Examining the Effects of Health Work Shortages and Deployment in Integrated Programme in Bihar, India: An Institutional Ethnography

Vikash Kumar

International Journal of Health Planning and Management, 2025, vol. 40, issue 2, 335-345

Abstract: The integration of health programms in low‐resource settings is a common approach aimed at providing quality and cost‐effective healthcare services. However, programme integration can unintentionally impact service provision and disrupt the overall organisation of service delivery. In this paper, I examine the integrated programme for non‐communicable diseases (NCDs) and explore the challenges related to the deployment of health workers. Specifically, I investigate the institutional processes that shape the work of health workers and the working conditions in district hospitals. To explore the social organisation of the implementation of the integrated NCD programme, I employed institutional ethnography as a research method. Data collection involved interviews, participant observation, and document reviews. Data analysis was conducted using social mapping, analytical writing, and textual analysis methods. The findings of the study suggest that due to staff shortages and a lack of doctors, health workers are continuously subjected to deployment and often required to undertake multiple tasks and responsibilities without any incentives or non‐monetary benefits. Administrators perceive health workers in integrated programs as additional human resources available for use in district hospitals. However, the removal of health workers from integrated programs can have negative implications for service delivery and patients' health outcomes. Finding of the study suggests that it is recommended that administrators improve the staff recruitment process and promptly address the grievances of health workers to enhance healthcare delivery.

Date: 2025
References: Add references at CitEc
Citations:

Downloads: (external link)
https://doi.org/10.1002/hpm.3872

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:bla:ijhplm:v:40:y:2025:i:2:p:335-345

Ordering information: This journal article can be ordered from
http://www.blackwell ... bs.asp?ref=0749-6753

Access Statistics for this article

International Journal of Health Planning and Management is currently edited by Calum Paton

More articles in International Journal of Health Planning and Management from Wiley Blackwell
Bibliographic data for series maintained by Wiley Content Delivery ().