Indian Health Information Networks (2017-2018)

Background

In Uttar Pradesh, a state of over 200 million people in northern India, childhood health indicators such as infant mortality and malnutrition have remained among the highest in the world despite multiple initiatives to improve delivery and quality of services and to provide micronutrient supplements through public sector institutions.

The ineffectiveness of health and nutrition services delivered by the public sector is driven by factors including widespread absence of providers, lack of supplies and poor quality of care. Social accountability interventions, which seek to empower community members and facilitate monitoring of public healthcare providers and local officials, have shown remarkable impacts in recent small-scale efficacy studies.

Typically, social accountability interventions provide information to households on health-related indicators in their community and establish opportunities for them to communicate grievances and hold local healthcare providers accountable over time. This increased accountability leads to improved performance of providers and delivery of services. These improvements, combined with improvements in household awareness, increases utilization of appropriate care, and healthy behavior among households has the potential to significantly improve child health and nutrition outcomes.

Project Description

The Uttar Pradesh Health Systems Strengthening Project, supported by the World Bank, implemented social accountability interventions in 12 districts in May and June 2016—the largest such intervention implemented to date—and selected two of the districts for robust impact evaluation. Detailed social network data were collected in the intervention villages of these two districts and then used to implement a series of network interventions to study peer effects and information diffusion within social networks. An important potential consequence of the interventions is the effect they may have on individual networks, with new social connections being created during implementation.

To further study the network effects of these social accountability interventions, this Bass Connections project will focus on the collection of social network data and comparison of networks pre- and post-intervention in 80 villages that are randomly assigned to treatment arms.

The project team will assist in planning and carrying out social network data collection in the 80 villages, including developing the survey, monitoring incoming data in real time to ensure a high standard of quality and studying differences in networks at the individual and village levels.

This work will provide insights into the mechanisms behind information diffusion and collective action that are key drivers of the theory of change behind social accountability interventions. The results of the social network analysis undertaken by this project will inform the overall intervention results.

Anticipated Outcomes

Dynamic network dataset covering 80 villages at two points in time; descriptive paper on social features that determine network structure (such as the effect of similarity in health and education, caste) and how these change over time; article submitted to a social science journal; proposal submitted to NIH to align these data with other economic and health-related network data collection projects at Duke

Timing

Fall 2017 – Spring 2018

  • Fall 2017: Finalize survey by first week in September; monitor and provide quality assurance for incoming data
  • Spring 2018: Initial results expected by end of January; finalized results expected by end of March; finish project by April

Crediting

Course credit available for fall and spring semesters

Faculty/Staff Team Members

Manoj Mohanan, Sanford School of Public Policy*
James Moody, Trinity - Sociology*
Kendal Swanson, Sanford School of Public Policy

Graduate Team Members

Joseph Quinn, Sociology-PHD
Lavanya Singh, Masters of Public Policy

Undergraduate Team Members

Felicia Chen, Computer Science (AB), Public Policy Studies (AB2)
Pranav Ganapathy, Economics (AB), Global Health (AB2)

Community Team Members

Mudit Singh, Visiting Research Scholar, Duke Network Analysis Center

* denotes team leader

Status

Active