Performance assessment of health policies from a social marketing perspective: a case study of communication diseases control programmes of government of India

Abstract

In developing nations, the governments are still grappling with the prevention and control of deadly communicable diseases. In India health is a state subject but due to the importance of the subject, the Central Government along with the states, is trying relentlessly to control and eliminate these fatal diseases. Two such programmes that have been getting immense focus are the Revised National Tuberculosis Programme(RNTCP) and National AIDS Control Programme (NACP). Despite sincere efforts, it has been found that these programmes have not been able to reach the targeted customers. Moreover, the level of impact of these programmes varies from state to state. This research assesses the performance of health policies from a social marketing perspective. Chapter I gives a general background of the health scenario in India and the efforts made by the Government of India to fight tuberculosis and HIV/AIDS. Chapter II highlights the available literature on public health and social marketing as well as the response to the two diseases in India. Chapter III discusses the research methodology used for the study. A secondary data analysis helped to identify the areas of enquiry for primary data collection. The research conducted in the two states of Delhi and Bihar was done using both qualitative and quantitative tools. The data was collected among the policy formulators at the center and the implementers at the state. NGOs, doctors and patients too were interviewed. For the data collection, a set of indices were devised, adapted from the ones used by the international agencies. Chapter IV presents the secondary data analysis. Chapter V presents findings from field. These are Both programmes suffer from lack of countrywide prevalence surveys indicating the extent of the problem. Another important aspect is the absence of monitoring on a regular basis to evaluate the impact of programmes on the socio-economic status of beneficiaries. The performance of NGOs involved with the programmes are not properly monitored. The human rights aspects have also been not given much significance. Discrimination against the patients of tuberculosis, especially women, does not seem to be the concern of the government. In Chapter VI, the following major policy recommendations, along with some other general recommendations, have been made: Greater use of social marketing techniques Introduction of Result Based Management (RBM)Change of mind set of stakeholders Apart from these the general recommendations include Conduct Incisive Research Provide Flexibility in the Programme Develop effective Communication Strategies with Innovations in Media Address Stigma Increase Involvement of Stakeholders Include Human Rights Issues into the Programme