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Using a transaction costs approach, this paper attempts to understand the allocation of medical oxygen during India’s second wave. In this background, it argues for transparency in allocative decision making of health related commodities. Through process tracing methodology, it focuses on the case of the oxygen crisis in Delhi at a time when different governments within India’s federal set-up accused each other of mismanagement of this commodity. The sequence of events in the case are traced to understand the grounds of allocative decisions during this emergency. Understanding the issue of allocation of medical resources becomes important as matters of life and death are often policitized. In this case, it appears that certain questionable decisions were made by both the Central government and the state government at the peak of the country’s second wave. However, the lack of availability of good quality data even hindered the judicial committee from reaching a conclusive opinion. As a result, this paper recommends the usage of Information Communication Technology tools for sharing health related information in real time. With ICT tools, the costs of exchanges made between Central and State governments could be lowered, which could in turn result in fairer or more optimal decisions. This paper argues that within India’s federal structure, if information costs are too high, factors other than efficiency and fairness can affect allocation of resources. It concludes by recommending the creation of centralized health supply data exchange can help increase allocative efficiencies. This study uses a process tracing method to answer its research question. Process tracing refers to an in-depth empirical analysis of causal processes in a real case. Through a standardized process of data acquisition and transmission with ICT tools, transaction costs made in exchanges between central and state governments could be lowered. By automating collection and transmission processes through tamper-proof devices, the integrity of the local level data will be maintained, and transaction costs will be lowered further. As a consequence, economic efficiency and fairness would underpin the allocation of the critical medical commodity.

This paper summarises the arguments and counterarguments within the scientific discussion on the issue of the implementation of Electronic Medical Records (EMR). The primary purpose of the research is to present a framework for gathering end-user requirements in EMR system implementation. The cross-geographical literature review demonstrates EMR system implementation to be a complicated task to manage. A systematic review of literature sources and approaches for solving the problem indicates that a lack of end-user participation often results in technology rollbacks. The failures to implement electronic medical records are considered to be the reasons for financial losses, followed by the rearrangements of key personnel. The author of the article investigates the role of the main actors involved in the healthcare process. Consequently, as the market adoption of EMRs grows and its impact as a workflow management tool in care facilities increases, focusing on end-user requirements during the implementation phase becomes essential. Investigation of the topic reveals that the opposing points of view, learning investments, and the embedded nature of older technologies deter users from accepting new technology. Methodological research tools involved studying the workflows in a regular outpatient journey. Taking the case of a standard outpatient facility, the paper attempts to present its results through a framework for requirement gathering in the pre-implementation stages. A plan of action for eliciting end-user requirements for the users in a three-stage framework is being proposed. Considering the diverse number of actors in the standard outpatient journey, the three-stage framework breaks down requirements by roles and educational backgrounds and gathers into 1) antecedent or existing conditions; 2) formal and informal communication channels; 3) user and system-generated requirements. This framework relies on synthesising existing frameworks and arranging them in sequential order for real-world implementations based on existing research papers.

In policy documents worldwide, the issue of maternal and child mortality and morbidity is identified as an urgent health concern [SDGs, 2016]. The Integrated Child Delivery Service [ICDS] and National Health Mission [NHM] jointly attempt to address the issue of maternal and child health in India. On the ground, these programs are operationalized by the frontline workers of the two programs – the Accredited Social Health Activists [ASHAs], the Auxiliary Nursing Midwives [ANMs] and the Anganwadi Workers [AWWs]. The purpose of designing joint activities between the two programs is to integrate both the social and the medical aspects of health [Sharma, 2014]. However, while the two programs are designed to be compatible, coordination issues exist in their joint implementation [Kim et al., 2017; Prasad et al., 2012].  Currently, because of the allocation of additional responsibilities for the frontline workers, challenges for frontline workers have exacerbated [Indian Express, 2020]. In real terms, the increased problems in coordination in integrated care provision could potentially result in increased incidents of morbidity and mortality for this demographic. In this context, this article discusses and anticipates challenges for the frontline workers for providing maternal and child health in India.