Impact of Reproductive Health Research

1. Impact of Reproductive Health Research P.K. Mehrotra Director General Madhya Pradesh Academy of Administration Bhopal (India)

2. Preamble • Reproductive health research is critical to making reproductive health programmes adaptive to reproductive health needs of the people. • Research has been an integral component of National Family Welfare Programme in India. • Research in India has mostly been confined to evaluation research.

3. Preamble • A network of Population Research Centres have been established in the country with a view to providing independent and objective assessment of the working of National Family Welfare Programme. • National level surveys have been organized at regular intervals to evaluate impact of the Programme.

4. Preamble • An internal system of evaluation research has also evolved within the National Family Welfare Programme. • In-house evaluation research activities within the Programme are based on the target-based model of programme evaluation – a corollary of target-based approach of programme implementation.

5. Impact on Service Delivery • Despite substantive research activity under the National Welfare Programme, its impact has mostly been limited to policy formulation and setting up priorities at the national level. • Research has contributed little to improving service delivery.

6. Reasons for Limited Impact • Research activities under the National Family Welfare Programme have followed a top-down approach. • Nearly all the research activities are conceptualized, planned and implemented at the national level whereas service delivery is the responsibility of the state governments.

7. Reasons for Limited Impact • The National Government does not deliver family welfare and reproductive health services. • There is little research activity at the state level and at the level where the family welfare and reproductive health services are actually delivered to the people.

8. Reasons for Limited Impact • Basic orientation of the National Family Welfare Programme continues to be on achieving pre-fixed demographic targets. • Orientation of the research has also been towards programme outcomes and not towards programme processes. Research in processes remain neglected.

9. Reasons for Limited Impact • Because of the basic approach towards reproductive health research, services providers are never involved in the research activities. • Research findings are rarely incorporated in development plans and in training reproductive health services providers.

10. Issues • At the macro (national) level reproductive health research in India has contributed substantially in policy formulation and in setting up priorities. • At the implementation (state, district, development block, village) level, contribution of research to improving services delivery has been abysmal.

11. Issues • The target-based approach of programme implementation has now been replaced by a decentralized, community-needs based approach. • The change in the basic approach of implementation has made the target-based model of evaluation research redundant.

12. Issues • Promoting use of research in delivery of reproductive health services requires involvement of providers and receivers of services in the research processes. • Research conducted outside the system has a very limited scope of being used in the delivery of services at the grass roots level.

13. Issues • Promoting reproductive health research for improving service delivery requires building up the research capacity at the lowest level of the services delivery system. • Such research capacity is lacking even at the state level. • Lack of the capacity is the biggest impediment to research at the local level.

14. Issues • Perhaps the most critical issue is how to develop the evidence-based analytical acumen in minimally trained and minimally educated reproductive health services providers who work almost in isolation and in very diverse and trying social and cultural conditions.