Project Closure Report

TAMIL NADU OPERATIONAL

RESEARCH PROGRAM
Using Research to Improve Health Systems

TNHSRP and IIT Madras

Contents
1. Project Overview ............................................................................................................................. 2
2. Project Objectives ........................................................................................................................... 2
3. Project Process Flow ....................................................................................................................... 3
4. Project Governance and Quality Management .............................................................................. 4
4.1 Monitoring of Field Survey ........................................................................................................ 4
5. Project Achievements ..................................................................................................................... 4
5.1 Meeting Objectives ................................................................................................................... 4
6. Budget Performance ....................................................................................................................... 4
7. Knowledge Transfer – Dissemination of Studies ............................................................................. 4
8. Lessons Learned .............................................................................................................................. 5
9. Challenges ....................................................................................................................................... 5
Appendix 1 : List of Themes Year Wise ............................................................................................... 6
Appendix 2 : List of Studies Year Wise ................................................................................................ 7

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 1. Project Overview

The primary purpose of this program is to encourage and financially support “operational research”
studies that would contribute to strengthening the public healthcare delivery system in Tamil Nadu.
Research teams from across the country are encouraged to take part in this program.

The Project was Launched in launched by the Department of Health and Family Welfare, as part of
TNHSRP supported by World Bank in JAN 2020 in a phased approach manner to cover wide themes
and area of health research.

The agreed Phase Approach year were

• Phase 1 : 2020-21
• Phase 2 : 2021-22
• Phase 3 : 2022-23
• Phase 4 : 2023-24

The Phased approach allowing adequate time to implement the overall vision of number of ongoing
programmes related Reproductive and Child health (RCH), Communicable and Non-Communicable
diseases, Trauma care, mental health etc., having operational issues.

2. Project Objectives
Operational Research Program (ORP) aim is to encourage researchers (from across the country)
working in public or private institutions, interested in carrying out empirical research that will
contribute to strengthening healthcare delivery system in Tamil Nadu.

Eventually, this program is expected to

(a) provide evidence for introducing operational measures to improve the performance of public
health care delivery system,

(b) build “research capacity” in public health system and

(c) promote networking among research groups within Tamil Nadu and other parts of the country.

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 3. Project Process Flow

Each Phase Year the is followed by a discrete set of activities, each of which has an associated
definition and guidelines11.

Figure 1 : Operational Research Programme Process Flow

ORP Phase - Year

Dissimenation of Selection of Broad

Research Studies Research Theme

Monitoring and
Periodic Review of Call for proposal
Studies

Selection Committee
Awarding of
(Expert Group,
proposals and MoU
Technical Committee
signing
and )

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Tamil Nadu Operational Research programme – OR Guidelines
https://tnhsp.org/tnhsrp/images/files/TNHSRP%20Operational%20Research%20Program.pdf

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 4. Project Governance and Quality Management

The project oversight, leadership and control managed through a number of groups and subgroups
as follows

Group1: TNHSRP

Group2 : IIT Madras

Group3 : External Experts

The role of above groups were to provide assurance of delivery, escalate issues and negotiate
changes as required.

Few key deliverables of the governance group were:

• Provision of access to government data/ government health care facilities for survey
• Contract negotiation, agreement and monitoring
• Periodic activity review

4.1 Monitoring of Field Survey

The IIT Madras Nodal Agency of the OR programme has visited most of the study field site to
observe the smoothness and challenges if any faced by the study team.

5. Project Achievements

The program has initiated 29 studies (refer annexure 2) (from about 202 research proposals received
over the last four call for proposals), on diverse topics ranging from primary health care to higher
tertiary hospital in Tamil Nadu. Research teams from several private and public Institutions have been
engaged in this program.

5.1 Meeting Objectives

6. Budget Performance
The World Bank has sanctioned Rs.2 Crore for each financial year to commission 6-8 studies for each
phase year.

DLI

7. Knowledge Transfer – Dissemination of Studies

Among the 29 Studies initiated during the period 2020 -24 , 14 studies results disseminated and the
results are presented to Health secretary , DDHS, District Officials , public heath department through
Dissemination workshop.

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These study reports, lessons learnt, dissemination brochure will be made available on TNHSRP and
IITM portal for knowledge sharing.

8. Lessons Learned

Among the 29 Studies initiated during the period 2020 -24 , 14 studies results disseminated.

Figure : Implementation Lessons learnt

•The OR programme has led to think for the major public health issuse such has RCH, NCD,
Health Area to be studied Mental Health.
•Wide varitey of Health Themes were considered to strengthen the public health system.

Implementing Study •A wide range of study designs and research methods are used
Design / research method •Quantitative and qualitative methods are explored in depth

Identify Gaps from the •The Result of the studies helped to identify the gap to strenghten public health sytem
Results •The reulsts has also highlted some good pracitce to be scaled up.

Key Policy •The 14 disemnated studies has provided more than 60 Policy recommendations , average of
4-5 recommedations for the each study carried.
Recommendations •These reommendations shall be considdered to strenghten the public health system.

9. Challenges
The Phase 1 / the beginning the OR programme 2020 was the period when COVID 19
pandemic started. Despite the pandemic the phase 1 was able to complete their research
studies successfully.

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Appendix 1 : List of Themes Year Wise

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Appendix 2 : List of Studies Year Wise

Study Title Phase

Process evaluation and Implementation Challenges of National Patient Safety Implementation Framework in Selected 1
1 Public Healthcare Facilities in Tamil Nadu – A Mixed Method Study
-ESIC Medical College & PGIMSR, Chennai
Are antibiotics appropriately used in public health facilities as per the treatment guidelines for antimicrobial use in 1
2 common syndromes?
- ESIC Medical College & PGIMSR, Chennai
1
Operational Challenges in Adopting Bio- Medical Waste Management Protocols in Public Health Facilities
3
- Development Solutions, Delhi

Challenges of Rural People in Effective Utilization of 108 Emergency Ambulance Services in Tamil Nadu – An Empirical 1
4 Study
- Madras Christian College, Chennai
Evaluation of Tamil Nadu Accident and Emergency Care Initiative (TAEI) Programme in selected districts of Tamil Nadu, 1
5 2021
-Tirunelveli Medical College
Reasons for the delay in diagnosis of common cancers (Breast and Uterine Cervix) among women in Tamil Nadu: A 1
6 Qualitative Approach
- Tamil Nadu Dr MGR Medical University, Chennai
Factors for poor acceptance of screening for cancer cervix and cancer breast 1
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- ICMR-National Institute of Research in Tuberculosis, Chennai
8 Strengths and gaps of the District Mental Health Program to reduce suicide rates in Tamil Nadu 2
- Institute of Mental Health, ICMR- NIE, SCARF, Chennai
Strengthening the existing Mental Health Programme to reduce suicide rates in Tamil Nadu: Operational research to 2
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reduce suicide rates in Tamil Nadu
- St. John’s Medical College, Bangalore
Analysis of District Mental Health and Primary Care Personnel Involvement in Suicide Prevention and Mental Health 2
10 Promotional Activities: A community-based qualitative study
- Karur Govt. Medical College
Impact of COVID-19 on the Utilization of Reproductive, Maternal and Child Health Services in Selected Districts of Tamil 2
11 Nadu: A Mixed Method Study
- School of Public Health, SRM IST, Kattankulathur
Impact of COVID-19 pandemic on utilisation of maternal and child health services in three priority districts of Tamil 2
12
Nadu: An explanatory mixed methods study
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry
13 2
Study on the effect of COVID-19 on the Incidence of TB in Tamil Nadu - SAATHII & State TB Cell, Tamil Nadu

14 The potential impact of COVID-19 pandemic on TB epidemic in Tamil Nadu 2

- ICMR-National Institute of Research in Tuberculosis, Chennai