healthcare sector estimated the manpower requirements for their upcoming 1680 bedded hospital, improve the efficiency and effectiveness of the staff to better the performance and the reputation of the hospital.
Final and Mid Term Evaluation of Urban Slum Health Project in Sambalpur under Public-Private Partnership Initiative of NRHM-Orissa
Research Team:Dr.Vinay Tripathi & Dr. K S Srinivasa Rao
Orissa Urban Slum Health Care Project is one of the PPP initiatives of NRHM which is targeting urban slums. Under the initiative, NRHM Orissa in close coordination with Department of Health and Family Welfare, Orissa has been supporting NGOs to establish Urban Health Centers in different municipalities. The Urban Health Centers mainly focuses on three major components, namely, service delivery, community mobilization, and Behavior Change Communication. IHMR- Bangalore was entrusted with the responsibility to assess the impact of the Urban Slum Health Project based on the input and process indicators supplemented by outcome indicators available from the baseline survey, performance reports and other records of health centre and project.
Rapid Assessment of IMNCI in Karnataka, Consultant Team
Research Team:Dr.Fehmida Visnegarwala, Dr. Suresh Joshi, and a Team from UNICEF and NRHM Karnataka
A rapid assessment of IMNCI in select districts in Karnataka was done with a team comprising of consultants from UNICEF, SIHFW, NRHM and IHMR Bangalore, IIHMR Jaipur. This assessment helped the Government of Karnataka to understand status of IMNCI implementation in field and identify the gaps if any; so as to take necessary steps for further strengthening its implementation all across the state. The recommendations from this project were disseminated to the NRHM which helped in assessing knowledge and skills of Health and ICDS workers/supervisors using IMNCI protocols; the support provided by the health and ICDS systems to frontline functionaries in terms of trainings (initial and refresher), maintenance of supplies, record keeping, and supportive supervision and identify good practices, gaps and bottlenecks in implementation and prepare a follow-up action plans to improve the implementation in these 4 districts as well as in other districts.
External Evaluation of Mobile Health Clinics under Karnataka Health Systems Development and Reforms Project (KHSDRP)
Research Team:Ms.Veena Nair, Dr.KSS Rao, Dr.Bhavana Naik, Dr. GV Nagaraj, Dr.Vinay Tripathi, Dr. Fehmida Visnegarwala
Mobile Health Clinics (MHC) is one of the innovative endeavors planned to serve the underserved, unreached and the tribal areas of Karnataka. The project aimed at increasing demand for, access to, affordability of and utilization of public and private health services, particularly in underserved area and amongst vulnerable groups. In the first phase, this project was operationalized into five taluks to evaluate various dimensions / factors, related to accessibility, affordability, demand and utilization of health care facilities. Mix methods (Quantitative and Qualitative) were used for the purpose of evaluation and information drawn from both primary and secondary data. Findings suggested that MHC has been of great benefits to the poor, remote, hilly, forest and inaccessible areas. MHC successfully helped to generate the demand for health care in those areas. MHCs had been able to reach out to marginalized population and vulnerable groups. IHMR research team successfully identified institutional, organizational and operational gaps, constraints and bottlenecks that impede the implementation of MHC programme.
Social Assessment under Health & Nutrition Project
Research Team:Dr. GV Nagaraj and the team at IHMR Bangalore
IHMR-Bangalore has successfully completed the social assessment study for Karnataka Health Systems Development Project with support from World Bank. This study was of vital importance as it emphasized on the needs and health status among the vulnerable communities. Study focused on identifying health status needs, accessibility and affordability of existing health facilities and barriers thereon. As the title suggests, it was a qualitative study based on focused group discussions, in-depth interviews and case studies to assess the perception of vulnerable communities towards their health problems, availability and utilization of health care facilities. Study used a systematic stratified sampling frame. This study had successfully identified the barriers and gap in implementation of health care related facilities and perception of locals towards the health related issues/problems and faith in public health facilities. Study, under the able stewardship of researchers and experts, proposed various intervention strategies.
Evaluation of the first phase of SANKALP-Karnataka Project
Agency:Hindustan Latex Family Planning Promotion Trust
Research Team:Prof. NSN Rao, Dr.Vinay Tripathi and Dr.Bhavana Naik,
The past one decade has witnessed significant initiatives for the prevention and control of HIV/AIDS in the country. To a large extent these initiatives have been successful. One such initiative is Project Sankalp of Employee State Insurance Corporation (ESIC). The secondary data of the VCTC centers of ESI hospitals indicated high prevalence of HIV which is as high as 2 percent among general population coming for voluntary testing. Since attendees in ESI are from industries, this called for urgent attention for prevention of HIV among the ESI insured persons and their families. Along with the HIV prevention strategies, it was also envisaged to focus on the RCH component under the project. Accordingly, the ESIC and Hindustan Latex Family Planning and Promotion Trust (HLFPPT) came together and the Sankalp Project was evolved in Karnataka with the goals of reversing and halting the spread of HIV infection in the country and contributing towards the NRHM goals of reduction in TFR, IMR and MMR
The first phase of the Project was over in November 2009 and HLFPPT intended to have an evaluation of the Project. The services of Institute of Health Management Research (IHMR), Bangalore were hired to conduct the evaluation of the first phase of the Project in December 2009. A detailed evaluation report was prepared and submitted to HLFPPT.
Mid-Term Evaluation of Functioning of two PHC’s under Public-Private Partnership in Ganjam and Mayurbhanj district of Orissa
Research Team:Dr.Vinay Tripathi , Dr.K S Srinivasa Rao, Dr. Fehmida Visnegarwala
NGOs under the PPP mode were managing PHC (N) Rahada and Gadigaon for over a year. National Rural Health Mission, Orissa decided to have a midterm evaluation of these two PHCs (N) in order to review its functioning. Accordingly, the services of Institute of Health Management Research (IHMR) – Bangalore were hired and the Institute was entrusted with the responsibility of evaluating Rahada and Gadigaon PHC (N). The domains such as infrastructure, ambulance, pharmacy and drugs, service delivery, etc. were explored during midterm evaluation. A detailed evaluation report was prepared and submitted to NRHM Orissa.
Evaluation of PHC – Bhadrak District under NRHM, Government of Orissa
Agency: NRHM, Orissa
Research Team:Dr.Vinay Tripathi & Dr.K S Srinivasa Rao, Dr. Fehmida Visnegarwala
IHMR Bangalore assessed the impact of PPP on basic RCH and other health indicators. Assess the quality of management functions and systems at the PHCs introduced by NGO and single out best practices for scaling up. Assess the relative quality of services delivered and impact of capacity building efforts under the project. Review the existing evidence, MIS, quality of documentation etc. and to suggest improvements to improve the quality of evidence. Assess the community governance mechanisms and level of community involvement and approval of the model: could the model build ownership of the community. Assess the perceptions of various district, taluk and ZP/Panchayat level stakeholders about the model. Assess the scalability of specific components of the model and suggest specific components which can be taken up for scaling up. Conduct a Strengths Weaknesses Opportunities Threats (SWOT) analysis of the model in terms of scalability and provide recommendations if required.
Final Evaluation of MNGO/FNGO Programme under RCH-II in Jharsuguda Districts
Research Team:Dr.Vinay Tripathi , Dr.K S Srinivasa Rao, Dr. Fehmida Visnegarwala
MNGO – FNGO Program is a key intervention of the government under PPP as it caters to the needs of the neediest section of the population living in most inaccessible, un-served and underserved areas. The involvement of NGOs in delivering Reproductive and Child Health (RCH) services in such areas is the essence of the programme. The Department of Family Welfare in the Ninth Five Year Plan (1997-2002) introduced the Mother NGO scheme under the Reproductive and Child Health Programme. Under this scheme, the Department of Family Welfare identified selected NGOs called Mother NGOs in allocated district/s and sanctioned grants to them. These MNGOs, in turn, issued grants to smaller NGOs, called Field NGOs (FNGOs), in the allocated district/s. The grants were primarily meant to be used for promoting the goals/objectives of Reproductive and Child Health (RCH) Programme of Government of India. The role of the Mother NGO scheme has been one of nurturing and capacity building. Under RCH-II programmes, 12 Mother NGOs (MNGOs) through 54 field NGOs (FNGOs) are implementing RCH-NGO programmes in 13 districts. The main objective of the project is to address the gaps in the RCH service delivery in selected un-served/underserved areas so as to enable such districts/blocks to achieve an overall RCH status equivalent to the average for the State.
Institute of Health Management Research (IHMR) – Bangalore was entrusted with the responsibility of evaluating one of such MNGO in Jharsuguda district of Orissa to determine the effectiveness, outcome and impact of the programme. A detailed report for the same has been submitted to NRHM, Orissa.
Tumkur District Health Management: Swasthya Karnataka
Research Team: Dr.Kishore Murthy, Dr.Bhavana Naik, Ms.Veena Nair
IHMR – Bangalore, Institute of Public Health (IPH), Karuna Trust (KT) & St. John’s Research Institute approached the Government of Karnataka to pilot a capacity building programme in five districts of the state. The government approved this proposal and through a government order we were given permission to build the district health management capacity in the districts of Karnataka with Tumkur as a pilot project.
Baseline Evaluation of Four PHCs in Jewargi Taluk, Gulbarga District
Agency: Dharam Singh Foundation, Jewargi, Gulbarga
Research Team:Dr. Kishore Murthy and Ms. Preety Iyer
Dharam Singh Foundation is in the process of taking over the management of two PHCs in Jewargi taluk in Gulbarga district. In this context the Foundation requested Institute of Health Management Research (IHMR), Bangalore to conduct a baseline evaluation of the two PHCs and 2 more adjoining ones to gain an insight into the current status of the PHCs
Baseline Evaluation of Quality of Care in Secondary Care Hospitals in Districts of Tamil Nadu jointly with Ma Foi, Chennai
Agency: Tamil Nadu Health Systems Project (TNHSP)
Research Team: Dr. Hari Singh, Mr. Sunish, Dr. Gururaj
The study brought out the gaps and shortcomings in service provision and development of quality care indicators in secondary level hospitals in Tamil Nadu. Data collection tools adopted were facility survey inventories, service provider’s satisfaction and patient satisfaction questionnaires, which were used to gather data from 270 hospitals across the state.
External Evaluation of India CLEN
Agency:INCLEN Trust and IndiaCLEN
Research Team:Dr. Hari Singh
An external evaluation of IndiaCLEN, one of the 7 regional networks of INCLEN, was carried out in March 2006 to improve its effectiveness and efficiency in terms of organizational structure and operations.
Public Private Partnership: Evaluation Study of PHC’s taken over by Karuna Trust, Karnataka
Agency: Karuna Trust, Bangalore
Research Team:Dr.GV Nagaraj
Karnataka took a lead and under the concept of Public-Private Partnership (PPP) handed over the management of few PHCs to NGOs. The government provides 75% of the running cost of the PHC and the rest 25% is contributed by the NGO. Karuna Trust is a NGO managing 24 PHCs in Karnataka and PHC Suganahalli is one among them. The objective of the study was to assess the effectiveness of health care services provided at PHC, Suganahalli.
Reducing Vulnerability Caused by HIV/AIDS on Children in Karnataka
Agency: Plan India
Research Team:Dr. HariSingh, Dr. Sunish
In Karnataka, HIV/AIDS program is being implemented by CCF-India in partnership with 14 NGOs covering 263 villages and 39 slums. In order to increase the effectiveness of the program, the CCF-India intends to involve a resource agency that will be responsible for providing technical support to partner NGOs in strategy formulation, planning, and implementation of the project activities; monitoring and evaluation. IHMR was entrusted as a nodal agency to provide technical and program support to the partner organizations of CCF in their HIV/AIDS project in Karnataka.
Evaluation study of R L Jalappa teaching hospital, Kolar
Agency: Dev Raj Urs University, Kolar
Research Team:Dr.Kishore Murthy, Dr.Bhavana Naik
Sri Devaraj Urs Medical College and Hospital was affiliated to Rajiv Gandhi University of Health Sciences. It is approved by the Government of Karnataka and is presently a part of the deemed university. Within a short time the college has made rapid progress academically and has achieved a proud place among the Medical Colleges in the Country. Postgraduate courses in clinical subjects were started in 1997. It is a teaching hospital. The hospital is situated on the national highway NH4. This hospital aims at better care and quality facility to its population. Therefore needs to upgrade the lacunas currently present in their system of faculty, infrastructure and work force.
Assessment of St. John’s Medical College Hospital, Bangalore
Agency:St. Johns National Academy of Health Sciences, Bangalore
Research Team:Dr. Hari Singh
The concepts of “Continuous Quality Improvement” are based on the premise that there is always scope for improvement in an organization. Therefore, it is important to periodically review the performance of the organization. The aim is not to find fault but to improve the performance of the organization and quality of services. St John’s Medical College Hospital is one the most reputed healthcare organizations in India. The management decided to get the evaluation of St John’s hospital done through an external agency and the task was assigned to the IHMR, Bangalore. The Institute carried out a comprehensive assessment to determine the patient and staff satisfaction, quality and cost-effectiveness of different services and to what extent the mission of the hospital has been achieved. The study sample included Governing Board members, administrators, doctors, nurses, para-medical staffs, technicians, aides and helpers. The data were collected through in-depth interviews, focus group discussions, observations, review of records etc. Besides these, the Delphi Technique was used for validation of conclusions and recommendations.
NABH Consultancy – PD Sindhi Hospital, Bangalore and KR Hospital, Bangalore Establishing an Eye hospital in Gulbarga-needs assessment study
Agency:Bhoruka Charities, Bangalore
Research Team: Dr. GV Nagaraj
Mobilizing Civil Society for Universalizing Birth Registration in Karnataka State
Agency: Plan International, New Delhi
Research Team: Dr. Hari Singh, Mr. Sunish
Increase in Female Birth Registration in Gulbarga District – An Exploration of the Reasons and Impact of this Trend
Agency:Plan International, New Delhi
Research Team:Dr. Gururaj, Mr. Prasanna Joshi
Bangalore Healthy Urbanization Project
Agency:WHO-SEARO, New Delhi
Research Team:Mrs. Preety Iyer, Mr. Prasanna Joshi
Universal Birth Registration: Implementation of Universal Birth Registration in 8 Districts of Karnataka
Agency:Plan India, New Delhi
Research Team:Dr. Hari Singh, Mr. Sunish