What Is Reproductive Health Operations Research?

What Is Reproductive Health Operations Research? FRONTIERS in Reproductive Health Program 2008

Operations Research for Managers of Reproductive Health Programs © 2008 The Population Council, Inc.

Operations Research (OR) is the study of factors under the control of program managers.

OR uses research techniques to help choose among alternative uses of resources to meet specified program objectives.

Operations Research for Managers of Reproductive Health Programs © 2008 The Population Council, Inc.

Research Focus  

Factors controlled by managers Outcomes desired by managers and clients Independent variables: manipulated by managers Dependent variables: program outcomes

Operations Research for Managers of Reproductive Health Programs © 2008 The Population Council, Inc.

OR Supports EvidenceBased Programs • Supports decisions with empirical evidence

• Arrives at “best practices” by comparison • Tests service delivery innovations

Operations Research for Managers of Reproductive Health Programs © 2008 The Population Council, Inc.

Programs are the Substance of OR Health programs are organized activities that seek to promote the health and well-being of communities or populations.

Operations Research for Managers of Reproductive Health Programs © 2008 The Population Council, Inc.

Program Objectives    

Access: Availability of services geographically, economically, administratively Efficiency: Maximization of outcomes at a given resource level Quality: Appropriateness and competency of services Impact: Improvements in health

Operations Research for Managers of Reproductive Health Programs © 2008 The Population Council, Inc.

Programs Produce • Outputs: Program services • Outcomes: Client behaviors • Impacts: Improvements in health status

Operations Research for Managers of Reproductive Health Programs © 2008 The Population Council, Inc.

Managerial Control Factors Under Control Program systems: training, pricing, information, counseling …

Operations Research for Managers of Reproductive Health Programs © 2008 The Population Council, Inc.

Factors Not Under Control Cultural beliefs, location, economic status, religion, education…

OR Access Problem • Program Problem: How to get more adolescents to use reproductive health clinic • Managerial Factors: Price, hours, provider training… • Output: More visits to clinic by adolescents • Outcome: More contraceptive use • Impact: Fewer unwanted pregnancies

Operations Research for Managers of Reproductive Health Programs © 2008 The Population Council, Inc.

Achieve a Specified Outcome The outcome must be determined in advance: –

Lower cost per service – Reduction in C-sections – Decreased HIV incidence – Increased postnatal visits

Operations Research for Managers of Reproductive Health Programs © 2008 The Population Council, Inc.

Research Techniques •

Systematic data collection

•

Diagnostic/formative studies to identify problems

•

Experiments, simulations to choose between alternatives

Operations Research for Managers of Reproductive Health Programs © 2008 The Population Council, Inc.

Diagnostic/Formative Research • Descriptive studies • Done when reason for program problem is unknown or to determine if problem exists • Suggests possible solutions

Operations Research for Managers of Reproductive Health Programs © 2008 The Population Council, Inc.

Intervention Research • • • •

Experiments Factors under manager’s control Tests solutions to program problems Compares alternatives

Operations Research for Managers of Reproductive Health Programs © 2008 The Population Council, Inc.

Evaluation • Usually descriptive and retrospective • Deals with factors under and not under managers’ control • Focus on attainment of project objectives • Can use experiments • Line between OR and evaluation often blurred

Operations Research for Managers of Reproductive Health Programs © 2008 The Population Council, Inc.

OR: Applied to all Service Delivery Modalities • • • • • •

Hospitals Clinics Community Programs Public Programs NGO Programs For-profit Providers

Operations Research for Managers of Reproductive Health Programs © 2008 The Population Council, Inc.

OR Requires Collaboration • Managers: responsible for decision parameters and desired outcome • Researchers: responsible for recommending and implementing research techniques

Operations Research for Managers of Reproductive Health Programs © 2008 The Population Council, Inc.

OR is Not Methodologically Defined Different methods used in OR studies: • Quantitative • Qualitative • Surveys • Experiments • Focus Groups • Simulations

Operations Research for Managers of Reproductive Health Programs © 2008 The Population Council, Inc.

Decision Determines Method • What information is needed to make decision? • When must the decision be made? • How much can we spend? • What precision is needed in data (consequences of wrong decision)

Operations Research for Managers of Reproductive Health Programs © 2008 The Population Council, Inc.

Steps in the OR Process 1. 2. 3. 4. 5.

Identify the problem Generate solutions Test intervention to solve the problem Ensure results are used Disseminate results

Operations Research for Managers of Reproductive Health Programs © 2008 The Population Council, Inc.

OR is successful only if the results are used to make program decisions

Published papers are not valid indicators of OR success

Operations Research for Managers of Reproductive Health Programs © 2008 The Population Council, Inc.