Assessing the Functioning of the Primary Health Centers in Karnataka, India

Last registered on August 20, 2013
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Pre-Trial

Trial Information

General Information

Title
Assessing the Functioning of the Primary Health Centers in Karnataka, India
RCT ID
AEARCTR-0000040
First published
August 20, 2013, 9:29 AM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Locations

Country
India
Region
Karnataka

Primary Investigator

Name
Rema Hanna
Affiliation
Harvard University
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Other Primary Investigator(s)

PI Name
Rema Hanna
PI Affiliation
Harvard
Contact Investigator
PI Name
Iqbal Dhaliwal
PI Affiliation
JPAL
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Additional Trial Information

Status
On going
Start date
2010-06-01
End date
2014-05-30
Keywords
Governance, Health
Additional Keywords
JEL code(s)
Secondary IDs
Abstract
India has an extensive network of Primary Health Centers that provide essential medical care to the very poor. However, despite the large budgetary allocations made to the public health care system, the quality of care remains low, as do health outcomes. One key reason for this is the high level of absenteeism amount the medical staff (see Duflo, Hanna, and Ryan, 2010 for a discussion of absenteeism among government workers in India).

The State of Government of Karnataka (GoK), India, proposes to tackle this issue through the use of technology via a pilot project in five districts of the state. In the pilot, the Multi Function Devices (MFDs) will be used to (a) digitally capture the thumb impressions of health staff to monitor attendance, (b) capture beneficiary photograph and signature electronically to ensure only the genuine patients receive the benefits, and (c) transmit information on local disease and health patterns in real time to state health authorities to enable effective response to emerging local health threats. This technology will be coupled with a system of incentives to encourage improvements in staff attendance, reduce leakages, and ensure prompt action on emerging local health threats.
The government has asked for a randomized evaluation of the study. 322 PHCs will be in the study. The government will run their intervention as they normally would, in roughly half of the PHCs (140). They will pay for the costs of the intervention.

The evaluation design, data collection effort and analysis is led by JPAL researchers.
External Link(s)

Registration Citation

Citation
Dhaliwal, Iqbal, Rema Hanna and Rema Hanna. 2013. "Assessing the Functioning of the Primary Health Centers in Karnataka, India." AEA RCT Registry. August 20. https://doi.org/10.1257/rct.40-1.0
Former Citation
Dhaliwal, Iqbal, Rema Hanna and Rema Hanna. 2013. "Assessing the Functioning of the Primary Health Centers in Karnataka, India." AEA RCT Registry. August 20. https://www.socialscienceregistry.org/trials/40/history/279
Sponsors & Partners

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Experimental Details

Interventions

Intervention(s)
The Government of Karnataka will pilot the use of Multi Function Devices (MFDs) in government primary health centers (PHCs). The Multi Function Devices (MFDs) will be used to (a) digitally capture the thumb impressions of health staff to monitor attendance, (b) capture beneficiary photograph and signature electronically to ensure only the genuine patients receive the benefits, and (c) transmit information on local disease and health patterns in real time to state health authorities to enable effective response to emerging local health threats. They will fund and run the intervention as they normally would. They have decided to randomly select which PHCs will initially have the program in the first year, and then if successful, they plan to scale the program across Karnataka the following year.
Intervention Start Date
2011-06-20
Intervention End Date
2013-03-31

Primary Outcomes

Primary Outcomes (end points)
staff attendance based on random checks, punctuality, delivery of health benefits
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
The evaluation of the digital attendance and public service delivery through primary health centers will be randomized control trials, where about half the PHCs will receive the intervention while the rest will comprise control. The random assignment is stratified at the sub-district (taluk/block) level.
Experimental Design Details
Randomization Method
The randomization was done in office by running a program in Stata
Randomization Unit
PHC
Was the treatment clustered?
Yes

Experiment Characteristics

Sample size: planned number of clusters
322 PHCs
Sample size: planned number of observations
5000 PHC staff over many time series
Sample size (or number of clusters) by treatment arms
140 PHCs in treatment 182 in control
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Supporting Documents and Materials
IRB

Institutional Review Boards (IRBs)

IRB Name
MIT
IRB Approval Date
2010-06-01
IRB Approval Number
1005003887
IRB Name
Harvard
IRB Approval Date
2010-06-01
IRB Approval Number
F19257-104
Analysis Plan

Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
No
Data Collection Complete
Data Publication

Data Publication

Is public data available?
No

Program Files

Program Files
Reports, Papers & Other Materials

Relevant Paper(s)

Reports & Other Materials