This program has been completed and is no longer receiving projects applications.

Improving Governance and Increasing Community Engagement
in Preventive Health Services

Instruments for Assessing the Quality of Essential Public
Health Services - completed

New tools for assessing the quality of preventive health service delivery were developed. They include three sets of questionnaires for use at national, state and district levels. Two sets focus on core public health functions, with sections on assessment, policy development and assurance and a smaller section on the organizational and institutional background of the public health system. The third set looks at other governance-related issues.

View the three sets of questionnaires:

• National-Level Instrument [PDF 408K]
  National-Level Qualitative Instrument [PDF 120K]
• State-Level Instrument [PDF 298K]
  State-Level Qualitative Instrument [PDF 134K]
• District-Level Instrument [PFG 239K]
  District-Level Qualitative Instrument [PDF 109K]
  District-Level Governance Instrument [PDF 219K]
  Field Staff Governance Instrument [PDF 197K]

These survey instruments build on and add to the governance/public sector reform toolkits designed by the Poverty Reduction and Economic Management unit of the World Bank, and health service tools developed by the US Centers for Disease Control and the Pan-American Health Organization.

All questionnaires were adapted for use in India, with inputs and feedback from counterparts at national level, and at state and local community levels in the state of Karnataka.*

Case study of Karnataka - completed

The case study focusing on the organization of communicable disease prevention in Karnataka state of India was developed. It was based on a survey of around 200 officials, health workers and community representatives, using the developed tools. The survey was administered in two districts in Karnataka: one with a record of relatively strong public health performance, the other without. In particular, questions were asked regarding the nature and extent of community involvement and the incentive environment facing front-line health and sanitation workers. These lessons were summarized in the case study with observations on modest organizational changes which could substantially improve health outcomes. This study was a background paper for the World Development Report on Service Delivery.

The full version of the study can be downloaded if you click on Case Study of Karnataka.

Disseminating "Best Practices" from Other Countries' Public Health Systems, and Applying them to Improve Public Health Systems in India - completed.

Case studies were commissioned to extract the “best practices” from different countries in the governance of preventive health services, and in stimulating local demand for such services. The focus is on countries which have in recent decades made rapid advances in their health transitions, through putting innovative public health systems in place. Through dissemination of “best practices” showing practical points of entry, the project sought to encourage governments and agencies involved in health sector reform to consider different approaches to preventive health service delivery.

In India, these issues were discussed at workshops in Bangalore.* The Government of Karnataka has expressed strong interest in re-organizing and strengthening the state's preventive health service delivery. This is being developed in collaboration with the World Bank, in a loan under preparation.

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* Attendees in the October 2003 workshop included the Health Commissioner, Director Health Services, as well as representatives from the Health Task Force and several academic and civic organizations. In the May 2004 workshop, attendees included the Secretary and Commissioner of the Department of Health, the Secretary of the Department of Rural Development, and the Managing Director of the Karnataka Urban Infrastructure Development Finance Corporation, as well as national public health experts, academics, and representatives of civil organizations.