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Working Papers | 2006

Maternal Health Financing – Issues and Options: A Study of Chiranjeevi Yojana in Gujarat

Bhat Ramesh, Amarjit Singh, Sunil Kumar Maheshwari, and Saha Somen

Government of Gujarat announced a "Chiranjeevi Yojana" in April 2005. The objective of this scheme is to encourage private medical practitioners to provide maternity health services in remote areas which record the highest infant and maternal mortality and thereby improve the institutional delivery rate in Gujarat. The scheme was finally launched as a one year pilot project in December 2005 in five districts viz., Banaskantha, Dahod, Kutch, Panchmahal, and Sabarkantha. The private empanelled providers are reimbursed on capitation payment basis according to which they are reimbursed at a fixed rate for deliveries carried out by them. The payments are made for a batch of 100 deliveries. This is expected to take care of case-mix differences (i.e., normal or complicated deliveries) and help the providers to keep the costs below the reimbursed amounts. The scheme proposes to use a voucher system to target the people living below poverty line. The objective of this paper is to document the experience in implementing this scheme and discuss the issues in up-scaling it further.

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Working Papers | 2006

An Optimization-Based Decision Support System for Strategic Planning in a Process Industry: The Case of a Pharmaceutical Company in India

Goutam Dutta, Robert Fourer, Majumdar Akhilesh, and Dutta Debabrata

We describe how a generic multi-period optimization-based decision support system (DSS) can be used for strategic planning in process industries. Built on five fundamental elements-materials, facilities, activities, time periods and storage areas-this DSS requires little direct knowledge of optimization techniques to be used effectively. It is user friendly and requires little knowledge of optimization. Results based on real data from a pharmaceuticals company in India demonstrate significant potential for improvements in revenues and profits.

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Working Papers | 2006

Managing Bullwhip Effect: Two Case Studies

N. Ravichandran

The purpose of this article is to present two examples based on real life experiences where the Bullwhip effect in supply chain is considerably reduced. Both examples relate to the consumer durables industry in India. The first example uses Enterprise Resource Planning and Vendor Managed Inventory as tools to reduce the Bullwhip Effect. The second example uses a modification of the classical inventory control policies to eliminate Bullwhip Effect. Based on these two empirical case studies, we argue that managing Bullwhip Effect is a strategic initiative by organization and the best approach is a combination of several tactical initiatives.

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Working Papers | 2006

Feasibility Study of Setting up Information Technology-Enabled Services (ITES) and Business Process Outsourcing (BPO) Hubs in the North Eastern States of India: A Report

Rajanish Dass and Lethil Nangmuansang

This report aims at identifying the various state administrative/commercial capital cities in the North East Region where IT-enabled service industry could be set up, and whether the necessary conditions conducive to the industry exist. It is also an attempt to rank the various cities in terms of their investment friendliness when it comes to the ITES industry. This report involves a macro environmental analysis where the focus is mainly on the STEEP sector of the business environment-social, technological, economic, environmental and political aspects that impact competitiveness.

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Working Papers | 2006

A Scheme for Efficient Subsidisation of Kerosene in India

Sebastian Morris, Ajay Pandey, and Samir K. Barua

The distortions in price based subsidisation are very severe. The direct fiscal cost of ensuring that a rupee of value is delivered to all household users of kerosene is as high as Rs.3 and when the consideration is the benefit that finally reaches the poor "below the poverty line" consumers it is much more. This is well known. This excludes the indirect costs in the form of negative externalities imposed by adulteration, and environmental costs. Worse still are the "third order" effects of entrenched rent seeking and corruption of distribution networks and the conversion of retailing to patronage. In such situation reform and deregulation become problematic. At the core of all these failures in the "price arbitrage" that arises when price based subsidies are resorted to. The total fiscal losses on account of kerosene subsidisation are in excess of Rs. 24,000 crore far above the conventional estimates (around Rs. 8000-10,000 crore) which do not recognise the fiscal cost of diversion and adulteration. This paper studies the current design of the public distribution system and price based subsidisation to bring out the perversities, and argues that a complete replacement is called for. The Public Distribution System (PDS) which had value in an era of shortage and rationing has no role today. Market based distribution can bring down the direct costs since now kerosene distribution could then enjoy the synergies of oil and provisions distribution channels. There is clear evidence that a significant percentage (about 40) of kerosene is diverted out of the PDS and sold at higher prices. The commission paid to the distribution channel, in particular to the retailers of kerosene does not make the business financially viable. The rents being earned by those associated with the distribution channel for kerosene are very large. The rent extractors have become so well entrenched over time that it is plausible that other agencies in the system and even the regulatory process itself may be hostage today to their influences. The indirect losses from use of sub-optimal fuel mix, product mix and investment decisions are very large and may harm the economy significantly in the long term. The subsidy through uniform low pricing of kerosene, though intended for the poor, is in fact not reaching them as they are in no position to buy much of the kerosene allotted to them even at the low issue prices being charged by the fair price shops. It is imperative to bring into play information and communication technologies so as to break the stranglehold of the distribution channel by capturing information at the point of sale and thereby creating a permanent audit trail of all relevant transactions. Only by empowering the target segment, the BPL families, by providing them with the freedom to choose the manner in which they would like to consume the subsidy intended for them can the problem be overcome. The well-documented failure of TPDS (Targeted Public Distribution System), implemented on an experimental basis, clearly demonstrates that tinkering with the existing system would not achieve the twin goal of benefiting the really poor and not-benefiting the non-poor. The direct subsidy scheme, which is based on free market pricing of kerosene, and therefore a radical departure from the current method of uniform low pricing is the answer for achieving effectiveness of subsidization. The subsidy is to be disbursed to the poor through smart cards and the accounting of disbursal is to be done using systems similar to those used by credit card companies. The purchasing power put in the hands of the beneficiaries would allow them to use it for spending on their choice of commodities and services and thereby not only enhance the use of subsidy to the full but would also add greatly to their welfare. The proposed system would almost completely eliminate the indirect losses arising from distorted choices since the price of kerosene would be market determined and therefore not relatively cheap compared to alternate fuels. A task force (TF) must be set-up for implementation, with wide-ranging powers and full financial backing of the government of India so as to be able to function autonomously. The task force should consist of eminently qualified individuals with diverse skills and known for their integrity and appreciation for the significance of the task to be performed. The critical task of identifying the beneficiaries at micro-level should be done using all possible sources of data and information (outlined in the report) so as to minimize both, Type I and Type II errors, that is, chance of exclusion of genuine beneficiary and chance of inclusion of spurious beneficiary in the list of target beneficiaries. There are interesting ways by which private information can be brought to bear, and incentive compatibility ensured in correct identification. The disbursement of subsidy should be such that the disbursement is recorded at the point of transaction and get immediately captured in a large centralized database, thereby creating a permanent audit trail, akin to operation of credit cards (details outlined in the report). The activities associated with initial identification of beneficiaries, disbursement of subsidies and updating the list of beneficiaries is to be done by well-qualified private agencies. The operations of the system should be monitored by an SPV to be specially created for the purpose and working under the broad supervision and direction of the task force. The SPV and the TF should ensure full transparency of operation of the private vendor and the scheme by making public all relevant information on the operation of the system and opting for periodic audit of operations. The appropriate organisation design and policy framework for the same is elaborated. The immediate gain to the exchequer from the proposed system, due to market based pricing of kerosene would be an estimated inflow of Rs. 14000 crore per year by way of additional taxes. This gain from additional taxes, based on certain assumptions, is expected to rise to over Rs. 37000 crore in 2010-11, at Jan. 2006 petroleum prices. The gain to the economy and society at large from elimination of indirect losses due to sub-optimal choices of fuel-mix, product-mix, and asset mix would be immense as they would be completely eliminated in the new system. The most important gain however is that the beneficiaries would be in a position to fully utilize their entitlements and spend the same on products and services of their choice, significantly enhancing thereby the utility of their consumption. This should also make direct subsidies politically rewarding.

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Working Papers | 2006

IIMs Expansion - Myths, Realities and Policy Choices

Gupta Ramesh

This paper suggests a roadmap for IIM Ahmedabad to increase its intake substantially with available resources in its flagship 'Post Graduate Program in Management' (PGP equivalent to MBA). Solutions for other IIMs should be similar as all share similar programs, ethos and culture; differences would be only in details. The suggested measures are: a) Restructure Fellow Program in Management (FPM)-IIMs Ph.D. Program Currently 22 equivalents of faculty resources are used in teaching 10-15 FPM students in the second year alone. Only 6-8 students graduate every year. To justify efficient use of available faculty resource - FPM intake either should be increased four-fold (to 60 from present 15), or merge all streams and award 'Fellow in Management' with specialization at thesis stage. This is very common in many universities facing similar constraints. The first option would increase supply of faculty for hire in future (should have been done lone time ago); the second would immediately release 15 faculty for PGP expansion. b) Review expansion plans of PGP for Executives (PGPx). There is not much international about its student body or academic offering. Admitted students are mostly NRIs who are seeking leverages with PGP brand for better placement abroad after getting the cheapest possible MBA in the world. Moreover, it is heavily subsidized Rs. 3 lakh per participant (Rs. 2 crore for current batch) just to recover direct cost. c) Require faculty who migrated to centers/groups (like health, energy etc.) to have same teaching load as others. All these centers are leveraging on PGP brand and concerned faculty involved must fulfill their obligations to PGP. d) At present two dorms on new campus are kept for non-regular events (cultural and intellectual). These can house 60 students on regular basis. Temporary arrangements can be planned for non-regular events. e) There is no justification for offering married accommodation for one year program on campus, particularly when IIMs practice a 'pressure cooker' approach of teaching. Families with children are distraction. Two students can easily be put in newly built apartments accommodating additional 100 participants. To sum it up, IIMA can increase its PGP intake substantially by a) better utilization of physical infrastructure b) better faculty time management by restructuring programs and active faculty recruitment in deficit areas; and c) by defining its priorities more sharply. IIMs PGP product is the best and why dilute it by allowing remotely related activities to have free ride on it? The paper also covers issues like autonomy, increasing role of alumni and almost extinct faculty governance. It is not concerned with 'OBC reservation policy'.

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Working Papers | 2006

Capacity Management of Intensive Care Units in a multi-specialty Hospital in India

Vohra Seema, Goutam Dutta, and Ghosh D K

In this paper, we describe the capacity management of Intensive Care Units (ICUs) in a 300-bed multi-specialty hospital where the alternative ICU is utilized when the appropriate ICU is full for a set of two types of ICUs. Inter-arrival time and service time distributions in these ICUs have been tested and found to be exponentially distributed. While most capacity management models are deterministic in nature, we have developed a queuing model to provide a basis for decision-making in the design and management of these ICUs. The model results in around 19800 linear steady state equations, which are solved using the CPLEX linear optimization solver. Based on real data available from a hospital in India, the results demonstrate that the utilization of the ICU beds will improve up to 28 percent when admissions to the alternative ICU are permitted.

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Working Papers | 2006

Small and Medium Enterprise in India - Overcoming Policy Constraints to Achieving Rapid Growth in a Globalizing Economy

Sebastian Morris and Rakesh Basant

Sustained very high rate of growth (above 8% in the context today in India) would be able to achieve (since a labour productivity growth of 4 to 4.5 % is to be factored in) a labour absorption rate of 3.5 to 4% which is about a percent above the growth in the rate of the workforce. But slower growth of around 6% which is what India seems to be achieving in the 90s on an average would keep disguised unemployment alive for long. Similarly, the transformation of firms and especially SMEs which have little autonomous capacity is itself a function of growth oriented policies. In the nineties labour has been sufficiently flexible to allow rapid growth whenever demand was high. In any case the unorganised workers, did not have the ability to resist hire and fire. Demand has been lower than possible otherwise since the rupee especially in comparison to the East Asian currencies has not been aggressively priced. Lacking a very rapid growth in the market sufficient to overcome disguised unemployment, the transformation of these industries has itself been affected. Similarly the continuation of tariff inversion, high and uncompensated energy taxes hurt manufacturing and especially the small and medium sector whose dependence on relative factor cost is higher. The slow movement towards de-reservation has further attenuated the process. The dynamic inefficiencies and distortions are far more significant than the static efficiency penalty that the economy pays in the continuation of reservation. Without these corrections the move to have "free-trade" agreements with the ASEAN countries would hurt manufacturing in India and especially the SMEs. Many of the traditional small firms are in clusters, and a cluster oriented approach would be important for their success. A strategy based on leveraging trade names /brand names, many of which could be argued to be "geographic indicators", with much equity world wide, would require immediate changes in our intellectual property rights regime. Costs of excise registration and dealing with excise authorities are too large, and there is a fixed component to this cost which cannot be spread over a large value of turnover. Only significantly lower excise rates for small firms could compensate them sufficiently. The criteria of "with and without the use of power" in the Factories Act, be entirely dispensed with. All units with more than 50 employees including the entrepreneur and family labour, be brought /retained under (all) the provisions of the Factories Act. And all other units be entirely exempt from its provisions. Credit is the single most important constraint for small firms. Incentivisation of priority sector targets is the solution. The policy of directed lending to small firms (the targets for priority sector lending) ought to shift from targets or quotas to incentives to banks for lending to small firms. Responsible risk taking in lending would have to re-emerge. Tax based incentives for banks and financial intermediaries are possible. Statutory Reserves based incentives for banks too are possible. Concessions on interest rates are dysfunctional, though the margin above PLR rates ought to be subject to a ceiling. State Finance Corporations which could play a crucial role in financing of SMEs would have to go through quick restructuring and refocus on promotion of new enterprises typically where vast positive external effects are anticipated, such as in technology based small firms, promising industries, nodal industries, industrial estate corporations, in exchanging specific infrastructural support to existing clusters of small firms, etc. Investments in infrastructure especially general roads, power, railways, and water supply would help to improve the performance of small firms significantly. For all small firms power and water continue to remain constraints shamefully after nearly 10 years of reform. These can easily come down at least for export industries if the taxes and cross subsidies on them are made vattable. Despite the Electricity Act 2003, it is shameful that open-access has not been extended to SMEs. Technology based and skill labour using industries such as IT, BT, pharmaceuticals and auto oriented industries, also need to be exploited. In automobiles taxes are still very large and the inverted tariffs / high cost of materials and energy that are uncompensated hurt the prospects of India emerging as a base for manufactures. In IT, Biotechnology, pharmaceutical industries and other related offshoring activities the challenges lie in bringing about better IPR regimes that reduces the risk faced by foreign firms in their operations in India. IPR regimes requiring much insight would have to be worked work out that is able to balance the interest of Indian firms and yet lead to much industrial relocation. The addition of a petty patent register could considerably enhance the extraction of value from the many innovations that take place in the SME sector. Municipal infrastructure is inadequate and its correction in at least a few cities is of crucial importance to the growth of the off-shoring activities and growth in these industries. Financial institutions could usefully develop strong venture capital arms to finance innovative small firms that have a good potential to emerge in the near future in many industries. Problems with government procurement which are designed to fail keeps alive a very large market for shoddy goods among SMEs. Merging of the umpteen laws and regulations into one wherever feasible can reduce the currently large costs of SMEs in dealing with government.

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Working Papers | 2006

Factoring affecting the Demand for Health Insurance in a Micro Insurance Scheme

Jain Nishant and Bhat Ramesh

Health insurance schemes are increasingly recognised as preferable mechanisms to finance health care provision. In this direction micro health insurance schemes and community based health insurance schemes are assuming significant importance in reaching large number of people. However, at the community level despite low premiums the penetration of health insurance is small. The objective of this paper is to analyse factors determining the demand for private health insurance in a micro insurance scheme setting. The study uses two-stage model to examine this issue. First, we determine the factors which affect the insurance purchase decisions and at second level we focus on studying factors which affect the amount of insurance purchase using Heckman two-stage estimation procedure. The data of this study is based on survey and collection of primary data from the Anand district of Gujarat where Charotar Arogya Mandal is offering a health insurance scheme. The results indicate that income and healthcare expenditure are significant determinants of health insurance purchase. Age, coverage of illnesses and knowledge about insurance were also found to be affecting health insurance purchase decision positively. For the decision regarding amount of health insurance purchase, income was found to be having significant but non-linear relationship. In addition, number of children in the family, age, and perception regarding future healthcare expenditure were also found to be significant. The study discusses implications of these results.

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Working Papers | 2006

Issues and Concerns in the Implementation and Maintenance of HRIS

Manjari Singh and Krishnan Sandeep K

The paper looks at the issues and concerns faced by nine Indian organisations in implementing and managing HRIS. The organisations are diverse in terms of size and sector that they belong. The critical success factors and weaknesses in various stages of implementing an HRIS are explored in the paper. The problems are rooted in mainly two factors. One is the fact that HR department lacks knowledge about HRIS and hence is not able to clearly elucidate the requirements of the system. Poor need assessment is a continuation of this problem. Second is the lack of importance given to HR department in the organisations. The spectrum of cases covered shows the clear variation in terms of the success of implementation. In poorly managed implementations, the potential of HRIS has been under-utilised. Only a few modules have been implemented and at best HRIS's role is that of a centralised database. Very high dependence is placed on the vendors without having a clear idea about how to select vendors or a proper process or contract to ensure vendors' accountability. Another area of concern is that level of cooperation needed across various functions and divisions of the organisation for proper implementation of HRIS is also lacking. User satisfaction is low because there is minimal user involvement in the implementation project and the implemented package is not user-friendly.

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