An
Institution with a difference[1]
One
TV commercial claimsthat “an idea can change your life”. However in
case of IIHMR,the idea has gone beyond changing an individual’s life. It has
changed the way the government and corporate sector both in India and abroad have perceived the health sector
and its management. The idea has changed millions of lives and is still
changing many more. Today, the discipline of health and hospital management is
a well-accepted reality in India but this did not happen overnight.
Let
me take you threedecades back. A young medical graduate from National Medical College,
Kolkata,,was looking for a post graduate degree to specialize. As luck would have
it, he ends up at the Johns Hopkins School of Hygiene and Public Health (now Johns
Hopkins Bloomberg School of Public Health). Rest, as they say, is a history.
At
the school, he is baptized into public health and the new challenges and
horizons it offered.The young man finishes his Masters in Public Health and returns
to India. Almost at the same time, he loses his father. The corporate group (TCI
BhorukaGroup of Institutions), which was founded by late Shri Prabhu Dayal
Agarwal,setaside a corpus to establish memory of its legendary founder. Since the
family has its origin in Marwar region of Rajasthan, it was expected that
family will either come up -with a hospital or a community hall or somethingsimilar
to it forcommemorating the contribution of Shri PD Agarwal to the society.
However, the family had different ideas.
The
Agarwal brotherstasked their youngest brother Dr. Ashok Agarwal, to come up with
an idea which befits the stature of Shri P D Agarwal. Dr. Ashok Agarwal,equipped
with his public health credentials,venturedaround the globe and within country looking
for new innovative ideas. On this sojourn, he met some of the leading
industrialists, academicians and practicing minds of various fields and came up
with an idea of establishing an Institutewhichwill worktowards improvement ofthe
health standards through better management of public health and healthcare
related services.He envisaged that this improvement will be carried out through
managementresearch,training, consultation and institutional networking in
national and global perspectives.One of the leading public health practitioners
in the country, Prof. N.S. Deodhar was
entrustedto come up with the first detailedproject report for establishing this
Institute which was christened asIndian Institute of Health Management Research.
On 5thOctober 1984,Society
for Indian Institute for Health Management Research was established with
some of the leading practitionerslike Shri V.P. Agarwal, Dr. Ram S. Tarneja,
Dr. Ashok Agarwal, Mr. M.L. Mehta and Dr. Rusikesh M. Maruas the members of
first management board. .
As
it happens with any new idea, there was initial resistance and hardly any
buyers of this idea of ‘health management’. Therefore the promoting familydecided
to support most of the finances of the Institute for first few years. It was
also felt that the first and foremost need of the health sector is to create a culture
of evidence based decision making andtherefore research in health sector was
identified as first activity of the institute. This gave IIHMR a leading edge
and distinct identity from other B schools in years to come. Gradually, some of
the UN agencies started giving project evaluation and other assignments to
IIHMR.
After
first decade of experimenting, somewhere in the mid-90s, IIHMR started
establishing itself as a center of excellencefor quality research. People in
the government set up as well as international academic and development sectors
started accepting the value of research conducted by IIHMR. Gradually the
Institute networked with prestigious universities and organizations of
international and national level. The John
Hopkins University (JHU), John Hopkins Bloomberg School of Public Health
(JHBSPH) also signed Memorandum of Understanding (MoU) with IIHMR in area of
research, education and training. In 1998, the Institute was designated
as the WHO Collaborating Centre for District Health System Based on Primary
Healthcare for its excellence in health management research, training and
educational programs. As a collaborating centre, the Institute works in the
areas of organization and management of health system based on primary
healthcare with particular emphasis on district health system in urban and
rural areas and quality assurance in healthcare. Since then, IIHMR has been
operating as a resource center, organizing inter-country training programs,
collaborating with World Health Organization (WHO) for monitoring and
evaluation and providing its expertise in health system management and
research. The IIHMR also get the recognition as an Institute of Excellence by
the Ministry of Health and Family Welfare, Government of India.
While
making its presence known in national and international level, national and
international agencies started giving more and more assignments to IIHMR.The
Institute was nominated as a nodal agency in year 1994-5 for managing one of
the world’s largest user fee-based rural drinking water supply, AapniYojana - a
unique drinking water project launched with the support by KfWGermany.The
project has benefitted 9 lakh people ensuring round the clock supply of potable
water. In 2006, the IIHMR also partnered with the DFID supported multi country
consortium formed for the Future Health Systems Research Program Consortium
(FHSRPC), which envisages providing high quality knowledge about how health
systems can improve quality of and access to basic health services for the
poor. As a partner of this consortium and under a research programme titled
“Future Health System: Innovations for Equity”, IIHMR in 2012 has carried out a household survey in three
districts of West Bengal to capture the data on out of pocket payments for
inpatient care, travel costs, and board and lodging costs for the patients
admitted in a hospital.
The
Institute is also a partner in Health of the Urban Poor (HUP) project
consortium, which aims to improve the delivery of a comprehensive package of
maternal, child health and nutrition interventions, including promotion of
water supply, sanitation and hygiene services in urban communities. The project,in
partnership with Population Foundation of India and support of United States
Agency for International Development, is being implemented in Rajasthan and
Chhattisgarh since September 2010.The IIHMR, with the support of Global
Alliance for Improved Nutrition (GAIN), is also involved in a food
fortification programme to reduce the prevalence of micronutrient deficiencies
in the State of Rajasthan, especially iron deficiency, Vitamin A and D
deficiency which will have far reaching implications in solving long standing
problem of anemia in the population particularly women and children since 2011.
The project makes available fortified wheat flour, oil, milk and pulses through
both the open market and government distribution channels including Public
Distribution System and other public funded programs such as the Integrated
Child and Development Scheme and Mid-Day Meal programs. A Project Management
Unit has been operational for over a year now at IIHMR for the implementation
of the project.
As
days passed, IIHMR had made its presence felt in other countries also. From
2003, the Institute has been actively involved in Afghanistan in association
with John Hopkins School of Public Health in terms of providing technical
support for monitoring and evaluation, acting as the Third Party Evaluator for
the delivery of health services, capacity building of Afghan nationals for
managing health services, and formulating health research policy. The
activities never looked back in Afghanistan and now the IIHMR is one of the
most respected academic institutions in the country providing technical
assistance to Ministry of Public Health and beyond.IIHMR in close consultation
with(JHUin 2004 developed a balanced scorecard for monitoring health services
in Afghanistan. The Ministry of Public Health (MoPH) was so impressed with the
balanced scorecard for health sector that it decided to adoptthe same for
hospital sector as well in the year 2006. IIHMR also initiated Afghanistan
Mortality Survey (AMS),with support from USAID and ICF Macro, USA in whole
Afghanistan. It was a unique, largest and first of its kind large scale
nationwide survey that has provided the latest health status information of the
country. It provided information on various demographic indicators related to
mortality and fertility of the country, with special emphasis on maternal and
child mortality apart from data on the socio-economic situation of the
population. The MoPH also mandated IIHMR to help Afghan National Institute of
Public Health to develop a research policy and strategy. IIHMR, in 2009, has
also signed a MoU with Afghanistan Center for Training and Development (ACTD),
one of the leading NGOs in Afghanistan, a registered non-profit, non-political
and non-governmental organization working for development and transformation of
the civil society in Afghanistan, to further strengthen research, training, and
consultancy services in health management areas in Afghanistan.
While
doing research and interacting with various stakeholdersof health sector, it
was realized that one of the weaknesses of the health system islack of
managerial insights among itshealth managers. Since all those who are
responsible for managing health sector wereprimarily clinicians, expecting them
to transform as efficient managers when they get promoted as districtlevel
officers was unfair. Therefore,as a second activity IIHMRtook upon itself to
work with people who are already a part of the health system to buildtheir
skills in managerialaspects of the healthcare. A series of managerial
healthcare programs were launched to fill the gap in this important sector. The
key focused areas of these programs included: leadership and strategic
management, policy analysis and formulation, project/program management, human
resource management, logistics and supply management, monitoring and
evaluation, etc.
The
next breakthrough in IIHMR life came in 1995 when the Management Board of IIHMR
approved the idea of starting a 2 year Post GraduationProgram in Hospital and
Healthcare Management. Afterpreparation of aboutone year, the program was
launched in July 1996 at Jaipur with 23 young graduates from all disciplineslike
medicine, arts,science, and commerce. This was the first revolutionary step in opening
up the managerial course. Almost two decades down the lane, this Post Graduate
Program has helped IIHMR in establishing itself as a brand both asnational and
international level.As the course picked up so did demand for these graduates. On
campus jobs and placement of these graduates encouraged themanagement to increase
the intake from 60 to 120 at Jaipur campus.Later, keeping in view the demand of pharmaceutical
industry (allied health sector), Post
Graduate Diploma in Pharmaceutical Management waslaunched. In 2010, the School of Rural Management was
established at Jaipur campus to cater the need of rural development sector. Today IIHMR as an institutionhas a critical
mass of about 2,000 graduates from its various campuses working across the
globe in improving health sector functioning and taking it forward.
The
IIHMR society, in 2004, opened its second campus in Bangalore to cater the growing
need of management in health sector of southern part of India.IHMR Bangalore
initially started with one year Post Graduate Programme for doctors and allied
sciences graduates. However, from 2010, the IHMR-Bangalore
started running two years AICTE approvedPost Graduate Diploma
in Hospital and Health Management.
The Institute has successfully rolled out seven batches of students
enrolled for its earlier one year PGPHM program and two batches of two year programme. Besides teaching, the institute has a very
strong and sound research wing wherein various research projects and studies
pertaining to the health policies, projects, systems and management are carried
out.The Institute has also been actively involved in providing wide range of
consultancy services to existing and upcoming hospitals since its beginning.
The Institute also conducts various Management Development Programs on
all the facets of management and its application
in health sectorfor the professionals of medical and health care.
In
2007, the IIHMR society and itsManagement Board took another step and decided
to establish a campus at Delhi with the prime focus on national and
international health and with an aim to play a major role in promoting and
conducting research in policy analysis and formulation, strategy development
and effective implementation of policies. The International Institute of Health
Management Research Delhi was launched in 2008. The first AICTE approved
Post-graduate Diploma on Hospital and Health Management began in July 2008 with
60 students.Considering the growing application of information technology, the
Institute also launched a specific course on Healthcare IT in 2010. Research has
been forte of IIHMR Delhi and the Institute is developing centers of excellence
in three areas, namely, non-communicable diseases, health and environment, and
management of national programme. Needless to say, during the short span of
four years, IIHMR Delhi has carved a niche for itself in the field of research,
training and academics.
Strengths of the Institute
The
tremendous growth of the Institute lies in the core strengths of operational
model which it has evolved and adopted across the branches of IIHMR. The
Institute doesn’t follow any traditional hierarchy of operational structure.
Rather, it believes in a flat structure, wherein every faculty has uniform,
transparent and direct access to the management. This operational model ensures
that the creativity and innovations of the faculties get a positive environment
to grow, which constitutes one more aspect of IIHMR strengths. Having flat
structure restricts unnecessary inhibition of creativity and encourages the
faculties to share and experiment with their own ideas and innovation.
Added
to this, the strong willingness and openness of the management towards
exploring and encouraging innovations and ideas further plays a critical role.
The Institute has been fortunate enough to have dynamic Governing and
Management Board who were never been bounded by traditional thinking. The same
has been the case with the Directors of IIHMR, which includestowering personalities
like Prof Rameshwar Sharma, Dr. G. Giridhar, Prof. Rushikesh M. Maru and Dr.
S.D Gupta.
What
we have been able to do in 3 decades?
The
learning made in last three decades has been phenomenal. IIHMR has been
successful in making a distinct image in health sector as one of the pioneers
in health management sector. With the students of its Post-graduate Diploma in
Hospital and Health Management spread across the country and working in various
hospitals and healthcare organization at various levels, the IIHMR continues to
enhance the health system with workforce who are steadily making a change in
the system with their managerial knowledge and skills. The high quality
research and projects both national and international level is ensuring that
critical and significant inputs are provided at the policy level which will
further strengthen the health system of the country. Though a long way to go,
yet IIHMR strives to achieve its mission of improving the standards of health
of people through high quality management research, education and capacity
development of health professionals.
What
makes IIHMR unique?
Expertise
on management aspects of healthcare sector, which IIHMR has gained from its
rich experience of research, teaching and training over the last three decades,
makes IIHMR unique. The open culture of interaction, an apt mix of experienced
and young faculties, encouragement for innovations and exploring ideas adds
stimulating environment for Institute and individual growth and further makes
IIHMR unique. Another prime driver of our research is that we engaged in
research that has direct program implications and enhances program delivery and
efficiency.
Where are we going?
We
are committed to make IIHMR a world class learning Centre in health management
and allied research. We are launching new programs in Health Informatics at our
Delhi campus Masters of Public Health (joint degree with Johns Hopkins) and
other programs are in the offing at other campuses.
We
are opening a full Institute at Kolkata in 2014 and we have plans to goFar-East,
Middle East and East Coast of Africa in the years to come. As always we will be
expanding our network and adding more partners locally, regionally and
globally. We are very excited about the challenges that health sector offers
and are geared to meet them heads on. We are convinced that this millennium
belongs to us and we have to make sure that agenda is India centric in the
years and decades to come.
References:
§ IIHMR
Jaipur 25 years: Health Management Journey towards Excellence
§ IIHMR
Jaipur27th State Institute Report, 2012
§ IIHMR
Delhi: State of Institute Report (2008-2012)
[1] L. P. Singh, Director –
International Institute of Health Management Research – Delhi (IIHMR-D),
Email:lps@iihmr.org, Ph: +91 11 3041 8908
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