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Research Projects/Studies Completed Year-2013-2014


Monitoring and Evaluation: Technical Assistance for Strengthening Health of the Rural Poor (METASHARP)

Agency:MoPH, Afghanistan

Project Team:S.D. Gupta, L.P. Singh, Anubhav Agarwal, Rajpal SinghYadav, Suhail Ismail Sheikh,BGowtham Ghosh

METASHARP project was a contract between the Ministry of Public Health (MOPH), Islamic Republic of Afghanistan and the Johns Hopkins School of Public Health (JHSPH), USA. IIHMR provided technical support to the Provincial Health Offices and MOPH to enable them to play a greater role in data analysis and monitoring and evaluation activities under National Health Services Performance Assessment (NHSPA) of all types of health facilities in Afghanistan.The first round of NHSPAstarted in 2004 andwas completed in 2009- 10.

The Ministry of Public Health (MoPH) of the Islamic Republic of Afghanistan, with technical assistance from the Johns Hopkins University Bloomberg School of Public Health (JHSPH) and the Indian Institute of Health Management Research (IIHMR), has used the Balanced Scorecard (BSC) to measure the performance of Afghanistan’s provinces in the delivery of the Basic Package of Health Services (BPHS), and to provide policymakers, health managers and the public with evidence concerning areas of strength and weakness. The BSC was used by the MoPH to clarify its vision and strategies, and to manage change through a set of indicators that reflected the policies and strategies of the MoPH.

The BPHS BSCwas revised substantially in 2011 to reflect the changing policies and conditions in the country. The 2012-13 BSCwas based on the data collected from 725 randomly selected BPHS health facilities in 34 provinces across the country, and involved observations of 6,930 patient-provider interactions and patient exit interviews, along with 2,403 healthworker interviews. The indicators and methods used for estimation in 2012-13 BSCwere the same as those used in 2011-12 BSC.

The revision was carried out through a participatory process that was led by the MoPH and with active involvement of various other stakeholders in the Afghan health sector including the non-governmental organization (NGO) implementing partners, donors, health worker association representatives, and other stakeholders, including a MoPH led BSC Technical Working Group. The Third Party Evaluation team from the Johns Hopkins Bloomberg School of Public Health (JHSPH) and Indian Institute of Health Management Research (IIHMR) facilitated the process.


Strengthening of HMIS in Bihar

Agency:UNFPA

Project Team:Santosh Kumar, S.P. Chattopadhyay, Tukaram Khandade, Akhil Agrawal, Bimlesh Sinha,Vikash Singh, Vishal Singh, Ganesh Rajpoot, Aash Mohammad

To improve the quality of HMIS data in terms of timeliness, completeness and correctness and its utilization in planning and decision- making at every health facility level in Bihar, IIHMR Jaipur undertook a project titled “Strengthening of HMIS in Bihar” with the support of UNFPA.The Projectwas implemented from October 2009 to March 2014.

The Specific objectives of the project were:

  • to train health functionaries at different levels of facilities and to oversee the quality of the data generated at different levels (HSC, PHC, District, and State);
  • to build analytical capacity of the middle level managers to use the data in planning, monitoring, evaluation and decision making;
  • to establish a system of feedback and suggest measures for improvement at different levels;
  • in order to to make the project efforts sustainable, to transfer the skills and learning by the project and its protocols to government officials.

To change the HMIS of Bihar was not a short-term task. Adequate infrastructure and trained staff in the area were vital aspects of strengthening the HMIS. User participation from the inception of ideas of such systems, their initiation, design, development and implementation were also required in order to develop gradual changes in the user’s understanding and to enable IT to become a normal way of doing things. Such changes needed to be carried out incrementally, enabling users to learn from previous changes and to incorporate new changes that emerge over time. Thus, the actors needed to create an environment that enabled in-house and external generation and sharing of knowledge within the sustainability strategy framework. Efforts to bring the above-mentioned change at all management levels are now beginning to take root. As a result, support to the system by higher management now will play a significant supportive role and will be a crucial pivot in the roll-out of the system and continued and effective utilization of generated data/information.

Finally, HMISwas not only about technology, butwas also important to support it with social and political commitment to making it a game changer – a sustainable, reliable and effective tool in health system information management in the state in the years to come.


Evaluation of Demand Side Interventions for Revitalization of Post-Partum Family Planning in Bihar

Agency:JHPIEGO,USA

Coordinator:VinodKumar,Vivek Lal,BGowthamGhosh,DanishAhmad,DineshChandra,Mohammed Sharif

JHPIEGO had worked to strengthen Post-Partum Family Planning/Post-Partum Intrauterine Contraceptive Device (PPFP/PPIUCD) services as a part of Government of India’s program for the introduction of PPIUCD services in the country. IIHMR was assigned to conduct an independent baseline and end-line assessment in Bihar in the districts of Begusarai and Darbhanga for both supply-side and demand-side interventions.

With the objective of assessing the knowledge and attitude of service providers, community based workers and the awareness of post- partum family planning among post-partum women, the baseline and end-line evaluation was done by IIHMR during 2011and 2013 respectively. The report has been submitted toJHPIEGO.


Utilization of Emergency Contraceptive Pills among Rural and Urban Women in Rajasthan: A Study of Psycho-social Determinants

Agency:ICMR

Project Team:Neetu Purohit, Shilpi Mishra, Rakhi Mathur, Priyanka Bakhshi, Sonia Luna, Lalit Mohan Nayak,Vrinda Mehra

Emergency contraceptive pill (ECP) is a back-up birth control method that is used within days of unprotected sex or in the event of a known contraceptive failure. It is not intended for use as a regular contraceptive method. The broad objective of this study was to understand the pattern of use of emergency contraceptive pill and associated psycho-social determinants among rural and urban women of Rajasthan. The specific objectives of the study were to assess the level of awareness and knowledge of the women about emergency contraceptive pill; to find out the utilization pattern of these pills and perceived immediate and prolonged health effects; to discover the facilitating and hindering factors influencing their availability, accessibility, acceptability and affordability, and the role of mass media in dissemination of information and knowledge. A cross-sectional study was conducted in urban and rural areas of Jaipur district. Both married and unmarried women were interviewed. While married women (N- 978) were contacted through household survey, unmarried women (N-228)were contacted at eating joints and shopping malls.

It was found that more than 95 percent of the respondents were aware of contraceptive methods like OCP, IUCD, and female and male sterilization. About 45 percent of the married women were aware of ECP; this proportion increased to 87 percent for unmarried women. Close to three-fourths married respondents were not aware of circumstances in which ECP is to be used. Around six percent of respondents reported the use of ECP (8% in urban areas and 5% in rural areas). The users of ECP had gained knowledge of ECP through TV(46.8%) or from their husbands (29.8%). In case of unmarriedwomen, a majority of them (82%) recognizedECPby their brand names. Television advertisements (96%) were the main source of information about ECP while friends and newspapers were the source of information for 58 percent and 48 percent of the respondents respectively. Around 63 percent of these women used ECP as a regular method of contraception. About 69 percent of married respondents admitted that the availability of ECP had benefitted women and 88 percent reported that due to its availability they no longer had to live under fear of pregnancy. About 71 percent of the women suggested that awareness generation on side effectswould curb irrational use of ECP.


Pilot for 7 Gram Panchayats on Community Managed Water Supply System in Tonk

Agency:UNICEF,PHED,Government of Rajasthan

Project Team:Gautham Sadhu, Arindam Das, ParvinderKumar Sharma, Suresh Siwal

The project intended to develop a workable model in seven Gram Panchayats of Tonk district involving the VillageWater and Sanitation Committee (VWSC) to manage and monitor drinking water supply schemes. Also, the project aimed to strengthen the capacities pertaining towater and sanitation to the members of theVWSCsin these villages so that they could manage theirwater supply schemes in a sustainable manner.The projectwas supported byUNICEFandPHED,Government of Rajasthan.

The major activities of the projectwere: 1) baseline survey to assessKAPof thecommunity pertaining towater and sanitation, the status of water supply, and the demand for improved services with regard to drinking water supply; 2) sensitizing and creating awareness among implementers like government functionaries, PRIs, representatives of VWSCs and the community; 3) planning and designing of various community participation strategies related to drinking water supply schemes; 4) training and capacity building of the community in formulation, implementation and maintenance of the schemes; 5) supporting the execution of community managed works and services related to drinking water supply schemes; 6) post execution activities like handing over the responsibility of operation and maintenance of these schemes to thecommunity.


Strengthening Hospital Operations at Kothari Hospital, Bikaner

Agency:Kothari Hospital, Bikaner

Project Team:SantoshKumar, Vijay Pratap Raghuvanshi

Kothari Hospital and Research Center is a 130-bedded hospital located in Bikaner district. IIHMR was involved in strengthening the existing processes and bringing professionalism in the day-to-day management of the hospital and thus preparing the hospital for NABH. The objectives of the studywere to develop standard operating procedure (SOP) to determine equipment requirements as perNABH/JCI standards and to provide briefing to the key hospital staff. The methodologies of the projectwere:

  • Going round the hospital and discussing with the staff in different areas and with hospital management to understand the existing processes and the problems faced and the future plans
  • Developing the infrastructural requirements andSOPas per new demands
  • Providing onsite support in implementing changes through monthly meetings at the hospital site.

Social Mobilizing and Marketing: Positioning Food Fortification

Agency:GAIN-PMU, IIHMR

Project Team:Neetu Purohit, Seema Mehta, Priyanka Bakhshi, Rakhi Mathur and Sonia Luna

Malnutrition is common in India; one in every three children is malnourished. Food fortification is a practical and inexpensive alternative to deal with the problem of micronutrient deficiency. Food fortification is the addition of key vitamins and minerals to staple foods to address nutritional gap. Food fortification project has already launched fortified wheat flour, oil and milk through open market channel in Rajasthan. The study was aimed at understanding the behaviour of consumers and identifying selling and resistance aspects from the point of view of consumers and retailers towards buying grocery products. It was found that about two-thirds of the respondents were buying wheat grains. Packed flour was being bought by about one-fourth of the respondents. In case of oil, a large segment of the respondents (84.7%) bought packed oil. Only about 18 percent of the consumerswere aware of fortified foods, out of which 29 percent belonged to the upper class. A majority of the respondents who had heard of fortified foods did not know what it meant. Of those who were aware, about five percent had used fortified products. Further, in the study, the retailer’s practices of selling grocery productswere also explored to know the factors which contributed to increased selling of grocery products. According to the retailers, the reason for the brands which were selling was established brand name (46.2%), reasonable pricing (27.5%) and advertisement of the product through various mediums (13.8%).


Review of HMIS of Mother Child Tracking System (MCTS) and Women & Child Development (WCD) in Rajasthan, Odisha and Bihar

Agency:Save the Children

Project Team:Santosh Kumar, Rajeev Kamal Kumar, Veena Nair Sarkar, Kanika Pawar, Kalpa Sharma, Suman, Saheli Manish Kumar, Lalchand, RajpalYadav

Save the Children (Bal Raksha Bharat) is implementing Strengthening Maternal, Newborn, Child Health and Nutrition (MNCHN) project in three states, namely Rajasthan, Odisha and Bihar. The main purpose of this project was “to contribute to strengthening evidence-based MNCHNinterventions, services and practices” in the intervention area. As part of the said intervention, IIHMR has been assigned the task to review the HMIS (Health Management Information System) of Mother Child Tracking System (MCTS) and Women & Child Development (WCD).The outcome of the studywas used to developHMISin order to strengthen programs in the above states.


Concurrent Monitoring of Food Fortification Project (IPS) in Rajasthan

Agency:GAIN-PMU, IIHMR

Project Team:Tanjul Saxena, Sunita Nigam, Gunjan Mishra , Shirish Harshe

In order to address the problem of micronutrient deficiency in the state, Institute of Health Management Research (IIHMR) Jaipur has signed a Grant Agreement (GA) as Executive Agency (EA) to implement the project on Food Fortification – Integrated Program Strategy in Rajasthan with the Global Alliance for Improved Nutrition (GAIN), Geneva. The Program Management Unit (PMU) required conducting concurrent monitoring of the project encompassing all three project components i.e. production and distribution, legislation and quality control, and social marketing and communication. The concurrent evaluation was designed in such a manner that the project gets benefitted from external monitoring including suggestions for improving the implementation mechanism, and also to improve the overall functionality of the project. The monitoring was done from February 2013 till April 2013 and the report was submitted to PMU in May 2013.


Follow-up Study on Technical Appraisals of Producers (Flour and Oil) for Enhancing Partnership in Food Fortification Project (IPS)

Agency:Project Monitoring Unit –Global Alliance for Improved Nutrition

Project Team:Suresh Joshi, Anoop Khanna,N.D. Sharma, Lalit Mohan Nayak, Suresh Siwal

The main purpose of the studywas to followthe producers (flour mills and oil mills) covered under the categories of Technical Assessment to explore the creation of new partnerships and making the existing partnerships more operational in terms of fortified production and supply. The objectives of the study were to understand the factors which had influenced the mill owners for joining the program and to study the factors which had restrained the millers to join the food fortification project. The study was commissioned by PMU-GAIN on ‘Scoping Assessment for Fortification through Identified Manufactures, and Flour Mills and Oil Producers in Rajasthan’. In the study, a total of 112 mills (95 wheat flour and 17 oil mills) were visited and mill owners/ managers of the mills in 17 districts of Rajasthan were interviewed. The study found that 40 mills were willing to participate in the food fortification project. A majority of the wheat flour mill owners needed continuous training on the food fortification project. They also expressed the need of a test kit or tie-up with any local laboratory for regularly testing premix and finished product. IEC activities to generate awareness of the importance of fortified foods among consumers through advertisements in local channels with fortified brand names of wheat flour and oil producers were also indentified as major issues. The study findings also presented the scope for research in public nutrition as well as food fortification services in the State.


Client Exit Interview Survey in Rajasthan, 2013

Agency:Marie Stopes International

Project Team:Laxman Sharma,DanishAhmad, Lalchand Sharma

Marie Stopes International (MSI) has been delivering family planning and safe abortion services in India. Marie Stopes India (a subsidiary of MSI) provides high quality family planning and safe abortion services in National Rural Health Mission’s high-focused states. The specific objectives of the Exit Survey Research were: to assess the extent of service utilization by the clients; to assess the extent of client satisfaction and quality of care provided by the MSI; to assess the client profile in order to get the percent of the clients under the BPL category; to assess the existing marketing strategies; and to suggest necessary modifications required. The Surveywas conducted in three different states i.e. Rajasthan, Madhya Pradesh and Uttar Pradesh.


Facility Survey in Rajasthan - DLHS-4:

Agency:Ministry of Health and FamilyWelfare,Government of India and International Institute for Population Sciences, Mumbai

Project Team:Laxman Sharma, Arindam Das, Danish Ahmad, Mohammad Sharif,Kailash Prajapati.

The Ministry of Health and FamilyWelfare, Government of India, assigned Institute of Health Management Research, Jaipur (IIHMR) to carry out the Facility Survey under the District Level Household and Facility Survey (DLHS-4). The overall objective of the survey was to assess the performance with regard to the implementation of various programs under NRHM at the district level. The specific objectives were: to estimate or assess the availability of critical inputs in public health care establishments through facility survey; to ascertain the extent of utilization of facilities for providing the RCH services; and to assess service quality using appropriate outcome indicators at each level i.e. Sub-health Centres, Primary Health Centres,Community Health Centres, Sub-divisional Hospitals and District Hospitals. Atotal of 2212 health facilities (SHC,PHC,CHC,SDHandDH)were covered throughout the state.


District Level Household Survey (DLHS) Round 4 in Punjab and Chandigarh

Agency:Ministry of Health and FamilyWelfare,Government of India and International Institute for Population Sciences, Mumbai

Project Team:J.P. Singh, Arindam Das, Vinod Kumar SV, Pradeep Singh Kachhawa, B Gowtham Ghosh, Prafull Kumar, Mukesh Gehlot, Kailash Prajapati

Specific objectives of the Survey: To estimate or assess:

  • Antenatal care and immunization coverage.
  • Extent of safe delivery and coverage of JSY.
  • Contraceptive prevalence and unmet need for family planning.
  • Awareness of RTI/STI and HIV/AIDS
  • Assessment of the quality of RCHservices
  • Contribution of public-private sectors toRCHservices
  • Availability of RCHservices nearest to the selected PSUs
  • To know the level of aneamia, blood sugar, BP and anthropometric parameters through the Clinical, Anthropometric and Bio- Chemical (CAB) test and measurements.
  • Availability of critical inputs in public health care establishments through facility survey

 

Institute of Health Management Research, Jaipur (IIHMR) was assigned to carry out the District Level Household Survey (DLHS) Round 4 in Punjab and Chandigarh by theMoHFWin which IIPS, Mumbaiwas the nodal agency. In addition, itwas the responsibility of IIHMR to carry out the survey for the government health facilities for the aforementioned states. The survey was conducted in all 21 districts (including Chandigarh). In all, 1300 Primary Sampling Units (PSUs) and 1360 health facilities were covered in this survey. Overall, 35016 households were surveyed in which 32875 eligible women were interviewed. During the survey, the respondent’s weight, height, blood sugar, blood pressure and hemoglobin were also measured as health was an important component in DLHS-4. More than 1,47,000 blood samples were sent to PGI, Chandigarh (partner institute for Punjab and Chandigarh under DLHS-4) to test hemoglobin. The overall objective of the survey was to assess the performance with regard to the implementation of various programs underNRHMat the district level.


Piloting Mobile-based MCTS HMIS at Village Level in Bihar

Agency:Dimagi (USAID)

Project Team:SantoshKumar, RajeevKamalKumar, S.P.Chattopadhyay,AkhilAgarwal,TukaramKhandade

Health system in India strives for timely and quality data for proper planning, monitoring and evaluation. In a paper based recording system it takes 15 days for data collection (at the sub-center), data updation (at the primary health center) and then data transfer (to MoHFWWeb Portal MCTS), which severely affects the services delivery of maternal and child health in our country.

To improve the timeliness of data collection, updation and reporting, a pilot project was commissioned in Kanti block of Muzzafarpur district of Bihar in January 2013. Under this project, 10 ANMs who were capable of handling mobile phones were given android based mobile phones loaded with a software which was identical to the government‘s records. In-built service reminders, due lists and counseling videos were also loaded in each phone. Using the phones the data were sent to a central database system using both offline and online methods. IIHMR and Dimagi International imparted rigorous one-week training to all the ANMs. During ground level implementation, ANMswere observed andwere given on-field support for six months.

An analysis of the data showed that timeliness of reporting had improved with almost no time lag between data collection and data reporting. Using the mobile based reporting, various validation rules and data checks improved correctness and completeness of the data. Most of the ANMs were happy that computerized data collection had reduced their involvement in preparing the monthly reports as all reports could be generated automatically.


Future Health System’s Young Researchers’ Grants

Agency:DFID,UKand JohnsHopkinsUniversity

Project Team:Upasona Ghosh, Lalitha SwathiVadrevu, DivyaKBhati

Joining a tough competition, three junior researchers from IIHMR had individually won small research grants from the FHS consortium head office at the Bloomberg School of Public Health, the Johns Hopkins University in 2013. The primary objective of these three grants was to develop research capacity of young researchers from the partner institutions of the FHS consortium. The following were the researchers and their research topic:

Upasona Ghosh: Effect of women’s social network on mother and child health in women-headed households: a case study of Indian Sundarbans.
Lalitha SwatiVardevu: Assessing the need for psycho-social care for children in the Sundarbans.
DivyaKBhati:Reality of girl child health rights in the arid zones of Rajasthan

The research activities of each of the above grants have been completed and the research products including a brief report and a publishable paper for each grant are under preparation for wider dissemination.


End- line valuation of the roject entitled E P ‘PARIVARTAN ’: A Family Welfare and Population Development Project

Agency:Population Foundation of India

Project Team:Shilpi Mishra Sharma, Anoop Khanna, Pradeep SinghKachhawa, Mohammed Sharif, Lalchand Sharma

An end-line evaluation of “PARIVARTAN”: A Family Welfare and Population Development Project jointly resourced by J K Tyre and Population Foundation of India (PFI) was carried out to document good practices, success and learning from the project. The project was being implemented in 60 villages in Rajsamand Block, District Rajsamand, Rajasthan, covering a population of 41,000. The goal of the projectwas to build capacity, generate and provide basic health care to the rural population in the selected area to bridge the gap between the need and access toRCHservices.

The approach for the end-line evaluation was entirely qualitative in nature. The study involved interaction with the primary stakeholders: women beneficiaries of the project and key members of the community, village level monitors (VLM) and secondary stakeholders: key project officials of the implementing and funding agency;community stakeholders; and at the institutional level, PRIs,ANMs,GNMs, male nurses, anganwadi workers (AWW), and school teachers. In-depth interviews with various level stakeholders including women in the reproductive age group (15-49 years) and FGDs with the community were instructed to gather the relevant information. Case studies of project beneficiarieswere also documented.The evaluation had been completed and the final reportwas submitted to PFI,NewDelhi.


National Healthcare Survey

Agency:Global Advisor Associated Services Pvt. Ltd.

Project Team:Santosh Kumar, S.P. Chattopadhyay, Dhirendra Kumar, Kalpa Sharma, Tukaram Khanda d e, K. Sreenath Reddy, ManojKumar Gupta,Veena. R, Lalchand Sharma

Disease burden estimations based on sound epidemiological research provide the foundation for public policy. In the absence of any single reporting system, the estimates of the diseases are primarily drawn from public hospitals’ statistics, which leaves out those who prefer to go to any kind of private hospitals or prefer to ignore their treatment. In view of this, it was conceptualized to carry out a quick reference estimate of diseases’ burden both in urban and rural India. The survey was supported by Global Advisory & Associated Services Pvt. Ltd, Disease Management Association of India, Continua Health Alliance, USA, and HIMSS Asia Pacific India Chapter. Institute of Health Management Research, Jaipur, was assigned to develop a survey design, field work, and datamanagement. The purpose of the study was to understand the disease load and disease distribution in urban and rural areas of India in order to identify causes of ill health that can be addressed through better planning and program management.

This was an explorative study based on primary data collected from the households in different parts of India. Considering the size of the country, Indiawas divided into twelve zones, and from each zone one statewas selected.


Rapid Assessment of Promotion of Fortification of Wheat Flour through small millers in the Sarada and Salumber blocks of Udaipur district

Agency:Project Monitoring Unit –Global Alliance for Improved Nutrition

Project Team:Goutam Sadhu,Tanjul Saxena, PrafulKumarBarla,Audrey Pareira,Kailash Prajapati and Lalchand Sharma

The study was commissioned to rapidly assess the pilot project by Global Alliance for Improved Nutrition (GAIN) for “Use of Fortified Atta by Community Using Small Chakki for Flour Fortification in Tribal Blocks of Udaipur District”. The objective of the study was to assess the present knowledge among rural families (including general population, pregnant and lactating women) on food fortification and their attitude and behavior towards regular use of fortified atta.

The study also aimed to assess the knowledge, attitudes and practices of the fortification of atta done at small chakkis (flour mills) in the villages of the flour produced from wheat brought by families for grinding.

The survey used structured questionnaires to interview two categories of respondents i.e. the community (general population, pregnant and lactatingwomen) and chakki owners. Focus Group Discussions and interviewswere also conducted to capture the qualitative results of the pilot project.


Capacity Building Preparation of IWRM Plan and Facilitation of Plan through Panchayati Raj System

Agency:SWRPD,Government of Rajasthan

Project Team:Monika Chaudhary, Prince Purohit

The objectives of the project were to build the capacity of the VWHSC members and other community members to prepare GP level IWRMplan and facilitate them for the implementation of IWRMplan through PRI/water user groups.


A Study on the Effect of Consumer Participation on Price Sensitivity of Fortified Products

Agency:Project Monitoring Unit –Global Alliance for Improved Nutrition

Project Team:Monika Chaudhary, Md. Shahnawaz, DivyaVyas, Sandeep Narula

The objective of the study was to understand the impact of the non-economic factors which could have an influence on the purchase decision of the consumer in order to find out whether these non-economic factors were powerful enough to negate the impact of economic factors and reduce price sensitivity of fortified products.


Mentoring for Maternal Health Young Champion

Agency:Institute of International Education (IIE)

Project Team:Nutan P Jain/p>

The Maternal Health Young Champions (MHYC) program with funding from the Harvard School of Public Health (HSPH) was designed to support young leaders who were passionate about lowering maternal mortality through new and innovative practices that helped save women’s lives. To reduce maternal mortality and morbidity over the long-term, emerging public health leaders needed to be equipped with the skills, commitment, and vision to respond fully tomultiple causes and consequences of this threat. In 2013, out of a cohort of 10 young people selected to receive this prestigious fellowship to support their development as a leader in the field of maternal health in the country and globally, one of them was hosted by the Institute. TheMHYC conducted a study on “Accessibility to Maternal Health Care in a Paharia and Santhal Village in Jharkhand” to answer the following research questions:

  • How and why do socio-cultural contexts lead to financial and geographical inaccessibility to care during pregnancy and skilled birth attendance among vulnerable tribal populations viz. Santhals and Paharias in Sundarpahari Block, Jharkhand?
  • Is the lack of access stemming from a cultural reluctance of the tribes or from the system which has not reached out to these communities?
  • How do thewomen of the twocommunities cope with these access-related barriers?
  • How and to what extent do the government programs and schemes related to provision of care during pregnancy and skilled birth attendance address the inaccessibility concerns of the populations?

Independent Monitoring Activities for Bihar School-based Deworming in 2014

Agency:DtWI,NewDelhi

Project Team:SantoshKumar, S.P. Chattopadhyay,TukaramKhandade,AkhilAgrawal,Bimlesh Sinha,Vishal Singh, Lalchand Sharma

Deworm the World Initiative (DtWI) prides itself in its evidence-based approach to policy implementation and evaluation. The organization conducts independent monitoring of process and coverage evaluation for each round of deworming in every state in which it operates. IIHMR team supported the DtWI in organizing a survey in 33 districts of Bihar as per the terms of reference. To ensure the quality of field work and related activities under the project, the following methods were considered by the IIHMR team on Deworming Day, Mop-Up Day andValidation Day in Bihar:

  • During training/induction of monitors and supervisors on the questionnaire, pre-and post-testswere given as per DtWI guidelines
  • On the Deworming Day and Mop-Up Day, filled questionnaires and schedules were checked by the supervisor on the ground level (school) and sample basis. A few students were re-interviewed by the supervisor to understand the aberration of the responses, if any.
  • During the CoverageValidation days, the monitorswere supported by the supervisors to complete the process in all respects.


The projectwas completed as per theTORand the deliverableswere submitted to DtWI within the time frame.


Market Survey for Seth Anandram Jaipuria Eye Hospital, Nawalgarh

Agency:Jaipuria Hospital

Project Team:SantoshKumar,Kalpa Sharma, Lalchand Sharma

Seth Anandram Jaipuria Eye Hospital was established in 1942 at Nawalgarh, Rajasthan. It provides comprehensive care ranging over preventive services, anticipatory guidance, assessment of well-being, treatment of illnesses covering minor to most complicated and life threatening ones to all age groups. The objectives of the study were to assess the community’s perception of the Hospital, to assess the reasons for less utilization of services available at the Hospital by the community, and to assess the services and facilities provided by other health care providers and diagnostic centers.

The studywas carried out in 53 villages of Jhunjhunu and Sikar districts of Rajasthan.