Rajani Ved

• National Health Systems Resource Centre

This paper proposes a taxonomy for Community Health Workers (CHWs) and others engaged in front-line community health activities, encompassing formally-employed workers extending government primary health care (PHC) service delivery as well as a range of other actors with roles at the nexus of government PHC and communities. The taxonomy is grounded...

Background Direct-to-beneficiary communication mobile programmes are among the few examples of digital health programmes to have scaled widely in low-resource settings. Yet, evidence on their impact at scale is limited. This study aims to assess whether exposure to mobile health information calls during pregnancy and postpartum improved infant feed...

Objectives Efforts to understand the factors influencing the uptake of reproductive, maternal, newborn, child health and nutrition (RMNCH&N) services in high disease burden low-resource settings have often focused on face-to-face surveys or direct observations of service delivery. Increasing access to mobile phones has led to growing interest in ph...

Mobile phones are increasingly used to facilitate in-service training for frontline health workers (FLHWs). Mobile learning (mLearning) programmes have the potential to provide FLHWs with high quality, inexpensive, standardised learning at scale, and at the time and location of their choosing. However, further research is needed into FLHW engagemen...

The Kilkari programme is being implemented by the Government of India in 13 states. Designed by BBC Media Action and scaled in collaboration with the Ministry of Health and Family Welfare from January 2016, Kilkari had provided mobile health information to over 10 million subscribers by the time BBC Media Action transitioned the service to the gove...

Introduction India has become a lighthouse for large-scale digital innovation in the health sector, particularly for front-line health workers (FLHWs). However, among scaled digital health solutions, ensuring sustainability remains elusive. This study explores the factors underpinning scale-up of digital health solutions for FLHWs in India, and the...

Digital health solutions offer tremendous potential to enhance the reach and quality of health services and population‐level outcomes in low‐ and middle‐income countries (LMICs). While the number of programs reaching scale increases yearly, the long‐term sustainability for most remains uncertain. In this article, as researchers and implementors, we...

Adolescents are an increasing proportion of low and middle-income country populations. Their coming of age is foundational for health behaviour, as well as social and productive citizenship. We mapped intervention areas for adolescent sexual and reproductive health, including HIV, mental health and violence prevention to sectors responsible for the...

Background In 2017, India was home to nearly 20% of maternal and child deaths occurring globally. Accredited social health activists (ASHAs) act as the frontline for health services delivery in India, providing a range of reproductive, maternal, newborn, child health, and nutrition (RMNCH&N) services. Empirical evidence on ASHAs’ knowledge is limit...

Health systems are critical for health outcomes as they underpin intervention coverage and quality, promote users' rights and intervene on the social determinants of health. Governance is essential for health system endeavours as it mobilises and coordinates a multiplicity of actors and interests to realise common goals. The inherently social, poli...

Background: Respectful maternity care (RMC) is a key barometer of the underlying quality of care women receive during pregnancy and childbirth. Efforts to measure RMC have largely been qualitative, although validated quantitative tools are emerging. Available tools have been limited to the measurement of RMC during childbirth and confined to obser...

India’s National Health Mission constituted Village Health Sanitation and Nutrition Committees (VHSNCs) as a key mechanism for community health governance. Health committees provide citizens with the opportunity to shape health systems and policies. Yet much remains to be learnt on how best to sustain health committees as vehicles for community hea...

Background: Efforts to work with civil society to strengthen community participation and action for health are particularly important in Gujarat, India, given that the state has resources and capacity, but faces challenges in ensuring that services reach those most in need. To contribute to the knowledge base on accountability and maternal health,...

Role of district health management teams in child health strategies Well functioning district health systems are essential for planning and implementation of health services, and their efforts are key to improving quality of care and achieving health goals, say Tanya Doherty and colleagues Key messages • Districts, led by district health management...

Health committees are a common strategy to foster community participation in health. Efforts to strengthen committees often focus on technical inputs to improve committee form (e.g. representative membership) and functioning (e.g. meeting procedures). However, porous and interconnected contextual spheres also mediate committee effectiveness. Using...

In-depth interview guide: Village health committee members. (DOCX)

Scott, K., George, A.S., Harvey, S.A., Mondal, S., Patel, G., Raman, VR, Sheikh, K. Government helper and citizen advocate? A case study of the multiple roles and pressures facing a non-governmental organization contracted by government to strengthen community health in northern India. Status as of 29 June 2017: Unpublished manuscript, submitted to...

In-depth interview guide: Health system functionaries (block medical officer and ASHA supervisors). (DOCX)

Background Convergence of sectoral programs is important for scaling up essential maternal and child health and nutrition interventions. In India, these interventions are implemented by two government programs – Integrated Child Development Services (ICDS) and National Rural Health Mission (NRHM). These programs are designed to work together, but t...

ABSTRACT Background: Patient Help Desks, called Rogi Sahayata Kendras (RSKs) were set up by West Bengal in selected public health facilities as an ‘innovation’ under the National Rural Health Mission during 2008-09. The aim was to provide facilitation, information to patients for ease and timely access of services at the hospital. They were set up...

Background Health committees are a popular strategy for facilitating community participation in health, particularly in low- and middle-income countries. Their potential effects are mediated by a number of factors including the contextual environment in which they function. George and colleagues1 in 2015 put forward a framework that identifies four...

Health committees, councils or boards (HCs) mediate between communities and health services in many health systems. Despite their widespread prevalence, HC functions vary due to their diversity and complexity, not least because of their context specific nature. We undertook a narrative review to better understand the contextual features relevant to...

This paper proposes an approach to periodically measure the extent of progress towards universal health coverage using a set of indicators that captures the essence of the factors to be considered in moving towards universalisation. It presents the rationale for the approach and demonstrates its use, based on a primary household survey carried out...

Facilitation to patients and their grievance redressal is an important function in all health facilities. In absence of this, patients may be subjected to confusion due to lack of information, inability to avail several benefits that they are entitled to, leading to underutilization of services and quite often falling prey to exploitation from tout...

Background: In India, delivery of interventions to improve child nutrition requires active IC between the Ministries of Health and Family Welfare (MOHFW) and Women and Child Development (MWCD). This in turn requires linked actions in policy formulation, implementation, and monitoring & evaluation (M&E), but little is known about IC or how to optimi...

The Janani Suraksha Yojana (JSY) was launched in 2005 as a response to high maternal mortality in India. The scheme was driven by global evidence that conditional cash transfers enable behaviour change, in this case, rise in institutional delivery. The scheme had a differential incentive entitlement based on urban or rural areas and high or low per...

One of the challenges that the National Rural Health Mission (NRHM) faces is its ability to evaluate the progress of the programme in diverse contexts and use such evidence to constantly improve programme design and implementation. The National Rural Health Mission has put in place several measures for concurrent evaluation to review the progress o...

Approximately one-quarter of all maternal deaths occur in India, far more than in any other nation on earth. Until 2005, maternal mortality reduction was not a priority in the country. In that year, the cause emerged on the national political agenda in a meaningful way for the first time. An unpredictable confluence of events concerning problem def...