Evaluating the Effectiveness Efficiency and Quality of the National Program for Health Care of the Elderly NPHCE Implementation throughout India Global Comparative Systematic Review and Quantitative Analysis of Indian Survey Data

Abstract

Population aging is an issue that continues to present a challenge for global health policy and can be anticipated to continue to impact developing economies including India in the future. Both the World Health Organization (WHO) and the Indian government define older adulthood as beginning at age 60. To serve the needs of an aging population, there are numerous community health programs that have been developed throughout the world. Among these is the National Program for Health Care of the Elderly (NPHCE), which was begun in 2010 in India. However, there is currently a dearth of published evaluation research regarding the efficacy of the NPHCE and other comparable programs. This project uses a mixed methods approach to (a) first review the published evaluation literature on community health programs aimed at older adults in other countries, and (b) analyze quantitative health data from a large population survey of older adults in India to compare outcomes in regions with and without NPHCE implementation. The systematic review is designed with the goal of explicating the field of evaluation research as it relates to public and community health programs serving populations of older adults, globally. In support of this goal, a literature search was conducted based on a set of standardized criteria, yielding a total of 58 articles that had evaluated 46 programs instituted in 14 countries around the world. Findings indicated that the most positively evaluated service modalities were those that were concerned with creating networks of facilities aimed at providing comprehensive health service access. Other general types of progams with more limited success included those designed to provide coordination of care, whereas those providing education alone had only limited efficacy. The most common barrier to program success was insufficient funding. A key finding of this element of the study was the importance of building in a program evaluation component at the outset of future interventions of this nature, with the goa