OPERATIONAL
RESEARCH
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Moderator-Dr Subhod Gupta
Presenter-Dr Rashmi Gode
FRAMEWORK
Introduction
 Objective of OR
 History
 Features of OR
 Methodology of OR
 Approach to carry OR
 Types of OR study
 OR examples from India
 Importance of OR
 OR and Public Health of India
 Organisations funding/supporting OR
 References.

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INTRODUCTION
Terminology-Operational research / Operations research
/ Management science/Industrial engineering/decision
science/problem solving.
 Single term-OR
 An interdisciplinary mathematical science that focuses
on the effective use of technology by organizations.
 OR arrives at optimal or near-optimal solutions to
complex decision making problems.
 Science of better

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WHAT IS OR?

Definition- Any research producing practically usable
knowledge (evidence, findings, information, etc.) which
can improve program implementation (e.g. effectiveness,
efficiency, quality, access, scale up, sustainability)
regardless of the type of research (design, methodology,
approach) falls within the boundaries of operations
research”

OR uses research techniques to help choose among
alternative uses of resources to meet program objectives
.
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OBJECTIVE OF OR

To provide the information to program managers and
policy decision makers to improve and expand existing
services.
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HISTORY
Charles Babbage –(1791-1871) Believed to be father of OR
 1940- World war II –team of UK scientists applied scientific
techniques to research military operations to win the war and
the technique was named as OR
 World war II- Aim of OR was to discover most efficient usage of
limited military resources by application of quantitative
techniques.
 Conclusion of war- defence research in US was increased and
OR expanded to other departments.
 1951- 1st Book On “Methods of Operations Research” by Morse
& kimball
 India-Operational research society was founded in 1957

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FEATURES OF OR
Decision-making: Every organisation faces multifaceted
problems to identify best possible solution to their problems.
 OR aims to help the executives to obtain optimal solution with
the use of OR techniques.
 Also helps the decision maker to improve his creative and
judicious capabilities, analyse and understand the problem
situation leading to better control, better co-ordination,
better systems and finally better decisions


Scientific approach- Scientific methods, techniques and tools
for analysis and solution of complex problems.
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Inter-disciplinary Team Approach : Every problem needs
team effort to handle it. It needs Study Between various
parameters and evaluate the outcome
 System Approach.-To trace for each proposal all significant
and indirect effects on all sub-system and to evaluate each
action in terms of outcome
 Use of Computers– Possible to handle complex problems
requiring large amount of analysis /calculations.

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WHO IDENTIFIES OR PROBLEMS
The patient
 The programme staff
 The programme manager
 The district manager
 National staff
 Team approach is needed to identify the problem

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OR METHODOLOGY
Operations
Research
Problem
Analysis
Solution
Development
Solution
Validation
Evaluation
Implementation
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APPROACH TO CARRY OR
Approach
Definition
Advantage
Example
Primary
level
research
as factual, first hand
accounts of the study
written by a person
who was part of the
study
▪Written by researcher
▪ Original study
▪ Addresses the
issues specific to
the situation
Surveys,(FP)
Interviews,
Screening,
Personal talk,
Observations
Secondary
data
analysis as
retrospecti
ve record
reviews
defined as an analysis
and interpretation of
primary research
▪Re-examination
▪Getting
information
easily in least
possible time,
▪Minimum
ethical challenges
*Switch over
from 3 sputum
examination
to-2 smear in
diagnosing
Pulmonary TB
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TYPES OF OR STUDIES
Exploratory or diagnostic
 Field intervention
 Monitoring and Evaluative
 Cost effectiveness

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EXPLORATORY STUDY
Help in problem identification
 Gathers information about interests , attributes ,and need
of population.
Methods

Qualitative
▸Interviews
▸ Observations
▸ Group discussions
Quantitative
▸ Cross-sectional
▸ Case control
▸ Cohort studies
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INTERVENTION STUDY
Quasi experimental study
 Intervention and comparison
 Pre-post test studies
 Randomized experiments
on effectiveness and efficiency
implementation.

Highest level of evidence
best Choice for
Eg: cluster randomised trial In AP –evaluate neonatal
mortality reduction
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MONITORING AND EVALUATION
M’
Input , processes
and outputs
OR
E’
Outcome /Impact
evaluation
 Continuous Data collection
 Implementation
 Measuring the implementation
Eg: RAHI-Rapid appraisal of innovative health interventions
under NRHM
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ECONOMIC ANALYSIS
Costing and calculating cost effectiveness
 Looking for less expensive pathways
 Eg. Can nurses do the same job as a doctor ?

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SCOPE OF OR
National Planning And Budgeting-Preparation of
Five years plans, health services and national health
Programmes.
 Defence services
 Industrial establishment and Private sector units
 Research and development and Engineering
 Business management
 Agriculture and irrigation
 Education and training- In Training out the
participatory to meet the national project
requirements.
 Transportation

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OR STUDIES IN INDIA
1) Author--Babu et al. (2008)
 Study type—Cross sectional
 Objective--To evaluate reasons for Treatment non-initiation
in smear positive pulmonary TB patients diagnosed and
reported as initial defaulters (ID) in 20 dist.. Of AP
 Result-1304 ID, 619 (47.5%) place on Treatment. Out of
confirmed (685) ID, 51% were untraceable, 22 % -died before
initiation, 5.5% Treated Privately, & 13.5%- had other
reasons
 Program relevance/Policy -Inadequate documentation of
referrals, delays in treatment initiation and registration along
with deficiencies in address, documentation were highlighted
areas for programme improvement
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2) Authors- Bang & co-workers (1993-2003)
 Study typeField trial
 ObjectivesReduction of neonatal mortality in
Gadchiroli by Home Based Neonatal care
( HBNC) by capacity building of village level workers
 ResultsStudy was conducted in 39 interventions and 47
control villages in district

Demo significantly declined neonatal, infant and
perinatal mortality rates
 Programme /policy relevance-These study with
International evidence on same -2 projects were Initiated
 ANKUR
(2001-05)-In 7 sites in Maharashtra
 ICMR-5
sites

HBNC is adopted in few dist.
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3) Author- Patel et al.(2003)
 Study typeEconomic analysis
 ObjectivesTo ascertain the efficiency of zinc and copper
supplementation in the treatment of acute diarrhoea
under 5 years.
 ResultsThe study demonstrated lower cost of treating
acute diarrhoea, lower cost per unit health and
incremental cost effectiveness ratio
 Programme / policy relevanceCost savings as
evidenced by the study makes a stronger case for
micronutrients supplementation as an adjunct therapy to
ORS management
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IMPORTANCE OF OR
Global fund believes OR has important role to play in
success and strengthening of health program
 GF support helps to build program’s overall research
capacity and ability from data and implementationhelps
 Eg.1.Systems for delivering antiretroviral treatment
(ART) identifying seeking among different population
groups, Tanzania
2.Rapid diagnostic test vs. microscopy for malaria
in peripheral health facilities , Afghanistan

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OUTCOME MEASURES OF OR
Publications
 Capacity building of service providers and
academic researchers
 Changes in practice and /or policy

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OR AND PUBLIC HEALTH INDIA
Organises Short term training courses as a part of National
Health programmes
 Short-term training projects
 Medical colleges also organises research workshops
 Public health institutions-NIHFW,PHFI
 WHO-India and USEA initiated TB-OR to develop capacity
of professional associated with RNTCP

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ORGANISATIONS FUNDING/SUPPORTING OR
Organisation
Bill & Melinda
Gates
foundation
Web
Grand challenges
explorations website
Links
www.gatesfoundation.org/default
.htm
www.gcgh.org/explorations/pages
/introduction.aspx
Council for the CODESRIA-pioneer
development of African social research
Social science
organization
research in
africa
www.codesria.org/french/default.
htm
Training Grants and Fellowships
www.codesria.org/training_grants
.htm
Global fund to
fight AIDS,TB
and Malaria
Finances AIDS Tb and
Malaria
Or proposal must be as
part of national disease
control proposals
www.theglobalfund.org/en/
International
development
Research
centre
IDRC-Canada-buil
healtheier,equitable and
prosperous societies
www.idrc.org/en/ev-1-201-1DO_TOPIC.html
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REFERENCES
1. Malhotra S, Zodpey SP. Operations research in public health.
Indian J Public Health. 2011; 54(3) :145–50.
2. The Global fund, USAID, WHO, framework for operations and
Implementation research in Health and Disease Control
Programs,2013
3. The Global WHO, Guide to operational Research in Programs
Supported by the Global Fund,2010
4. Y.Liker Topcu, PhD & Ozgur kabak, Ph.D, Operations research
Lecture Notes ( 2015-2016)
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