Insights
Why having data does not always lead to better public health decisions
Over the past two decades working in public health systems, one observation continues to stand out:
We often have abundant data, but limited clarity for decision-making.
Districts generate enormous volumes of information through surveillance systems, program reports, surveys, and administrative data. Yet decision-makers frequently struggle to answer simple questions such as:
• What are the top three health risks in this district today?
• Which problems will worsen under climate stress?
• Where will investments produce the greatest impact?
The challenge is rarely lack of data.
The challenge is synthesising data into actionable intelligence.
Public health systems increasingly need structured analysis that translates evidence into clear priorities and practical action plans.
This gap between data and decision is something I have been reflecting on recently, and it is also one of the motivations behind initiating Swasthya Intelligence Lab (SIL) — a platform focused on transforming health evidence into strategic insights.
Curious to hear how others working in public health or development sectors see this issue.
Climate change is no longer an environmental issue alone
For many years, climate change was discussed primarily in environmental or ecological terms.
Today, it is increasingly clear that climate change is fundamentally a public health issue.
Across many regions we are already observing:
• Changing vector ecology
• Heat-related health risks
• Flood-linked disease outbreaks
• Water and sanitation challenges
• Impacts on nutrition and livelihoods
These shifts demand a stronger integration of climate intelligence into health planning.
Public health systems cannot operate in isolation from environmental realities.
District-level planning will increasingly need to consider questions such as:
• Which populations are most climate-vulnerable?
• Which diseases are likely to shift geographically?
• How can surveillance systems adapt to environmental changes?
Integrating climate and health intelligence into planning frameworks will become an important frontier for public health practice in the coming years.
Why evaluation is essential for effective health programs
Public health programs are often implemented at scale, with significant investments of resources and human effort.
However, a crucial question is sometimes overlooked:
Are these programs achieving the outcomes they were designed for?
Program evaluation is not about criticism.
It is about learning, improving, and strengthening systems.
A well-designed evaluation can help identify:
• Operational bottlenecks
• Gaps in coverage or access
• Implementation challenges
• Opportunities for innovation
Importantly, evaluations should aim to produce practical recommendations that can guide program improvements rather than simply documenting findings.
In my experience, structured evaluations often generate insights that can significantly improve program effectiveness and sustainability.