Operational research (OR) aims to improve the effectiveness of programs through systematic study and experimentation. It originated during World War II when teams conducted research to improve operations like radar defense systems. OR analyzes health services to identify solutions to problems limiting quality and efficiency. It provides decision-makers information to enhance program performance. OR involves identifying issues, selecting and testing strategies, disseminating and applying findings to facilitate beneficial change.

1. OPERATIONAL RESEARCH
Dr Menaal K
JR II
Department of SPM
S. N. Medical College, Agra
22/07/14
1

2. IntroductionIntroduction
• OR is tool of sociological science.
• It has become one of the key management tools
of modern times.
• In operational research one is concerned all
the times with the activities of a group of
people with the purpose of inducing
beneficial changes.
222/07/14

3. • During World War II, In 1937
• At Bawdsey Research Station in the UK
• During the development of radar defense
systems for the Royal Air Force
• A. P. Rowe, a British Air Ministry official,
constituted teams to do "operational researches"
on the communication system and the control
room at a British radar station.
22/07/14 3
HistoryHistory

4. • Physicist, P. M. S. Blackett
• Blackett’s convinced the authorities of the
need for a scientific approach to manage
complex operations, and
• He is regarded as the original
operations research analyst and the
22/07/14 4

5. • Phillip Morse is widely regarded
as the “Father" of O.R. in
the United States
22/07/14
5

6. • The studies had to do with improving the
operational efficiency of systems (an
objective which is still one of the cornerstones of
modern O.R.).
• This new approach of picking an
"operational" system and conducting
"research" on how to make it run more
efficiently soon started to expand into other
arenas of the war.22/07/14 6

7. Operational Research in HealthOperational Research in Health
• Provides decision-makers with information to enable them
to improve the performance of their programs.
• Helps to identify solutions to problems that limit
program quality, efficiency and effectiveness, or to determine
which alternative service delivery strategy would yield the
best outcomes.
22/07/14
7

8. What is operational/operations research ?What is operational/operations research ?
OR is defined as the systematic study by
observation and experiment of the working of a
system eg: health services, with a view to
improvement.
- John M Last in Dictionary of Epidemiology
22/07/14 8

9. Goals of Operational ResearchGoals of Operational Research
• To increase the efficiency, effectiveness, and
quality of services delivered by providers, and
the availability, accessibility, and acceptability of
services desired by users.
22/07/14 9

10. ObjectiveObjective
• To provide managers, administrators and
policymakers with the information they need to
improve existing delivery activities and plan
future ones.
• Central objective always is to obtain a better
understanding of the “operations” of
programs so that, needed improvements can be
made.22/07/14 10

11. Categories of Operational Research StudiesCategories of Operational Research Studies
1. Diagnostic Studies/ Exploratory: Problem Not
Known
▫ To determine the parameters of a problem situation before
programming begins
▫ Whenever there is a perceived problem but the nature of
the problem and the correct program responses to it are not
known
▫ Search for programmatically manipulable variables
▫ Usually retrospective or cross sectional
22/07/14 11

12. Categories of Operational Research StudiesCategories of Operational Research Studies
2. Field Intervention Studies: Program
Approach Not Known
▫ Test on an experimental basis new approaches to
overcoming a probable problem
▫ Test new service delivery modes
▫ Studies are prospective
22/07/14 12

13. Categories of Operational Research StudiesCategories of Operational Research Studies
3. Evaluative studies: Impact Not Known
▫ For examining the effect of program activities
▫ Can be done retrospectively or cross- sectionally
Note:
•These three categories not mutually exclusive
22/07/14 13

14. Categories of Operational Research StudiesCategories of Operational Research Studies
4. Cost- effectiveness studies: Cost
Effectiveness Not Known
▫ Are frequently a part of intervention and
evaluation studies.
Note:
•These four categories not mutually exclusive
22/07/14 14

15. MethodsMethods
• Qualitative methods include focus group
discussions or individual interviews with service
providers or clients or observational studies,
e.g., observing health care workers.
• Quantitative methods include structured
questionnaires or the analysis of service
statistics.
22/07/14 15

16. Benefits of operational researchBenefits of operational research
• Improve Quality
• Decrease in cost or investment
• Increase revenue or return on investment
• Achieve improved utilization form limited
resources
• Demonstrate feasibility and workability
22/07/14 16

17. Who does operational research ?Who does operational research ?
• Any health care provider, including the public
sector, NGOs
• A team of program implementers and
researchers.
• Stakeholders should be involved as advisors
22/07/14
17

18. Some topics of OR studies- examplesSome topics of OR studies- examples
1. Training Programs: to examine the content and
methods of training, or to compare one type of
training approach against another in terms of field-
worker knowledge and performance.
2. Management Information Systems: Studies can
be designed to experiment with new data
collection systems and to test new procedures
for using the information collected to improve services.
22/07/14 18

19. Some topics of OR studies- examplesSome topics of OR studies- examples
3. Program Impact: OR studies can test prospectively
and in field settings the impact of different approaches
to service delivery, such as the use of community-
based distributors (CBDs) or traditional birth
attendants(TBAs).
• Impact can be measured in many different ways by
examining e.g. contraceptive prevalence,
contraceptive continuation rates or increased
availability and accessibility of services.22/07/14 19

20. Some topics of OR studies- examplesSome topics of OR studies- examples
4. Quality of Care: OR studies can be directed at
evaluating the quality and acceptability of services offered
to clients. These studies can provide an analysis of the
current situation of health services.
5. IEC: OR studies can be designed to compare different
communication approaches in terms of message
understanding, message retention, cost-effectiveness, and
the ability to reach specific target audiences.
22/07/14
20

21. How to carryout an OR ?How to carryout an OR ?
22/07/14 21

22. Steps of Operational Research:Steps of Operational Research:
• It is a continuous process with five basic steps:
1. Problem identification and diagnosis
2. Strategy selection
3. Strategy testing and evaluation
4. Information dissemination
5. Information utilization
22/07/14 22

23. Step 1: Problem DiagnosisStep 1: Problem Diagnosis
• Potential research situation arises when
three conditions exist :
i. Perceived discrepancy between what is and
what should be
ii. Question about why the discrepancy exists
iii. At least two possible and plausible answers to
the question
22/07/14 23

24. What to do in step 1 ?What to do in step 1 ?
• Attempt at identifying the problem situation by
using this format:
▫ Problem Situation
▫ Discrepancy
▫ Problem Question
▫ Possible Answers
22/07/14 24

25. ExampleExample
• Problem Situation: District A is always flooded during the
monsoon season.
• Recognizing this problem, the national family planning
program established a new supply logistics system for the
district. Each pill user is given a four-month supply before
the monsoon begins.
• During the monsoon, small motorboats are available to
transport new supplies to selected distribution centers
accessible to village-level family planning workers.
• Despite these new measures, this year service statistics
indicated that there are no pill supplies in District A.
22/07/14 25

26. • Discrepancy: The new logistics system should
be able to assure a continuous supply of pills,
but this year there are no supplies.
• Problem Question: Why has the new supply
logistics system been incapable of delivering
contraceptive pills to users?
22/07/14 26

27. Possible Answers:
▫An order for new pill supplies was not placed in
time before the monsoon rains.
▫The riverboats used to transport the supplies are
out of order.
▫Field-workers were not told about the new system
and failed to give users a four-month supply of pills
before the monsoon.
22/07/14 27

28. In this example:In this example:
• There are several possible and plausible
reasons for the problem situation
• One or more of these reasons might be correct,
and
• At least two of the possible problems may be
under the control of managers to fix: ordering
drugs on time and improving maintenance of the
boats.
• Therefore, this is a potential research situation.
22/07/14 28

29. 5 basic steps5 basic steps
1. Problem identification and diagnosis
2. Strategy selection
3. Strategy experimentation and evaluation
4. Information dissemination
5. Information utilization
22/07/14 29

30. What to do in step 2 ?What to do in step 2 ?
• Identify potential strategies that could be used to
solve the program problem.
• Indicate which one or more of the potential strategies
are the most appropriate to solve the program
problem- Let the problem determine the
strategy
22/07/14 30

31. Guidelines for selection of strategyGuidelines for selection of strategy
a. Review the strategies other people have used to
solve similar program problems.
b. Hold a meeting with the people who are most
affected by the problem or most concerned with it.
c. Look for strategies that can be implemented
without overburdening the implementing institution.
d. Select strategies that can be sustained over time.
22/07/14 31

32. Guidelines for selection of strategyGuidelines for selection of strategy
e. Seek strategies that are simple to implement.
f. Develop strategies where the proposed solution is
under the control of program managers.
g. Avoid strategies where the cost of a field test is
higher than the expected benefits.
h. Avoid strategies that are not consistent with the
implementing institution's goals, objectives, and
development plans.
22/07/14 32

33. 5 basic steps5 basic steps
1. Problem identification and diagnosis
2. Strategy selection
3. Strategy experimentation and evaluation
4. Information dissemination
5. Information utilization
22/07/14 33

34. What to do in step 3 ?What to do in step 3 ?
• Write Ultimate Goals, Immediate Objectives, and
hypotheses
• Intervention Description
▫ Who will be responsible for implementation?
▫ Where will the intervention take place?
▫ What activities will be initiated at what level of
intensity?
• Operational definitions
• Sampling and data collection
• Data analysis
22/07/14 34

35. 5 basic steps5 basic steps
1. Problem identification and diagnosis
2. Strategy selection
3. Strategy experimentation and evaluation
4. Information dissemination
5. Information utilization
22/07/14 35

36. What to do in step 4 ?What to do in step 4 ?
• Determine :
▫ Who are the potential users of the findings from the
operations research study?
▫ Which particular findings will be of most interest to
each potential user group?
▫ What are the best media channels to reach each
potential user group?
22/07/14 36

37. 5 basic steps5 basic steps
1. Problem identification and diagnosis
2. Strategy selection
3. Strategy experimentation and evaluation
4. Information dissemination
5. Information utilization
22/07/14 37

38. What to do in step 5 ?What to do in step 5 ?
▫ Identify the organizations you believe will be most
interested in the study.
▫ Discuss how you will involve these organizations in the
various planning, implementation, analysis and
dissemination stages of the study.
▫ Indicate the most likely policy or program implications
to arise from the study.
22/07/14 38

39. Lets take an example:Lets take an example:
• Problem Identification: In a State, there is a
wide variation in the CPR in different villages.
Although all villages get same level of health&
FP services, some villages have a CPR of 80%
while others have it as low as 5%
• Immediate Objective: to study the social,
economic& health factors associated with the
variation in CPR
22/07/14 39

40. Lets take an example:Lets take an example:
• Implication: the ultimate objective is to
provide policymakers and program
administrators with a better understanding of the
reasons why the national FP program is
successful in some areas but not in others.
• This information will be used to develop
educational strategies& modify existing service
delivery approaches to uniformly raise the CPR
in all regions
22/07/14
40

41. In Conclusion…In Conclusion…
• Whenever social medicine passes from the
stage of observation and classification to that of
discovering and recommending appropriate
action, it is involved in Operational Research
22/07/14 43

42. 22/07/14
44