Exploring health inequities amongst Particularly Vulnerable Tribal Groups: Case studies of Baiga and Sabar in Chhattisgarh and Jharkhand states of India [Sree Chitra Tirunal Institute for Medical Sciences and Technology]

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 key personnel involved in this research project were Ms. Sulakshana Nandi, Dr. Ganapathy Murugan, Ms. Deepika Joshi, Ms. Smruti Sudha Behera, and Mr. Haldhar Mahto. Dr. Vandana Prasad and Dr. Rama Baru served as advisers. The rationale for the study was that PVTG communities are often overlooked or neglected in planning for health programmes, and that there is scarce information regarding this. 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, Chhatisgarh on 3rd November, 2017 and in Ranchi, Jharkhand on 6th November, 2017. The final report is being prepared and will soon be shared.

Study on the impact of privatization of public health services (including public-private partnerships)

PHRS undertook a research study titled “Study on the impact of privatization of public health services (including Public-Private Partnerships)” in three states of Bihar, Chhattisgarh, and Delhi. This study was funded by Oxfam India, and entailed the development of four case studies describing the status and impact of privatization on public sector health care services. The key personnel involved were Ms. Sulakshana Nandi, Dr. Ganapathy Murugan, Dr. Indira Chakravarthi, Mr. Chandan Kumar, Mr. Shahnawaz Khan, and Mr. Mohammed Alam Ashraf. State specific topics chosen for the study included: 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 study was successfully conducted and completed. The studies were disseminated to a larger audience for policy advocacy through a national seminar on PPPs in healthcare. The national seminar was conducted on 20th January 2017 at India International Centre in New Delhi.

Assessment of Capacity Building of Frontline Workers in the ICDS in Odisha

This study was undertaken at the request of the Government of Odisha by PHRS and was commissioned by APPI. The key personnel involved were Ms. Swati Priyambada Das and Mr. Gouranga Mahapatra. Dr. Vandana Prasad provided overall leadership to the project. The objectives were (i) to assess the existing capacity building/training programme for ICDS workers (ii) to critically examine content of training curriculum (iii) to examine pedagogy used in trainings and (iv) to understand the institutional processes involved in the training. The focus of this research was Anganwadi Training Centres (AWTCs) and ICDS functionaries. The Government of Odisha supported the data collection and all other processes throughout the study period. The study has been completed; the report is in two parts. The first part has been submitted and disseminated to the Government of Odisha. The second part and the consolidated report has been submitted, and is awaiting dissemination.

Study on understanding ICDS governance system in Jharkhand (mobile crèches)

A study was conducted for Exploring Decentralized Implementable Model for Early Childhood Development (ECD).  The study took place in different districts and blocks of Jharkhand, Odisha and Delhi, led by a consortium of organisations. In Jharkhand, it was led by PHRS (Ms. Shampa Roy and Ms. Smruti Sudha Behera). The study covered Raidih block of Gumla district and Ratu block of Ranchi district. The study was to understand the status of ECD Services in three states with special reference to institutionalization of democratic decentralization and community participation. The main goal was conceptualization of a base unit as a workable model of convergence for providing holistic services to young children.

The objectives of the study were:

  • To enable understanding of the systems and processes involved in different states in the provision of services for young children.
  • To examine the respective status of the fundamental elements that contribute towards efficient functioning, for example: convergence, decentralization, mobilization and financial issues.
  • To glean insights into key issues and challenges in provision of holistic services for young children.
  • To recommend reforms, if any, in the functioning of systems and enabling efficient provision of services through increased interdepartmental convergence, democratic decentralization and community participation.

The final report has been submitted to the project coordination team in mobile crèches.

Contribution of Civil Society for “Health for All” in India: PHRN-JSA

This research project was undertaken by PHRN on behalf of Jan Swasthya Abhiyan. It is part of a larger three-year research with the support of IDRC. This project is intended to document (and support) the People’s Health Movement (PHM) in its activities as a social movement that promotes ‘Health for All’, while locating health in an understanding that embraces the structural and social determinants. Much of this work is centred around 6 countries where PHM has activist groups: Brazil, India, South Africa, Italy, Colombia and the Democratic Republic of Congo. The overall coordination of this (action) research project will be undertaken by PHM globally, through a small group of personnel located in three offices of the PHM: India, South Africa and Egypt.

The country-specific research part of this project is centred on key themes related to successful campaigns, movements; knowledge generation, capacity building and networking that promote “Health for All. This research project in India was housed in PHRS and it was steered by a research group (consisting of Amit Sengupta, N Sarojini, Deepa V, Joe Varghese, Indranil Mukhopadhyay, VR Raman, Ganapathy Murugan, Susana Barria, Kajal Bhardwaj, Rohan Matthews and Vandana Prasad).

The data collection for this study included in-depth interviews with a number of JSA members/members of the broad ‘health movement’, of any significant activities at the state or national level that they or their organisation may have initiated or participated on specific key themes.  The study was successfully conducted and concluded.

Study on working condition in a Multinational Health-care Corporation in India-PSI

PHRN was commissioned by Public Services International (PSI) to undertake a research titled “Study on Working Conditions in a Multinational Health-care Corporation in India”.  This project was intended to explore and document the working conditions in big private hospitals, and inform PSI on the process and consequences of privatization.

This was an exploratory study and had a very brief timeline. Therefore, a few interviews with the staff in the hospital (across various cadres) was done to understand the terrain and to aid in doing a larger full-fledged study planned in the near future. The study focused on employment conditions (kinds of contracts, outsourced departments) and how they impact perceived ability to perform and quality of care (which is linked to conditions of work too), as well as on perceptions of unionizing and trade unions. This research study was led by a research group with Dr. Indira Chakravarthi as the lead investigator. The study is completed, and the report has been submitted.

Research undertaken in the past