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Working Papers | 2007

Management Capacity Assessment for National Health Programs: A study of RCH Program in Gujarat State

K. V. Ramani and Dileep Mavalankar

The Ministry of Health and Family Welfare, Government of India administers a large number of national health programs such as Malaria control program, Blindness control program, National AIDS control program, Reproductive and Child Health (RCH) Program and so on. However, effective management of these programs has always come under scrutiny, as these programs consume a large amount of resources. As health is a state government subject in India, it is necessary to assess the management capacity of the department of Health and Family Welfare (H & FW) in each state. In this paper, we focus on the management capacity assessment for RCH program. Based on extensive literature survey, and discussions with senior officers in charge of RCH program at the centre and several states, we have developed a conceptual framework for management capacity assessment. Central to our conceptual framework are the following determinants of management capacity at the state dept of H & FW: (1) Capacity to formulate a clear statement of the state's RCH Policy, Goals, and a Strategic Plan to achieve the Objectives, consistent with the resources available, (2) A well designed organizational structure for the H&FW department to provide the necessary support for achieving the policy goals, (3) Capacity of the H & FW department for effective management of RCH program, (4) Clear documentation of HR policies (qualifications, transfer, promotions, training etc) for RCH managers, (5) Role of External Stakeholders (6) Management Systems for Planning, Implementation and Monitoring RCH program, and (7) Institutional Processes and procedures For each of the above determinants, we have identified a set of indicators to assess the management capacity and designed a management capacity assessment tool to estimate these indicators. A pilot survey of our management capacity assessment tool in a few states helped us to refine certain instruments in our tool and finalize the same. Our management tool has been accepted by the Ministry of H & FW, Government of India and it has asked all the states and union territories to carry out a self assessment of their management capacity for RCH program. We have also recommended a suitable structure for effective management of RCH program for each state based on its population, the number of people in the reproductive age group, expected number of childbirths, and the current status of its H&FW department in delivering RCH services. This recommended structure can be used as a guideline by each state to identify its capacity gaps and take the necessary steps to augment its management capacity.

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Working Papers | 2007

Finland-India Business Prospects 2007-2017

Ajeet N. Mathur

Finland-India Economic Relations were researched for the first time in a study that analysed mutual trade and investment potential through the lens of revealed comparative advantage and identified profitably tradable goods at 4-digit and 8-digit disaggregated levels in the standard international trade classification (Mathur, 1998). This study was made freely available on the world wide web for five years through http:// www.uta.fi/kati as part of longitudinal action research to study how small and large players would take advantage of this freebie. This paper provides initial results of a sequel study initiated in 2005 to understand what happened thereafter, whether trade grew, and to analyse how trade could diversify from identification of new opportunities for product-services linkages after the expiry of the transitional period that brought GATS into effect in 2005. Finlands share in Indian imports and exports has grown rapidly and exponentially and the prospects are vast but the potential realised by 2007 remains considerably untapped and far below comparable figures for other EU countries. This study emphasises the need for policy research on institutional barriers to design new gateways beyond an increased frequency of contact between people from the two countries. The conclusion that robust bridges could be built through tripartite fora comprising business, government and academia points to the need for new institutionalities and deepening research studies, some of which initiated as part of the Finland-India Economic Relations project, are at various stages of progress and expected to be completed during 2007-2010.

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Working Papers | 2007

Turnaround of Indian Railways: A Critical Appraisal of Strategies and Processes

G. Raghuram

Indian Railways (IR), which was declared to be heading towards bankruptcy as per the Expert Group on Indian Railways in 2001, is today the second largest profit making Public Sector Undertaking after ONGC. The fund balance crossed Rs.12,000 crores in 2005-06, which had reached a low of just Rs.149 crores in 1990-2000. The total investment being planning for the eight-year time frame (2007-2015) is tentatively in the order of Rs.350,000 crores. This confidence is not only due to the rising trend of performance, but also due to the significant growth in the past two years. These two years coincided with Mr. Lalu Prasad being at the helm of affairs of the IR, having moved into his position on 23rd May, 2004. Railway officials called this as the 'turnaround' of IR. This paper attempts a diagnosis of the 'turnaround,' beginning with the question as to whether it really was a 'turnaround'. This paper then carried out an analysis of the various determinants of the 'turnaround' related to goods, passenger and other operations. This is followed by a critical assessment of the strategies and key processes being the 'turnaround'. Finally the sustainability of the 'turnaround' is explored.

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Working Papers | 2007

Agriculture: A Perspective from History, the Metrics of Comparative Advantage, and Limitations of the Market to Understand the Role of State in a Globalising World

Sebastian Morris

Multilateral agencies and economists with much influence have been urging laissez-faire in agriculture. While success with the rich countries has been minimal despite the commitments under the WTO, many poor countries with much agricultural potential in the long run have been coaxed to adopt near free trade in agriculture with disastrous results especially for the poor in these economies. There are fundamental problems in achieving even global (leave aside optimum for any particular country) optimality through world trade in agriculture given the immovability of land. Additionally the fact that poor countries start their transformation process with much of their population engaged in agriculture imposes special requirements upon agriculture. Incomes have to rise in agriculture to overcome poverty and to constitute rising domestic demand for modern manufactures and therefore the infant industry argument holds with additional force. We bring together the historical experience of agricultural development, the relationship between economic development and agriculture, trade in agriculture, the role of state action especially in the late industrialisation context. The differences between land endowed and land poor countries are recognised in their analyses. We develop a perspective on the comparative advantage of nations in agriculture and the evolution of the same. The metrics of agriculture and trade, arising out of the dynamics of the share of agriculture in GDP, the dependence of agriculture on land endowments, the biological limits to consumption of agricultural products, underlie a dynamic structural model of the revealed comparative advantage which is developed and tested using panel data from about 100 countries. The nature of agricultural products on several dimensions-its long lead in production, its perishability in some cases, its storability in others, but above all the grouping of many agricultural products into low price and income elasticity of demand-is used. The purpose is to draw insights that can usefully inform the content of state intervention, and trade policy especially from the point of view of a country like India which is likely to lose its comparative advantage in many agricultural products as incomes rise. The comparative advantage of countries in agriculture is most usefully characterized as rising of the arable land endowments per person and declining as the per capita income rises relative to the worlds "average" per capita income. A structural model on the lines above is estimated empirically. The Model is also dynamic since the rise in per capita incomes at a faster rate in transforming countries can be used as data to predict with a high degree of reliability that they would see a decline in their competitiveness. Similarly countries with low arable land per person would see a rapid fall in their competitiveness. Yet land abundance in poor countries does not automatically result in high competitiveness. [The abundance of easily mined other natural resources like fuels acting through the balance of payments could lower greatly the revealed competitiveness of agriculture]. To realize the same, much land has to be brought under the plough and enhanced, a task where the role of the state is important. Irrigation development as also the use of machinery on land enhances the competitiveness of agriculture. And the former is dependent much upon the ability of the state to put together public irrigation and support private irrigation. Even more importantly the investments in storage, market support, transportation, information provision, demonstration of new technologies and extension all of which are required at the beginning of the agricultural transformation require active intervention of the state. The problem for the poor countries with land abundance is compounded by the large distortion of international prices resulting from subsidization by rich countries as they face declining competitiveness in agriculture due to very high incomes. The coaxing of land rich poor countries in this situation to embrace laissez faire policies by the multilateral agencies is shameful and nothing short of suicide for these countries. The costs of subsidization in the rich countries are very small and the political benefits very large, so a roll back of subsidization is least likely. Agriculture is the first industry where surpluses can arise to stoke development as such. The historical evidence that no country of substantial size has been able to industrialize without a prior or simultaneous agricultural revolution has to be noted. And the infant industry argument is valid for agriculture as much as for industry. Both these further condemn the laissez faire position. Protection of agriculture is therefore the least distortionary way for the "large" land-poor poor countries as they advance to protect their employment. Protection alone without active support of the state to overcome the significant market distortions in agriculture and its inputs may not be enough. Protection in land scarce economies ought to be scaled down only as such economies are able to absorb labour shed by an advancing agriculture in other segments of the economy. Functionality also demands that the role of the state in agriculture and subsidization recognizes not only the market failures arising out of the public good nature of many inputs, but also the perversities that low price and income elasticities, when combined with the long "lead" can bring to the functioning of markets. Similarly the structure of the value chain from production to final consumption in distant lands-especially the fact that the aggregators and processors in the value chain would be able to capture rents-creates the basis for a crucial role for the state in trading, stocking and processing. Shortages and variations in output again create the need for buffer stocking. Successful late agricultural transformations have been built upon the state playing these roles. The state's role in processing while crucial has not generally been successfully realised, the complexity of the tasks being a basic bottleneck. Laissez faire policies in agriculture when without reference to the stage of development, and state failure to compensate for the market perversities underlie the disaster that agriculture has been for poor countries with much agricultural potential.

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Working Papers | 2007

A Study on Mush-room growth of Two-year Management Programme and its Impact on Quality of Management Education in Tamil Nadu

Subramanian Saravanan

This paper addresses the quantum jump in the number of two-year management programmes in India. It examines the quality adherence by taking institutions approved and affiliated by All India Council for Technical Education (AICTE), University Grants Commision (UGC), Central Government Autonomus Institue (NIT,Trichy) and Deemed universities, which offers two-year management programmes over the past fifteen years from Tamilnadu as a sample unit. The objective is to identify the key reasons for increase in numbers and initiative in quality implementations process. It enables us to understand the qualitative terms of inorganic growth and its impact on quality of management education. It provides experiential understanding of quality implementation process and suggestions to increase its effectiveness.

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Working Papers | 2007

Analysis of Mixed Outcomes: Misclassified Binary Responses and Measurement Error in Covariates

Roy Surupa and Tathagata Banerjee

The focus of this paper is on regression models for mixed binary and continuous outcomes, when the true predictor is measured with error and the binary responses are subject to classification errors. Latent variable is used to model the binary response. The joint distribution is expressed as a product of the marginal distribution of the continuous response and the conditional distribution of the binary response given the continuous response. Models are proposed to incorporate the measurement error and/or classification errors. Likelihood based analysis is performed to estimate the regression parameters of interest. Theoretical studies are made to find the bias of the likelihood estimates of the model parameters. An extensive simulation study is carried out to investigate the effect of ignoring classification errors and/or measurement error on the estimates of the model parameters. The methodology is illustrated with a data set obtained by conducting a small scale survey.

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Working Papers | 2007

Provision of Reproductive Health Services to Urban Poor through Public-Private Partnerships: The Case of Andhra Pradesh Urban Health Care Project

Bhat Ramesh, Dileep Mavalankar, Sunil Kumar Maheshwari, and Saha Somen

Andhra Pradesh had initiated the Urban Slum Health Care Project to provide basic primary healthcare and family welfare services to urban poor living in slums in 2002. As of now, the project has established 192 Urban Health Centres (UHCs) in 74 municipalities of the state through contracting-out process to the NGOs. These UHCs cover population of about 3 million. State government has played pivotal role in creating capacities to monitor and supervise the functioning of these UHCs. This project was started with the World Bank support and the state has effectively managed the transition from a donor-funded project to government programme and at the same achieving demonstrable impact on health status among its target population. The scheme ensures people's participation in management of the UHCs and placing the power for identifying the health priority in the hand of the community. The case study identifies emerging challenges in the scheme implementation relating to (a) involvement of NGOs as partners in service delivery, (b) financing and financial management system, and (c) need to reposition the UHCs in view of changing epidemiological scenario. Some of the areas needing attention to address the challenge include: need to refine the service mix to better respond to the health needs of the population served; evolving a financial management practices to increase efficiency in disbursement; motivating NGOs to actively participate in the scheme; developing management capacity and competencies of both partners; and repositioning relationship between the state and non-state actors away from a contractual basis to an effective partnership.

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Working Papers | 2007

Attitudes of the Youth towards Entrepreneurs and Entrepreneurship: A Cross-cultural Comparison of India and China

A. Goel, Neharika Vohra, Zhang Liyan, and Bhupinder Arora

This study argues that social support is an important enabler in entrepreneurial activity in a country or a region. One untested assumption in policy making on entrepreneurship development has been that all regions are equally desirous of entrepreneurial activity and one policy could address issues in all regions. It was argued that societal attitudes towards entrepreneurs and entrepreneurship are important determinants for future entrepreneurial activity. These attitudes would be impacted by the family background of an individual and entrepreneurial development in the region an individual comes from. It was hypothesized that more positive attitude would be seen in (i) people form entrepreneurial backgrounds, and (ii) entrepreneurially more developed regions. These hypotheses were tested on more than 5,000 respondents in India and China. The results for family background's influence on attitudes found strong support in both India and China. Regional development showed stronger influence on attitude in India than in China. The findings and implications for studying attitudes and policy making are discussed.

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Working Papers | 2007

Contracting-out of Reproductive and Child Health (RCH) Services through Mother NGO Scheme in India: Experiences and Implications

Bhat Ramesh, Sunil Kumar Maheshwari, and Saha Somen

Partnership with NGOs in delivering and provision of Reproductive and Child Health (RCH) services through mother NGO (MNGO) in the un-served and under-served regions is one of the important initiatives in India. The scheme involves large number of contracts between government and the NGOs. As of April 2006, 215 MNGOs were working in 324 districts of the country. In addition to this there are about 3 to 4 Field NGOs attached with each MNGO in a district. This paper discusses this scheme with an objective to understand the make up of the partnership and the development of management capacity in the system. MNGO scheme is a central sponsored scheme. This scheme faces management challenge to implement it in all states in India. Further, the case study of three states presented in this paper suggests that this challenge emanates several factors. Inter alia, these include delay and uncertainty of funding and contract renewal, lack of partnership orientation in the scheme, lack of trust among the key stakeholders, capacity constrain in the district and state health system, weak monitoring system, procedural delays and multiple points of authority and reporting relationships. It is also observed that the capacity of field NGOs to deliver in the programme is constrained due to non-availability of financial and human resources. The scheme demands a strong leadership at local levels and ownership from the state health system. This can be achieved through effective decentralisation, flexibility in decision-making and creating adequate accountability systems. Regional Resource Centres has to play an important role in coordination between state/district RCH society and the NGOs and strengthening their capacities. The central government instead of focusing on micro-management of the scheme at state level should focus on developing and strengthening the enabling environment and capacity of various stakeholders to implement the scheme. Also, they need to address various systemic issues including development of accountable and performance oriented system, ensuring financial autonomy and decentralisation, delegation of authority, building trust and accountability in the system, effective integration, continuity of the scheme and fostering true sense of partnership between the state and non-state sector.

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Working Papers | 2007

Leveraged Innovation Management: Key Themes from the Journey of Dewrain Harvest Systems

M. R. Dixit and Girja Sharan

Systems for harvesting dew for human consumption are new to India. This paper provides insights from the tracking of the innovation journey of dewrain harvest systems from incidental observation to commercialization. It traces the key phases in the innovation journey and documents the activities and outcomes in each phase. Based on the analysis it identifies a class of innovations called 'leveraged innovations'. These innovations leverage on the early innovating experience of the innovator, the knowledge base of the stakeholders and the available infrastructure. Data for the paper was collected from the narrative of the innovator and the documents prepared by the innovator and his team. The paper has been divided into three sections. The phases in the innovation journey are presented in the first section. Key themes in leveraged innovation are identified based on the insights from phases, and their link with the literature on innovations management are discussed in the second section. The third section provides concluding remarks and suggests ways forward for mapping the innovation journeys of individual innovators and developing the themes further. The overall view is that the development of the dewrain harvest system was facilitated by the background of the innovator, the observation of spin offs, the larger externally linked definition of the problem, linkage with the local community that shared the need for solving similar problems, association with local laboratory and network of scientists, and independent learning to augment the received knowledge facilitated the leveraging process for a successful journey.

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