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The paper seeks to show that health and socio‐economic developments are so closely intertwined that is impossible to achieve one without the other.

This paper sees that building health systems that are responsive to community needs, particularly for the poor, requires politically difficult and administratively demanding choices. Health is a priority goal in its own right, as well as a central input into economic development and poverty reduction.

The paper finds that, while the economic development in India has been gaining momentum over the last decade, the health system is at a crossroads today. Even though Government initiatives in public health have recorded some noteworthy successes over time, the Indian health system is ranked 118 among 191 WHO member countries on overall health performance.

This working paper describes the status of the health system, discusses critical areas of management concerns, suggests a few health sector reform measures, and concludes by identifying the roles and responsibilities of various stakeholders for building health systems that are responsive to the community needs, particularly for the poor.

Governments all over the world are getting increasingly concerned about their ability to meet their social obligations in the health sector. In this paper, we discuss the design and development of a management information system (MIS) to plan and monitor the delivery of healthcare services in government hospitals in India. Our MIS design is based on an understanding of the working of several municipal, district, and state government hospitals. In order to understand the magnitude and complexity of various issues faced by the government hospitals, we analyze the working of three large tertiary care hospitals administered by the Ahmedabad Municipal Corporation. The hospital managers are very concerned about the lack of hospital infrastructure and resources to provide a satisfactory level of service. Equally concerned are the government administrators who have limited financial resources to offer healthcare services at subsidized rates. A comprehensive hospital MIS is thus necessary to plan and monitor the delivery of hospital services efficiently and effectively.

Providing public healthcare to people is a major challenge for governments. In this sector, public-funded systems are grossly inadequate in India, and excessive commercialization and exploitation by the private sector are a stark reality. The cooperative healthcare model is emerging as an alternate system in Kerala with its strong service objective to challenge the woes of private healthcare. The cooperative hospitals in the state worked round the clock to serve the poor and needy during the devastating COVID-19 pandemic. The pandemic has also badly exposed the weakness of our healthcare system in the wake of challenges posed by an increase in demand for health services, especially in rural areas. The resultant rise in the cost of treatment has put severe strains on the people at a time when even their day to day jobs were in peril. India has a strong cooperative movement and world-class institutions to serve as models in each sector. The Thrikkakara Municipal Co-operative Hospital, located at Cochin in the Kerala State of India on which this case study is written was established by the Hospital Society Ltd. in 1999, as a project under the People’s Planning Programme of the Government. Today, it has grown into a medium-sized healthcare establishment with the prime objective ‘Modern healthcare to all at affordable costs’ and cater to an average of 700 outpatients a day. This case study reveals the inception, development over years, facilities available, operations, management, public interface, and outlook for the hospital to become a modern healthcare institution to serve the people still better.

To provide a public private partnership (PPP) model for urban health centres (UHC) in developing countries that can be useful for urban local governments and private service providers willing to enter into meaningful partnerships so as to improve primary healthcare services.

This research is based on geographical information system methodology to identify suitable locations to address availability, access, affordability and equity concerns and to provide a practical framework for PPP for establishing UHC. The methodology involved survey and mapping of slum communities and private healthcare facilities.

The research provides intricate details about planning healthcare services for urban poor, operational and managerial aspects of service provision and processes involved in PPP for urban health.

The model is developed and tested for Ahmedabad city (sixth largest city in India) and may need a certain amount of customisation for application in other cities.

The outcome of the research is a working model based on a set of legal documents (memorandum of understanding) signed by all the PPP stakeholders. This model is useful for planning and managing similar healthcare facilities in other cities with adequate context‐specific modifications given the increasing importance of urban health.

While a range of published work provides theoretical frameworks for PPPs in general and for urban health in particular, our model has field‐tested all the steps for establishing a PPP model for solving urban health problems. The proposed UHC will start functioning in its new premises soon.

Aims to give an overview of the re‐engineering of processes and structures at Gujarat Cancer Research Institute (GCRI), Ahmedabad.

A general review of the design, development and implementation of reengineered systems in order to address concerns about the existing systems.

GCRI is a comprehensive cancer care center with 550 beds and well equipped with modern diagnostic and treatment facilities. It serves about 200,000 outpatients and 16,000 inpatients annually. The approach to a better management of hospital supplies led to the design, development, and implementation of an IT‐based reengineered and integrated purchase and inventory management system. The new system has given GCRI a saving of about 8 percent of its annual costs of purchases, and improved the availability of materials to the user departments.

Shows that the savings obtained are used not only for buying more hospital supplies, but also to buy better quality of hospital supplies, and thereby satisfactorily address the GCRI responsibility towards meeting its social obligations for cancer care.

This paper aims to focus on the management capacity assessment of the Reproductive and Child Health (RCH) program at the state level.

Based on an extensive literature survey, and discussions with senior officers in charge of RCH program at the central and state level, the authors have developed a conceptual framework for management capacity assessment. Central to their framework are a few determinants of management capacity, a set of indicators to estimate these determinants, and a management capacity assessment tool to be administered by each state. A pilot survey of the management tool in a few states helped the authors to refine each instrument and finalize the same. A suitable management structure is suggested for effective management of the RCH program based on the population in each state.

The assessment brought out the need to strengthen the planning and monitoring of RCH activities, HR management practices, and inter‐departmental coordination.

The Ministry of Health and Family Welfare, Government of India has accepted the management tool and asked each state to administer it. The recommended management structure is used as a guideline by each state to identify the capacity gaps and take necessary steps to augment its management capacity.

The authors’ framework to assess the management capacity of RCH program is very comprehensive, the management tool is easy to administer, and assessment of capacity gaps can be made quickly.

The Abdur Razzaque Ansari Memorial Weavers Hospital (ARAM) came into effect on 7 April 1996, and is dedicated to the people of Jharkhand and weavers. To deal with the issues of inequity in healthcare services, ARAM was founded for the extension of affordable healthcare services to the needy in and around the area of Jharkhand. Visualised by a great social worker and legend Abdur Razzaque Ansari, it has been successfully run by his eldest son Mr Sayeed Ahmad Ansari for 28 years. This research uses mainly a case-study approach through secondary data from the hospital website and other websites citing ARAM and its functions. Consent to use data for the study was obtained from Mr. Sayeed Ahmad Ansari. Primary information was collected through the patients who availed facilities from the hospital. They were interviewed through a semi-structured questionnaire each taking 30-40 minutes. Taken over by Medanta Group on 8 July 2015 (earlier being managed by Apollo Hospitals Group for 20 years), it is the first super speciality community hospital in Eastern India. Treating over 50,000 patients yearly with state-of-the-art medical equipment and providing discounts to lower-income groups, people from the weaver’s community, freedom fighters and members of ICSI have intrigued people from these sections for affordable treatment and facilities in and near Jharkhand. With a 200 bed-capacity, nine different disciplines and 12 departments spread across the city of Ranchi, the hospital caters to a massive population at a much-subsidised rate. Reaching out to rural villages through free medical camps and awareness campaigns, the hospital showcases how a successful model of healthcare cooperative can be replicated accordingly in similar developing and underdeveloped regions.

The purpose of this paper is to provide empirical evidence concerning: the relationships between decentralization, perceived environmental uncertainty, and management accounting systems (MAS) information and the relationships between MAS information and managerial performance within Egyptian hospitals.

Data were collected using questionnaires that were sent personally to the managers or heads of departments of Egyptian hospitals. Departmental level was used as the unit of analysis. Data obtained from 200 hospital managers were analyzed using partial least squares.

The study reveals that decentralization and environmental uncertainty, to some extent, are essential factors in designing efficient and effective MAS. Hospitals with decentralized structure make better use of timely, aggregated and integrated MAS information. Environment in which the hospitals operate does have significant influence on the type of information provided by the MAS.

Using personally administered questionnaires causes the sample to be rather limited and not comprehensive enough.

The current study offers the hospital managers some useful aspects related to the function of MAS information that can be used to enhance their managerial performance. The provision of broad-scope and timeliness of MAS information can facilitate more effective managerial decisions. MAS designers and Egyptian policy makers should emphasize on decentralized decision-making by delegating sufficient authority to lower level managers as much as possible.

This study is one of the few studies done in Africa in the field of MAS, particularly in the context of Egyptian hospitals.

The purpose of this paper is to illustrate how Lean Six Sigma (LSS) methodology was applied to a medical records department (MRD) of a hospital in India to reduce the Turn-Around-Time (TAT) of medical records preparation process and thus to improve the productivity and performance of the department.

The research reported in this paper is based on a case study carried out using LSS approach and in improving the medical records preparation process.

The root causes for the problem were identified and validated through data-based analysis from LSS tool box, at different stages in the project. As a result of this project, the TAT was reduced from average 19 minutes to eight minutes and the standard deviation was reduced by one-tenth, which was a remarkable achievement for department under study. This was resulted in the reduction in the work-in-process inventory of medical records from 40 units to 0 at the end of the day. Project in-turn reduced the staffing level from the earlier level of six to a current level of four.

The paper is based on a single case study executed in IP-MRD of a single hospital and hence there is limitation in generalizing the specific results from the study. But the approach adopted and the learning from this study can be generalized.

This paper will be helpful for those professionals who are interested in implementing LSS to healthcare organization to improve the productivity and performance.

The purpose of this paper is to carry out queuing analysis to analyse patient load in outpatient and inpatient services to facilitate more realistic resource planning.

The paper adopts an analytical approach based on real life data (e.g. not a priori or an academic one where data are mingled to fit a theoretical stance) in accordance with the service level prescribed by the hospital administration. A service level is usually specified in terms of admissible range of queuing characteristics, such as mean patient waiting time, reduction of inordinate delays, incidences of minimum delays, average queue length, etc. which the management of a health organisation may decide to aim and control.

Queuing analysis reported in this case study provides a basis for estimating medical staff size and number of beds, which are two very important resources for outpatient and inpatient services in a large hospital, and all other hospital resources in one way or another depend on them.

The study challenges and aims to replace thumb‐rule approaches, which can be very conveniently carried out with efficient computer aids available at present for any hospital. Queuing analysis provides valuable insights into a hospital system, though it may not be the best approach as several underlying assumptions may not always hold true. In hospitals, for example, there can be several interacting queues, many of which could be cyclic with interaction among them. Accordingly, treatment of each queue individually, independent of others may not be a valid assumption.

Medical staff (doctors) and beds are very basic hospital resources, which largely depend on the hospital load in terms of arrival rates of patients in outpatient and inpatient services. When hospitals are adequately staffed and equipped in terms of beds and other key resources, it is unlikely that patients will turn away to other hospitals for treatment and there will be all round satisfaction with the hospital performance.

The authors do not claim the findings to be novel or unique but rather more well‐documented and comprehensive in coverage than available in existing literature. The practice‐based themes such as this well‐documented case study may evoke global interest as a multiplier effect for using such methodologies for resource planning in hospitals.