The World Health Organization defines health policy and systems research as the production of new knowledge to improve how societies organize themselves to achieve health goals. According to WHO, “by nature, it is inter-disciplinary, a blend of economics, sociology, anthropology, political science, public health and epidemiology that together draw a comprehensive picture of how health systems respond and adapt to health policies, and how health policies can shape − and be shaped by − health systems and the broader determinants of health”.
We, at PHRN, have strived to constantly engage in health policy and systems research. Through our work, we aim to promote evidence-informed policy making, as well as alleviate the status of the health systems. This work is largely led by our Chhattisgarh office.
Some samples of our work are given below:
Tribal Health Series
Exploring health inequities amongst Particularly Vulnerable Tribal Groups: Case studies of Baiga and Sabar in Chhattisgarh and Jharkhand states of India
A research study was carried out on “Exploring health inequities amongst Particularly Vulnerable Tribal Groups: Case studies of Baiga and Sabar in Chhattisgarh and Jharkhand states of India”. This was part of “Closing the gap: health equity research initiative in India” funded by the International Development Research Centre, through the Achutha Menon Centre for Health Sciences Study, Thiruvananthapuram. The study was based on both anthropological and socio-medical healthcare research and used a mixed methods design. The main objectives of the research project were to study the social, cultural, political and economic determinants of health among Baigas and Sabars; to study the access of Baigas and Sabars to government health and allied systems; and to study the experience of health-related events among Baigas and Sabars in Chhattisgarh and Jharkhand. The study has been completed and the results were deliberated under the headings of: nutritional status, self-reported morbidity and hospitalisation, access to health care, reproductive and maternal health, identity, livelihood and food security, and access to public services. These results were discussed at state dissemination meetings held in Raipur, Chhattisgarh on 3rd November, 2017 and in Ranchi, Jharkhand on 6th November, 2017.
Public health advocacy to reinstate reproductive rights of Particularly Vulnerable Tribal Groups (PTGs) in Chhattisgarh
Through this study, 1200 households of Baiga, Pahari Korwa and Kamar communities in Kawardha, Sarguja and Gariaband districts of Chhattisgarh were surveyed to understand access of PTGs to health and nutrition services, status of their livelihoods, ownership of resources, and land tenure under Forest Rights Act. As an output, advocacy on the emerging issues were organised through mass media in the present of government officials. The study and the sammelans were funded under the Chhattisgarh National Rural Health Mission Programme Implementation Plan 2011-12 under the initiative for vulnerable groups. The report is available at https://bmcproc.biomedcentral.com/articles/10.1186/1753-6561-6-S5-P1.
Health Insurance Series
We have done a series of studies on health insurance, specifically on the Rashtriya Swasthya Bima Yojana. The methodology was mainly qualitative and explorative. Some of the publications arising out of these studies can be found at http://journals.sagepub.com/doi/abs/10.1177/0049085713493043
Public Private Partnership Series
Study on the impact of privatization of public health services
PHRS undertook a research study titled “Study on the impact of privatization of public health services (including Public-Private Partnerships)” in the three states of Bihar, Chhattisgarh, and Delhi. This study was commissioned by Oxfam India, and entails the development of four case studies describing the status and impact of privatization on public sector health care services. State specific topics chosen for the study include: diagnostic services being run in PPP mode in Bihar, and the outsourcing of dialysis facilities in Delhi. In Chhattisgarh, two areas were chosen (i) outsourcing the recruitment and management of human resources to private agencies to remote and conflict areas, and (ii) outsourcing mobile medical units. The reports are available at
Public Health Resource Network, Jan Swasthya Abhiyan and Oxfam India (2017). Outsourcing of Recruitment and Management of Human Resources for Remote and Conflict areas in Chhattisgarh: A Case Study. https://www.oxfamindia.org/sites/default/files/CH_HR_PPP%20Study%20Report.pdf
Public Health Resource Network, Jan Swasthya Abhiyan and Oxfam India (2017). Outsourcing of Mobile Medical Units in Chhattisgarh: A Case Study. https://www.oxfamindia.org/sites/default/files/CH_MMU_PPP%20Study%20Report.pdf
Public Health Resource Network, Jan Swasthya Abhiyan and Oxfam India (2017). Outsourcing of Haemodialysis Services in Delhi: A Case Study. https://www.oxfamindia.org/sites/default/files/Delhi_Dialysis_PPP%20Study%20Report.pdf
Public Health Resource Network, Jan Swasthya Abhiyan and Oxfam India (2017). Outsourcing of Radiology Services in Bihar: A Case Study. https://www.oxfamindia.org/sites/default/files/Bihar_Radiology_PPP%20Study%20Report.pdf
Human Resources in Health Series
Evaluation of the Chhattisgarh Rural Medical Corps (CRMC)
PHRS, together with National Health Systems Resource Centre (NHSRC), and State Health Resource Centre (SHRC), Chhattisgarh undertook this evaluation study. The aim was to evaluate the implementation and impact of CRMC in Chhattisgarh. The main objectives were to study and document the process of implementation of CRMC, assess its impact of in improving the availability of human resource in these areas, identify the gaps and give recommendations. The study was a mix of quantitative and qualitative research, which included analysis of data and information pertaining to the CRMC scheme and a closer case study of three districts, Gariyaband, Jashpur and Kanker. The report is available at http://phrsindia.org/wp-content/uploads/2015/08/Evaluation-report-of-Chhattisgarh-Rural-Medical-Corps-2013-14.pdf .
A Study to Assess the Mitanin (ASHA) Referral System in Chhattisgarh
PHRS undertook a study to understand the Mitanin referral system in Chhattisgarh, and to identify areas of strength and weakness. This research included primary data collection from both mitanins and patients referred by them in select blocks of Raipur and Kanker district. In all, 124 participants from 14 villages were interviewed. A brief report of this study is available at http://phrsindia.org/wp-content/uploads/2015/03/mitanin-study-report.pdf.
We have been involved with NHSRC on a series of evaluations of the Janani Suraksha Yojana, and are also involved in a series of scoping exercises to develop a framework for NUHM.
Some other evaluations are listed below:
- Evaluation of the Rogi Sahayata Kendra in West Bengal, 2014
- National ASHA (CHW) Evaluation in Punjab state, 2013
- Evaluation of effectiveness of Family Planning Services in Chhattisgarh state, 2012
- Common Review Mission of NRHM in Tripura state, 2012
- National ASHA (CHW) Evaluation in Assam state, 2010
- Evaluation of Janani Suraksha Yojana in Chhattisgarh, 2010