Manoj Mohanan works with small armies of researchers who conduct surveys, crunch numbers and analyze large quantities of data to determine if a given health care policy is effective, and why.
Mohanan, assistant professor of public policy and global health at the Sanford School of Public Pollicy and the Duke Global Health Institute, said he’s learned over the years that consumer behavior often defies the intention of health care incentives put in place by governments, foundations and private health care providers.
Why, for example, would a pregnant woman in rural India prefer to pay an informally trained midwife when she could see a formally trained obstetric gynecologist for free?
Mohanan’s research will aid the government of India, which does provide free obstetric care and large subsidies to pregnant women in different parts of the country.
The government’s goal is to increase the number of hospital births and reduce the number of often risky home births; and Mohanan’s goal is to determine why pregnant women would choose one option over the other.
“The idea is not merely to look at the impact of program x, y or z,” he said, “but what are the key behavioral factors that lead to the impacts we see or sometimes do not see.”
In a separate study, Mohanan is working with the Bill & Melinda Gates Foundation to determine the effectiveness of social franchising and telemedicine in the Bihar state of India, an impoverished region where, he said, health indicators are often worse than in many parts of sub-Saharan Africa.
The Gates Foundation project targets four diseases—childhood diarrhea, childhood pneumonia, tuberculosis and a mosquito-borne illness known as kala-azar - by opening medical franchises largely reliant on telemedicine.
The telemedicine capabilities allow health care providers in rural Bihar to transmit vital information, such as blood pressure, heart rates and EKG results, to doctors in New Delhi and to consult with them via webcams and cell phones about patient care.
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