Improving Governance and Health Outcomes for the Poor Through Innovative Technology
Women’s health in India is neglected because the public health system is not functioning properly. A recent study found that nearly 40 percent of health staff in India are absent from work on a typical day; and it gets worse in rural areas. This problem negatively affects both the way women use health facilities and their health outcomes: Only 18 percent of births take place in a public facility, and the neonatal mortality rate in India is almost 40 percent. In partnership with J-PAL, the Government of Karnataka is employing an innovative new technology in its Primary Health Centers to improve health outcomes and access to services. Machines placed in PHCs will capture the thumb impressions of health staff to monitor attendance and transmit the information in real time over the cell phone networks. This will be coupled with a system of incentives and penalties for the health staff to reduce absenteeism. JPAL is evaluating this program to measure its precise impact, and provide a cost-effectiveness analysis of the intervention. Additionally, this research lays down a blueprint for active collaboration between researchers and governments to ensure that policy is driven by scientific evidence. If J-PAL’s evaluation finds that the program is effective in achieving the desired outcomes, the government plans to scale it up to the entire state (population 52 million). The underlying technology and design of this program can be easily adapted to most states in India, as well as other developing countries, that face similar challenges.