improving performance of an ms for safe delivery in jharkhand dtd feb.,2012
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HR in HealthTRANSCRIPT
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Improving Performance of ANMs for Safe Delivery in
Jharkhand
February 2012
Dr. Manju Shukla, State Director, Jharkhand
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Factors Responsible for Optimal Performance• Clear Job Expectations
• Knowledge & Skills
• Supplies
• Supportive Supervision – Review
– Timely feedback
– Problem-solving
• Motivation– Rewards
– Recognition
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CONS IDERINS TITUTIONAL
CONTEXT
MIS S IO N
G O ALS
S TR ATE G IE S
C U LTU R E
C LIE NT AND
C O MMU N ITY
PE R S PE C TIVE S
OBTAIN AND MAINTAIN S TAKEHOLDER AGREEMENT
MONITOR AND EVALUATE PERFORMANCE
DEFINE DES IREDPERFORMANCE
FIND ROOTCAUS ES
WH Y D O E S TH E
PE RFO R MAN C E
G AP E X IS T?
S ELECTINTERVENTIONS
WH AT C AN BE D O N E
TO C LO S E TH E
PE R FO R MAN C E G AP?
DES CRIBE ACTUALPERFORMANCE
PERFORMANCEGAP
EXTERNAL FACTORS
Performance Improvement Framework
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SBA Technical Assistance Framework
Improvement in quality of delivery and other services
by SBAs
Reduced maternal and infant mortality
Increase in number of deliveries by SBAs
Improving quality of training
Ensuring regular supplies
Supportive supervision &
feedback
Motivating with
rewards & recognition
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Key Inputs• Skill and competency-based training
• Focus on weak trainees
• Job aids – partograph, drug list
• Post-training follow-up for skill retention
• Supportive supervision to
– Review performance
– Solve problems
– Encourage, recognize good performance and motivate
– Job aid for supervisors
• Use of data for decision-making
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Supportive Supervision: A Framework for Capacity-Building
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Recognition of High-Performing SBAs
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Key Results• Almost all SBAs listed midwifery as one of their top three
primary job functions
• Increase in SBAs who reported receiving support from supervisor
• Availability of supplies increased for SBA-related activities at sub-centres
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Increased Job Priority
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Improved Supplies
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Improved Supervision
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Increased Skilled Attendance at Birth
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Improved Quality of Care by SBAs
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Lessons Learned
• Gaps in all factors influencing SBA performance need to be addressed
• Competency-based training and quality can be ensured by trainer selection and capacity-building, site readiness, focus on clinical practicum and participatory training
• Regular feedback and review of performance are critical for training to result in improved performance
• Building a culture of performance and quality requires a shift in attitude and supervisory processes
• Agreement on eligibility criteria and process for validation of data for reward and recognition is important to ensure transparency and consistency
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