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• J Korean Med Sci
• v.34(27); 2019 Jul 15

Open Access Publishing in India: Coverage, Relevance, and Future Perspectives

Durga prasanna misra.

Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Vikas Agarwal

Open access (OA) publishing is a recent phenomenon in scientific publishing, enabling free access to knowledge worldwide. In the Indian context, OA to science has been facilitated by government-funded repositories of student and doctoral theses, and many Indian society journals are published with platinum OA. The proportion of OA publications from India is significant in a global context, and Indian journals are increasingly available on OA repositories such as Pubmed Central, and Directory of Open Access Journals. However, OA in India faces numerous challenges, including low-quality or predatory OA journals, and the paucity of funds to afford gold OA publication charges. There is a need to increase awareness amongst Indian academics regarding publication practices, including OA, and its potential benefits, and utilize this modality of publication whenever feasible, as in publicly-funded research, or when platinum OA is available, while avoiding falling prey to poor quality OA journals.

Graphical Abstract

PUBLISHING MODELS

Various scholarly publication channels are used for dissemination of information. Peer-reviewed journals, conference abstract books, news outlets, blogs, social media platforms, and pre-print archives are all designed to publicize innovative ideas and implement these into further research and practice.

Journal publication involves submission of manuscripts which are initially checked for suitability, methodological rigour, and integrity by handling editors and forwarded to the external reviewers for commenting. 1 With the advent and increased reach of the Internet, traditional print journals started providing content online, most switch to online-only model, and numerous start-up e-journals sprung up. 2 The publishing enterprise requires financial investments which encompass subscription and pay-to-view fees, open access (OA) charges, and supporting organizations' funding for sustainable development. 3

The concept of OA publishing caught wind in the early 2000s, during which period three notable declarations in Europe (the Berlin 4 and the Budapest 5 declarations) and North America (the Bethesda declaration 6 ) proposed the principles of OA publishing. These documents proposed that scholarly publications should be free to read and reproduce for all concerned, with proper citation to the original source. Such OA publishing would involve costs, which could be borne by scientists, their funders, or their institutions. Journals proving such OA publishing could exist on their own, or operate on a hybrid model of providing both traditional (with restricted copyrights) and OA publishing (with liberal copyrights). OA publishing may save financial resources spent on library subscriptions for content of traditionally-published journals. 4 , 5 , 6 Content published traditionally may also be permitted to be available in an institutional repository or the author's own website, generally the accepted version of the manuscript (unedited by the typesetter) and with a clear reference to the final published manuscript (green OA). Such green OA content may be subjected to a period of embargo (after final journal publication), following which it may be posted on any online repository such as ResearchGate and Academia.edu. Other types of OA include gold OA, where authors, grant funders, or academic institutions pay the required publication charges, and platinum OA, where journals bear the requisite charges. 3

The aim of this article is to discuss specifics of scholarly OA publishing in India. Specifically, we shall discuss the emergence of OA publishing in India, initiatives for OA publishing in India (but not limited to OA journals), the role of publishing (including OA publications) in academic promotions in India, the challenges for OA science in India (including the relevance of Plan S), and future perspectives on this.

INDEXING AND ARCHIVING OF OA JOURNALS

Knowledge is of little use unless it is identified, read, and reproduced. Herein lies the importance of indexing scientific content in databases, and such databases should inherently have quality control mechanisms. 7 , 8 , 9 Another important principle espoused in the Berlin, Budapest, and Bethesda declarations is the need to archive published knowledge permanently. 4 , 5 , 6 Initiatives like the Lots of Copies Keep Stuff Safe 10 aim to archive all digital content, whether webpage- or journal-based, permanently in an archive, so that posterity can access such information if the need for the same arises.

The Directory of Open Access Journals (DOAJ) and PubMed Central (PMC) have mechanisms to implement quality control and increase visibility of trustworthy OA content. Both PMC and DOAJ check editorial policies and technical specifications of applying journals to ensure the users are supplied with quality contents. 11 Furthermore, some journals on DOAJ are awarded the DOAJ seal, which is an affirmation from the DOAJ that these journals meet the best technical standards of publishing. 12

In the context of our discussion on OA in India, we explored OA journals from India listed in DOAJ and PMC. We searched the National Library of Medicine catalog on PubMed on April 17, 2019 with the search terms “journalspmc” and “India,” and identified 135 local and regional journals archived by PMC. Of these, 126 are currently published, and further results refer to these journals. Only 13 of these (10%) are currently indexed in MEDLINE, and 79 (63%) started publishing in the past two decades ( Fig. 1 ). Notably, a number of Indian professional society journals related to cardiology, critical care medicine, dermatology, endocrinology, nephrology, parasitology, periodontology, and neurology are available on PMC.

PMC = PubMed Central.

Also, we identified 273 Indian sources registered with the DOAJ. About two-thirds of these journals are listed from 2014 onwards ( Fig. 2 ). Only 77 of these charge article-processing fees from authors. Surprisingly, only 1 journal has the DOAJ seal.

DOAJ = Directory of Open Access Journals.

Our searches on PMC and DOAJ led us to infer that regionally relevant information published in most Indian society journals is freely available, and the trend is not to charge article-processing fees. Another important finding is that a significantly lesser number of journals published from India were listed in DOAJ when compared to a few years back, 13 which may point to tightened indexing policies of the DOAJ over the last few years. A limitation of our analysis is that some of the journals from other regions are published in India.

CHALLENGES FOR ACADEMIC PROMOTION

We shall explore the requirements of the Indian Medical Council (IMC, formerly, the Medical Council of India) for academic promotion in the context of OA publishing. The entry level for academic physicians is assistant professor, followed by associate, and then full professor. The IMC lays down clear guidelines for recruitment as assistant, associate/additional, and full professor, prescribing the minimum basic postgraduate qualification required for each specialty, the amount of teaching experience garnered until that stage, and the number of scientific publications as first author and corresponding author. Importantly, only original articles are considered for recruitment and promotion. There is no a requirement for publications to be recruited as assistant professor. As an associate professor, one must have at least two publications, and, for a full professor appointment, at least four publications, two of which must be after appointment as associate professor, are required. The regulations mention the need for these publications to be in indexed journals, without defining which indexing databases are considered. There is no specific prerequisite for a national or an international journal, and no mention of OA requirement. 14 The University Grants Commission of India (UGC), which is an Indian federal body regulating higher education (not just medical education), has prescribed a list of journals, which is revised annually, from which publications may be considered for use in applications for academic recruitment or promotion. This list includes mostly journals indexed in Scopus, Web of Science, and the Indian Citation Index, which is a collection of more than a thousand journals published in India. 9 , 15 Journals indexed in MEDLINE, Scopus and Web of Science, or those available on PMC and listed on the UGC journal list are considered for academic promotion.

The faculty responsibilities in an Indian medical academic institution involve the daily care of an increasing patient load (in understaffed practice settings without help from healthcare workers), and teaching of students. 16 Research is sparingly funded. This is why even the best-intentioned researchers may struggle to attain the publication goals set by the IMC. In our opinion, future revisions of the promotion guidelines should not increase the publication requirements, for fear of pushing individuals into a race to publish or perish, with little emphasis on the quality. The prevailing situation in certain neighbouring regions, where publications are linked to the income of an academician, should be avoided in an Indian context. 11 , 17 , 18 Another concern is that inordinate attention is paid to the journal impact factors, rather than the quality of the publication per se. 19

Also, the faculty may publish in poor-quality local journals (a majority of which claim to be OA) owing to their unawareness of what constitute quality OA. What is required is an effort to educate undergraduate students the principles of research and ethical science, particularly in the changing world of publishing. 9 , 11 , 16 , 17 , 18 , 19

CURRENT SPECIFICS OF OA PUBLISHING

An editorial in a prominent Indian journal in 2004 discussed the OA concept and its relevance in an Indian scenario at a time when access to computers and the Internet was limited. 20 With time, the concept of OA publishing has gradually gained a foothold in India. A country-wise analysis of publications and publication models in Web of Science from 2006 to 2015 revealed that, although India ranked 10th in overall research output and 8th in research output following the gold OA model worldwide, it ranked 3rd when it came to publications in OA journals. The number of Indian publications in OA journals was 2% higher than the global average. 21 A majority of Indian authors covered the expenditure for OA out of their pockets. 22 Another analysis of Indian journals registered with the DOAJ from 2003 to 2012 revealed that green (55%) and gold (45%) OA models were predominant. 13

In 2015, a Web of Science-based analysis of more than 1000 papers from a conglomerate of Indian centres for advanced engineering training (known as the Indian Institutes of Technology or IITs) revealed that 69% of these were for OA, including 58% for green OA. Alarmingly, the papers posted on institutional repositories and on websites such as ResearchGate were not compliant with the green OA standards. 23

Traditional Indian journals, which recently switched to online publishing, have digitized their old issues, occasionally by manually scanning print papers. 24 The Indian scientific community has made significant efforts toward OA not only through journals, but also through institutional repositories at major scientific hubs such as the Indian Institute of Science. Also, OA repositories for theses, such as the Shodhganga initiative, are admirable government-funded efforts to promote the worldwide accessibility of Indian research. 25 Despite the efforts to develop such repositories, literature suggests that their utilisation remains sub-optimal. A survey of more than 500 researchers from India revealed that the major reason for the underutilization of such institutional repositories were concerns regarding plagiarism and copyright of articles submitted to such repositories. 26 This suggests that there is still an unmet need to sensitize stakeholders about unethical scientific practices.

CHALLENGES FOR OA

The 2013 paper in Science , known as the Bohannon sting, changed forever the landscape of publishing. The author of the paper exposed the breaches in OA across numerous established and start-up journals. The study exposed substandard or non-existent quality checks in journals claiming to be peer-reviewed. The experiment resulted in the acceptance of nearly half of 304 submitted dummy manuscripts. Alarmingly, more than 80% of the journals based in India accepted the dummy manuscript. 27 The hitherto identification of such poor quality OA journals was also highlighted by the work of Jeffrey Beall, a North American librarian who coined the term “predatory publishing.” 28

The high prevalence of publications in low-quality OA journals from India was also highlighted in another recent paper. 28 An analysis of responses from 480 corresponding authors from India who published in substandard journals pointed to the fact that more than half of these authors were not aware that the journals were ‘predatory.’ Only a fifth confessed having published articles in such journals without adequate knowledge of the problem. A majority of such authors bore the publication charges themselves. 22

There has been an increasing awareness of the dangers of publishing in substandard OA journals in Indian academic circles. However, much work remains to be done. A major step in this regard is the aforementioned UGC list of legitimate journals. 15 In addition, there should be a greater awareness of which indexing services are reliable. 29

It is imperative to consider the challenges OA publishing faces in an Indian context. An analysis of more than 2,500 Indian researchers revealed awareness about the existence of the OA publishing model in about 56% respondents. A majority (72%) professed a lack of willingness to consider journals with publication charges for their papers. A major impediment toward publishing in OA journals was a perceived lack of prestige of such journals which charged fees from authors. 30 In the personal experience of the authors, such negative sentiments regarding OA fees are not uncommon amongst Indian scientists.

RELEVANCE OF PLAN S

“Plan S (Science)” is a major recent development in scientific publishing. It emanated from 11 funding agencies in Europe. 31 Plan S emphasizes the benefits of open science and mandates OA for publicly funded research. 31 , 32 While its statements are filled with noble intentions, the global applicability of suggested radical changes remain highly debatable. The first major question is with whom does the responsibility of bearing OA fees rest? If all studies are published as OA, what would be the source of such massive OA publication charges, and what would be the sustainability of governmental support for such initiatives? Also, discarding subscription-based publishing, when there is a lack of compelling evidence that this modality is inferior to OA publishing, whether in terms of quality or citability, may not be appropriate. 33 Plan S differs from previous OA initiatives, such as that adopted by the National Institutes of Health, that the latter allows for both green OA and gold OA, whereas Plan S originally seemed to emphasise on purely gold OA, completely discarding traditional subscription-based publishing. 34 A recent notable amendment in Plan S clearly mentions that green OA shall be acceptable, at least for the initial few years, in hybrid journals, should the same be allowed by the journal immediately for articles funded by the organizations in the Plan S coalition. 35 Unless Plan S is carefully implemented with due consideration of stakeholders from all the world over, such a move might have an effect similar to jumping out of a frying pan into the fire. This is especially relevant in the Indian context, since a move to absolute gold OA could potentially be detrimental to scientists from lesser economically developed regions of the world, and hinder their ability to publish in journals of international repute. 36

Speaking from a regional standpoint, the present-day India is still a developing country. In such a scenario, where government funding for research and research publication is suboptimal, understandably so, due to greater priorities elsewhere, including healthcare and agriculture, it may be stretching too far to ask the government to cover OA publication charges for all such published work. Indian scientists who choose an academic career often do so at the cost of lucrative jobs in the private sector, where the pay is much higher. In the real life, Indian scientists have to struggle for access to research services which may be considered routine in other parts of the globe, such as plagiarism checks and access to Scopus, Web of Science, and subscription-based aggregators of information. Therefore, it is highly unlikely that Indian scientists or their institutions will be able to afford OA publication fees in the majority of instances. These considerations strengthen the viewpoint that Plan S is of little relevance in the current Indian scenario.

PERSPECTIVES FOR OA PUBLISHING

There exist myriad opportunities to provide OA to research in India, at an affordable cost. Opening institutional repositories should be encouraged, and their uptake promoted to the faculty. This would enable at least full and free access to research from the locality. Since a previous paper identified the fear of inappropriate copyright and plagiarism issues as a major impediment for authors to submit their work to institutional repositories, 26 this reiterates the need to further inculcate the principles of scientific writing and ethical publishing in students right from an early age. Formally evaluated courses in these subjects may be made compulsory for all under- and postgraduate students. Further efforts should be made to teach students and faculty regarding publishing models. These would serve the dual purpose of making them aware about the dangers of predatory journals, as well as to dispel their myths about genuine OA publishing. Journal editors should follow updated editorial strategies to eliminate content of dubious scientific merit from their journals. Their overall efforts to improve scientific and technical standards may raise awareness of authors about proper scientific writing. 37 Authors and editors alike should be encouraged to conform to the standards of the International Committee of Medical Journal Editors and the Committee on Publication Ethics. All scholarly contributors should be encouraged to utilize Open Researcher and Contributor IDs to raise transparency and integrity of OA publications. 38 Overall, the principles espoused in two recent notable documents on the integrity of scholarly publishing (the OA Scholarly Publishers Association principles 39 and the Sarajevo Declaration 40 ) should be followed rigorously by the editors of all OA journals. Specifically, there should be transparency from journals as to their editorial practices, their publication processes, copyright, article processing charges, addresses of editorial offices, policies for dealing with potential misconduct, sources of journal revenue, and advertisement policies. Information regarding such issues should be clearly visible on the websites of such OA journals. 39 , 40 It may also be considered good practice to endorse such declarations publicly on the journal websites, after implementing them. 39 , 40 Revision of promotion criteria to incorporate an actual quality assessment of the published work by the assessor, rather than relying on bibliometric indicators, such as the impact factor, will also improve the overall standards of publishing. In an utopian future, there should be unlimited research funding and institutional support for funding OA publication charges for all Indian authors. However, the reality in India is quite distant from this, and efforts should instead focus on increasing the awareness of scientists about quality OA, with utilization of this model in an ethical manner whenever feasible.

ACKNOWLEDGMENTS

The authors would like to acknowledge Dr Armen Y Gasparyan for inputs during the planning and editing of the article.

Disclosure: The authors have no potential conflicts of interest to disclose.

Author Contributions:

• Conceptualization: Misra DP, Agarwal V.
• Data curation: Misra DP.
• Formal analysis: Misra DP.
• Investigation: Misra DP, Agarwal V.
• Methodology: Misra DP, Agarwal V.
• Software: Misra DP.
• Validation: Agarwal V.
• Writing - original draft: Misra DP.
• Writing - review & editing: Agarwal V.

• Open access
• Published: 07 October 2013

Outcomes research resources in India: current status, need and way forward

• Jatin Shah 1 ,
• Akshay Pawaskar 2 ,
• Smit Kumar 3 &
• Nilima Kshirsagar 4 , 5  

SpringerPlus volume  2 , Article number:  518 ( 2013 ) Cite this article

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Despite their importance, the number of outcomes research studies conducted in India are lesser than other countries. Information about the distribution of existing outcomes research resources and relevant expertise can benefit researchers and research groups interested in conducting outcomes research studies and policy makers interested in funding outcomes research studies in India. We have reviewed the literature to identify and map resources described in outcomes research studies conducted in India.

We reviewed the following online biomedical databases: Pubmed, SCIRUS, CINAHL, and Google scholar and selected articles that met the following criteria: published in English, conducted on Indian population, providing information about outcomes research resources (databases/registries/electronic medical records/electronic healthcare records/hospital information systems) in India and articles describing outcomes research studies or epidemiological studies based on outcomes research resources. After shortlisting articles, we abstracted data into three datasets viz. 1. Resource dataset, 2. Bibliometric dataset and 3. Researcher dataset and carried out descriptive analysis.

Of the 126 articles retrieved, 119 articles were selected for inclusion in the study. The tally increased to 133 articles after a secondary search. Based on the information available in the articles, we identified a total of 91 unique research resources. We observed that most of the resources were Registries (62/91) and Databases ( 23/91) and were primarily located in Maharashtra (19/91) followed by Tamil Nadu (11/91), Chandigarh (8/91) and Kerala (7/91) States. These resources primarily collected data on Cancer (44/91), Stroke (5/91) and Diabetes (4/91). Most of these resources were Institutional (38/91) and Regional resources (35/91) located in Government owned and managed Academic Institutes/Hospitals (57/91) or Privately owned and managed non – Academic Institutes/Hospitals (14/91). Data from the Population based Cancer Registry, Mumbai was used in 41 peer reviewed publications followed by Population based Cancer Registry, Chennai (17) and Rural Cancer Registry Barshi (14). Most of the articles were published in International journals (139/193) that had an impact factor of 0–1.99 (43/91) and received an average of 0–20 citations (55/91). We identified 193 researchers who are mainly located in Maharashtra (37/193) and Tamil Nadu (24/193) states and Southern (76/193) and Western zones (47/193). They were mainly affiliated to Government owned & managed Academic Institutes /Hospitals (96/193) or privately owned and managed Academic Institutes/ Hospitals (35/193).

Conclusions

Given the importance of Outcomes research, relevant resources should be supported and encouraged which would help in the generation of important healthcare data that can guide health and research policy. Clarity about the distribution of outcomes research resources can facilitate future resource and funding allocation decisions for policy makers as well as help them measure research performance over time.

Introduction

Outcomes research is concerned with determining the end results and in turn the effectiveness of healthcare practices, interventions and systems. Outcomes research focuses on topics ranging from effectiveness, appropriateness, access, quality of care, quality of life, health status, disease prevention, screening, drug treatment, medical procedures, medical practices, diagnostic tests, guidelines and healthcare policy (Jefford et al. 2003 ).

Despite the role of outcomes research studies in discerning practice variation (Pilote and Tager 2002 ), quality of care and determining “What actually works”, a quick literature search in Gopubmed (GoPubMed® 2013 ) conducted by the authors revealed that the number of outcomes research studies in India have been lower in comparison to countries like USA, UK and Germany. (9362, 195663, 46028, 36693 respectively). (Search strategy: “Outcome Assessment (Health Care)”[mesh], Gopubmed,) Although there is a lack of studies evaluating the reason behind this trend, paucity of funding, non availability of infrastructure, lack of relevant expertise and trained staff could be factors responsible for this trend. Even when these factors are available, there exists a significant disconnect amongst them as data about existing resources is not widely accessible. If made available, information about existing resources can help 1. Policy makers to plan efficient strategies that can build up on existing outcomes research resources thus ensuring economies of scale as well as predict resource use and improve efficiency in the allocation of resources (Liu et al. 2008 ). 2. Researchers and research groups become aware of existing research resources thus avoiding duplication and facilitating higher productivity at a lower cost. Despite the importance of this information, till date no previous study has worked on compiling and sharing this information in a systematic manner.

India currently faces a mixed burden of both communicable and non-communicable diseases, the latter responsible for two-third of the total morbidity burden and more than half (53%) of total mortality in India. (WHO 2013 ) This dual burden poses significant public health challenges before India like safeguarding public health, expanding health care coverage and improving quality of care while controlling costs. Given the current economic downturn, Indian policy makers need to take cue from Australia, Japan, South Korea and China where Outcomes Research data are used for setting national policy, designing drug formulary and drafting pharmaceutical economics guidelines. (Garman 2013 ) In order to encourage and facilitate the conduct of outcomes research studies, knowledge, access and sustained support of pre-existing resources is essential. Few studies have mapped outcomes research resources in India.

In order to bridge this gap, we carried out a review of the literature to identify and map resources described in previous outcomes research studies conducted in India.

We carried out a review of published literature and hence did not seek ethics approval for this review.

Definitions

Outcomes research resources include outcomes researchers, infrastructure, trained staff/manpower and electronic data sources like databases, registries, electronic health records, electronic medical records and hospital information systems. Data on researcher and electronic resources are reported in published literature but data on infrastructure and manpower is rarely published. Accordingly, we decided to focus on the former. For the purpose of this study, we used the following definitions of outcomes research resources:

Databases and Registries that collect data as a part of clinical practice or for research purposes. We used the following operational definition for a biomedical registry: A system for the registration, record keeping and referral of biomedical data, material or resources. (Dict.md, Medical dictionary, 2013 )

(i) Electronic medical records defined as computerized systems that collect, manage and deliver healthcare data and information in electronic format as a part of routine practice (Luo 2006 ) (Rustagi and Singh 2012 ) and (ii) Electronic Healthcare records defined as a “comprehensive, cross-institutional, longitudinal collection of a patient’s health and healthcare data”. (Hoerbst and Ammenwerth 2010 )

Experts – Details about researchers who carried out outcomes research studies using prospective or retrospective study designs.

Search strategy

Two reviewers (JS and AP) having previous experience in the conduct of reviews carried out an independent search in the following online biomedical databases: Pubmed, 1985 to 2012 (Home - PubMed - NCBI 2013 ), SCIRUS, 1980 to 2012 (Scirus search engine for scientific information 2013 ); CINAHL, 1985 to 2012 (CINAHL | Cumulative Index to Nursing and Allied Health | EBSCO 2013 ) and Google scholar (Google Scholar 2013 ). The cut-off dates for each database vary. They indicate the period of availability of articles in each of the databases.

We combined the following keywords and their MESH terms using Boolean operators to build a search strategy: Outcomes, Database, Registry, Electronic Medical records, Electronic Healthcare records, Hospital Information systems and India. Details of the search strategy are described below.

Search strategies:

“Outcomes” AND (“Database” [Publication Type]) OR “Registries"[Mesh]) AND India

outcomes AND database AND India

outcomes AND registry AND India

(registry OR database) AND India AND “outcomes research”

(electronic health records) AND India

(electronic medical records) AND India

(electronic healthcare records) AND india

(India) AND electronic medical record[MeSH Terms]

Eligibility criteria

We defined criteria that would help us filter through the initial list of search results and identify articles that would provide us the required data.

We used the following inclusion criteria:

Articles published in English language,

Articles reporting outcomes research studies,

Articles reporting studies conducted using Indian data,

Articles providing information about outcomes research or epidemiological resources (databases/registries/electronic medical records/electronic healthcare records/hospital information systems) in India,

Articles describing epidemiological studies based on outcomes research resources (databases/registries/electronic medical records/electronic healthcare records/hospital information systems).

In case when a full text version of the article was unavailable, we included the abstract if it provided detailed information about the study. Articles retrieved by applying the search strategy were screened first by title, then by abstract and later by reviewing their full text version. At each step, articles dissatisfying the selection criteria were excluded. The shortlisted articles retrieved by each reviewer were compared and disagreements were resolved by discussion and mutual consent. Based on data present in the shortlisted articles, we compiled a list of outcomes research resources (Additional file 1 ). In order to cross-check our search results, we searched for all outcomes research articles published using these resources. We applied the selection criteria to the results of this secondary search and included articles that our search strategy missed during the primary search.

Data collection and data items

Two reviewers (JS and AP) independently reviewed each shortlisted article and captured information about the variables of interest in separate spreadsheets. The resulting data abstraction files populated by each reviewer were compared and disagreements were resolved by discussion and mutual consent.

After removing duplicate entries, we identified a list of resources, articles published based on the resources, bibliometric data for the articles and bibliometric data for researchers who published the articles.

Resource dataset

We reviewed the methods section of each article to extract information about each resource. We also reviewed and extracted information available on their individual websites (if present) and internet in general (using Google search). We categorized the data for each resource using the following categories:

Type of resource: Resources developed/initiated as a part of a research project/study were categorized under 'Study specific’, those developed/initiated by a department in an organization were categorized under 'Departmental’, those developed through an institutional/organizational initiative or national initiative were categorized under 'Institutional’ and national initiative respectively. We evaluated

Type of affiliation: We analyzed the location of each resource and categorized its institutional affiliation into six sub-categories based on presence in Government owned academic institutes/hospitals (Example: A Government owned Medical College and attached Tertiary Care Municipal hospital), Privately owned and managed Academic Institute/hospitals (Example: A Private Medical College and attached Tertiary Care Hospital), Privately owned and managed non - Academic Institute/hospitals (Example: A Privately owned Tertiary Care Hospital), For profit private organizations (Example: a resource owned by a Pharma company), Government organizations (Example: A resource owned by the Health ministry) and Non Government organization/Society/Associations (Example: A resource owned by a national cardiology society)

Location state: We analyzed the geographical location of each resource and categorized it as per states and zones. For the purpose of facilitating analysis, we divided India into four zones viz: North, East, West and South.

Type of disease: By analyzing the articles retrieved and reviewing any additional information available on the web, we identified the disease type for which data was collected in the resource

Total number of articles published based on data of each resource

Bibliometric dataset

For each individual resource, we identified the total number of articles published till date (Nov 18, 2012). Next for each article, we extracted data on journal name, corresponding journal impact factor and citations received. Journal name was identified from the full citation of the article. We extracted data on journal impact factor from each individual journal website or referred to the ISI Thomson impact factor database ((Thomson Reuters | The Thomson Reuters Impact Factor | Science 2013 ). We extracted data on the total citations received by each article till date (Nov 18, 2012) by referring to Google scholar.

Researcher dataset

From the 133 articles, we extracted the names of first and last authors, their institutional affiliations, location details (city, state, country) and email addresses.

Finally we carried out descriptive analysis of the 3 datasets described above.

Search results

We identified a total of 4911 articles based on keyword search. After removing duplicate entries (31) we were left with 4846 articles for review. After reviewing titles and abstracts of articles and applying selection criteria, we shortlisted 126 articles. Next, we reviewed the full text of 126 articles and excluded 7 articles dissatisfying our selection criteria thus yielding a total of 119 articles which were selected for inclusion in the study. After analyzing these 119 articles, we were able to identify a total of 91 unique resources. 14 more articles were retrieved through a secondary search carried out with an aim of identifying additional publications related to the resources reported in the articles. This increased the tally to 133 articles. We were able to identify a total of 91 unique resources and 193 researchers who had published outcomes research articles using these resources. (Figure  1 : Flowchart describing review and article retrieval process)

Resource data

Type of resource

Our analysis reveals that most of the resources are registries (62/91) and databases (23/91) [Table  1 ].

Analysis of geographical distribution of the resources reveal that most of them are located in Maharashtra (19/91), Tamil Nadu (11/91), Chandigarh(8/91) and Kerala(7/91) States of India. Analysis on zonal perspective revealed their predominant presence in Southern (32/91) and Western (26/91) zones [Table  2 ].

Initiative driving/supporting the resource

Analysis of the affiliation data for each resource reveal that most of the resources are either institutional (38/91) or regional (35/91) initiatives [Table  3 ]. Further, analysis of their affiliation data also revealed that they were present in Government owned academic institutes/hospitals (57/91) and privately owned and managed Non - Academic Institute/hospitals (14/91) [Table  4 ].

Type of disease

Analysis of data collected by each resource and publications based on them reveal that most of the resources are collecting data on Cancer (44/91) followed by Stroke (5/91) and Diabetes (4/91) [Table  5 ].

Bibliometric data

Journal analysis

Our analysis revealed that most of the publications based on data from the 91 resources were published in international journals (139/193).

Citation analysis

We observed that the publications based on these resources received an average of 0–22 citations (55/91) and 21–40 citations (17/91) [Table  6 ].

Journal impact factor analysis

We noted that the articles using the data from the 91 resources were usually published in journals with an impact factor of 0–1.99 (43/91) and 2–3.99 (18/91) [Table  7 ].

Researcher data

Location of outcomes researchers

Analysis of geographical location data for each researcher revealed that they are primarily located in Maharashtra (37/193), Tamil Nadu (24/193), Chandigarh (16/193) and Karnataka (16/193) States. They are predominantly located in southern (76/193) and western zones (47/193) of India. Some of the authors (17/193) are located outside India [Table  8 ].

Affiliation of outcomes researchers

Analysis of the affiliation data for the outcomes researchers reveal that more than half of them are working in Government owned and managed Academic Institutes/Hospitals (96/193) and some in Privately owned and managed Academic Institutes/Hospitals (35/193). Some of them were affiliated to organizations outside India (10/193) [Table  9 ].

Flowchart describing review and article retrieval process.

To the best of our knowledge, this is the first study that carried out a systematic analysis of outcomes research resources in India as reported in published literature. We collected information relevant to 91 outcomes research resources in India and report details about each resource, bibliometric data of publications derived from these resources and researchers that conducted research studies using data derived from these resources.

We observed a predominance of registries and databases in India. Research registries collect long term clinical, health services and epidemiological data for a given population. They are essential to understand clinical and epidemiological trends as well as useful for policy analyses, planning and management of health care resources. (Roos and Nicole, Roos and Nicol 1999 ) (Broemeling et al. 2009 ). Databases are usually study specific or project specific. They are usually designed to collect data to answer a specific research question. The low number of EMR, EHR and HIS in India might be because of the fact that India has been slow in the adoption of biomedical and research informatics tools. Although having a wide range of advantages (Fraser et al., 2005 ) (Lobach and Detmer, 2007 ) (Mildon and Cohen, 2001 ) (Rustagi and Singh, 2012 ) concerns about privacy, reduction in clinical productivity, being resource intensive, (Rustagi and Singh, 2012 ) (Kluger, 2009 ) high purchase and maintenance costs make their adoption slower (Jha et al., 2009 ) (Hillestad et al., 2005 ).

We observed a geographical predominance of resources and researchers in southern and western zones indicating an imbalance. This imbalance may be further complicated by the fact that researchers from one zone may not have access to data from a resource located in another zone. This may significantly influence policy and funding decisions further resulting in a vicious cycle of resource duplication, under utilization of resources, and wastage of funding.

We also observed a predominance of Institutional and regional initiatives in spearheading/managing the resources. Although this trend is noteworthy and beneficial, it reflects small scale and medium scale research projects. National registries have their own importance in nationwide policy decisions as data cannot always be extrapolated from regional data. There are numerous examples of large scale nationwide initiatives like Nationwide inpatient sample (HCUP-US NIS, 2013 ), National Health Insurance Research Database (NHRI, Taiwan, 2013 ), Disease registries maintained by National Registry of Diseases Office (NRDO, Singapore, 2013 ) that have and continue to significantly contribute to national healthcare decision making and planning as well as in the improvement of quality of healthcare. Thus a balanced distribution of regional and national resources is essential. We also noted that most of the resources and researchers were located in Government or Privately owned academic organizations. Although a good trend, these organizations usually serve the urban population and provide tertiary care. Given the fact that India is largely an agrarian country, equitable distribution of resources into urban and rural areas would facilitate the collection of data that is truly representative of the Indian population. Policies derived from such a representative sample will be more effective than those based on extrapolated data that do not represent real life scenarios.

Most of the resources collected data on Cancer, Stroke and Diabetes. Given the significant rise in cancer, cardiovascular and metabolic disorders in India, (Takiar et al., 2010 ) (Young et al., 2009 ) this distribution appears to be moving in the right direction. Yet, it should be noted that there exists a vast difference amongst number of resources in each of these groups indicating a predominance of cancer resources. Accordingly, it prepares the case for the need of similar outcomes data resources for nationally prevalent diseases like Malaria, Tuberculosis. This can be implemented by incorporating relevant outcomes data variables in surveillance and national programs.

A predominance of publications derived from the short listed resources in international journals is a good trend as it helps disseminate results to a global audience. Yet the Journal impact factor (JIF) and citation index of these publications may be indicative of the quality and impact of results published. Training programs to help clinicians and researchers collect data using global accepted data standards and report them using standard reporting guidelines may make future publications reach a larger audience and gain higher impact. In this regard, a workshop on imparting outcomes research skills to medical faculty members was recently conducted with the aid of Indian Council of Medical Research. (Savardekar L, Shah J, Bacchav S, Kshirsagar N, Translating Ideas into Research Projects and Manuscripts in Outcomes Research:Experiences of An ICMR Workshop. unpublished observations).

Most of the registries and databases identified through this study have not been explored to their true potential. In most cases, data from these registries have resulted in one to three publications. Further, most of them do not have their own websites or web pages within their organization. Sharing of data dictionaries or actual data – a norm of current times is hardly applicable to these resources. This demonstrates that detailed information about these resources is not easily accessible. The Department of Science and Technology (India) conducted a National Survey on Resources Devoted to Science &Technology Activities (National Science & Technology Management Information System, India, 2013 ) but the resultant data is not publicly available. Secondly, the survey questionnaire does not capture granular information about research resources. Finally, we are not aware about its utility and effectiveness in facilitating collaborations and guiding policy decisions at a state and national level. It is thus evident that awareness of existing outcomes research resources in India is low thus impairing the ability of 1. Researchers and research groups to optimally utilize existing outcomes data for carrying out outcomes research studies and 2. Research policy makers to utilize resource availability and resource performance data while making resource allocation decisions.

Limitations

All efforts were made to do an exhaustive review of the literature but given the nature of research question and limitations in terms of keywords and filters, we may have missed relevant publications reporting information about outcomes research resources. Secondly, data resources and researchers are not the only factors that contribute to outcomes research. Factors like skilled manpower, training opportunities, availability of funding, institutional policy have a role to play. Since this information is not readily available on the web or in publications, we interpreted based on the data that was available to us. There is a need for national level initiatives to collect data about the location, capabilities and performance of outcomes research resources. Thirdly, we did not include keywords related to surveillance data in our search strategy as surveillance in itself is a huge area and beyond the scope of this project. We intend to pursue this in a subsequent study. Finally, although semi automated methods like natural language processing and computational ontologies could have been utilized to carry out data extraction and reasoning of data extracted from published articles (Lin et al., 2010 ) (Ceci et al., 2012 ), we preferred the manual method as 1. The number of relevant articles identified through an initial review was low and 2. To ensure higher quality of data abstraction.

Abbreviations

Acute coronary syndrome

Myocardial infarction

Obstetrics & gynecology

Human immunodeficiency virus infection/Acquired immunodeficiency syndrome

Not applicable

Electronic medical records

Electronic healthcare records

Health information system.

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Akshay Pawaskar

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Clinical Pharmacology, Indian Council of Medical Research, Government of India, New Dehli, India

Nilima Kshirsagar

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Authors’ contributions

NK: Conceptualized the study, reviewed the review results, approved final version of the manuscript. JS: Conceptualized the study, Carried out review of literature as per search strategy, data abstraction and wrote the manuscript. AP: Carried out review of literature as per search strategy, data abstraction and formatted the manuscript. SK: Carried out data analysis. All authors have read and approved the final manuscript.

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Shah, J., Pawaskar, A., Kumar, S. et al. Outcomes research resources in India: current status, need and way forward. SpringerPlus 2 , 518 (2013). https://doi.org/10.1186/2193-1801-2-518

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• Outcomes research
• Research resources

India’s R&D expenditure & scientific publications on the rise

India is placed 3rd among countries in scientific publication.

India’s gross expenditure in R&D has tripled between 2008 & 2018 driven mainly by Govt sector and scientific publications have risen placing the country internationally among the top few. This is as per the R&D Statistics and Indicators 2019-20 based on the national S&T survey 2018 brought out by the National Science and Technology Management Information (NSTMIS), Department of Science and Technology (DST).

"The report on R&D indicators for the nation is an extraordinarily important document for the evidence-based policymaking and planning in higher education, R&D activities and support, intellectual property, and industrial competitiveness. While it is heartening to see substantial progress in the basic indicators of R&D strengths such as the global leadership in the number of scientific publications, there are also areas of concern that need strengthening," said Prof Ashutosh Sharma, Secretary,DST

The report shows that with the rise in publication, the country is globally at the 3 rd   position on this score as per the NSF database, 3 rd in the number of Ph.D. in science & engineering. The number of researchers per million population has doubled since 2000.

The report captures the R&D landscape of the country through various Input-Output S&T Indicators in the form of Tables and graphs. These pertain to Investments in national R&D, R&D investments by Government and Private sector; R&D relationship with economy (GDP), Enrolment of S&T personnel, Manpower engaged in R&D, Outrun of S&T personnel, papers published, patents and their international S&T comparisons.

The survey included more than 6800 S&T Institutions spread across varied sectors like central government, state governments, higher education, public sector industry, and private sector industry in the country, and a response rate of more than 90% was achieved.

Some of the key findings of the report are the following:

India’s gross expenditure in R&D has tripled between 2008 & 2018

• The Gross expenditure on R&D (GERD) in the country has been consistently increasing over the years and has nearly tripled from Rs. 39,437.77 crore in 2007- 08 to Rs. 1,13,825.03 crore in 2017-18.
• India’s per capita R&D expenditure has increased to PPP $ 47.2 in 2017-18 from PPP $ 29.2 in 2007-08.
• India spent 0.7% of its GDP on R&D in 2017-18, while the same among other developing BRICS countries was Brazil 1.3%, Russian Federation 1.1%, China 2.1% and South Africa 0.8%.

Extramural R&D support by central S&T agencies has increased significantly

• DST and DBT were the two major players contributing 63% and 14%, respectively of the total extramural R&D support in the country during 2016-17.
• Women participation in extramural R&D projects has increased significantly to 24% in 2016-17 from 13% in 2000-01 due to various initiatives undertaken by the Government in S&T sector
• As on 1st April 2018, nearly 5.52 lakh personnel were employed in the R&D establishments in the country

The number of researchers per mn populations has doubled since 2000

• Number of researchers per million population in India has increased to 255 in 2017 from 218 in 2015 and 110 in 2000.
• India’s R&D expenditure per researcher was 185 (‘000 PPP$) during 2017-18 and was ahead of Russian Federation, Israel, Hungary, Spain and UK.
• India occupies 3rd rank in terms of number of Ph. D.’s awarded in Science and Engineering (S&E) after USA (39,710 in 2016) and China (34,440 in 2015).

India is placed 3rd among countries in scientific publication as per NSF database

• During 2018, India was ranked at 3rd, 5th  and 9th  in scientific publication output as per the NSF, SCOPUS and SCI database respectively
• During 2011-2016, India’s growth rate of scientific publication as per the SCOPUS and SCI database was 8.4% and 6.4% as against the world average of 1.9% and 3.7%, respectively.
• India’s share in global research publication output has increased over the years as reflected in publication databases

India is ranked at 9th position in terms of Resident Patent Filing activity in the world

• During 2017-18 a total of 47,854 patents were filed in India. Out of which, 15,550 (32%) patents were filed by Indian residents
• Patent applications filed in India are dominated by disciplines like Mechanical, Chemical, Computer/Electronics, and Communication.
• According to WIPO, India’s Patent Office stands at the 7th position among the top 10 Patent Filing Offices in the world

[1. Research and Development Statistics At a Glance 2019-20

https://dst.gov.in/document/reports/research-development-statistics-glance-2019-20

2. S&T Indicators Tables 2019-20

https://dst.gov.in/document/reports/st-indicators-tables-2019-20

For more details, please contact Dr. Parveen Arora, Sc-G & Head, CHORD Division, DST

Email: parora[at]nic[dot]in , Mob.: +91-9654664614]

UNESCO Science Report 2021

In India (chapter 22), the government launched the Digital India programme in 2015 to transform the ecosystem of public services. Sharp growth in access to Internet has fuelled the digital economy, including e-commerce. 

The flagship Make in India programme has sought to promote investment in manufacturing and related infrastructure, among other things. Although it may have helped to improve the business environment, it has had little tangible impact on manufacturing itself. Since Covid-19, the manufacturing sector has been developing frugal (low-cost) technologies, including lung ventilators.  

Since 2016, the Start-up India initiative has boosted the number of start-ups but these remain concentrated in the services sector, in general, and software development, in particular. 

Overall research intensity remains stagnant and the density of scientists and engineers remains one of the lowest among BRICS countries, despite having risen somewhat. 

The government has reduced the tax incentive for firms conducting R&D, which is consistent with the finding of the previous UNESCO Science Report (2015) that the tax regime had ‘not resulted in the spread of an innovation culture across firms and industries’. Pharmaceuticals and software still account for the majority of patents. Although inventive activity by Indian inventors has surged, foreign multinational corporations remain assignees for the vast majority of patents.  

The phenomenon of ‘jobless growth’ that has plagued India since 1991 has worsened. Moreover, in 2017, the size of the workforce contracted for the first time since independence. Another concern is the low employability of graduates, including those enrolled in STEM subjects, although this indicator did improve over 2014–2019. The ambitious National Skills Development Mission aims to train about 400 million Indians over 2015–2022.  

Air and water pollution remain life-threatening challenges in India. The government is striving for universal electrification and the diffusion of electric and hybrid vehicles.  

Selected data

almost doubling each year since 2016

India’s top cross-cutting strategic tech subject by volume

of all Indian students in higher education in 2018

Infographics

• Figure 22.1 : Socio-economic trends in India  
• Figure 22.2 : Trends in research expenditure in India  
• Figure 22.3 : Trends in scientific publishing in India  
• Figure 22.4 : Trends in Innovation in India  
• Figure 22.5 : Revenue foregone in India as a result of R&D tax incentive, 2008–2019  
• Figure 22.6 : Trends in human resources in India  
• Table 22.1 : Indian pharmaceutical companies active in Covid-19 vaccine research, 2020  
• Table 22.2 : Indian strategies and policies for Industry 4.0 technologies 

India in the UNESCO Science Report

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Outcomes research resources in India: current status, need and way forward

Affiliation.

• 1 Maharashtra University of Health Sciences, Nashik, Maharashtra India.
• PMID: 24171151
• PMCID: PMC3804670
• DOI: 10.1186/2193-1801-2-518

Background: Despite their importance, the number of outcomes research studies conducted in India are lesser than other countries. Information about the distribution of existing outcomes research resources and relevant expertise can benefit researchers and research groups interested in conducting outcomes research studies and policy makers interested in funding outcomes research studies in India. We have reviewed the literature to identify and map resources described in outcomes research studies conducted in India.

Methods: We reviewed the following online biomedical databases: Pubmed, SCIRUS, CINAHL, and Google scholar and selected articles that met the following criteria: published in English, conducted on Indian population, providing information about outcomes research resources (databases/registries/electronic medical records/electronic healthcare records/hospital information systems) in India and articles describing outcomes research studies or epidemiological studies based on outcomes research resources. After shortlisting articles, we abstracted data into three datasets viz. 1. Resource dataset, 2. Bibliometric dataset and 3. Researcher dataset and carried out descriptive analysis.

Results: Of the 126 articles retrieved, 119 articles were selected for inclusion in the study. The tally increased to 133 articles after a secondary search. Based on the information available in the articles, we identified a total of 91 unique research resources. We observed that most of the resources were Registries (62/91) and Databases ( 23/91) and were primarily located in Maharashtra (19/91) followed by Tamil Nadu (11/91), Chandigarh (8/91) and Kerala (7/91) States. These resources primarily collected data on Cancer (44/91), Stroke (5/91) and Diabetes (4/91). Most of these resources were Institutional (38/91) and Regional resources (35/91) located in Government owned and managed Academic Institutes/Hospitals (57/91) or Privately owned and managed non - Academic Institutes/Hospitals (14/91). Data from the Population based Cancer Registry, Mumbai was used in 41 peer reviewed publications followed by Population based Cancer Registry, Chennai (17) and Rural Cancer Registry Barshi (14). Most of the articles were published in International journals (139/193) that had an impact factor of 0-1.99 (43/91) and received an average of 0-20 citations (55/91). We identified 193 researchers who are mainly located in Maharashtra (37/193) and Tamil Nadu (24/193) states and Southern (76/193) and Western zones (47/193). They were mainly affiliated to Government owned & managed Academic Institutes /Hospitals (96/193) or privately owned and managed Academic Institutes/ Hospitals (35/193).

Conclusions: Given the importance of Outcomes research, relevant resources should be supported and encouraged which would help in the generation of important healthcare data that can guide health and research policy. Clarity about the distribution of outcomes research resources can facilitate future resource and funding allocation decisions for policy makers as well as help them measure research performance over time.

Keywords: India; Outcomes research; Research resources.

The World Bank In India

With a population of more than 1.4 billion, India is the world’s largest democracy. Over the past decade, the country’s integration into the global economy has been accompanied by economic growth. India has now emerged as a global player.

AT A GLANCE

India is one of the fastest growing economies of the world and is poised to continue on this path, with aspirations to reach high middle income status by 2047, the centenary of Indian independence. It is also committed to ensuring that its continued growth path is equipped to deal with the challenges of climate change, and in line with its goal of achieving net-zero emissions by 2070.

The growth of the past two decades has also led to India making remarkable progress in reducing extreme poverty. Between 2011 and 2019, the country is estimated to have halved the share of the population living in extreme poverty - below $2.15 per person per day (2017 PPP) (World Bank Poverty and Inequality Portal and Macro Poverty Outlook, Spring 2023). In recent years, however, the pace of poverty reduction has slowed especially during the COVID-19 pandemic, but has since moderated in 2021-22.

Certain challenges persist. Inequality in consumption continues, with a Gini index of around 35 over the past two decades. Child malnutrition has remained high, with 35.5 percent of children under the age of 5 years being stunted, with the figure rising to 67 percent for children in the 6-59 months age group. Headline employment indicators have improved since 2020 but concerns remain about the quality of jobs created and the real growth in wages, as well as around the low participation of women in the laborforce.

India’s aspiration to achieve high income status by 2047 will need to be realized through a climate-resilient growth process that delivers broad-based gains to the bottom half of the population. Growth-oriented reforms will need to be accompanied by an expansion in good jobs that keeps pace with the number of labor market entrants. At the same time, gaps in economic participation will need to be addressed, including by bringing more women into the workforce.

The World Bank is partnering with the government in this effort by helping strengthen policies, institutions, and investments to create a better future for the country and its people through green, resilient, and inclusive development.

Economic Outlook

After real GDP contracted in FY20/21 due to the COVID-19 pandemic, growth bounced back strongly in FY21/22, supported by accommodative monetary and fiscal policies and wide vaccine coverage. Consequently, in 2022, India emerged as one of the fastest growing economies in the world, despite significant challenges in the global environment – including renewed disruptions of supply lines following the rise in geopolitical tensions, the synchronized tightening of global monetary policies, and inflationary pressures.

In FY22/23, India’s real GDP expanded at an estimated 6.9 percent. Growth was underpinned by robust domestic demand, strong investment activity bolstered by the government’s push for investment in infrastructure, and buoyant private consumption, particularly among higher income earners. The composition of domestic demand also changed, with government consumption being lower due to fiscal consolidation.

Since Q3 FY22/23, however, there have been signs of moderation, although the overall growth momentum remains robust. The persisting headwinds – rising borrowing costs, tightening financial conditions and ongoing inflationary pressures – are expected to weigh on India’s growth in FY23/24. Real GDP growth is likely to moderate to 6.3 percent in FY23/24 from the estimated 6.9 percent in FY22/23.

Both the general government fiscal deficit and public debt to GDP ratio increased sharply in FY20/21 and have been declining gradually since then, with the fiscal deficit falling from over 13 percent in FY20/21 to an estimated 9.4 percent in FY22/23. Public debt has fallen from over 87 percent of GDP to around 83 percent over the same period. The consolidation has largely been driven by an increase in revenues and a gradual withdrawal of pandemic-related stimulus measures. At the same time, the government has remained committed to increasing capital spending, particularly on infrastructure, to boost growth and competitiveness.

Last Updated: Sep 27, 2023

THE WORLD BANK GROUP AND INDIA

The World Bank Group’s (WBG) over seven decade-long partnership with India is strong and enduring. Since the first loan to Indian Railways in 1949, the WBG’s financing, analytical work, and advisory services have contributed to the country’s development. International Development Association – the WBG’s soft-lending arm created for developing countries like India - has supported activities that have had a considerable impact on universalizing primary education; empowering rural communities through a series of rural livelihoods projects; revolutionizing agriculture through support of the Green and White (milk) Revolutions; and helping to combat polio, tuberculosis, and HIV/AIDS.   In FY18, the relationship reached a major milestone when India became a low middle-income country and graduated from International Development Association financing.

COUNTRY PARTNERSHIP FRAMEWORK

The WBG’s present engagement with India is guided by its Country Partnership Framework for FY18-22 (CPF).  The CPF builds on the decades-long partnership and seeks to address the country’s development aspirations and priority needs identified in the Group’s  Systematic Country Diagnostic for India . It aims to work with India so that the country’s rapidly growing economy makes much more efficient use of resources; fosters inclusiveness by investing in human capital and generating more quality jobs; and develops strong public sector institutions that are capable of meeting the demands of a rising middle-class economy. The CPF’s approach combines a focus on ‘what’ the WBG will work on and ‘how’ it will engage India in the process.  What  will   the WBG work on?

• Promoting resource-efficient growth , including in the rural, urban, and energy sectors as well addressing disaster risk management and air pollution;
• Enhancing competitiveness and enabling job creation , including improving the business climate, access to finance, connectivity, logistics, skilling, and increasing female labor force participation;
• Investing in human capital  through early childhood development, education, health, social protection, and rural water supply and sanitation. 

How  will the WBG amplify the impact of its work in India?

• By leveraging the  private sector
• By harnessing India’s  federalism
• By strengthening  public institutions
• By supporting  Lighthouse India  to foster knowledge exchanges within the country and between India and the rest of the world. 

In all its activities, the WBG will seek to address  climate change, gender gaps,  and the  challenges and opportunities afforded by technology .  

WORLD BANK GROUP PROGRAM

The World Bank’s lending program consists of 98 lending operations. Of the $21.4 billion in commitments, $19.3 billion is from IBRD, $2.0 billion is from IDA – the Bank’s soft lending arm - and $0.1 billion is from other sources, primarily grant funding from the Global Environment Fund. 

Roughly a little more than one third of these operations and around 40% of commitments are either for central or multi-state operations, while the remainder consists of state-specific operations in 26 of India’s 28 states. 

The four largest portfolios are  Agriculture  (15 operations totaling $3.1 billion in commitments),  Energy , (11 projects totaling $4.0 billion in commitments), Health, Nutrition & Population  (11 projects totaling $2.8 billion) and Transport  and Water (11 projects each totaling $2.5 billion respectively).

In FY23, the Bank approved 15 operations amounting to $4.37 billion.  Of this, $ 4.32 billion is lending from IBRD and $0.05 billion from IDA (recommitted from cancelled IDA programs). Around 15-18 projects are expected to be delivered in FY24, with total commitments in the range of $3.5 – 4 billion.

For the IFC, India is the biggest client country, accounting for over 10 percent of its global portfolio with a committed portfolio of US$6.5 billion as of June 30, 2023. IFC has more than 250+ active projects in sectors including infrastructure, health, energy, manufacturing, housing, technology, and finance. Since its first engagement in 1958, IFC has invested more than US$27 billion (including mobilization) in over 500 companies in India. India is the sixth largest shareholder in IFC, owning a 4.01 percent stake.

IBRD and IFC work together in several areas, most notably in energy, transport, water and health. The World Bank partnership has been particularly strong in raising financing for renewable energy initiatives, especially in supporting the Government of Madhya Pradesh in setting up the largest solar park project that provides solar power with a total capacity of 2.25 gigawatts at a record low cost, reducing carbon emissions by 3.8 million metric tons per year and powering 60% of the Delhi metro. Similarly, IFC and IBRD collaborated under the Government of India’s flagship Clean Ganga program, ‘ Namami Gange ,’ helping revamp sewage treatment plants using hybrid annuity-based PPP projects, treating 218 million liters of water per day in three cities, and contributing to the steady rejuvenation of the sacred river for millions. IFC led the PPP mandate, while IBRD loan facilitated payment guarantees to boost private sector participation in the sector.

The Multilateral Investment Guarantee Agency (MIGA) does not have exposure in India. MIGA has been working closely with the Ministry of Finance to provide credit enhancement solutions at the state-level and state-owned enterprise (SOE) level. This will enable state governments and SOEs to utilize long-term commercial financing, which can complement concessional lending provided by other multilaterals and development finance institutions.

The WBG has a wide-ranging program of Advisory Services & Analytics. The program informs policy debate, provides analytical underpinnings and learnings for operations and strategy, facilitates the scale up of innovative solutions, and helps to improve state capability. As of October 2021, some 18 analytical studies and 15 advisory activities were ongoing. Key areas of focus include  poverty and macroeconomic analysis ,  financial sector reform ,  enhancing human capital including universal health coverage  and  gender ,  air quality management , as well as  state capability and governance . 

*FY23 means Financial Year from July 2022 - June 2023

WBG financing supported India’s achievement of numerous results over the past five years, highlights of which include:

Education : The World Bank’s approximately $2.7 billion support for education in India covers primary, secondary, and tertiary education, as well as skills development for its young population.  

The World Bank’s $250 million Skill India Mission Operation (SIMO) is backing Central and State government initiatives to skill young people—including the disadvantaged and vulnerable—to acquire the skills needed for a wide range of jobs that are in demand in the market. The project has trained almost 6 million young people, 34 percent of whom are women. Some 40 percent of the trainees were employed within six months of completing their course.

The World Bank also supports state government programs for reforms in primary and senior secondary education. School education projects in Andhra Pradesh , Chhattisgarh , Gujarat and Nagaland are helping strengthen foundational learning of the students, provide training and resources for the professional development of teachers, and use data-driven programs to  improve learning assessment systems for remedial education.

A new World Bank program - Multidisciplinary Education and Research Improvement in Technical Education Project   to be implemented in 14 States and Union Territories will support research and innovation in climate change and sustainable energy. The program is expected to benefit around 350,000 students. In Madhya Pradesh and Odisha , reforms in tertiary education have helped close to 2 million students from disadvantaged groups get access to quality higher education and skills, making them more employable.

Social Protection :

During the COVID-19 pandemic, World Bank support of $1.65 billion through two projects, Accelerating India’s COVID-19 Social Protection Response Program  and Creating a Coordinated and Responsive Indian Social Protection System  helped protect the poor and vulnerable through transfers in cash and kind. About 320 million vulnerable people received cash transfers into their bank accounts.  About 800 million people received additional food rations.

In Jharkhand , a market-driven skills training and secondary education program has helped set up about 13,000 strong community level clubs that provide skills and education to over one million adolescent girls and young women.

In West Bengal , an ongoing program is providing social protection services to poor and vulnerable groups, with a focus on strengthening institutions for delivering care to elderly persons and those with disabilities. The program is also working to increase female labor force participation. Digital transfers through the Jai Bangla Platform reached 3.1 million beneficiaries in the first half of 2023.  

The World Bank’s current health portfolio in India of around $2.8 billion includes both national and state-level projects:

A $1 billion COVID-19 Emergency Response Project helped the government strengthen health facilities in states, procure essential medical supplies – such as testing-equipment and kits, personal protective equipment, gloves, masks, and oxygen cylinders. It also helped insure 2.2 million frontline health workers. In addition, it helped expand health facilities dedicated to COVID-19, raising their number from 163 in March 2020 to more than 23,000 in June 2022.  Over 926 million COVID-19 tests were supported and 3,362 testing laboratories created.

An additional $1 billion in World Bank support is helping the government strengthen health service delivery . This includes all aspects of pandemic preparedness and response , improving real-time disease surveillance, better One Health coordination and enhancing  capacity for biosecurity.

World Bank is also supporting the National Tuberculosis (TB) Elimination Program to improve success rates of treatment, including of multidrug-resistant TB (MDR-TB). It is also scaling up direct transfer of cash benefits into the bank accounts of TB patients.

In Andhra Pradesh , Meghalaya , Mizoram , Nagaland , Tamil Nadu , and Uttarakhand ongoing programs focus on improving the quality of health care services, and strengthening the management of non-communicable diseases. In Uttarakhand, clusters of public health facilities, using a public private partnership (PPP) model, now have specialists available regularly, resulting in improved service delivery.  Digital health strategies for improved service delivery are being implemented in Andhra Pradesh, Nagaland and Tamil Nadu.

Rural Water Supply and Sanitation : Since 2000, World Bank projects have contributed over $2.8 billion in financing for rural water supply and sanitation. About 30 million people from over 30,000 villages—with populations ranging from 150 to 15,000—have gain better access to drinking water. About 167 million rural people have benefitted from improved sanitation. Many of the projects have helped promote women’s participation in discussions around changing age-old sanitation behaviors. Local institutions have been strengthened to improve operations and maintenance of water and sanitation infrastructure and upgrade service delivery.

Agriculture

World Bank-financed projects are promoting climate resilient agriculture in Andhra Pradesh, Himachal Pradesh, Karnataka, Maharashtra Odisha and Tamil Nadu. The focus is on introducing climate smart technologies, using water more efficiently, adopting crop diversification for better soil health and using climate resilient seeds.  World Bank is also focusing on reducing greenhouse gas emissions and using clean energy in post-harvest activities. Since 2016, World Bank-financed projects have brought around 1.7 million hectares of land under climate resilient agriculture.  Around 2 million farmers are adopting improved agriculture technologies.

Empowering Rural Women

Since 2003, World Bank has provided $2.2 billion in support of the Women’s Self-Help Group (SHG) movement in India through several state and national projects. Around 32 million rural women have been mobilized into 2.9 million SHGs.   Rural women have been trained and now earn their own livelihood as Pashu Sakhis (looking after animals), Bank Sakhis (helping rural people operate Bank accounts), or operating canteens at government hospitals and offices, and as masons building toilets.  These empowered women have also been encouraged to become entrepreneurs, running small businesses like poultry and goat farms, grocery shops, and cottage industries, and provided access to markets.   These entrepreneurial initiatives have helped the SHGs access commercial finance of over $14.5 billion.  These projects were also the genesis of the Government of India’s National Rural Livelihoods Mission (NRLM), which is world’s largest platform for women’s social and economic empowerment.  As of April 2023, the NRLM supports over 91 million women through 8.4 million SHGs.

households are now receiving 24/7 water supply in three cities in the Indian state of Karnataka

India: Commitments by Fiscal Year (in millions of dollars)*

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Innovation in India: A review of past research and future directions

• Published: 09 November 2015
• Volume 32 , pages 925–958, ( 2015 )

Cite this article

• Anil Nair 1 ,
• Orhun Guldiken 1 ,
• Stav Fainshmidt 2 &
• Amir Pezeshkan 3  

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The rapid economic growth that India enjoyed following the start of its economic reforms in 1991 has led to a growing scholarly interest in Indian organizations and management practices. In this paper, we bring together extant yet dispersed research on one important and salient element of Indian economic growth: innovation. We organize and review the substantive innovation research in India based on its scope and focus, and find that it has yielded unique insights about India’s innovation systems and processes at both the institutional and firm levels. Three interesting trends emerge from this review of the literature. First, a growing body of research has started identifying innovation phenomena unique to India, such as “frugal innovation” and the related notion of “ jugaad .” Second, a discernible arc in Indian innovation research can be observed, that is, a shift from a focus on the role of the state to the role of MNEs and Indian businesses in innovation. Finally, unlike much innovation research elsewhere, there appears to be significant interest in innovation that serves the need of the poor. We conclude with directions for future research on innovation within the Indian context.

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https://www.forumforthefuture.org/sites/default/files/images/GreenFutures/India/India_lowres_SPREADS.pdf

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http://nif.org.in/innovation/pulley_with_stopper/93 , accessed Mar. 30, 2015.

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Acknowledgment

The authors thank Sanjay Jain for his extensive comments on an earlier version of this paper. The authors also thank Marc Ahlstrom of Rowan College at Burlington County for his editorial assistance.

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Nair, A., Guldiken, O., Fainshmidt, S. et al. Innovation in India: A review of past research and future directions. Asia Pac J Manag 32 , 925–958 (2015). https://doi.org/10.1007/s10490-015-9442-z

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A perspective on national drinking water monitoring

National drinking water monitoring and policy research in india, methodology and data, major national observations using the imis database, the prospects and constraints for explanatory policy analysis and planning, conclusions and implications, acknowledgments, national rural drinking water monitoring: progress and challenges with india's imis database.

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James L. Wescoat , Sarah Fletcher , Marianna Novellino; National rural drinking water monitoring: progress and challenges with India's IMIS database. Water Policy 1 August 2016; 18 (4): 1015–1032. doi: https://doi.org/10.2166/wp.2016.158

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National drinking water programs seek to address monitoring challenges that include self-reporting, data sampling, data consistency and quality, and sufficient frequency to assess the sustainability of water systems. India stands out for its comprehensive rural water database known as Integrated Management Information System (IMIS), which conducts annual monitoring of drinking water coverage, water quality, and related program components from the habitation level to the district, state, and national levels. The objective of this paper is to evaluate IMIS as a national rural water supply monitoring platform. This is important because IMIS is the official government database for rural water in India, and it is used to allocate resources and track the results of government policies. After putting India's IMIS database in an international context, the paper describes its detailed structure and content. It then illustrates the geographic patterns of water supply and water quality that IMIS can present, as well as data analysis issues that were identified. In particular, the fifth section of the paper identifies limitations on the use of state-level data for explanatory regression analysis. These limitations lead to recommendations for improving data analysis to support national rural water monitoring and evaluation, along with strategic approaches to data quality assurance, data access, and database functionality.

Monitoring rural water coverage and quality at the national level poses challenges for all countries. Most wealthy countries, including the USA, have not produced comprehensive databases of local water system attributes and performance. India's Integrated Management Information System (IMIS), designed to monitor its National Rural Drinking Water Programme (NRDWP), constitutes an important exception to this pattern and is the focus of this paper.

National monitoring of rural access to drinking water has faced a number of systematic challenges since the 1977 Mar de la Plata Action Plan, which led to an emphasis on monitoring during the International Drinking Water Supply and Sanitation Decade from 1981 to 1990. Challenges include: (1) self-reporting of uneven and inconsistent data; (2) unsystematic sampling of water access, quantity, and quality; (3) inconsistent data metrics over space and time; and (4) simplistic distinctions between rural and urban. One expert went so far as to describe national data as ‘nonsense statistics' ( Satterthwaite, 2003 ).

Since that time, substantial progress has been made in improving national data monitoring. The United Nations Children's Fund (UNICEF) and the World Health Organization (WHO) have undertaken a Joint Monitoring Programme (JMP) that uses multiple samples and surveys. The JMP developed standardized survey instruments and common methods for reporting water and sanitation data discrepancies. Using these methods, India reported increases in rural access to safe drinking water from 64% in 1990 to 76.1% in 2000 and 90.7% in 2012 ( WHO and UNICEF Joint Monitoring Programme, 2015 ). The JMP also developed common questionnaires and methods for compiling national and international datasets to estimate progress toward drinking water coverage goals ( WHO and UNICEF, 2006 ). While the JMP constitutes a major advance over early self-reported percentages, it still relies on sample data and episodic (e.g. decennial) censuses, the specifications of which vary by source and time period. Interestingly, it does not appear that JMP data have incorporated national drinking water databases, such as India's IMIS.

At the national level, comprehensive efforts to monitor drinking water access are rare. The Rural Water Supply Network (RWSN), supported by the IRC International Water and Sanitation Centre, has a strong emphasis on monitoring (United Nations Economic Commission for Europe (UNECE), 2014 ; Schouten, 2015 ). RWSN notes that some countries in Africa have compiled national data ( Ssozi & Danert, 2012 ), such as Ethiopia, but those datasets are not presently in the public domain (Sean Furey, pers. comm., 8 June 2015; United Nations Educational, Scientific and Cultural Organization [UNESCO]/WHO, 2015, p. 39). A new Water Point Database ( Water Point Mapping, 2015 ) is being compiled in local areas of Tanzania on a voluntary basis. In addition, the IBNET water utility benchmarking database, initiated by the World Bank, provides information on a large and growing number of cities, particularly in Asia, Africa, and Latin America, but not for rural areas, or for all cities in a country ( World Bank, 2015 ).

It is interesting to compare these international monitoring efforts in developing countries with those of wealthier countries such as the USA, which lags behind India on rural water supply monitoring. The US Geological Survey ( Maupin et al ., 2014 ) estimates water use only by state and sector on a five-yearly basis. The US Census Bureau (2009) reports aggregate data on domestic water supply and plumbing systems of different types and sizes, but not their specific names and details, or detailed demographics of population served. The American Water Works Association publishes aggregate utility benchmarking data ( Lafferty et al ., 2005 ), but no data for specific utilities (as IBNET does) due to utilities' confidentiality preferences. The US Department of Agriculture's Rural Utilities Service lists helpful support programs, and the National Drinking Water Clearinghouse compiles a large body of useful information online, but not on monitoring of specific rural water systems ( Wescoat et al ., 2013 ). Where the USA does stand out in comparison with India and other countries is in its online Safe Drinking Water Information System, which reports on the water quality performance of drinking water suppliers ( US Environmental Protection Agency (EPA), 2015 ).

An institutional challenge for national drinking water data collection is the constitutional primacy of states over water issues in federal systems of government such as Australia, Brazil, India, and the USA. As an alternative, some state governments are creating their own drinking water databases, such as New South Wales in Australia (2014) . Similarly in India, some states such as Maharashtra are supplementing IMIS with additional monitoring and evaluation data and tools ( World Bank, 2014 ).

The aim of this paper is to assess the current capabilities and limitations of India's IMIS database. The next section reviews national-level research on drinking water in India, with an emphasis on uses of the IMIS database to date. The third section describes the IMIS database structure and methods used to assess it. The fourth section of the paper describes state-level national drinking water coverage and water quality patterns across states. The fifth section assesses the extent to which these national patterns can be explained through statistical analysis of IMIS state data, and a sub-state case study analysis in Gujarat, and it discusses the additional data needed to evaluate program outcomes. The concluding section of the paper identifies strategic priorities for enhancing national database development, analytics, and planning applications.

It is exceptional when a country invests in a full annual monitoring of drinking water supplies at the habitation level, as India has. This section discusses the scope and significance of this commitment, and reviews the evolution of India's drinking water programs and policies to date.

(i) documents all habitations, rather than a sample survey;

(ii) provides descriptive data for policy planning at each level of government;

(iii) offers insights into leading and lagging states, districts, and localities;

(iv) sheds light on data gaps and quality;

(v) enables statistical modeling for policy analysis.

IMIS water data are updated annually at the habitation level and aggregated at district, state, and national levels. The constitutional role of states in federal systems of governance may limit the scope and resources for national monitoring of local drinking water services in some countries, but India has managed to create a coordinated compilation of local, state, and national drinking water data. State and local organizations benefit by participating in national water monitoring because it is used for funding decisions. Consistent metrics enable comparisons of progress toward planning and policy goals, and sharing of experience and expertise on successful water and sanitation programs.

Evolution of drinking water programs in India

This section briefly reviews the development of India's national drinking water policies, which led to the IMIS monitoring database. Regulations for water and sanitation date back at least to the second century bce , with the compilation of Kautilya's Arthashastra , or Book of Statecraft. It specifies the provision of water reservoirs for villages and animals; and the prohibition and fines related to pollution, poor drainage, and defecation near water bodies. This legacy continued in various traditions of customary law and practice that compile principles, proscriptions, and remedies for dealing with impurities in water and sanitation. However, the condition of water supplies deteriorated by the mid-19th century, when colonial sanitation reformers in India and worldwide pushed for drinking water and hygiene standards, first for military cantonments and later for wider urban areas, supported by greater emphasis on collecting health and sanitation statistics ( Harrison, 1994 ).

Drinking water policies in India.

This survey of policies and related data sources indicate the significance of the shift to the IMIS national rural drinking water database in 2009, which moves beyond the reliance upon less frequent and less comprehensive data sources in earlier periods.

Literature search and review

This section of the paper reviews previous research on India's drinking water sector at the national level. State and local research is voluminous, but major national reviews that draw upon large datasets are few. A systematic bibliographic search was conducted using the search terms ‘India’ and ‘rural water’ in online indexes (WorldCat, Proquest Dissertations, Web of Science, Scopus, and Water Resources Abstracts) and grey literature sources (Government of India, UNICEF, Water Aid, and India Water Portal) ( Wescoat, 2014 ).

The search indicated that early assessments used Census of India, National Sample Survey, and other periodic surveys in which drinking water is one of a large number of questionnaire topics. WHO and UNICEF (2006) prepared guidelines for local water and sanitation survey questionnaires. Local surveys usually do not have enough common variables for synthesis at the national level. At the regional scale, Prokopy (2005) collected local data on community participation and expenditures to compare two states' water programs.

A transitional period occurred in studies that employed national data pre-dating the IMIS database. These studies estimated national drinking water coverage ( Srikanth, 2009 ). Biswas & Mandal (2010) went beyond descriptive statistics to measures of correlation among drinking water variables. WaterAid ( Khurana & Romit, 2009 ) compiled a historical perspective on rural drinking water policies and organizations in India, but relied upon Census data for descriptive statistics. The IRC developed a qualitative perspective on water supply service models and institutional analysis ( James, 2011 ).

Although IMIS data became available from 2009 onwards, they have not been widely analyzed in national assessments. WaterAid's (2011) ‘India Country Strategy 2011–2016’ includes propositions that could be tested through IMIS data analysis. Balasubramaniam et al . (2014) use econometric methods with Census data to draw inferences about the roles of caste and religion on differences in household drinking water access. Excellent reviews by UNICEF (2013 ) and Cronin et al. (2014) did not analyze IMIS data.

Studies that do draw upon IMIS data include a paper by Shrivastava (2013) on the presence of fluoride in drinking water. A national report by the Safe Water Network (2014) explores strategies for community water management, supported by IMIS as well as Census data. Cronin & Thompson (2014) discuss advances and limitations in the IMIS database, including data access, visualization, and quality. Most recently, Novellino (2015) examines IMIS in detail for rural water supply sustainability monitoring at the state and district levels, using Gujarat as a case study. As recommended by Cronin and Thompson, Novellino documents the data collection and compilation process, as well as data discrepancies, apparent data gaps, and detailed descriptive statistics relevant for analyzing slipback and sustainability. Here, we build upon Novellino's research to show how IMIS data can be assessed in analytical and explanatory ways at the national scale.

This section of the paper provides an analytical description of the IMIS database, based on a review of government documents, interviews with IMIS users and managers in Gandhinagar and New Delhi, and examination of online web content. The following section of the paper uses IMIS data to generate state-level maps and descriptive statistics for drinking water coverage and quality. The penultimate section of the paper then assesses the potential, and constraints, for using IMIS in explanatory statistical analyses to support policy and planning.

IMIS was launched in 2009 with the establishment of the NRDWP as a web-based platform to enable annual online monitoring of the status of water supply projects and coverage across rural India. IMIS includes some historical data dating back to 2003. While historical records available within IMIS are limited, they will become a valuable resource for longitudinal analysis over time.

IMIS has four types of data for every habitation: habitation data (e.g. population, households, scheduled caste, scheduled tribe); scheme data (e.g. types of water storage, piped water supply, treatment, and costs); water source data (e.g. types of groundwater wells and surface water supplies); and water quality data (biological and chemical).

IMIS water supply and quality data

The habitation is a local community of households and is the smallest unit in IMIS. Habitations are classified as fully covered (FC), partially covered (PC), not covered (NC), and/or quality affected (QA). Coverage status is based upon the minimum national water supply standards of 40 liters per capita per day (lpcd) and 55 lpcd. The minimum quantity per person was 40 lpcd under the Swajaldhara water sector reforms program noted in Table 1 , and the next standard to be achieved by 2017 is 55 lpcd. The long-term goal for 2022 is to provide all rural areas with at least 70 lpcd of adequate water within the household or a 50-metre radius ( Department of Drinking Water Supply (DDWS), 2011 ). An FC habitation has 100% of the population with adequate quantity and quality of water. If a habitation has quality problems, it is categorized as QA and therefore deemed NC regardless of the quantity of water available. A PC habitation must meet national water quality standards even if it has less than 100% of the population covered.

It is important to note that a habitation can have more than one water source and more than one water supply scheme. Thus, if a habitation is NOT categorized as FC, it means that ALL schemes for this habitation fail to meet the minimum requirements of water supply on quantity and quality. Similarly, if one water supply scheme fails, it does not necessarily mean that the habitation is NOT FC because there is often more than one scheme per habitation. If a water source fails, it means that any scheme entirely dependent upon this source fails. But if the scheme has multiple sources, then the scheme can remain functional.

Data entry and approval process

Data are entered at block, district, and state levels on an annual, monthly, or quarterly basis. The annual data entry is required for financial planning and budget allocation at central and state government levels. Annual data update the status of water coverage for all habitations in India (as FC, PC, QA, or NC). They also provide updated demographic data for habitations. After this survey is completed and annual plans are prepared, a group of projects is selected based on their priority and budget availability. These projects are called ‘Target Habitations and Schools' and must be completed within the financial year.

Once the budget is allocated for annual target projects, monthly data are entered as progress reports (MPRs). The MPRs include infrastructure and financial data for ongoing and completed schemes, water quality of sources, community support activities, and operation and maintenance. Data entry is limited to district offices for the district MPRs. Based on MPRs, financial disbursements are approved and monitored at the state government level. The regular data entry process includes changes in sources, water quality facilities, and financial releases.

A small selection of users was interviewed to learn about the IMIS data entry process, and we found that they use IMIS as a required procedure for budgetary and accounting purposes. Few IMIS data entry officers download data for further analysis. Some keep duplicate data on separate spreadsheets at district offices. These duplicates may have formats that make it easier for district officials to keep track of their projects. Reasons for this practice include delays in updating the IMIS website, delayed website response, complex display of data on the website, lack of granularity of data below district level, and lack of familiarity with the full IMIS interface. This means that local users are not taking advantage of the full detail, functionality, and comparative power of the IMIS database.

Scope of the IMIS database

The discussion above is a simplified description of the IMIS database. The actual number of variables for each of the four main categories of IMIS is high ( Novellino, 2015 ). The spatial scope of the IMIS database includes all geographical divisions in India: national, state, district, block, panchayat, village, and habitation. Field surveys performed at the habitation level are aggregated to create district-level data. Data for some formats are not collected at all spatial levels, resulting in limitations on local data analysis. Even when habitation data are available, it is only by drilling down through district and block tables. Compiling data across larger administrative areas entails downloading and reassembling myriad habitation-level tables, a major limitation for national program evaluation and policy analysis. Ready access to local data across administrative areas is limited to the central government.

With this understanding of the IMIS database structure, we now use it to analyze patterns of drinking water coverage, investment, and water QA habitations.

Percent of fully covered habitations nationwide, cumulative public expenditures, and cumulative schemes from FY 2010–2011 to FY 2014–2015.

To dig deeper into this trend, we look at expenditures by state from April 2010 to March 2015. We find that the proportion of state and national funding varies considerably across states, with Sikkim, Punjab, and Nagaland receiving more than 95% of their expenditures from the national government while some states, notably Gujarat, provide more than half of their own expenditures. Expenditures are highest in Rajasthan and Karnataka (12% and 10% of total national expenditures, respectively), which have arid or semi-arid conditions with regular water shortages, followed by the relatively large states of Uttar Pradesh, Gujarat, and Maharashtra (9%, 9%, and 8% of total national expenditures, respectively).

Current coverage status

Water coverage status by state at the 40 lpcd threshold as of January 2014: (a) (top) displays the percentage of habitations that are fully covered; (b) shows the number of habitations in each of the water coverage status categories.

Water coverage status by state at the 55 lpcd threshold as of January 2014: (a) (top) displays the percentage of habitations that are fully covered; (b) shows the number of habitations in each of the water coverage status categories.

Water QA habitations

QA habitations by state (%), 2014.

Water quality test results by state.

When we look closer at the types of contamination reported by state, four observations may be made. First, the number and percentage of tested sources vary greatly by state. In other words, these data provide a sample rather than a census of water quality. The sampling protocols are not fully specified. Second, and as noted in Figure 4 , the proportion of negative test results is very high, perhaps in part because sampling of sources is primarily of groundwater and protected wells. Third, the majority of positive test results involve chemical contamination (e.g. arsenic, fluoride, salinity, and nitrates). Biological contamination reports are surprisingly few in light of sanitation concerns. Finally, the current categorization of habitations as FC, PC, or QA does not allow for failure of both quantity and quality. As the emphasis to date has been on water coverage, water quality has not received the attention needed to achieve health objectives.

Kerala stands out for reporting higher levels of biological contamination per number of wells tested, but overall that variable requires more rigorous examination at the national level. Chemical contamination, e.g. arsenic, fluoride, nitrates, and total dissolved solids (TDS), varies widely across the country, which warrants further analysis of geographic patterns. The Bengal region reports high arsenic contamination rates, as expected. Rajasthan and Karnataka have high TDS, and many agricultural regions of the country have high nitrate-affected habitations. Some of the states with low contamination rates are simply ones with fewer samples tested – such as Himachal Pradesh, Jammu and Kashmir, Arunachal Pradesh, Meghalaya, Mizoram, and Nagaland – so it is possible that states that appear to have low contamination rates are inadequately sampled. These initial observations suggest that water quality testing should be a top priority at the national policy level.

The previous section demonstrated the usefulness of the IMIS database in describing the current state of water access across India. Ideally, IMIS would also allow us to analyze the extent to which government investment in water infrastructure improves water access. In this section, we use regression analysis with the IMIS database to test whether differences in investment, infrastructure, and socio-economic variables can explain differences in state water coverage. We attempt this explanatory analysis, but limitations in the structure of the IMIS database prevent us from developing robust causal inferences. We describe below the methodology, limitations, and recommendations for enhancing database functionality.

IMIS variables and their expected impact on fully covered (FC) habitations.

*VWSC = Village Water and Sanitation Committee formed by local villagers.

State-level regression analysis

The best method to assess the relationship between the independent variables and water coverage status across India would be to use the full granularity of the IMIS data to develop a habitation-level regression model with data from all 36 states and union territories. However, while data are collected at the habitation level, the web-based public database aggregates those data series up to the district and state levels, making it difficult, if not impossible, to access the raw habitation-level data 1 . We therefore use state-level data to construct an initial countrywide model. The dependent variable is the proportion of fully covered (FC) habitations (i.e. the number of FC habitations out of the total number of habitations in a state). This state-level approach limits the number of observations in our dataset to 30 (this includes the removal of six states and union territories that have significant data gaps).

We use logistic regression with a binomial formulation, the most common model for dependent variables that are proportions, and develop several models from the variables available in Table 2 using common variable selection methods. However, the analysis of fit for all these models finds that none of them is a good fit; that is, none of them is able to assess the impact of investment and infrastructure variables on full water coverage status. In fact, most of them fail to perform significantly better than a constant model without any predictors. We ruled out typical model formulation problems by using data transformations, removing outliers, and testing alternative model structures instead of logistic regression. This leaves us to conclude that the data are insufficient to parameterize an accurate model. It is likely that some key predictors are missing, e.g. household or per capita income. Data quality issues at the state level of aggregation may also be relevant. Additionally, it's possible there are data reporting problems that did not show up as outliers. It is more likely in India, however, that the 30 state-level observations used here are too small a sample size, with too much variance within states, to fit a strong nationwide model that predicts habitation-level water coverage status.

We therefore conclude first, that the current IMIS database does not, by itself, enable state-level explanations of national water coverage and, second, that the IMIS database should develop increased functionality for national analysis using district-level and, if possible, habitation-level, data to enable explanatory policy analysis at the national level.

Habitation-level analysis

While the IMIS database does not provide ready access to national habitation-level data on the policy measures we are evaluating, we were able to obtain habitation data from the central headquarters of the IMIS at the National Informatics Center (NIC) on water coverage, the population of SC, the population of ST, and the general (non-SC or -ST) population (Gen Pop) at the habitation level. Given that we expect high SC and ST populations to be predictors of low water coverage status, we now present a preliminary habitation-level regression analysis for a case study district. Building on Novellino's (2015) research in Gujarat, we downloaded habitation-level data on coverage status for Gandhinagar, the capital district of Gujarat. We chose to use the 55 lpcd threshold as there was greater variation across habitations than at the lower threshold.

Descriptive statistics for habitations in Gandhinagar district ( n = 496).

Correlation analysis shows, as expected, a significant negative correlation between ST and coverage status. Interestingly, there is no significant correlation between SC and coverage status. Additionally, there is a significant positive correlation between Gen Pop and coverage status, indicating that habitations with larger populations are more likely to be fully covered.

Model fitting

Gandhinagar habitation-level regression model and results.

Assessing model fit for a logistic regression model is somewhat more complex than for linear regression. The common interpretation of R 2 for linear regression does not hold in logistic regression ( Hilbe, 2009 ); we use a log-likelihood pseudo- R 2 , which is 0.3575. This indicates a relatively weak model fit that is likely missing some important predictors, as expected. Additionally, standard outlier analysis identified many outliers, and repeating the analysis without the outliers yielded a second model with new outliers. This suggests a problem with the model formulation; most likely additional predictors are needed.

As in the state-level analysis, data availability prevents us from answering key policy questions. The issue here is different from that in the national analysis. We have the granularity in data needed for a district in India, but IMIS provides a small subset of potential socio-economic and institutional predictors. That said, we conclude with fairly high confidence that there is a negative relationship between ST population and FC status, and a positive relationship between population size and FC status in Gandhinagar district. The best regression model developed, which is shown in Table 4 , indicates that an increase of 1 in the square root of ST population decreases the odds of being fully covered by 1.31 times, while a unit increase in the square root of the general population increases the odds of being FC by 0.94 times. SC population was not statistically significant in this model, although it did have a significant negative relationship in other models tested. More information is needed to assess the complex local relationships between SC populations and FC status.

Five major conclusions for national rural drinking water programs stand out. First, India's investment in an online national rural drinking water database is an important precedent for other countries. Second, it is designed to compile consistent, systematic, transparent, and secure rural water data for policy support. Third, the IMIS database reveals the potential, and current limitations, of a national water database, particularly for data quality control and applied policy analysis. It has yet to be demonstrated how national-, state-, and district-level administrators and water managers actually understand, navigate, and use the large number of tables i n the database. Fourth, in descriptive terms, the IMIS database helps monitor advances in national and state water coverage (e.g. toward the 40 and 55 lpcd standards), and related water source, scheme, and sustainability variables. This analysis highlights the need for much greater emphasis on water quality monitoring. Fifth, while IMIS is valuable for descriptive monitoring, our regression analysis experiments showed that it currently has significant limitations for policy analysis. The regression analysis showed that state-level data in the IMIS database, by itself, cannot explain national patterns of full water coverage. Additional socio-economic variables from other databases (e.g. Census of India) could help address this issue. However, we also showed that it is more likely that policy analysis will require district-, block-, and habitation-level observations. The current IMIS database could have greater functionality by providing ready access to district- and block-level data nationwide (vis-à-vis for individual states). However, as an annual survey of water supply, the greatest power of the IMIS database will lie in habitation-level regression analysis. This will require greater access to habitation-level data in formats conducive to large-scale regression analysis. In contrast with the national-level models examined here, regression analysis of habitation-level data for the Gandhinagar case study district identified a significant negative relationship between the population of ST and full water coverage, but not between SC and full water coverage. This analysis also indicated that habitation size is positively correlated with water coverage. As might be expected, small systems need strategic emphasis.

The potential for more rigorous and useful policy analysis with the IMIS database thus appears to depend upon: (1) enhanced data access and web interface functionality; (2) ready linkages with other socio-economic databases; and (3) an emphasis on district-, block-, and, above all, habitation-level data.

We are grateful to the MIT-Tata Center for Technology and Design and director Dr Robert Stoner for supporting this research. In the Government of Gujarat, Mr Mahesh Singh and colleagues in the Water and Sanitation Management Organization (WASMO) were very helpful. Mr Divyang Waghela of the Tata Foundation water mission offered valuable insights. Ms Seemantinee Sengupta from the NIC – IMIS provided fundamental support for this research. In Maharashtra, the Department of Water Supply and Sanitation, Groundwater Survey and Development Authority, zilla parishads, and Jalswarajya II project with the World Bank are collaborating on important extensions of this work. Mr J. V. R. Murty offered encouragement and insights on demand management. Architect Surekha Ghogale of the Aga Khan Planning and Building Services, India, and her team supported fieldwork in rural Gujarat. Sean Furey of the RWSN provided useful information on country databases.

Note that the database aggregates information using unique ID numbers for schemes and sources. This prevents double counting of schemes, investments, etc. when the data are aggregated. This aggregation structure is documented in Novellino (2015) based on conversations with government officials and has been confirmed by the authors through a sample of 550 schemes in five districts.

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