HEALTH

GOVERNANCE HUB

PROGRESS UPDATE (Aug 2014) The Health Governance Hub is the Public Health Foundation of India’s interdisciplinary programme of health policy & systems research (HPSR), research capacity building and knowledge translation. The Hub was formed in 2011 and has been engaged in research on several thematic areas including human resources for health, decentralization and local governance, community action, health stewardship and regulation, and universal health coverage. The Hub consists of a cross-disciplinary research team across PHFI Central and the IIPHs, and combines a focus on investigating critical health policy and health systems challenges confronting India and other low and middle-income countries, and a commitment to advancing goals of health equity and justice.

Since inception, the Hub has successfully launched a wide ranging portfolio of research and capacity building initiatives, with support from WHO, IDRC, DfiD, Wellcome Trust, MRC UK, ESRC UK, Oxfam and other donors. Members of the Hub team have been central contributors to the PHFI led efforts for Universal Health Coverage (UHC), and we aim to continue and strengthen our focus on achieving UHC in upcoming programmes. PHFI has an extensive track record of collaborative initiatives, spanning six continents and over a 100 organizations. The Health Governance Hub’s network of partners now extends across multiple constituencies to a wide range of organizations including LSHTM, JHSPH, the Nossal Institute of Global Health, Columbia University, LASDEL Niger, ITM Antwerp, IDS Sussex, BRACU, University of the Western Cape, University of Cape Town, TISS Mumbai, IIM Bengaluru, IIT Madras, IIHMR Jaipur, SCTIMST Thiruvananthapuram, IPH Bengaluru, the Planning Commission, NHSRC, PHRN, SOCHARA, HSRII, Doosra Dashak, DASCBR, and Ekjut.

Current Research Projects u Strengthening village health committees for intensified community engagement at scale (VOICES)

Implementation research undertaken with the National Rural Health Mission to inform and strengthen an institutional support package for participatory Village Health Committees (VHC) in 100 villages in two states in India – Tamil Nadu and Rajasthan. The package includes community mobilization, village health committee reconstitution, and training and support for meetings. 2013-15. Funders / partners –AHPSR, IDRC / SOCHARA, JHSPH, NHSRC, Doosra Dashak, DASCBR VHSNC training session, Laxmangarh, Rajasthan

u Posting and transfer (PT) in the health sector. Exploration of posting and transfer policies and practices in the government health sector in four Indian states. A pilot case study has been undertaken on PT at primary care level in Tamil Nadu state. PHFI co-organized a Bellagio conference in Jan 2014, which launched a multi-country research network on PT. A satellite session on PT is planned at the 3rd Global HSR Symposium in Sep 2014. 2013-16. Funders / partners – DfiD / Columbia University, multiple

Bellagio Conference on Posting and Transfer in the Health Sector, Feb 2014

 

u Engaging grassroots institutions

for Universal Health Coverage (GRASSROOTS): A series of consultations and institutional support initiatives, toward developing a roadmap to strengthen the role of community-based organizations in Universal Health Coverage. 2013-14. Funders / partners – IDRC / multiple CBOs

State consultation on role of community based organizations in Universal Health Coverage, Tamil Nadu, Jan 2014

u Nurturing nursing in an era of Universal Health Coverage: Recent plans for Universal Health Coverage (UHC) in India have been developed on the expectation of a principal role of nurses in delivering essential health services. Yet this yeoman sector of professionals faces a distinct and formidable set of challenges for its role and future development. This research study applies ‘action-centred’ frameworks of implementation analysis, and aims to diagnose the operational, ethical and political challenges confronting nursing governance in India. 2013-16. Funders / partners – DfiD / National Health Systems Resource Centre

u What explains regulatory failure? Analysis of institutional architecture and implementation of health care regulation in several Indian states, using a customized policy-mapping tool. Piloted and extended to other states 2012-15. Funders / partners – Oxfam, DfiD / Nossal Institute of Global Health

Field Building Programmes u Nodal Institute for Health Policy & Systems Research: As the Nodal Institute of the Alliance for Helalth Policy

& Systems Research in India, PHFI has the mandate to support HPSR capacity development, extend collaborations with existing capacity building initiatives, and facilitate the use of HPSR evidence by health system decision-makers in the region. So far the Nodal Insitute has mapped national capacity for HPSR in India, convened and supported the presence of Indian HPSR researchers in global symposia, and launched KEYSTONE: a major nationwide capacity building initiative in HPSR. 2012-15. Funders/ partners – WHO (AHPSR)/ IIM Bengaluru, IITM Chennai, IIHMR Jaipur, TISS Mumbai, SOCHARA, SCTIMST Thiruvananthapuram, PGIMER Chandigarh, IPH Bengaluru, IIPH Gandhinagar, HSRI India

u KEYSTONE initiative: The Nodal Institute, in partnership with leading HPSR organizations in India and inputs from other global leaders in the field, is developing a nationwide capacity building strategy for HPSR. KEYSTONE: a specialized short course in HPSR methods will be launched in early 2015, as a result of these efforts. A 3-day meeting of KEYSTONE partners and advisors in Delhi in Jul-Aug 2014 launched the initiative 2014 - Funders/ partners – WHO (AHPSR)/ IIM Bengaluru, IITM Chennai, IIHMR Jaipur, TISS Mumbai, SOCHARA, SCTIMST Thiruvananthapuram, PGIMER Chandigarh, IPH Bengaluru, IIPH Gandhinagar

Delegates at the KEYSTONE development meeting in New Delhi, Jul 2014

 

u SHaPeS Thematic Working Group: This thematic working group of the Health Systems Global society convenes a range of activities and discussions on the use of social science approaches in health policy and systems research (HPSR) to strengthen and raise the profile of social science approaches within the wider field of HPSR. Kabir Sheikh and Aditi Bana provide leadership to SHaPeS in their respective roles as co-convenor and secretary. Hub members Raman VR, Joe Varghese, Kerry Scott and Devaki Nambiar are engaged in leading specific thematic area within SHaPeS.

Forthcoming Research Projects u How do local participatory governance reforms influence equitable access to health services? The role

of Panchayati Raj Institutions in Kerala, India 2014-15. Funders – JHSRI (DFID/ESRC/MRC/Wellcome Trust)

u District Health Management & Public Service Delivery: Evidence from India’s Flagship Health Programme 2014-16. Funders – JHSRI (DFID/ESRC/MRC/Wellcome Trust)

Completed Research Projects u Engaging traditional, complementary & alternative medical providers in the delivery of essential health

services in India 2011-13. Funders / partners – Wellcome Trust / LSHTM

u Scaling up community action for health in Chhatisgarh State: a realist exploration 2011-12. Funders / partners – Oxfam

u Adapting the Hunger Reduction Commitment Index for India 2011-12. Funders / partners – Oxfam / IDS Sussex

u Governance toolkits for Universal Health Coverage 2011-12. Funders / partners – Oxfam

u Why do some doctors serve in rural areas? 2010-12. Funders / partners: AHPSR, WHO / NHSRC, SHRC

Recent Publications 1. SHEIKH K, Ranson M, Gilson L. Explorations on People

Centredness in Health Systems. Health Policy & Planning (in press)

2. LAKSHMI JK, NAMBIAR D, NARAYAN V, SATYANARAYANA TN, Porter J, SHEIKH K. Cultural consonance, constructions of science, and co-existence: A review of the integration of traditional complementary & alternative medicine in low and middle-income countries. Health Policy & Planning (in press)

3. NAMBIAR D, NARAYAN VV, LAKSHMI JK, Porter JDH, SATHYANARAYANA TN, SHEIKH K. Experiences and meanings of integration of Traditional Complementary & Alternative Medical providers in 3 Indian states: an implementation research study. BMJ Open (in press).

4. VARGHESE J, Kutty VR, Paina L, Adam T. Advancing the application of systems thinking in health: Understanding the Growing Complexity Governing Immunization Services in Kerala, India. Health Research Policy and Systems (in press)

5. SHEIKH K George A, Gilson L. (2014) People-centred science: strengthening the practice of health policy and systems research. Health Res Pol & Systems, 12(1), 19.

6. SHEIKH K, SALIGRAM P, Hort K. (2013) What explains regulatory failure? Analyzing the architecture of health care regulation in two Indian states. Health Policy & Planning adv. access 15 Dec.

7. SHEIKH K, Porter JDH (2013). Communicative rationality in health policy. Indian Anthropologist 43 (1): 17-34 (Special issue on Anthropology and Public Health).

8. SHEIKH K (2013). Review of Zachariah A, Srivatsan R, Tharu S Eds. Towards a Critical Medical Practice: Reflections on the Dilemmas of Medical Practice Today. Social Scientist, 41(5-6), 83-87.

9. RAMAN VR, SHEIKH K, VERMA N, Sharma N. (2012) Governance ‘Toolkits’ for Universal Health Coverage in India: Guidance on Implementing the Expert Group’s Recommendations. BMC Proceedings, 6(Suppl 5), O6.

The Health Governance Hub Team

Aditi Bana (Sr Programme Officer) Araddhya Mehtta (Sr Research Associate)

Bhaskar Purohit (Sr Lecturer) Devaki Nambiar (Scientist)

Jaya Paul (Hub Administrator) JK Lakshmi (Asst Professor) Joe Varghese (Sr Scientist)

Juned Kamal (Research Assistant) Kabir Sheikh (Director)

Kanica Kanungo (Research Associate) Kerry Scott (Research Coordinator)

Prasanna Saligram (Sr Lecturer) Raman VR (Principal Fellow)

Sharanya Thanapathy (Research Assistant) Shinjini Mondal (Research Associate)

Surekha Garimella (Sr Scientist)

 

10. NAMBIAR D, SHEIKH K, VERMA N. (2012) Scale-up of Community Action for Health: Lessons from a Realistic Evaluation of the Mitanin Programme in Chhattisgarh. BMC Proceedings, 6(Suppl 5), O6.

11. SHEIKH K, RAMAN VR, MAYRA K. (2012) Nurturing Nursing in India: the Need for Governance Reform. BMC Proceedings, 6(Suppl 5), O6.

12. SHEIKH K. (2012) Analyzing power in health systems: the case of medical dominance in India. BMC Proceedings, 6(Suppl 5), O6.

13. NAMBIAR D, SALIGRAM P, SHEIKH K. (2012) Does ‘Giving’ influence Governance? Application of a Framework Describing the Role of Private Philanthropy in National Health Priority Setting. BMC Proceedings, 6(Suppl 5), O6.

14. LAKSHMI JK, SHEIKH K, NAMBIAR D, SATYANARAYANA TN, NARAYAN V, Porter J. (2012) Engaging TCAM (Traditional, Complementary & Alternative Medical) Providers for Essential Health Service Delivery in India: a Policy Analysis. BMC Proceedings, 6(Suppl 5), O6.    

15. Dey S, NAMBIAR, D., LAKSHMI, J., SHEIKH, K., & Reddy, K. (2012). Health of the elderly in india: challenges of access and affordability. In J. Smith & M. Majmundar (Eds.), Aging in Asia: Findings from New and Emerging Data Initiatives. Washington, D.C.: The National Academies Press.

16. SHEIKH K, Rajkumari, B., Jain, K., Rao, K., Patanwar, P., Gupta, G., Antony, K. R., et al. (2012). Location and vocation: why some government doctors stay on in rural Chhattisgarh, India. International Health, 4(3), 192–199.      

         Kabir Sheikh during his CHESAI Expert Residency, Cape Town, Mar-Apr 2014

Other Highlights PHFI, in its capacity as the Nodal Institute for the Alliance for Health Policy and Systems Research (AHPSR) in

India, organized a seminar: The Future of Health Policy & Systems Research (HPSR) in India: Knowledge for Systems Transformation", on 31 July 2014 in New Delhi. The seminar commenced with a call for greater support for HPSR by India’s apex health administrators, and comprised two panel discussions featuring twelve HPSR academicians of international repute.

Stills from the seminar: The Future of Health Policy & Systems Research in India, Delhi, 31 Jul 2014

 

The Health Governance Hub, Public Health Foundation of India and the Averting Maternal Death and Disability Program, Columbia University, jointly organized a Bellagio Conference on Posting and Transfer Practices in the Health Sector in Feb 2014 at the Rockefeller Center, Bellagio, Italy.

Kabir Sheikh travelled to Melbourne, Australia in July 2014, to receive his award of the inaugural Asian Century Visiting Fellowship of the University of Melbourne (2014-15). The Asian Century Fellowship is a prestigious award for outstanding Asian academics, aimed at enhancing Melbourne University’s academic collaborations with scholars and institutions in Asia.  

KEYSTONE development meeting: PHFI in its capacity as the Nodal Institute for AHPSR in India, and in partnership with leading HPSR organizations in India is developing a national capacity building strategy for HPSR, of which KEYSTONE: a specialized short course in HPSR methods, is a key strategy. This meeting of KEYSTONE partners and advisors was organized by PHFI in Jul-Aug 2014.

Kabir Sheikh was invited as a CHESAI Expert Resident to University of Cape Town and University of the Western Cape, South Africa (Mar-Apr 2014). The Collaboration for Health Systems Analysis & Innovation (CHESAI) is an IDRC-supported collaborative of HPSR researchers in South Africa. Kabir Sheikh receiving the University of Melbourne

Asian Century Visiting Fellow Award

Raman VR served as a member of two working groups (Community Processes and Convergence/ Urban Health Financing, Governance and Phasing) of the Technical Resource Group for the National Urban Health Mission, by the Government of India (2013-14). Devaki Nambiar and Prasanna Saligram were members of the working group on Reaching Vulnerable Populations, and Regulation and Governance respectively.

Raman VR and Surekha Garimella were invited as members of the 7th Common Review Mission, National Health Mission, Government of India (2013-14).

Surekha Garimella and Joe Varghese participated in a short course: Introduction to Complex Health systems at the University of the Western Cape (UWC), Cape Town, South Africa, and a CHEPSAA workshop on developing health policy & systems research (HPSR) training modules. CHEPSAA is an initiative to develop African capacity to produce and use high quality HPSR by harnessing synergies from a consortium of African and European universities with relevant expertise. Surekha and Joe will use the experience to help build India’s own KEYSTONE HPSR course.

Prasanna Saligram participated in a stakeholder consultation on regulation and accreditation of health services in India (Dec 2013) at New Delhi organized by the World Health Organization, India.

Joe Varghese and Surekha Garimella at the Winter School in Cape Town

The Public Health Foundation of India and the National Health Systems Resource Centre organized a special seminar by Prof Kara Hanson of the London School of Hygiene & Tropical Medicine: 'Achieving the promise of universal coverage – it’s all in the purchasing' on November 29th, 2013

The Health Governance Hub hosted a special seminar on "Contemporary Health Sector Challenges and Reforms in South Africa in a global context of UHC" by Prof Helen Schneider on 28 July 2014

 

Please write to Aditi.Bana@phfi.org or Jaya.Paul@phfi.org if you are interested in the work of the Health Governance Hub and would like to get involved!

THE HUB AT CONFERENCES The Hub will have an active presence at the Third Global Symposium on Health Systems Research, Cape

Town, Sep-Oct 2014. An organized panel on Health Committees and 14 individual abstracts from the Health Governance Hub have been accepted for the Symposium. The Hub is also co-organizing a satellite session: Posting and Transfer practices among health-care workers, and will be active in sessions related to the ShaPeS thematic working group, the launch of the symposium special supplement of Health Policy and Planning, and rapporteuring the conference. Kabir Sheikh is a member of the organizing committee of the conference.

Kabir Sheikh, Raman VR and Surekha Garimella co-organized and participated in a Bellagio conference on Posting and Transfer in the Health Sector in February 2014

Four members of the Hub, Kerry Scott, Shinjini Mondal, Aditi Bana and Bhaskar Purohit, will represent PHFI in Cape Town in the prestigious Emerging Voices program organized by ITM Antwerp, aimed at empowering health researchers from the Global South  

The 2nd Health Systems in Asia conference, Dec 2013, National University of Singapore: The Health Governance Hub featured prominently with one organized subplenary on mixed health systems, 2 sub-plenary talks (JK Lakshmi and Kabir Sheikh) and 4 individual presentations. Kabir Sheikh was a member of the conference organizing committee.

The Hub will be represented through individual abstracts and a panel presentation at the International Symposium on Global Governance and Health: Critical perspectives on transnational actors, mechanisms and processes and implications for population health in India’, to take place at Jawaharlal Nehru University, Delhi, Sep 2014.

Raman VR was a plenary speaker on “innovative measures for Universal Health Coverage in India” at the National Conference on “Health Care as a Human Right”, National Human Rights Commission, India, Nov 2013