IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0236169.html
   My bibliography  Save this article

Monitoring Universal Health Coverage reforms in primary health care facilities: Creating a framework, selecting and field-testing indicators in Kerala, India

Author

Listed:
  • Devaki Nambiar
  • Hari Sankar D.
  • Jyotsna Negi
  • Arun Nair
  • Rajeev Sadanandan

Abstract

In line with the Sustainable Development Goals (SDGs) and the target for achieving Universal Health Coverage (UHC), state level initiatives to promote health with “no-one left behind” are underway in India. In Kerala, reforms under the flagship Aardram mission include upgradation of Primary Health Centres (PHCs) to Family Health Centres (FHCs, similar to the national model of health and wellness centres (HWCs)), with the proactive provision of a package of primary care services for the population in an administrative area. We report on a component of Aardram’s monitoring and evaluation framework for primary health care, where tracer input, output, and outcome indicators were selected using a modified Delphi process and field tested. A conceptual framework and indicator inventory were developed drawing upon literature review and stakeholder consultations, followed by mapping of manual registers currently used in PHCs to identify sources of data and processes of monitoring. The indicator inventory was reduced to a list using a modified Delphi method, followed by facility-level field testing across three districts. The modified Delphi comprised 25 participants in two rounds, who brought the list down to 23 approved and 12 recommended indicators. Three types of challenges in monitoring indicators were identified: appropriateness of indicators relative to local use, lack of clarity or procedural differences among those doing the reporting, and validity of data. Further field-testing of indicators, as well as the revision or removal of some may be required to support ongoing health systems reform, learning, monitoring and evaluation.

Suggested Citation

  • Devaki Nambiar & Hari Sankar D. & Jyotsna Negi & Arun Nair & Rajeev Sadanandan, 2020. "Monitoring Universal Health Coverage reforms in primary health care facilities: Creating a framework, selecting and field-testing indicators in Kerala, India," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-15, August.
    • Handle: RePEc:plo:pone00:0236169
    DOI: 10.1371/journal.pone.0236169
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0236169
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0236169&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0236169?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Sabrina T Wong & Annette J Browne & Colleen Varcoe & Josée Lavoie & Alycia Fridkin & Victoria Smye & Olive Godwin & David Tu, 2014. "Development of Health Equity Indicators in Primary Health Care Organizations Using a Modified Delphi," PLOS ONE, Public Library of Science, vol. 9(12), pages 1-15, December.
    2. Government of India, 2017. "National Health Policy 2017," Working Papers id:11664, eSocialSciences.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Tajul Masron & Mduduzi Biyase & Talent Zwane & Thomas Udimal & Frederich Kirsten, 2023. "Ecological footprint and population health outcomes: an analysis of E7 countries," Economics Working Papers edwrg-07-2023, College of Business and Economics, University of Johannesburg, South Africa, revised 2023.
    2. G. Kent Fellows & Daniel J. Dutton & Aidan Hollis, 2018. "Making Sure Orphan Drugs Don’t Get Left Behind," SPP Communique, The School of Public Policy, University of Calgary, vol. 10(6), August.
    3. Shawhan, Daniel L. & Picciano, Paul D., 2019. "Costs and benefits of saving unprofitable generators: A simulation case study for US coal and nuclear power plants," Energy Policy, Elsevier, vol. 124(C), pages 383-400.
    4. Richard Isralowitz & Mor Yehudai & Daichi Sugawara & Akihiro Masuyama & Shai-li Romem Porat & Adi Dagan & Alexander Reznik, 2022. "Economic Impact on Health and Well-Being: Comparative Study of Israeli and Japanese University “Help” Profession Students," Social Sciences, MDPI, vol. 11(12), pages 1-11, November.
    5. Shu Yan & Lizi Pan & Yan Lu & Juan Chen & Ting Zhang & Dongzi Xu & Zhaolian Ouyang, 2023. "Towards Sustainable Drug Supply in China: A Bibliometric Analysis of Drug Reform Policies," Sustainability, MDPI, vol. 15(13), pages 1-20, June.
    6. Liang-Chung Huang & Wu-Fu Chung & Shih-Wei Liu & Jau-Ching Wu & Li-Fu Chen & Yu-Chun Chen, 2019. "Characteristics of Non-Emergent Visits in Emergency Departments: Profiles and Longitudinal Pattern Changes in Taiwan, 2000–2010," IJERPH, MDPI, vol. 16(11), pages 1-16, June.
    7. Bozena Wielgoszewska & Alex Bryson & Monica Costa-Dias & Francesca Foliano & Heather Joshi & David Wilkinson, 2021. "Exploring the Reasons for Labour Market Gender Inequality a Year into the Covid-19 Pandemic: Evidence from the UK Cohort Studies," DoQSS Working Papers 21-23, Quantitative Social Science - UCL Social Research Institute, University College London.
    8. Shi, Wunan & Wouters, Olivier J. & Liu, Gordon & Mossialos, Elias & Yang, Xiuyun, 2020. "Association between provincial income levels and drug prices in China over the period 2010–2017," Social Science & Medicine, Elsevier, vol. 263(C).
    9. Anshul Kastor & Sanjay K Mohanty, 2018. "Disease-specific out-of-pocket and catastrophic health expenditure on hospitalization in India: Do Indian households face distress health financing?," PLOS ONE, Public Library of Science, vol. 13(5), pages 1-18, May.
    10. Francesco Bogliacino & Rafael Charris & Camilo Gómez & Felipe Montealegre & Cristiano Codagnone, 2021. "Expert endorsement and the legitimacy of public policy. Evidence from Covid19 mitigation strategies," Journal of Risk Research, Taylor & Francis Journals, vol. 24(3-4), pages 394-415, April.
    11. Katie Adamek & Sarah Bardin & So O'Neil & Dara Lee Luca, "undated". "Accelerating Teen Pregnancy Prevention in Phillips County, Arkansas and Coahoma County, Mississippi," Mathematica Policy Research Reports 7fda86cbb1bf4303a84f466e8, Mathematica Policy Research.
    12. Kellen J. Karimi & Aijaz Ahmad & Adriano Duse & Mutuku Mwanthi & Richard Ayah, 2022. "Prevalence of Antibiotic Use and Disposal at Household Level in Informal Settlements of Kisumu, Kenya," IJERPH, MDPI, vol. 20(1), pages 1-12, December.
    13. ADEBOLA, Olukemi Grace, 2020. "Universal Health Coverage In Nigeria And Its Determinants: The Case Of National Health Insurance Scheme," Academic Review of Humanities and Social Sciences, Bursa Teknik Üniversitesi, vol. 3(1), pages 97-111.
    14. Signorelli, C. & Odone, A. & Oradini-Alacreu, A. & Pelissero, G., 2020. "Universal Health Coverage in Italy: lights and shades of the Italian National Health Service which celebrated its 40th anniversary," Health Policy, Elsevier, vol. 124(1), pages 69-74.
    15. Pankaj Bahuguna & Indranil Mukhopadhyay & Akashdeep Singh Chauhan & Saroj Kumar Rana & Sakthivel Selvaraj & Shankar Prinja, 2018. "Sub-national health accounts: Experience from Punjab State in India," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-17, December.
    16. Han, Lu & Koenig-Archibugi, Mathias & Opsahl, Tore, 2018. "The social network of international health aid," Social Science & Medicine, Elsevier, vol. 206(C), pages 67-74.
    17. Misty L. Heggeness & Donna K. Ginther & Maria I. Larenas & Frances D. Carter-Johnson, 2018. "The Impact of Postdoctoral Fellowships on a Future Independent Career in Federally Funded Biomedical Research," NBER Working Papers 24508, National Bureau of Economic Research, Inc.
    18. Burieva Nigora Hasanovna, 2019. "Models of Financing and Organization of Health Care System-International Experience," International Journal of Management Science and Business Administration, Inovatus Services Ltd., vol. 5(5), pages 7-12, July.
    19. J. Andrew Harris & Catherine Kamindo & Peter van der Windt, 2020. "Electoral Administration in Fledgling Democracies:Experimental Evidence from Kenya," Working Papers 20200036, New York University Abu Dhabi, Department of Social Science, revised Jan 2020.
    20. Carolina Cortes-Herrera & Graciela Artavia & Silvia Quiros-Fallas & Eduardo Calderon-Calvo & Astrid Leiva & Josue Vasquez-Flores & Fabio Granados-Chinchilla, 2023. "Analysis of Minerals in Foods: A Three-year Survey from Costa Rican Market Products," Journal of Food Research, Canadian Center of Science and Education, vol. 12(1), pages 1-9, January.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0236169. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.