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Health Economics Research Centre (HERC) - Building Health Economics Evidence for Policy Decision Making.
Health Economics Research Centre (HERC) in collaboration with UNICEF, India, has been established at PGIMER, Chandigarh. This centre will serve as a dedicated hub for advancing research and expertise in the field of health economics. By systematically collecting, curating, and disseminating up-to-date information, the HERC aims to empower policymakers, healthcare practitioners, researchers, and stakeholders with the insights needed to make well-informed decisions. The HERC will act as a knowledge hub for globally accepted and nationally relevant best practices aimed at improving maternal and child health outcomes. Further, the centre will be instrumental in assessing the impact and cost-effectiveness of various UNICEF-led interventions implemented in the various states of India. This shall pave the way for making appropriate recommendations for their scale-up at a national level. This comprehensive compilation will not only bridge the gap between programmatic implementation and generating research evidence, but it will also help in advocacy and making evidence-informed decisions.
Year: 2024
Status: Ongoing
Equitable, Quality Universal health coverage Implementation research Project for optimizing comprehensive primary health care through Health and Wellness Centres (EQUIP-HWCs)
India is committed to achieving Universal Health Coverage (UHC) for all by 2030. Ayushman Bharat - Health and Wellness Centres (AB-HWCs) are pivotal in delivering healthcare services at the community level, driving multiple reforms within the healthcare system. Implementation Research (IR) is vital to bridge the divide between established effective practices and their practical implementation within the healthcare system. This IR will be conducted in real-world district health systems, identifying policy-practice gaps and factors influencing healthcare delivery. It aims to co-develop strategies by involving stakeholders and co-implementing, testing, and refining them to achieve optimal healthcare service delivery strategies. This approach aligns with the national priority of enhancing comprehensive primary healthcare (CPHC) services through AB-HWCs. The broad objective of this research project is to co-develop a context-specific implementation delivery model for AB-HWCs that can deliver 12 quality CPHC services with high coverage (80%) equitably.
Year: 2024
Status: Ongoing
Assessment Of RMNCAH+N Service Delivery Costs, Work Patterns and Efficiency of Primary Healthcare Teams at Ayushman Bharat- Health and Wellness Centers
Primary Health Care is broadly acknowledged as the cornerstone of any strategy aimed at achieving Universal Health Coverage (UHC). This study aims to evaluate the costs, work patterns, and efficiency of comprehensive primary healthcare (CPHC) in India.
Year: 2023
Status: Ongoing
Study Of Implementation of Digital MCHN in Micro planning And Supportive Supervision to Improve Maternal and Child Health Outcomes
A digital supportive supervision tool has been developed and implemented in Rajasthan, India to improve the quality and enhance the coverage of maternal health, child health and nutrition (MCHN) sessions. The present research project aims to assess the impact and cost-effectiveness of using this digital technology in improving maternal and child health outcomes
Year: 2023
Status: Ongoing
Air Pollution Investment Case
Air pollution is the leading environmental cause of disease and death globally, responsible for an estimated 9 million premature deaths annually and substantial economic losses. In 2015, pollution-related welfare losses equalled 6.2% of the global GDP, with ambient and household air pollution accounting for 82% of these losses. In India alone, the total health impact of air pollution in 2019 resulted in a GDP loss of 1.36%, valued at $36.8 billion. Evidence shows that pollution control is highly cost-effective, as it not only reduces health risks but also mitigates climate change and biodiversity loss. This study aims to evaluate the economic cost of air pollution abatement interventions, estimate the benefits attributable to these interventions, and determine their overall economic value.
Year: 2023
Status: Ongoing
Economic Analysis for ESIS Primary Health Care Service Delivery
The Ayushman Bharat Health and Wellness Centre (AB-HWC) program, launched in 2018, aims to enhance primary healthcare in India by expanding service coverage, improving care quality, and promoting community participation and wellness. Key reforms include recruiting mid-level healthcare providers, upgrading infrastructure, enhancing diagnostics, and introducing performance-based payments. However, comprehensive data on the cost of delivering primary healthcare remains limited. Additionally, India's public health insurance schemes, such as the Employees? State Insurance Scheme (ESIS), provide comprehensive coverage, including preventive, primary healthcare, and inpatient care, offering financial protection through both direct and indirect healthcare services. Accurate cost data is essential to set proper reimbursement rates and ensure efficient resource allocation. This study seeks to provide economic evidence on primary healthcare costs under AB-HWC and ESIS, develop a financing strategy for purchasing services, and assess how strengthening primary care can reduce reliance on secondary and tertiary care.
Year: 2023
Status: Ongoing
Developing Standard Treatment Guidelines, Designing Health Benefit Packages to Improve the Efficiency of Pools (STG - HBP)
This research project aims to support evidence-informed priority setting and the provision of high-quality healthcare services by focusing on tour key outcome areas. First, it seeks to improve value-for-money decisions in the design and revision of Health Benefit Packages (HBPs) by key public health insurers. including the National Health Authority (NHA). Second, focuses or establishing sustainable cost systems that systematically generate cost evidence from network providers using digital platforms to inform price setting. Third, it endeavours to effectively translate Health Technology Assessment (HTA) evidence to inform health policies. Lastly, it aims to strengthen the quality of care and foster a culture of evidence-based medicine through the development and implementation of high-quality clinical guidelines.
Year: 2023
Status: Ongoing
Developing Capacity to Strengthen District Systems for PHC Performance
The goal of this research project is to identify and support the implementation of support strategies to achieve India?s goal of a patient-centred, equitable and high-quality primary healthcare system that delivers better health outcomes. This research project will have a dual focus on two important policy areas- ?Transformed health sector governance, accountability, institutional and management capacity? and ?Improved quality of CPHC service delivery?.
Year: 2023
Status: Ongoing
Estimation of Cost-effectiveness Threshold (CET) for India
Increasing healthcare costs and limited resources warrant the need for evidence-based priority setting followed by efficient resource allocation. Such decision-making, in turn, requires careful consideration, given the availability of competing healthcare technologies and the associated opportunity costs for allocating resources to a given intervention. Consequently, the use of health technology assessment (HTA) and economic evaluations has gained importance worldwide as a tool to guide the sustainable allocation of resources. HTA has been widely used to guide policy decisions in India and in the world. To interpret the outcome of such analyses, that is, the incremental cost-effectiveness ratio (ICER), a benchmark is required, which indicates the maximum amount of money a decision-maker is willing to pay for generating an additional unit of health gain. This is commonly known as the cost-effectiveness threshold (CET). Generally, if the ICER (with effectiveness often measured in QALYs gained or disability-adjusted life years averted) is less than the CET, it implies that funding the intervention will maximise population health for a given cost and vice-versa. However, there lies an uncertainty around the estimate of CET that should be used to judge the interventions that are under evaluation. Earlier, the WHO?s Commission on Macroeconomics and Health suggested the use of 1?3 times GDP per capita as the threshold. Nevertheless, the revised guidance by WHO on the interpretation of threshold criteria reveals that such criteria are not decision rules but just a guide to policymakers to assess value for money. In addition, WHO recommends that an intervention should also be assessed in terms of affordability, budget impact, fairness, feasibility and any other criteria considered important in the local context. Therefore, to make decisions regarding the cost-effectiveness of interventions in the Indian context, there is a need to generate a CET value against which the outcomes of HTA studies can be compared. In the absence of such a benchmark, it is not possible to make decisions regarding the potential cost-effectiveness of interventions. To ensure that the evidence generated by health technology assessment (HTA) is translated to policy, it is important to generate a threshold value against which the outcomes of HTA studies can be compared. In this context, the present study delineates the methods that will be deployed to estimate such a value for India.
Year: 2022
Status: Ongoing
Cost-effectiveness of Pradhan Mantri Janaushadhi Pariyojna (PMBP) and its impact on Financial Risk Protection in India
?Jan Aushadhi? is the novel project launched by Government of India in the year 2008 for the noble cause ? Quality Medicines at Affordable Prices for All. The Campaign was undertaken through sale of generic medicines through exclusive outlets namely ?Pradhan Mantri Janaushadhi Kendra? (PMJAK) in various districts of the country [1]. Pharmaceuticals & Medical Devices Bureau of India (PMBI) is the implementing agency of Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP). PMBI was established in December 2008 under the Department of Pharmaceuticals, Government of India. The main objective of the study is to assess the coverage and impact of Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) in achieving financial risk protection and ensuring universal health coverage in India from patient?s perspective and to conduct an extended cost-effectiveness of implementing Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) in India for government?s/ payer?s perspective.
Year: 2022
Status: Ongoing
Centre for Health Insurance Evidence Synthesis & Financing (CHIEF)
The Government of India launched the world's largest tax-funded health insurance scheme - Ayushman Bharat Pradhan Mantri-Jan Aarogya Yojana (AB PM-JAY), in 2018, which is covering 100 million families with an annual coverage of INR 500,000 per family for inpatient services at public and private hospitals empanelled under the scheme. The scheme provides cashless treatment for 1,573 Health Benefit Packages (HBPs) packages through a network of empanelled healthcare providers. The HBPs have undergone four revisions till date, from HBP 1.0 to HBP 2.0 in November 2019, HBP 2.1 in November 2020, HBP 2.2 in November 2021, and HBP 2022 in April 2022. HBP 1.0 covers 1394 packages among 24 specialties which were modified to 27 specialties with 1949 procedures during HBP 2022. These all-recent revisions emanate supply-side characteristics. The latest version, HBP 2022, introduced the concept of differential pricing. The fixed price, referred to as the National Reference Price (NRP), serves as a benchmark, and additional incentives are applied based on hospital characteristics to calculate reimbursement rates. This incorporates incentives based on the location of the hospital (Tier 1, 2, or 3 cities), the level of care (secondary or tertiary), and the type of procedure (medical or surgical). Further, incentives are provided to hospitals accredited by the National Accreditation Board for Hospitals & Healthcare Providers (NABH) (15%) and those located in aspiring districts (10%). However, the prices of procedures are not currently adjusted based on patient-level characteristics. In view of this, this research project aims to assess the impact of various HBP policy interventions including changes in prices, nomenclature, package construct or both on service utilization. Further, the study also proposes a method for refining the existing reimbursement rates under PMJAY based on patient-level characteristics.
Year: 2022
Status: Ongoing
Strengthening Health Economics Evidence for India
A review of a pilot-initiative led by the National Health Authority (NHA) to inform differential pricing of reimbursement rates for Health Benefit Packages (HBPs) under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) was undertaken. The findings highlighted concerns regarding the sustainability of the cost surveillance pilot and the quality of the information being generated, emphasizing the necessity of establishing a viable and scalable healthcare cost surveillance system. Additionally, a methods guide to systematize the processes for revising and updating HBPs under PM-JAY, and a CPHC process manual for undertaking adaptive HTA for timely generation of evidence were developed.
Year: 2021
Status: Ongoing
Evaluation of implementation of Beti Bachao Beti Padhao (B3P) Programme in Haryana state, India.
Over the past decade, India has implemented numerous programs aimed at improving child survival and development, with a focus on bringing social change. To ensure the effectiveness of these initiatives, a thorough evaluation of their outcomes is crucial to inform program and policy decisions. The project "Evaluation of Implementation of Beti Bachao Beti Padhao Programme, Women and Child Development Scheme and Validation of Civil Registration System in Haryana" aimed to assess the impact of various government schemes on child survival and development. The study evaluated the Beti Bachao Beti Padhao (B3P) program's effect on the sex ratio at birth, the accuracy and coverage of Civil Registration System (CRS) records, and the utilization of maternal and infant health services under ICDS. Additionally, the study assessed the awareness, coverage, and utilization of other schemes like Mukhya Mantri Doodh Uphaar Yojana, Pradhan Mantri Matru Vandana Yojana, and Apki Beti Hamari Beti.
Year: 2021
Status: Ongoing
Exploring The Content Validity of the EQ-5D Across Cultures Using Standardized Qualitative Methods
This project was the first attempt to fill a long-standing knowledge gap in relation to EQ-5D and its cultural relevance outside Europe. The purpose of this research was to understand the general public?s view of what characterizes ?poor health?. These are seen as ?characteristics of poor health?. Members of the general public were also asked to think about aspects of ?good health? that contribute to positive quality of life, or ?characteristics of good health?. This research also analysed that how do these health perceptions compare to the dimensions covered by the EQ-5D across all participating countries (Netherlands, Spain, USA, Argentina, China, India and Indonesia). It provided evidence, which was scientifically relevant, and strategically important to the EuroQoL Group. The information it generated has deepened the EuroQoL Group?s understanding of those aspects of health which are important to people in different areas of the world, help to better understand and explain the appropriateness of the instrument in those regions, and provide a strong foundation for future research in this direction
Year: 2021
Status: Ongoing
Intra-Partum Care Bundle to Prevent Epilepsy Caused by Birth
The Prevention Task Force of the International League Against Epilepsy estimated that perinatal brain insults accounted for the largest attributable fraction of paediatric and adult epilepsy in LMICs. It is hypothesized that epilepsy from perinatal brain injury can be reduced by the use of a pragmatic, evidenced based and generalisable intrapartum care bundle that involves birth companions, intelligent foetal heart rate monitoring, an e- partogram and brain oriented neonatal resuscitation, in Indian public sector hospitals. The study aimed to estimate the health system costs and out-of-pocket expenditure for intrapartum care, treating brain injury and epilepsy; followed by estimating the incremental cost per quality adjusted life year gained using the intrapartum care bundle as compared to current standards of care.
Year: 2021
Status: Completed
Price Regulation and Value Based Pricing for anti-cancer Drugs: Implications for Patients, Industry, Insurer and Regulator
The rising economic burden of cancer on health-care system and patients in India has led to the increased demand for evidence in order to inform policy decisions such as drug price regulation, setting reimbursement package rates under publicly financed health insurance schemes and prioritizing available resources to maximize value of investments in health. Economic evaluations are an integral component of this important evidence. In order to facilitate such analyses, strong information systems are needed to be put in place. High out-of-pocket payments and the indirect costs associated with cancer treatment, often result in financial toxicity. Therefore, characterization and prediction of these costs, alongside other health outcomes such as both quantity and quality of life, is important for planning strategies to mitigate the financial hardship due to cancer treatment. Several types of specific cancers do not even have a single case. Thus, another important evidence for conducting HTA is robust data for OOPE among cancer patients, which can be stratified by type of cancer, its health states, levels of severity and type of treatment. Considering the increasing costs of diagnostics and therapeutic interventions for cancer, their formal assessment is imperative to inform value-based standard treatment guidelines. Therefore, the present study aimed to evaluate the value-based prices for 42 anticancer drugs, which have come under price regulation
Year: 2020
Status: Ongoing
Identification of Factors Contributing to out-of-Pocket Expenditure on Medicine
The share of expenditure on medicines as part of the total out-of-pocket (OOP) expenditure on healthcare services has been reported to be much higher in India than in other countries. This study was conducted to ascertain the extent of this share of medicine expenditure using a novel methodology.
Year: 2020
Status: Completed
Comprehensive Primary Health Care: Innovation and Learning Centre (CPHC-ILC) 1.0
In order to understand how the roll-out of the Ayushman Bharat- Health and Wellness Centre programme takes place in Punjab, a support centre for testing innovations and generating learnings for scaling up of the programme, was established in the Department of Community Medicine and School of Public Health, PGIMER, Chandigarh in collaboration with the National Health Systems Resource Centre, New Delhi and the State Health Society, Punjab. The ?Innovation and Learning 2022 New Delhi Centre for comprehensive primary healthcare (CPHC-ILC)? supports the state implementation team for change management through technical inputs on the components of CPHC, training and capacity building, and works closely at the ground level to address implementation issues in service delivery of CPHC.
Year: 2020
Status: Ongoing
Developing a EQ5D5L Quality of Life Value Set for Indian Population
This is the largest 5-level version EQ-5D (EQ-5D-5L) valuation study conducted so far/worldwide and the first preference-based valuation study in South Asia. The study was conducted using a novel design in around 3500 respondents across six states of India. By developing the EQ-5D-5L value set for India, this study fills the long-existing evidence gap in the field of health technology assessment (HTA) in India. The value set generated as a part of this study will help to correctly assess the quality-adjusted life-years (QALYs) in Indian studies.
Year: 2019
Status: Completed
Support to Conduct Online Courses in Basic Health Economics and Economic Evaluation for HTA
Online courses in health economics are envisaged to promulgate the principles of basic health economics and economic evaluation for health technology assessment (HTA). These courses are being delivered with the ?Support to Conduct Online Courses in Basic Health Economics and Economic Evaluation for Health Technology Assessment? by the HRD Scheme of the Department of Health Research. The online course in basic health economics is of three months duration while the advanced course is of five months duration. Each course comprises six modules that cover topics pertinent to sensitise policymakers, program implementers, researchers, academicians, clinicians, and other health-related professionals. These users are from varied educational and professional backgrounds ranging from researchers and clinicians to top-level policy & decision-makers. These courses orient the audience towards the dynamics behind resource allocation decisions using economic evidence as the mainstay. The salient feature is enabling this understanding to be contextualised to the Indian health system.
Year: 2019
Status: Ongoing
Impact Evaluation of National Rural Health Mission in India
Year: 2019
Status: Completed
Economic Impact of Typhoid and Cost effectiveness of strategies for prevention Evaluation of Typhoid
World Health Organization has prequalified the use of typhoid conjugate vaccine (TCV) in children over six months of age in typhoid endemic countries. The present study assessed the cost-effectiveness of introducing TCV separately for urban and rural areas of India. From a societal perspective, introduction of TCV is a cost saving strategy in urban India. Further, due to low incidence of typhoid infection, introduction of TCV is not cost-effective in rural settings of India
Year: 2019
Status: Completed
Costing of Health Services in India (CHSI)
The ?Cost of Health Services in India (CHSI)? is the first large scale multi-site facility costing study to incorporate evidence from a national sample of both private and public sectors at different levels of the health system in India. A total of 38 public (11 tertiary care and 27 secondary care) and 16 private hospitals were sampled from 11 states of India. From the sampled facilities, a total of 327 specialties were included, with 48, 79 and 200 specialties covered in tertiary, private and district hospitals respectively. A mixed methodology consisting of both bottom-up and top-down costing was used for data collection.
Year: 2018
Status: Completed
Evaluation of National Multi- stakeholder Action Plan for NCDs in India
Year: 2018
Status: Completed
Evaluation of the ?Bhai Ghanhya Sehat Sewa Scheme? (BGSSS) in the state of Punjab, India
Year: 2017
Status: Completed
Economic Assessment of health impact and economic costs associated with unsafe & unnecessary injections and unsafe biomedical waste disposal in Punjab state and for India.
Globally, 16 billion injections are administered each year of which 95% are for curative care. India contributes 25?30% of the global injection load. Over 63% of these injections are reportedly unsafe or deemed unnecessary. The objective of the current study was to assess the incremental cost per quality-adjusted life-year (QALY) gained with the introduction of safety-engineered syringes (SES) as compared to disposable syringes for therapeutic care in India. The study findings revealed that RUP syringes are estimated to be cost-effective in the Indian context. SIP and RUP?+?SIP syringes are not cost-effective at the current unit prices. Efforts should be made to bring down the price of SES to improve its cost-effectiveness
Year: 2017
Status: Completed
Comparative cost-effectiveness of nurse-mentoring models in India
Year: 2017
Status: Completed
Medical Technology Assessment Board Resource Centre
In order to promote transparent and evidence-informed decision-making in healthcare, the Government of India established the Health Technology Assessment in India (HTAIn) under the Department of Health Research (DHR), Ministry of Health and Family Welfare. The HTAIn Regional Resource Hub at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, was initially set up in 2017 as the first Regional Resource Centre (RRC) of the HTAIn Secretariat, DHR, Ministry of Health and Family Welfare, Government of India. In 2024, it was further upgraded to the status of a Regional Resource Hub (RRH). Since its inception, the RRC has made substantial contributions to the development and strengthening of the HTA framework in India. Beyond conducting globally recognized HTA studies, it has played a pivotal role in building capacity, developing processes, and establishing guidelines and databases essential for the effective implementation of HTA across the country. In addition to supporting other technical partner institutes and RRCs in conducting their assigned HTA studies, the HTAIn-RRH at PGIMER has also contributed significantly to the work of the HTAIn Secretariat. It has organized a series of national and international conferences, workshops, and training programs aimed at advancing HTA practices. The evidence generated from the studies conducted by the HTAIn-RRH at PGIMER has resulted in numerous policy changes at both the central and state levels, leading to improved healthcare resource allocation and substantial cost savings.
Year: 2017
Status: Ongoing
Effectiveness of Costing of National Vector Borne Disease Control Program in North India
Despite significant resources being spent on National Vector Borne Disease Control Programme (NVBDCP), there are meagre published data on health system cost upon its implementation. Hence, the present study estimated the annual and unit cost of different services delivered under NVBDCP in North India. The evidence on cost of NVBDCP can be used to undertake future economic evaluations which could serve as a basis for allocating resources efficiently, policy development as well as future planning for scale up of services.
Year: 2016
Status: Completed
Partnerships for Affordable Healthcare Access and Longevity (PAHAL)
Year: 2016
Status: Completed
Cost Effectiveness of Dimagi?s Commcare Program for Maternal and Child Healthcare
A variety of mobile-based health technologies (mHealth) have been developed for use by community health workers to augment their performance. One such mHealth intervention?ReMiND program, was implemented in a poor performing district of India. Despite some research on the extent of its effectiveness, there is significant dearth of evidence on cost-effectiveness of such mHealth interventions. In this research project we evaluated the incremental cost per disability adjusted life year (DALY) averted as a result of ReMiND intervention as compared to routine maternal and child health programs without ReMiND. Overall, findings of our study suggest strongly that the mHealth intervention as part of ReMiND program is cost saving from a societal perspective and should be considered for replication elsewhere in other states.
Year: 2015
Status: Completed
Economic Burden of RF/RHD and Cost Effectiveness of its Prevention Strategies in India
There is a dearth of evidence on the cost-effectiveness of a combination of population-based primary, secondary, and tertiary prevention and control strategies for rheumatic fever and rheumatic heart disease. The present research project was aimed to evaluate the cost-effectiveness and distributional effect of primary, secondary, and tertiary interventions and their combinations for the prevention and control of rheumatic fever and rheumatic heart disease in India. The combined secondary and tertiary prevention and control strategy is the most cost-effective option for the management of rheumatic fever and rheumatic heart disease in India, and the benefits of public spending are likely to be accrued much more by those in the lowest income groups. The quantification of non-health gains provides strong evidence for informing policy decisions by efficient resource allocation on rheumatic fever and rheumatic heart disease prevention and control in India.
Year: 2015
Status: Completed
National Highway Accident Relief Service Scheme (NHARSS) and cashless scheme of health insurance for road accident victims
Year: 2015
Status: Completed
Strengthening Eco-system for Sustainable and Inclusive Health Financing in India
Year: 2015
Status: Completed
Universal Health Coverage: status, constraints, challenges and prognosis
Year: 2014
Status: Completed
The Impact of Road Traffic Injury: A Mixed Methods Study in North India
Injuries are a major public health problem, resulting in high health care demand and economic burden. They result in loss of disability adjusted life years (DALYs) and high out-of-pocket expenditure. However, there is little evidence on the economic burden of injuries in India. We undertook this study to report out-of-pocket expenditure and the prevalence of catastrophic health expenditure for injuries related hospitalizations in public sector hospitals in North India. Further, we also evaluate the determinants of catastrophic health expenditure. The economic impact of injuries is notably high both in terms of out-of-pocket expenditure and productivity loss. A high proportion of households experienced catastrophic expenditure and impoverishment following an injury, highlighting need for programs to prevent injuries.
Year: 2014
Status: Completed
Economic and Social Impact of Injury: A Pilot Study
Injuries are a serious cause of mortality and morbidity worldwide, with trauma being the leading cause of death in the first four decades of life. By contrast with the declining rates of injury seen in high-income countries, low-income and middle-income countries (LMICs) are experiencing an increase in injury rates, largely due to increased motorisation in these countries. This study assessed the extent out-of-pocket expenditure and financial risk protection from trauma care in a tertiary care hospital of India.
Year: 2013
Status: Completed
Evaluation of Medical Emergency Response Services in the state of Punjab
Emergency referral services (ERS) are being strengthened in India to improve access for institutional delivery. This study evaluated the publicly financed and privately delivered model of ERS in Punjab state, India, to assess its extent and pattern of utilization, impact on institutional delivery, quality and unit cost. The study finding revealed that emergency referral services in Punjab did not result in a significant change in public sector institutional deliveries. This could be due to high baseline coverage of institutional delivery and low barriers to physical access. Choice of interventions for reduction in Maternal Mortality Ratio (MMR) should be context-specific to have high value for resources spent. The ERS in Punjab needs improvement in terms of quality and reduction of cost to health system
Year: 2013
Status: Completed
Baseline Study to Assess the Access to Medicines Situation in India
Access to free essential medicines is a critical component of universal health coverage. However, availability of essential medicines is poor in India with more than two-third of the people having limited or no access. This has pushed up private out-of-pocket expenditure due to medicines. The states of Punjab and Haryana are in the process of institutionalizing drug procurement models to provide uninterrupted access to essential medicines free of cost in all public hospitals and health centres. Current study was undertaken to assess the availability of medicines in public sector health facilities in the 2 states. Secondly, we also ascertained the quality of storage and inventory management systems in health facilities
Year: 2013
Status: Completed
Cost Outcome Description of Liver-ICU Treatment in a Tertiary Care Hospital
Liver diseases contribute significantly to the health and economic burden globally. We undertook this study to assess the health system costs, out-of-pocket (OOP) expenditure and extent of financial risk protection associated with treatment of liver disorders in a tertiary care public sector hospital in India. Treatment of chronic liver disorders poses an economic challenge for both the health system and patients. There is a need to focus on prevention of liver disorders and finding ways to treat patients without exposing their households to the catastrophic effect of OOP expenditure.
Year: 2013
Status: Completed
Costing of primary and secondary health services in North India
With the commitment of the national government to provide universal healthcare at cheap and affordable prices in India, public healthcare services are being strengthened in India. However, there is dearth of cost data for provision of health services through public system like primary & community health centres. The aim of the current study was to bridge this gap in evidence by assessing the total annual and per capita cost of delivering the package of health services at PHC and CHC level. Secondly, we determined the per capita cost of delivering specific health services like cost per antenatal care visit, per institutional delivery, per outpatient consultation, per bed-day hospitalization etc.
Year: 2012
Status: Completed
Concurrent Evaluation of National Rural Health Mission
Concurrent Evaluation of National Health Mission, Haryana is a community-based household survey for assessing coverage and trends of various indicators on MCH, family planning, childhood conditions, curative care services utilisation and associated expenditure. The project also evaluates trends in coverage of indicators, quality and completeness of HMIS and coverage of universal health care in the state.
Year: 2012
Status: Completed
Evaluation of Medical Emergency Response Services in the state of Haryana
Various models of referral transport services have been introduced in different States in India with an aim to reduce maternal and infant mortality. Most of the research on referral transport has focussed on coverage, quality and timeliness of the service with not much information on cost and efficiency. This study was undertaken to analyse the cost of a publicly financed and managed referral transport service model in three districts of Haryana State, and to assess its cost and technical efficiency. The findings of the study revealed that the publicly delivered referral transport services in Haryana were operating at an efficient level. Increasing the demand for referral transport services among the target population represents an opportunity for further improving the efficiency of the underutilized ambulances.
Year: 2011
Status: Completed
Evaluation of Referral Transport Services in Haryana
Creation of a strong referral transport network across the country is necessary for improving physical access to public sector health facilities. In this study we evaluated the referral transport services in Haryana, i.e. Haryana Swasthya Vaahan Sewa (HSVS), now known as National Ambulance Service (NAS), to assess the extent and pattern of utilization, and to ascertain its effect on public sector institutional deliveries. The findings of the study showed a positive effect of referral transport service on increasing institutional deliveries. However, this needs to be backed up with adequate supply of basic and emergency obstetric care at hospitals and health centres.
Year: 2011
Status: Completed
Health Inequities in Three Northern Indian States: Role of Public Sector
Income inequality is associated with poor health. Inequities exist in service utilization and financing for health care. Health care costs push high number of households into poverty in India. The objective of this study was to ascertain inequities in health status, service utilization and out-of-pocket (OOP) health expenditures in two States in north India namely, Haryana and Punjab, and Union Territory of Chandigarh. The study findings indicates that public sector health service utilization needs to be improved. OOP health care expenditures at public sector institutions should be curtailed to improve utilization of poorer segments of population. Greater availability of medicines in public sector and regulation of their prices provide a unique opportunity to reduce public sector OOP expenditure.
Year: 2009
Status: Completed
Evaluation of ICDS program in Chandigarh
The Integrated Child Development Services (ICDS) scheme has been operational for more than three decades in India. The objective of this research study was to evaluate the various aspects of the ICDS program in terms of inputs, process and outcome (coverage), utilization, and issues related to the ICDS program. The study reported gaps in terms of infrastructure facility, different trainings, coverage, supply, and provision of SN, status of PSE activities in AWCs, and provision of different services to the beneficiaries.
Year: 2007
Status: Completed
Impact of user charges on service utilization in Haryana
User charges have been advocated on efficiency grounds despite the widespread criticism about their adverse effect on equity. This study assessed the effect of user charges on inpatient hospitalizations rate and equity in Haryana State. The findings of study showed that user charges had a negative influence on hospitalizations in Haryana especially among the poor. Public policies for revenue generation should avoid user charges.
Year: 2006
Status: Completed