On-going Research

Background:

There is lack of data regarding prescription practices in India. Given that poor quality prescription practices increases the risk of serious medication errors & health outcomes, a root cause analysis of such in the public and private sector is important to improve health outcomes. While a combination of prescription audit and feedback has been shown to be a successful technique which improves the quality of prescribing, relevant solutions & mechanisms for India need to be charted out based on some of the contextual drivers of prescription practices with a clear pathway to integrate these into the broader functioning of the health system.

Policy Objective:

To promote pharmacovigilance including prescription audit inclusive of antibiotic usage, in the hospital and community, in order to enforce change in existing practices.

Scope of the study:

This thematic area proposes to assess prescription practices in India and help identify bottlenecks, training needs and other factors for promoting rational use of medicines. The areas of research under this theme were narrowed down following due consultation with researchers and their vetting by policymakers. This was to ensure that research undertaken is aligned with academic need while also policy relevant.

Background:

Increase in burden of non-communicable disease is one of the biggest emerging challenge faced by health system in India. Access to affordable medicine is a crucial first line strategy to respond to it. There is a need to delineate factors that impact availability & affordability of NCD/non NCD medications in non-metropolitan & rural areas of India & strategies to improve access to medicines

Policy Objective:

To halt and reverse the growing incidence of chronic diseases. To ensure medication and access for select chronic illness on a ‘round the year’ basis.

Scope of the study:

This thematic area proposes to assess the availability and affordability of NCD/non NCD medicines in non-metropolitan urban & rural India and help identify the gaps in the same. The areas of research under this theme were narrowed down following due consultation with researchers and their vetting by policymakers. This was to ensure that research undertaken is aligned with academic need while also policy relevant.

Background:

Though a wealth of data exists within PM-JAY, the depth of data available and its use to inform programmatic and policy design & monitoring of the scheme remains unclear. It is important to carry out an assessment of available data parameters, potential to use them for deeper analytics and identify gaps in availability of key data metrics that will helps strengthen scheme performance and monitoring

Policy Objective:

To improve health outcomes and reduce out of pocket payments through use of data driven analytics that will help inform scheme design and operations.

Scope of the study:

This thematic area proposes to assess the gaps in PM-JAY insurance information system in order to promote efficient programmatic monitoring and evaluation as well as evidence based planning. The areas of research under this theme were narrowed down following due consultation with researchers and their vetting by policymakers. This was to ensure that research undertaken is aligned with academic need while also policy relevant.

Background:

PM-JAY has played a key role in promoting access to a wide array of hospital services for the most vulnerable section of society. However, patterns of utilization & how they relate to major drivers of disease burden in India is unclear. It is necessary to ascertain the degree to which PM-JAY utilization contributes to addressing India’s disease burden & how it could be shaped to target offering that will cater to these.

Policy Objective:

To assure the delivery of better health outcomes in terms of access, quality, affordability, lowering of disease burden and efficient monitoring of health entitlements to citizens.

Scope of the study:

This thematic area proposes to assess the utilisation patterns under the PM-JAY and to see its effect on the Indian global burden on disease to generate evidence for future improvements. The areas of research under this theme were narrowed down following due consultation with researchers and their vetting by policymakers. This was to ensure that research undertaken is aligned with academic need while also policy relevant.

Background:

The HWC program is India’s main primary health care strategy and aims to provide comprehensive primary health care services to the population. Given one year of its operation, it will be important to determine the extent to which HWCs has managed achieving the goals & the degrees to which most vulnerable households have benefited from the scheme. Understanding the bottlenecks in implementation of the scheme at state level will widen to scope of improvement in service delivery across the country.

Policy Objective:

To transform existing health centres to ensure universal access to an expanded range of Comprehensive Primary Health Care services which is people centric, holistic and equity sensitive to enable delivery of high quality and affordable services to citizens.

Scope of the study:

This thematic area proposes to undertake implementation research of Health and Wellness Centres  to help identify bottlenecks, training needs and other factors for improving service delivery and produce learnings. The areas of research under this theme were narrowed down following due consultation with researchers and their vetting by policymakers. This was to ensure that research undertaken is aligned with academic need while also policy relevant.

Background:

Financial risk protection of vulnerable households is a central mandate of PM-JAY. Given one year of its operation, it will be important to determine the extent to which PM-JAY has managed achieving the goals & the degrees to which most vulnerable households have benefited from the scheme. Understanding the bottlenecks in the scheme at state level will widen to scope of improvement in service delivery across the country.

Policy Objective:

To ensure availability and accessibility to hospital services to the most vulnerable and improve financial protection among these households.

Scope of the study:

This thematic area aims to conduct benefit incidence analysis for PM-JAY across selected Indian states in order to generate evidence for future decision making and improvements especially as they relate to equitable access to services and distribution of resources under PM-JAY. The areas of research under this theme were narrowed down following due consultation with researchers and their vetting by policymakers. This was to ensure that research undertaken is aligned with academic need while also policy relevant.

Background:

Experience from previous Government sponsored health insurance schemes across States suggest that some of the main barriers to scheme success has stemmed from concerns around challenges in execution of contractual terms and conditions on part of the purchaser and provider (primarily private). With PM-JAY now becoming a flagship scheme operative across States, to ensure its success, it is important to assess the primary areas of concern vis-à-vis contract management & execution as well as how these issues can be addressed to ensure better service provision for the population & sustainability of the program.

Policy Objective:

Improve access to healthcare services through systematic engagement with the private sector.

Scope of the study:

This thematic area proposes to explore some of persistent challenges in contractual relations between purchasers & private providers, their impact on beneficiaries & potential solutions to overcome the problems through better contract design & enforcement. The areas of research under this theme were narrowed down following due consultation with researchers and their vetting by policymakers. This was to ensure that research undertaken is aligned with academic need while also policy relevant.

Background:

Evidence suggests that there is an estimated gap of INR 19 lakh crores, which is required to achieve better health for the population (SDG 3) in India. Given this gap, it is imperative that resource allocation at State level is increased and made efficient especially in weaker States where capacity to meet SDG targets maybe limited. Exploring and understanding the challenges involved at State level would be beneficial to design strategies for efficient resource allocation in order to meet the expenditure targets.

Policy Objective:

To improve health systems performance & health outcomes in line with endorsed SDG 2030 goals and benchmarks.

Scope of the study:

This thematic area envisages to explore current State level allocation & expenditure for meeting SDG 3 goals & key challenges in ensuring greater efficiency & equity in health spending relevant to SDG goals within States. The areas of research under this theme were narrowed down following due consultation with researchers and their vetting by policymakers. This was to ensure that research undertaken is aligned with academic need while also policy relevant.

Background:

Several studies suggest that ASHA/ANMs are often overstretched given their expanding mandate under NHM, which could result in gaps in delivery of services owing to amount of tasks they are expected to cover, with task sharing is seen as possible solution to tackle this issue. There is a need to assess the current burden of service provision falling on ASHAs/ANMs & the potential role of Multi-purpose health workers to provide some of these services through structured task-shifting training strategies

Policy Objective:

To contribute towards the revival and strengthening of Multipurpose Male Health Worker cadre, in order to effectively manage the emerging infectious and non-communicable diseases at community level.

Scope of the study:

This thematic area proposes to assess the current burden of service delivery on ASHAs/ANMs. This will be useful for further policy planning based on geographic considerations, disease burdens, and time required for multiple tasks to be performed by ASHA/ Community Health Worker. The areas of research under this theme were narrowed down following due consultation with researchers and their vetting by policymakers. This was to ensure that research undertaken is aligned with academic need while also policy relevant.

Background:

To ensure sustainability of improved outcomes, incentives should  take in to account intrinsic motivational factors of health workers & the degree to which pecuniary & non-pecuniary incentives can help drive motivation among health workers to deliver quality services.

Policy Objective:

To determine drivers of performance & motivation among health workers and strengthen primary healthcare services and outreach to improve population health

Scope of the study:

This thematic area proposes to determine the impact of incentives on the performance and motivation of community health workers and will be useful for further policy recommendation. The areas of research under this theme were narrowed down following due consultation with researchers and their vetting by policymakers. This was to ensure that research undertaken is aligned with academic need while also policy relevant.

Background:

Analysing the existing policy framework and bottlenecks will be paramount to incorporate innovative models for improving the governance structures of health systems if required to meet SDG 3 targets at state level. Though State mandates exist, it is imperative that a clear roadmap to achieve these targets be formulated at a sub-national level (as well as an understanding of contextual challenges) to ensure that States are well resourced to realize SDG targets.

Policy Objective:

To facilitate decentralisation of decision making to a level as is consistent with practical considerations and institutional capacity, and put in place concrete plans & resources to achieve SDG targets across India.

Scope of the study:

This thematic area aims to identify State strategy for implementing the SDG targets, the institutional structures in place to achieve this and intersectoral coordination mechanisms. The areas of research under this theme were narrowed down following due consultation with researchers and their vetting by policymakers. This was to ensure that research undertaken is aligned with academic need while also policy relevant.

Background:

While HWCs look to address key gaps in primary care provision, it is imperative that community engagement play a key role in determining design of primary care models, specifically as they relate to health management strategies for NCDs.

Determining the potential role of the communities in determining such care models is essential to incorporate innovative models for improving the service provisions addressing NCDs.

Policy Objective:

To promote community participation in health planning processes & strengthen primary health care availability and accessibility across the country.

Scope of the study:

This thematic area aims to identify the role of community engagement in the design of primary care models to improve the service delivery, especially in the context of Non-Communicable Diseases. The areas of research under this theme were narrowed down following due consultation with researchers and their vetting by policymakers. This was to ensure that research undertaken is aligned with academic need while also policy relevant.