Dear Sir,

Greetings !

Thanks for sending the study findings on Nutrition services, which is an excellent study and the findings may help us to rectify the field level problems and to improve the attendence of the needy people on VHNDs. I circulated this articles to all our Block level SPHO (Senior Public Health Officer) to sensitize their medical teams to reduce the drop outs in Nutrition services. Once again I thanks for your support.

with regards,

Dr.R.Rama Rao

On Mon, Jun 25, 2012 at 10:46 AM, Shubhada <shubhada.kanani> wrote:

Dear all,
I liked the paper comparing private and public healthcare systems. I have carried out health-systems research relating to quality of implementation – monitoring and supervision of nutrition programs and the picture is truly dismal – nutrition receives lip service in policies and documents; it is hardly a priority at grassroots level. ICDS is doing a lot else; but little of effective malnutrition control; one key reason being that its workers are called upon by several development sectors to carry out their work; even if they pay the AWWs, the fact remains that attention gets diverted away from those servcies which are critical for reducing maternal-child under-nutrition. Attached is my paper in WHO forum highlighting a case study on ICDS and quality of care

I request HSRII to identify research papers / reviews highlighting the sad state of implementation of programs for undernutrition -anemia control and other deficiencies and suggest solutions.
In one sentence, what i can say is: unless governance improves and malnutrition control becomes a priority at field level, there is little hope for reduction of under-nutrition in our country

Shubhada Kanani
Nutrition Specialist

On Friday, 22 June 2012 10:15:12 UTC+5:30, Health Systems Reserach India Initiative wrote:

Basu S, Andrews J, Kishore S, Panjabi R, Stuckler D (2012) Comparative Performance of Private and Public Healthcare Systems in Low- and Middle-Income Countries: A Systematic Review. PLoS Med 9(6): e1001244. doi:10.1371/journal.pmed.1001244


Private sector healthcare delivery in low- and middle-income countries is sometimes argued to be more efficient, accountable, and sustainable than public sector delivery. Conversely, the public sector is often regarded as providing more equitable and evidence-based care. We performed a systematic review of research studies investigating the performance of private and public sector delivery in low- and middle-income countries.

Methods and Findings

Peer-reviewed studies including case studies, meta-analyses, reviews, and case-control analyses, as well as reports published by non-governmental organizations and international agencies, were systematically collected through large database searches, filtered through methodological inclusion criteria, and organized into six World Health Organization health system themes: accessibility and responsiveness; quality; outcomes; accountability, transparency, and regulation; fairness and equity; and efficiency. Of 1,178 potentially relevant unique citations, data were obtained from 102 articles describing studies conducted in low- and middle-income countries. Comparative cohort and cross-sectional studies suggested that providers in the private sector more frequently violated medical standards of practice and had poorer patient outcomes, but had greater reported timeliness and hospitality to patients. Reported efficiency tended to be lower in the private than in the public sector, resulting in part from perverse incentives for unnecessary testing and treatment. Public sector services experienced more limited availability of equipment, medications, and trained healthcare workers. When the definition of “private sector” included unlicensed and uncertified providers such as drug shop owners, most patients appeared to access care in the private sector; however, when unlicensed healthcare providers were excluded from the analysis, the majority of people accessed public sector care. “Competitive dynamics” for funding appeared between the two sectors, such that public funds and personnel were redirected to private sector development, followed by reductions in public sector service budgets and staff.


Studies evaluated in this systematic review do not support the claim that the private sector is usually more efficient, accountable, or medically effective than the public sector; however, the public sector appears frequently to lack timeliness and hospitality towards patients.

Kindly download the full article by following the link given below;