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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 Evidence-
Based 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 Factors Not
Control Under Control

Program systems: Cultural beliefs,


training, pricing, location, economic
information, status, religion,
counseling … education…

Operations Research for Managers of Reproductive Health Programs


© 2008 The Population Council, Inc.
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. Identify the problem
2. Generate solutions
3. Test intervention to solve the problem
4. Ensure results are used
5. 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.

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