Policy Wise

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An interesting new paper in the The Journal of Americal Medical Association argues that teaching villagers about services availability can improve health outcomes. The researcher conducted a cluster randomized control trial in 100 village clusters in U.P. First a baseline survey was conducted which found no siginificant differences in health outcomes across the villages. This was followed by an intensive information campaign over the next 12 months. What effect it had?

  We found that providing a structured informational program to villagers in north Indian districts about entitled services enhanced the delivery of health and social services among low- and mid- to high-caste households. Improvements occurred in prenatal services, infant vaccinations, excess school fees, and occurrence of village council meetings. Although nurse midwife visits did not increase, 20% to 25% more households in intervention villages reported that women were receiving prenatal services and that their infants were being immunized, suggesting that the nurse midwife was performing more duties when a visit did occur.[link](subcription required)

Interestingly enough, the visits by nurse-mid-wifes didn’t improve even in the intervention villages. Perhaps, that’s because they are not under the control of local panchyats--an interesting application of how lack of accountability at the local level can defeat even the informed population.

p.s Anyone who wants to read the paper and is unable to access it, send me an e mail and I will forward it you.

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