Operational research in Public Health in India

1. OPERATIONAL RESEARCH
In
public health
Dr. Dharmendra Gahwai
M.D. (Community Medicine)
Assistant Professor
Deptt. Of Community Medicine
CIMS, Bilaspur (C.G.)

2. • Why Domiciliary care in treatment of T.B. ?
• Why only Two sputum smear examination ?
• HBNC - Is it more beneficial ?

3. • Operational Research is scientific study of
operations with the purpose of making better
decisions.

4. • Keyword in OR is
improvements
• the research tools are utilized to bring about
improvements in performance of disease control
programmes.

5. • In simple terms it can be described as -
“Science of better”

6. Basic approach -
• Identifying problems in a timely manner,
• generating evidence based solutions.
• act according more effective and feasible
solution.
• yield maximum benefit in public health.

7. DEFINITION
• A global meeting held in Geneva in April 2008 defined OR as
“Any research producing practically usable knowledge which can
improve program implementation regardless of the type of research
falls within the boundaries of operations research”.
• 1- knowledge - (evidence, findings, information, etc.)
• 2- program implementation- (e.g. effectiveness, efficiency, quality, access, scale up,
sustainability)
• 3- research - (design, methodology, approach)

8. OBJECTIVES
• To study about the systems, organiztions,
institutions, programmes, socio-cultural behavior of
the people and economic factors that exist as
bottleneck to effective implementation.
• To develop more effective approaches to the
programmes.
• To secure optimum utilization of resources.

9. Process in Operational Research
1. Identification of problems of programme.
2. Collection of data. (If neccessary)
3. Analysis of data and formulation of hypothesis.
4. Deriving of possible solutions from Hypothesis or
Model .
5. Choosing of optimal solution and forecasting.
6. Testing of potential solution/hypothesis. (Pilot projects)
7. Results utilization.
8. Results dissemination.

10. PROCESS OF OPERATIONAL RESEARCH

11. HEALTH PROGRAMME
(Typical Logic Model)
INPUT Resources for services—technical and financial
PROCESS Programme activities such as training, logistics, etc.
OUTPUT Results at the programme level—services, service use.
OUTCOME Results at the level of target population - behavior,
practices.
IMPACT Ultimate effect of project in long-term in Society.

12. • Operational Research typically tries to
• Modulate - inputs and processes
• Measure - outputs, outcomes and impact.

13. Operational Research Team in Public Health
1. Public Health Administrator.
2. Epidemiologist.
3. Statistician and
4. Social scientist.
5. Auxiliary staff.

14. SYNONYMS
1. Operations research
2. Operational research
3. Implementation research
4. Action research
5. Health systems research
6. Health service research
7. Health practices research and
8. Decision-linked research.

15. Approaches of OR in Public Health
• There are two main approaches
1. Secondary data analysis - retrospective record
reviews, utilizing data that is already generated in
the programmes.
2. Primary Level Research

16. • There are four types of Primary level Operation
Research studies as defined by the Population
Council -
1. Exploratory/diagnostic studies.
2. Intervention studies.
3. Monitoring and Evaluation.
4. Economic Analysis.

17. OPERATIONAL RESEARCH
1. Exploratory study
Carried out to find extent of problem.
Community need study.
2. Interventional Study
RCT and Community Trial for reduction of
Neonatal Mortality.
3. Monitoring and Evaluation
M’OR’E
Monitoring – Input and Process
Evaluation – Output, Outcome and Impact
4. Economic Analysis
Cost effective analysis.
- Zinc and Copper supplementation in the
treatment of acute diarrhea.

18. Uses in Public Health
1. Identify and solve the problems of program in
timely manner.
2. Helps policy maker and program manager to make
evidence based program decisions.
3. Improve program quality and performance by using
scientifically valid methods.

19. Operational Research in Health Services
1. Optimal size of area/population for ANM ?
2. Basic Health Unit?
3. Ideal architectural design of hospital?
4. Queuing problem in OPD.
5. Length of stay in hospital.
6. Quality of medical care services.

20. THANK YOU