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Biomedical subjects

R M Maru

Publications and source records attributed to R M Maru.

5 recordsLinked to original sources
PubMed1983

The community health volunteer scheme in India: an evaluation.

In this paper, we have placed the discussion of community health volunteer (CHV) scheme within the larger context of the evolution of primary health care organization in India. Drawing on a national evaluation study and a micro village level study, we have outlined the key issues in the design and implementation of the CHV scheme. These issues relate to the range and quality of services, the characteristics of clients served, nature of health problems attended, community participation, extent of help rendered by CHV to PHC staff, and problems of logistics and supply of manuals, kits and medicines. Our analysis shows that the CHV scheme has succeeded in bringing primary curative care to the doorsteps of the people. To a smaller extent, it has also helped in improving related services such as family planning, immunization and detection and treatment of malaria. Both the village community and the field staff of the regular health care organization find the CHV as a useful link between the community and the primary health center. Also CHVs are not confining to only a privileged few but they are catering to a cross-section of different caste and class groups in the village community.

Allied Health Personnel↗
PubMedDate not supplied

Incentives and disincentives in the Indian family welfare program.

The Indian family welfare program has offered financial incentives since the early 1960s to both family planning motivators and acceptors of sterilization and the IUD. This article reviews the available evidence regarding the impact of incentives on the quality and quantity of family planning services in India. Administrative concerns related to the implementation of incentive programs are discussed, and the current debate on disincentives, as well as the brief period when disincentives were used, is summarized. The studies reviewed, though few in number and varying in quality and methodology, indicate that incentives to acceptors help to increase the level of contraceptive acceptance, especially when they are part of a well designed strategy of service delivery and client motivation. Incentives do not appear to have an adverse effect on quality of services and acceptors, and they do not seem to influence method choice. Disincentives, if they are used, should not impinge on fundamental individual rights of either the parents or the child.

Birth Intervals↗
PubMedDate not supplied

The effect of operations research on program changes in Bangladesh.

This article is based on the ten-year experience of an operations research project in Bangladesh. It assesses how, and under what circumstances, research-based advice and results of pilot projects contribute to change in large-scale public programs. It discusses project research on issues facing the national family planning program: recruitment and training of field-workers; delivery of injectable contraceptives; management information; field-workers' use of service registers; field supervision; satellite clinics; and contraceptive user fees. These issues are used to illustrate the advantages and disadvantages of a long-term institutionalized project, and to describe the diversity of means for communication with policymakers. The analysis shows that research, policy decision, and implementation can occur in any sequence. Policy advice that disrupts long-standing power relationships and organizational culture takes a great deal of effort to implement. Operations research can produce useful changes in organizational behavior, even when large-scale problems remain.

Bangladesh↗