nmi (non-monetary incentive) scheme to improve provider behavior presenters: ms. grishma shrestha,...

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NMI (Non-monetary Incentive) Scheme to improve provider behavior Presenters: Ms. Grishma Shrestha, Social Franchising Manager Mr. Pawas Rai, Sector Office Manager 2 nd Global SF Conference 23 rd Oct 2014

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Why NMI?  Motivation  IUCD – “not profitable” -Limited to one product -Time-consuming but limited income  Turnover  Complains -“Support not adequate” -“No sterilization equipments” -Incomplete recording and reporting – “time-consuming” -QA, community-level activities – “No time”

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Page 1: NMI (Non-monetary Incentive) Scheme to improve provider behavior Presenters: Ms. Grishma Shrestha, Social Franchising Manager Mr. Pawas Rai, Sector Office

NMI (Non-monetary Incentive) Scheme

to improve provider behavior

Presenters: Ms. Grishma Shrestha, Social Franchising Manager

Mr. Pawas Rai, Sector Office Manager

2nd Global SF Conference 23rd Oct 2014

Page 2: NMI (Non-monetary Incentive) Scheme to improve provider behavior Presenters: Ms. Grishma Shrestha, Social Franchising Manager Mr. Pawas Rai, Sector Office

OK Franchise Network Women’s Health Program Since 2009 Network of service providers Private clinic adjoining a

pharmacy Balanced Counseling and

IUCD services 400 approx. in 50 districts

(out of 75)

Page 3: NMI (Non-monetary Incentive) Scheme to improve provider behavior Presenters: Ms. Grishma Shrestha, Social Franchising Manager Mr. Pawas Rai, Sector Office

Why NMI? Motivation

IUCD – “not profitable”- Limited to one product- Time-consuming but limited

income Turnover Complains

- “Support not adequate” - “No sterilization equipments”- Incomplete recording and

reporting – “time-consuming”- QA, community-level activities –

“No time”

Page 4: NMI (Non-monetary Incentive) Scheme to improve provider behavior Presenters: Ms. Grishma Shrestha, Social Franchising Manager Mr. Pawas Rai, Sector Office

Process – Development & Implementation

Need assessment – Issues & Needs

Eligibility Criteria, Scoring Criteria &

Rewards

Scoring & Redemption Mechanism -

Forms & Formats

IEC Materials – Brochure, Scoring

Sheet

System/MISOrientationMonthly Scoring & NotificationMonitoring

Evaluation Improve

Page 5: NMI (Non-monetary Incentive) Scheme to improve provider behavior Presenters: Ms. Grishma Shrestha, Social Franchising Manager Mr. Pawas Rai, Sector Office

Eligibility and Scoring Criteria

Certified Minimum of 50 IUCD insertions

Scoring Criteria Points - several criteria

- QA Assessment scores- Participation in Bhalakusari (community) meetings- Record-keeping and reporting- Display of IEC materials- Behavior Rewards

Page 6: NMI (Non-monetary Incentive) Scheme to improve provider behavior Presenters: Ms. Grishma Shrestha, Social Franchising Manager Mr. Pawas Rai, Sector Office

Scoring Mechanism

Monitored - field staffs Monthly Reward points - observations &

MIS data Maximum points - 148 Multiple rewards

Page 7: NMI (Non-monetary Incentive) Scheme to improve provider behavior Presenters: Ms. Grishma Shrestha, Social Franchising Manager Mr. Pawas Rai, Sector Office

Impact of NMI in 2013Improved indicators

Fewer complaints Improved QA score - from 91.3% to 94.4% Increased % of providers attending Bhalakusari (community) meetings - from

6% to 18% Improved display of IEC materials Increased productivity - average IUCD insertion per provider - from 3.1 to 5.1

Successful in motivating providers

Page 8: NMI (Non-monetary Incentive) Scheme to improve provider behavior Presenters: Ms. Grishma Shrestha, Social Franchising Manager Mr. Pawas Rai, Sector Office

Challenges

Key motivator - monetary but against policy - Appealing non-monetary rewards

Behavior change – not easy & takes time - Monthly notify – points - Continuous motivation – improve performance and earn

better scores

Page 9: NMI (Non-monetary Incentive) Scheme to improve provider behavior Presenters: Ms. Grishma Shrestha, Social Franchising Manager Mr. Pawas Rai, Sector Office

Applicable to other SF Programs?

Page 10: NMI (Non-monetary Incentive) Scheme to improve provider behavior Presenters: Ms. Grishma Shrestha, Social Franchising Manager Mr. Pawas Rai, Sector Office

Next steps

Lesson learnt – Include facility owners

Page 11: NMI (Non-monetary Incentive) Scheme to improve provider behavior Presenters: Ms. Grishma Shrestha, Social Franchising Manager Mr. Pawas Rai, Sector Office