Development Research Group, Development Economics, DEC
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Poverty, POV, Health, HEA
Development Research Group
Development Economics, DEC
Development Economics, DEC
Externally Hosted Work
Last updated August 15, 2023
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Now showing 1 - 5 of 5
Strengthening Malaria Service Delivery through Supportive Supervision and Community Mobilization in an Endemic Indian Setting : An Evaluation of Nested Delivery Models(World Bank, Washington, DC, 2014-06) Das, Ashis ; Friedman, Jed ; Kandpal, Eeshani ; Ramana, GNV ; Das Gupta, R K ; Pradhan, Madan M ; Govindaraj, RameshMalaria continues to be a prominent global public health challenge, in part because of the slow population adoption of recommended preventive and curative behaviors. This paper tests the effectiveness of two service delivery models designed to promote recommended behaviors, including prompt treatment seeking for febrile illness, in Odisha India. The tested modules include supportive supervision of community health workers and community mobilization promoting appropriate health seeking. Program effects were identified through a randomized cluster trial comprising 120 villages from two purposively chosen malaria-endemic districts. Significant improvements were measured in the reported utilization of bed nets in both intervention arms vis-à-vis the control. Although overall rates of treatment seeking were equal across the study arms, treatment seeking from community health workers was higher in both intervention arms and care seeking from trained providers also increased with a substitution away from untrained providers. Further, fever cases in both treatments were more likely to have received timely medical treatment (within 24 hours) from a skilled provider. The study arm with supportive supervision was particularly effective in shifting care seeking to community health workers and ensuring prompt diagnosis and treatment. A community-based intervention combining the supportive supervision of community health workers with intensive community mobilization can be effective in shifting care seeking and increasing preventive behavior, and thus may be used to strengthen the national malaria control program.
Does Involvement of Local NGOs Enhance Public Service Delivery? Cautionary Evidence from a Malaria-Prevention Evaluation in India(World Bank, Washington, DC, 2014-06) Das, Ashis ; Friedman, Jed ; Kandpal, EeshaniUsing data from an experimental supportive intervention to India's malaria control program, this paper studies the impact of leveraging local non-state capacity to promote mosquito net usage and recommended fever care-seeking patterns. The supportive activities were conducted simultaneously by three nongovernmental organizations in two endemic districts in the state of Orissa. The study finds that program impact varied significantly by location. Examining three potential sources of this variation (differential population characteristics, differential health worker characteristics, and differential implementer characteristics), the analysis provides evidence that both population and nongovernmental organization characteristics significantly affected the success of the program. The paper discusses these findings as they relate to the external validity of development policy evaluations and, specifically, for the ability of the health system to benefit from limited non-state capacity in under-resourced areas.
Linking Results to Performance: Evidence from a Results Based Financing Pre-Pilot Project in Katete District, Zambia(World Bank, Washington, DC, 2015-04) Chansa, Collins ; Das, Ashis ; Qamruddin, Jumana ; Friedman, Jed ; Mkandawire, Akafwilangachi ; Vledder, Monique
Strengthening Malaria Service Delivery through Supportive Supervision and Community Mobilization in an Endemic Indian Setting: An Evaluation of Nested Delivery Models(BioMed Central, 2014-12-08) Das, Ashis ; Friedman, Jed ; Kandpal, Eeshani ; Ramana, Gandham N.V. ; Das Gupta, Rudra Kumar ; Pradhan, Madan M. ; Govindaraj, Rameshalaria continues to be a prominent global public health challenge. This study tested the effectiveness of two service delivery models for reducing the malaria burden, e.g. supportive supervision of community health workers (CHW) and community mobilization in promoting appropriate health-seeking behaviour for febrile illnesses in Odisha, India. The study population comprised 120 villages from two purposively chosen malaria-endemic districts, with 40 villages randomly assigned to each of the two treatment arms, one with both supportive supervision and community mobilization and one with community mobilization alone, as well as an observational control arm. Outcome measures included changes in the utilization of bed nets and timely care-seeking for fever from a trained provider compared to the control group. Analysis was by intention-to-treat.
Community Perceptions on Malaria and Care-Seeking Practices in Endemic Indian Settings: Policy Implications for the Malaria Control Programme(BioMed Central, 2013-01-29) Das, Ashis ; Das Gupta, R.K. ; Friedman, Jed ; Pradhan, Madan M. ; Mohapatra, Charu C.The focus of India’s National Malaria Programme witnessed a paradigm shift recently from health facility to community-based approaches. The current thrust is on diagnosing and treating malaria by community health workers and prevention through free provision of long-lasting insecticidal nets. However, appropriate community awareness and practice are inevitable for the effectiveness of such efforts. In this context, the study assessed community perceptions and practice on malaria and similar febrile illnesses. This evidence base is intended to direct the roll-out of the new strategies and improve community acceptance and utilization of services.