Table 1.

Examples of operational research

Authors	Type of study	Objective		Results		Policy relevance
Improving medical care
Zachariah et al. (2003)[11]	Cohort	To assess feasibility and effectiveness of voluntary counseling, HIV testing, and cotrimoxazole in patients with TB by use of historical controls in Thyolo, Malawi		Voluntary counseling and testing and adjunctive cotrimoxazole shown to be feasible, safe, and associated with reduced mortality in TB patients under program conditions		Helped in including HIV testing and cotrimoxazole administration in TB patients
Sai Babu et al.[12]	Cross-sectional	Evaluate reasons for noninitiation of t/t in smear positive pulmonary TB reported as ID in 20 districts of Andhra Pradesh, India		Of the total confirmed 685 ID, 51% were untraceable, 22% died before t/t initiation, 13.5% had other reasons (refusal of t/t, chronic case), and no data were available for 8%		Inadequate documentation of referrals, delays in treatment initiation and registration, deficiencies in address documentation were the highlighted areas for program improvement
Assessing feasibility of interventions in specific populations or settings
Bedelu et al. (2007)[13]	Descriptive		To weigh ART delivery services through decentralization to primary health care clinics, including nurse-initiated treatment as opposed to physician initiated in Lusikisiki, South Africa	HIV services in Lusikisiki achieved nearly universal coverage within 2 years without compromising quality of care thus proving that a decentralized, model of antiretroviral therapy delivery based on nurses was feasible in rural South Africa	Led to policy change to allow even non-physician clinicians to administer antiretroviral therapy
Tripathy et al. (2010)[14]	Cluster-randomized trial		To assess effect of community mobilization through participatory women’s group in improving birth outcome in tribal clusters of Jharkhand and Orissa, India	NMR was 32% lower in the intervention clusters after adjustments	Importance of involving women groups as an alternative to just having health worker to improve NMR
Advocating policy change
Zachariah et al.[15]	Retrospective cohort		To analyze routine treatment outcomes of patients on antiretroviral therapy who did and did not pay for treatment in Kenya	58% higher risk of loss to follow-up associated with payment for antiretroviral therapy; antiretroviral therapy dilutions by patients who pay for treatment	Policy change occurred and antiretroviral therapy begun to be offered free of charge to all patients in Mbagathi hospital, Kenya
Varkey et al.[16]	Nonequivalent control quasi-experimental		To investigate the feasibility, acceptability, and cost of a new model of maternity care encouraging husband’s participation in their wife’s antenatal and postpartum care in ESI dispensaries in Delhi	Significant improvement was noted in FP knowledge and behavior, and higher client-provider interactions occurred in both men and women in the intervention group. Cost of implementation Rs. 50,000/dispensary/year	On basis of the results, the model was scaled in all ESI dispensaries in Delhi

TB=Tuberculosis, ID=Initial defaulters, NMR=Neonatal mortality rate, ESI=Employee state insurance, ART=Anti retroviral theraphy, FP=Family planning