The Centre for Policy Research turns fifty this year. Fifty years in the service of Indian policymaking, of keeping a robust conversation between the government, policymakers and the Indian populace alive – this is indeed a moment of pride and reflection for us. As we celebrate this special milestone, we present some snippets of our impact on the Indian policy sphere over the years in various areas of research.

This edition of Policy in Action is dedicated to our work on Health. CPR has been working in the area of Health since the 1980s, with the noteworthy work of Meera Chatterjee on Health Policy and its implementation, and PD Malgavkar on Biotechnology. Through the years, CPR has partnered with organisations, governments and key players in the field, on various aspects of healthcare, access to health, health policy and most recently the Covid-19 pandemic.

Here’s a snapshot of our key work and impact in the area of Health over the years

• CPR’s Jishnu Das conducted research on the quality of care in public and private hospitals and clinics. This eventually led the Government of India to formulate a health insurance scheme that allowed patients to visit both public and private providers. Subsequently, CPR worked with the GOI from 2007 to 2009 to build out RSBY (Rashtriya Swasthya Bima Yojana) rules and implementation, including the full architecture and design of databases. We worked with states as they started implementing the program and published an edited book detailing the experience with the early days of the program. This program was later expanded to become PM-JAY.
• Starting in 2012, we developed the use of standardised patients (people recruited from the local community and extensively trained to portray the same condition to multiple healthcare providers) to assess the quality of clinical care. The methods were first used in India and then gradually expanded to multiple conditions and countries with help from our team in the development of methods, tools and training. They have currently been used in Peru, Tanzania, Senegal, Kenya, South Africa, India (multiple sites), China and Indonesia for more than 10 different conditions.
• Jishnu Das was also part of a team that worked with the Liver Foundation, West Bengal, to evaluate a training program for informal providers. The published paper showed large effects of the training on the correct diagnosis and management of patients leading to the scale-up of the program to more than 80,000 informal providers in the state.
• In 2003, we developed new tools for measuring the medical knowledge of healthcare providers. These methods were initially used in India and Tanzania and have now been expanded through the World Bank’s Service Delivery Initiative to more than 20 countries in Sub-Saharan Africa covering more than 20,000 healthcare providers.
• In 2020, CPR published a study titled Two Indias: The structure of primary health care markets in rural Indian villages with implications for policy which was based on ground research conducted by a team led by Jishnu Das in 2009 across 19 Indian states. The paper assessed the role played by informal medical workers in rural India and the impact of changes in socio-economic status in regions in terms of the quality of health care accessible to citizens. Our results highlight the complex structure of health care markets, the large share of private informal providers, and the substantial variation in the quality and cost of care across and within markets in rural India. Measuring and accounting for this complexity is essential for health care policy in India.

CPR’s Work during the COVID-19 Pandemic

During the COVID-19 Pandemic, our faculty was engaged in some key research to decode every aspect of this public health crisis. Here are some highlights of our work on COVID-19:

• In 2020, Jishnu Das, Partha Mukhopadhyay and Neelanjan Sircar were part of a study that assessed the heterogeneity in the transmission of the novel SARS-CoV-2 virus. The data for this research was collected from contact tracing during the lockdown in Punjab. The study found that a sequential strategy in contact tracing would yield better results in resource-constrained settings like India. Our results highlight how contact tracing, an important public health measure, can also provide important insights into epidemic spread and control.
• Jishnu Das and Partha Mukhopadhyay were part of the India Task Force of The Lancet COVID-19 Commission in 2021. The Commission was created to help speed up global, equitable, and lasting solutions to the pandemic. The Task Force published on various pressing issues like containment strategies, managing India’s second wave etc.
• In 2021, Yamini Aiyar was part of a team that authored a report for the Lancet Citizens’ Commission on Reimagining India’s Health System, which was launched to achieve Universal Health Coverage in 2020. Against the backdrop of the resurgence in COVID-19 cases in 2021, this report proposed eight recommendations for the central and state governments. Some of these points were voiced by authoritative voices in the country to chart out the immediate course of action, at the time.
• Partha Mukhopadhyay authored a chapter titled Making COVID-19 Vaccines Universally Accessible in a book edited by Kanni Wignaraja and Swarnim Wagle, published by the UNDP. This chapter outlined the key challenges in making COVID-19 vaccines universally accessible, highlighting decisions that governments needed to make along the way to tackle the crisis.

To know more about CPR’s work on Health, you can visit our website at https://cprindia.org/researcharea/health-nutrition/

Stay tuned for our next pop-up edition of Policy in Action, coming soon!