Research
Current research projects
EQUIP-HWCs
Ayushman Bharat Health and Wellness Centers (AB-HWC), a.k.a. Ayushman Aarogya Mandirs (AAMs), play a crucial role in delivering a comprehensive range of primary healthcare services at the community level, aligning with the principles of universal health coverage. But implementing these services faces several challenges including infrastructure issues, limited resources, and lack of trainings. There is a need to accelerate the progress towards the programme goals by identifying existing challenges, incorporating the best practices, and developing context-specific strategies within the existing resources to make the AAMs fully functional. The challenges and bottlenecks include sub-optimal continuum of care, difficulties in IT-enabled teleconsultations, issues with training, competencies, and teamwork among Community Health Officers/Mid-Level Healthcare Providers, ambiguity in roles, lack of infrastructure, human resources, and inadequate drugs and diagnostics. The delivery of CPHC through AAMs rests substantially on the institutional mechanisms, governance structures, and systems created under the National Health Mission (NHM), as well as on the overall work culture and adherence to the core values. Thus, understanding and addressing these issues and other determinants is crucial.
Overall Objective
This three-year Implementation Research (IR) shall identify, co-develop, implement, and optimize context-specific health service delivery models for the 12 CPHC services through AAMs.
Study Objectives
- To assess the current functioning of AAMs in delivering 12 expanded range of CPHC services.
- To identify the context-specific barriers and facilitators and their influence in the demand and delivery of 12 expanded range of CPHC services through AAMs.
- To co-develop, implement, and iteratively refine contextualised strategies to improve the equitable coverage and quality of the 12 expanded CPHC services through AAMs.
- To assess and evaluate the functioning of AAMs, coverage, and quality of CPHC services achieved through the model.
- To document the model characteristics and evolution, health system inputs, model adoption and its fidelity through observed improvements in AAM functioning.
- To develop improved guidelines/IR toolkits for implementing CPHC services, training modules, and modules for capacity building of AAMs.
Publications
Financing primary healthcare for rural areas
A Consultation on Financing Primary Healthcare was organized jointly by IIMU and Primary Healthcare Initiative (PHI) for financial sustenance of comprehensive and equitable primary healthcare initiatives. Eighteen academicians and practitioners, representing different institutions from across India, presented and engaged in discussions around the theme. Based on the discussions in the consultation, an article was authored by Dr. Pavitra Mohan, Dr. Sanjana Brahmawar Mohan, Prof Vedha Ponnappan, Prof Prakash Satyavageeswaran and Ms. Manisha Dutta. Please see the details below:
Fernandez Hospital: Pioneering excellence in maternal and newborn healthcare
The case explores the journey of Fernandez Hospital (FH) and its evolution from a small maternity clinic to a tertiary-level hospital for women and children with a focus on accessible and high-quality healthcare in the areas of obstetrics and gynecology. Dr. Evita Fernandez, CEO of FH, was a vocal advocate of natural birth, contrary to the trend towards Caesarean section (C-section) deliveries seen in most hospitals across India. The case is set in the year 2014 and deliberates on the options that Dr. Fernandez had at different stages of FH’s journey and the strategic decisions that she and her team made and implemented. It showcases the challenges FH faced in deciding what to do next while keeping its values intact. From studying the case, students will appreciate the need for organizations to develop a framework to help them analyze their current situation, establish priorities, identify opportunities, and make rational and well-informed decisions about the future. Dr. Fernandez had an expansive purpose of enabling safe deliveries in society at large. While an expansion of the existing hospitals may achieve this goal to the limited extent of enabling safe deliveries within her hospitals, it would not result in a much wider preference across the country for natural deliveries over C-section deliveries. The case ends with Dr. Fernandez and her team contemplating various options available to them.
The article was authored by Ms. Swati Sisodia, Prof. D.V.R. Seshadri, Mr. Ratan Jalan, Prof. Prakash Satyavageeswaran Please see the details below:
Factors Affecting Follow-up Adherence of Glaucoma Patients
This study explores the factors associated with non-adherence to the physician’s follow-up advice by persons with glaucoma. A four-year panel dataset containing demographic, clinical, and intervention details and doctor’s advised follow-up date for a random sample of 2,622 glaucoma patients from an Indian tertiary eye care hospital was studied for the same.
The article was authored by Ankit Singh, Balakrishnan Udaykumar, Thulasiraj Duraisamy Ravilla, Vedha Ponnappan, Ramaswamy Krishnadas & Prakash Satyavageeswaran. Please find the link below:
Factors Affecting Follow-Up Adherence of Glaucoma Patients
Effective, Respectful and Affordable Care: A Call for Decentralized Maternal Care
Despite government incentives, maternal and infant health gains in India remain minimal. Rising cesarean section rates and abuse during institutional deliveries are concerning. The article proposes decentralized maternal care through primary healthcare centres (PHCs) as a solution.
- Strengthening primary healthcare facilities is crucial to make this work.
- Equipping healthcare providers with enhanced training and skills is paramount.
- An effective referral mechanism is vital for decentralized care.
The article was authored by Dr Pavitra Mohan and Srividya Ramanathan. Please find the article on the link below:
Effective, Respectful and Affordable Care: A call for Decentralized Maternal Care
Grants
UNICEF Rajasthan: UNICEF supports the Rajasthan state government in working towards providing equitable primary healthcare with special focus on marginalized and hard-to-reach tribal populations. It has helped the state in undertaking several initiatives which encompass the overall development related to health and other issues of the society. It has supported the state government in improving the health indicators by providing quality of care for new-borns, maternal and child health, addressing gender discrimination issues, developing water safety plans, education planning, child protection plan and so on.
UNICEF has partnered with BHS and the CFH, IIMU to strengthen 10 existing PHCs and 20 HWCs in Aspur block of Dungarpur district by setting up a demonstration and resource unit for supporting comprehensive primary healthcare and documenting and generating evidence on the interventions. UNICEF will also ensure linkage with existing government systems, which will contribute in replication and scaling up of interventions through various government programmes.
