Implementing a Public Private Partnership Model for Managing Urban Health in Ahmedabad

Establishing a Public Private Partnership (PPP) requires a legal framework acceptable to all the partners, clarity on the commitment of resources, roles and responsibilities of each partner, as well as accountability to provide a given set of services at a desired level of quality and affordable user charges. This paper describes the design, development and implementation of a PPP for managing urban health services in Ahmedabad city, Gujarat. [adapted from abstract]

Tuberculosis Management by Private Practitioners in Mumbai, India: Has Anything Changed in Two Decades?

The objective of this research was to study prescribing practices of private practitioners in the treatment of tuberculosis, two decades after a similar study conducted in the same geographical area revealed dismal results. [from abstract]

Challenge and Change: Integrating the Challenge of Gender Norms and Sexuality in a Maternal Health Program

This report documents some of the processes undertaken to integrate gender and sexuality factors into a maternal health project in Uttar Pradesh, India from 2007-2009. [from foreword]

Meeting Challenges, Seeding Change: Integrating Gender and Sexuality into Maternal and Newborn Health Programming through the Inner Spaces, Outer Faces Initiative (ISOFI)

This document reviews the ISOFI program. The iterative steps of this system focus on building staff and organisational capacity to critically analyse the social construction of gender and explore how gender influences personal values and beliefs and programmatic designs and choices. In turn, through the analysis-reflection-action cycle of the ISOFI Innovation System, staff can help community health providers and other stakeholders to analyse gender issues, reflect on local barriers and opportunities, and make implementation plans to catalyze change. [from author]

Mobile-izing Health Workers in Rural India

This article outlines a project that deployed short videos on mobile phones designed to motivate health workers and persuade pregnant village women to use health services. The project also asked health workers to record their own videos. The results show evidence that the creation and use of videos helped engage village women in dialogue, showed positive effects toward health worker motivation and learning, and motivated key community influencers to participate in promoting the health workers. [adapted from abstract]

Private Pharmacists: the Missing Link in TB Control

India has the highest incidence of tuberculosis (TB) in the world. The Government’s TB programme uses Directly Observed Treatment Short course to supervise patients’ treatment. However an estimated 40-50 per cent of TB treatment is accessed through private pharmacists. A challenge is to engage these pharmacists in TB control. [from author]

Community Pharmacy Practice in India: Past, Present and Future

Today, community pharmacists play an important role in any country as they take responsibility for patient’s medicine related needs for access to healthcare. This article seeks to discuss the genesis of Indian community pharmacy, the majority of which are privately owned, and sketches its education, training and future prospects. [from abstract]

Estimating the True Shortfall of Medical Practitioners in Rural India

A researcher from the University of Surrey (UK) proposes a basic framework for estimating relative shortages of medical personnel in rural and urban areas of developing countries. The author distinguishes between qualified doctors, trained non-doctors and untrained non-doctors. Using data for Ujjain district in the state of Madhya Pradesh, India, the author then estimates their impact on the quality of health care available. [from author]

Provision of Emergency Contraceptive Services through Paraprofessionals in India

This two-year study to assessed the usefulness and effectiveness of using paraprofessionals in educating and providing emergency contraceptive pill services to potential users. [from summary]

Empowering Health Personnel for Decentralized Health Planning in India: the Public Health Resource Network

This article describes the Public Health Resource Network, an innovative distance-learning course in training, motivating, empowering and building a network of health personnel from government and civil society groups. Its aim is to build human resource capacity for strengthening decentralized health planning, especially at the district level. [from abstract]

Internationally Recruited Nurses from India and the Philippines in the United Kingdom: the Decision to Emigrate

The United Kingdom has recruited nurses from countries with a reported surplus in their nursing workforce, such as India and the Philippines. However, little is known about the decision to emigrate made by nurses from these countries. One theory suggests that individuals weigh the benefits and costs of migration: the push and pull factors. This paper challenges the restricted economic focus of this predominant theory and compares the diverse motivations of nurses from different countries as well as those of nurses with previous migratory experience and first-time migrants. [from abstract]

Leveraging Human Capital to Reduce Maternal Mortality in India: Enhanced Public Health System or Public-Private Partnership

This paper will use India as a lens to examine the broader issues surrounding human resources and public health. It will explore some of the HR strategies employed in a variety of settings with mixed results. Finally, it will look at several very contrasting approaches employed by two Indian states, Tamil Nadu and Gujarat, in dealing with human resource shortages as they struggle to reduce maternal mortality. [from author]

Reducing HIV Stigma and Gender Based Violence: Toolkit for Health Care Providers in India

The toolkit is a collection of participatory educational exercises for educating health care providers on the issues of stigma and gender-based violence. It was developed for and with health care providers in Andhra Pradesh, India. The goal is to facilitate open discussion on HIV stigma and gender violence, and on what health workers can do to promote a change in attitude and practice. [from publisher]

Nursing Brain Drain from India

In response to recent findings regarding migration of health workers out of Africa, we provide data from a survey of Indian nurses suggesting that up to one fifth of the nursing labour force may be lost to wealthier countries through circular migration. [abstract]

Focusing on the Essentials: Learning for Performance

There is increasing consensus that training programmes should focus on know-how instead of know-all. IntraHealth International’s Learning for performance: a guide and toolkit for health worker training and education programs offers a step-by-step, customizable approach designed to develop the right skills linked to job responsibilities. Using Learning for Performance yields more efficient training that focuses on what is essential for health workers to do their jobs and on effective learning methods.

Achieving Millennium Development Goal 5: Is India Serious?

This article suggests that India’s maternal mortality rate is so high due to political, administrative and managerial issues such as the lack of exclusive midwifery training and professional midwives. [adapted from author]

New Approaches to Regulation of India's Health Sector

India has traditionally had a bureaucratic approach to regulating its health service. Research suggests that this approach has failed to protect the interests of poor and vulnerable groups and has not gained the trust of providers or the public. So are there any other ways to make India’s health systems more accountable? [from author]

Working with Traditional Providers in Improving Health Outcomes in India

This presentation addresses the role and impact of traditional health service providers in India and how they help fill the gaps in health worker coverage. [from author]

Understanding and Measuring AIDS-Related Stigma in Health Care Settings: a Developing Country Perspective

This paper reports on AIDS-related stigma baseline findings from a study to evaluate the impact of a stigma-reduction intervention in three large hospitals in New Delhi, India. The study highlights issues particular to the health care sector in limited-resource settings. [from abstract]

Effectiveness of a Home Care Program for Supporting Caregivers of Persons with Dementia in Developing Countries: A Randomised Controlled Trial from Goa, India

This study was implemented to develop and evaluate the effectiveness of a home based intervention in reducing caregiver burden, promoting caregiver mental health and reducing behavioural problems in elderly persons with dementia. [from abstract]

Andhra Pradesh, India: Improving Health Services through Community Score Cards

The community score card process is a community-based monitoring tool that is a hybrid of the techniques of social audits and citizen report cards.The CSC is an instrument to exact social and public accountability and responsiveness from service providers. By linking service providers to the community, citizens are empowered to provide immediate feedback to service providers. [from author]

Community Involvement Saves Newborn Infants in India

In a rural village in India, newborn deaths have been halved not by neonatologists or high-tech interventions but by local villagers trained in simple life-saving practices. Some experts, however, are sceptical about whether this strategy can work everywhere. [from author]

Empowering the People: Development of an HIV Peer Education Model for Low Literacy Rural Communities in India

Despite ample evidence that HIV has entered the general population, most HIV awareness programs in India continue to neglect rural areas. Low HIV awareness and high stigma, fueled by low literacy, seasonal migration, gender inequity, spatial dispersion, and cultural taboos pose extra challenges to implement much-needed HIV education programs in rural areas. This paper describes a peer education model developed to educate and empower low-literacy communities in the rural district of Perambalur in India. [from abstract]

Provider Selection of Evidence-Based Contraception Guidelines in Service Provision: a Study in India, Peru, and Rwanda

This study evaluated biases in guideline untilization of evidence-based practice concerning contraception perscription. It was found that in India, Peru, and Rwanda, health care providers underutilize evidence-based practice guidelines as they prescribe contraceptives. This article ends with recommendations for providers to most effectively utilize evidence-based practice. [adapted from abstract]

Indian Public-Private Partnership for Skilled Birth-Attendance

This article describes the efforts of the Indian government to decrease maternal mortality by improving birthing conditions. The scheme created a partnership with the private sector and an NGO to provide free birth care to poor families through contracts with private obstetricians practicing in rural areas. The authors conclude that public-private partnerships can rapidly scale up the availability of human resources for skilled birth-attendance and emergency obstetric care to the poor in a very short time. [adapted from author]

High-End Physician Migration from India

This study shows that graduates from higher quality institutions account for a disproportionately large share of emigrating physicians in India. Even within high-end institutions, better physicians are more likely to emigrate. Interventions should focus on the highly trained individuals in the top institutions that contribute disproportionately to the loss of human resources for health. The findings suggest that affirmative-action programmes may have an unintended benefit in that they may help retain a subset of such personnel. [adapted from author]

India Local Initiatives Program: A Model for Expanding Reproductive and Child Health Services

The India Local Initiatives Program adapted a model used in Indonesia and Bangladesh to implement the government’s reproductive and child health strategy. From 1999 to 2003, three Indian nongovernmental organizations (NGOs) provided services for 784,000 people in four northern states. This model proved to be a suitable platform upon which to build health-care service delivery and create behavioral change, and the NGOs quickly found ways to sustain and expand services. [from abstract]

Options and Challenges for Converging HIV and Sexual and Reproductive Health Services in India: Findings from an Assessment in Andhra Pradesh, Bihar, Maharashtra, and Uttar Pradesh

The report aims to share findings from an assessment to explore how access to critical services for populations at risk of HIV and unintended pregnancy can be strengthened by converging HIV and sexual and reproductive health (SRH) services under the National Rural Health Mission (NRHM) and the National Aids Control Programme (NACP). The report provides information on the demand and opportunities for and the challenges of implementing HIV and SRH convergence in four states

Sexual Harassment in the Workplace: Experiences of Women in the Health Sector

The objective of this paper is to explore the context of sexual harassment of women in the health sector in Kolkata, West Bengal. Specifically, it explores women’s perceptions of the occurrence of sexual harassment in hospital settings, and probes women’s own experiences of sexual harassment and incidents of sexual harassment in the hospital environment about which women are aware. The study also investigates the nature of action taken to seek redress, and the extent to which working women are aware of the complaint mechanism outlined by the Supreme Court. [from introduction]

Expanding the Role of Community Based Workers and Advocates in Safe Motherhood

Under the ENABLE Safe Motherhood Core Initiative, CEDPA/India collaborated with the Community Aid and Sponsorship Program on the Safe Motherhood Initiative to reduce maternal death by showing women, their families and their communities how to prepare for a safe delivery, to identify pregnancy-related complications at their onset, and to seek medical help immediately. [publisher’s description]