Remote care for remote areas: the impact of telehealth in rural India
What is your research about?
Telehealth connects patients to qualified health care professionals via phone. Although its popularity dramatically increased since the onset of the COVID-19 pandemic, there is limited rigorous evidence of its impact, and no impact of its effect in low-income countries.
The impact of telehealth on health access and healthcare inequality in low-income countries is ex-ante ambiguous. On the one hand, telehealth could allow individuals currently out of reach of the official health system – e.g., because of their remote location or because of prevailing norms – to access quality healthcare providers, thus improving the quality of care and equalizing access. On the other hand, telehealth might crowd out in-person care, with potential negative consequences on health outcomes for those individuals who do not engage with technology, who are not e-literate, and who have little trust in modern medicine to start with (e.g. women, the elderly, the poor). This may result in telehealth excluding individuals who need care most, exacerbating inequality in healthcare.
The main questions this project will answer are:
- What is the long-term causal impact of telehealth on access to health services and health outcomes among people in rural areas? Does the presence of a facilitator increase the spreading and utilization of telehealth?
- Does telehealth reduce gender inequality in access to healthcare typically observed in many low-income countries? Which types of patients are more likely to use telehealth with vs. without the facilitator? Does the impact differ across gender, income, and age groups?
How will the Stone Centre grant help your research?
We have designed a field experiment taking advantage of the planned expansion of the activities of Healing Fields Foundation (HFF) within the state of Bihar in Eastern India. HFF, a reputable NGO, will implement the programs and randomize the services. We have a strong partnership with HFF and have signed a MoU. Our project is also associated with J-PAL, a renowned organization focused on poverty alleviation through randomized evaluations. J-PAL South Asia will manage the data collection process.
We will rely on three different data sources – a household survey, a provider survey, and administrative data – to understand the impact of the different treatments on households’ health service utilization and health outcomes. The project will involve the collection of novel data. The analysis will be based on two main rounds of data collection. Baseline data will be collected before the program is initiated (Jan 2024-March 2023). The intervention will start after the baseline will be completed. Endline data will be collected 2 years later (March-May 2026). The data will allow us to measure the causal effect of the programs by comparing outcomes (e.g., access to health services) in the treatment and control groups after the project has been running for some time.
The Stone Centre grant will fund the endline data collection.
What will you produce as part of your research?
We will make the baseline and endline data collections available, and produce an analysis and a report of findings.
About this grant
Title of the project: Remote care for remote areas: the impact of telehealth in rural India
Value of the grant: £48,482
Duration: September 2023 – ongoing
