MCSP Health and Wellness Centers Program Lessons Learnt

MCSP Health and Wellness Centers Program Lessons Learnt and Experiences from Intervention States

The Reach Arunachal Pradesh Assam Chhattisgarh 13 3921 facilities upgraded to HWCs States (12 USAID + 1 UPTSU) Jharkhand Madhya Pradesh Manipur 111 Meghalaya Training sites established Mizoram Nagaland Odisha Sikkim Tripura Uttar Pradesh 64 Districts (including 24 Aspirational Districts) 65. 3 Million Population

Technical Assistance in Operationalization of HWCs Strengthening Institutional Mechanisms Capacity Building Operational Planning IEC and Facility Branding Facilitate Infrastructural Strengthening Community mobilization and Demand Generation Leveraging Funds through nonconventional Health sources Supportive Supervision and Feedback

TA for Roll out of Certificate Course Establishment of Training Sites Creating a Resource Pool Academic Planning Stakeholder coordination Standardized Teaching Learning Materials Mentoring and Quality Assurance

Supportive Supervision Mechanism – HWCs Mentoring & Quality Assurance- PSCs

Supportive supervision visits Purpose: To assess the functionality of HWCs in terms of availability of physical infrastructure, human resources, drugs & diagnostics, IT services and wellness activities etc. Data Collection Tool: SSV checklist Collection Frequency: Quarterly (Program Officers are visiting all the targeted facility at-least once in a quarter) 6

Capturing real time SSV data through open source mobile application 7

Supportive Supervision – Key areas General Information Physical Infrastructure HR & Training Drugs & Supplies Diagnostics IT Services Wellness activities IEC Service Delivery

Data flow Data collection from HWCs & entry into mobile software by POs Data quality assurance, compilation, analysis and state level reporting – State level Sharing of data/report to state level Report shared with stakeholder s at State and District level

Supportive Supervision– Dashboard 10

Results of Supportive Supervision SS Visits supported in improving in HWC Infrastructure Baseline (Oct - Dec 2018) Endline (Apr - June 2019) 88% 76% 74% 71% 66% 58% 57% 48% 49% 55% 56% 75% 58% 77% 61% 39% External Waiting area branding as per with seating guidelines arrangements for 15 -20 beneficiaries Space/ room identified for Wellness activities Facilities for people with disabilities Space for laboratory/ diagnostics services Provision of Proper drainage Separate Storage space BMW system functional toilets management for staff 11

Results of Supportive Supervision SS Visits supported in improving availability of trained HR and IT logistics at HWCs Status of NCD Training of HR Availability of IT equipment Baseline (Oct - Dec 2018) Endline (Apr - June 2019) Baseline (Oct - Dec 2018) 85% 84% 85% 72% 66% 65% 83% 67% 53% 28% Desktop for MO (MBBS) Staff Nurse MPW / ANM Endline (Apr - June 2019) 23% Tablet available with MPW / ANMs ASHA 12

Results of Supportive Supervision Improvement in availability of Drugs Baseline (Oct - Dec 2018) 90% Endline (Apr - June 2019) 94% 81% 65% 29% 37% All essential drugs as Anti-hypertensive drugs per CPHC guidelines available 28% 31% Anti-epileptic drugs available Anti-diabetic drugs available 13

Results of Supportive Supervision Improvement in Availability of IEC Materials Baseline (Oct - Dec 2018) 69% Endline (Apr - June 2019) 59% 50% 49% 45% 16% 20% Display of contact details of the HWCs team 24% Display of standard protocols 25% 27% Display of citizen charter Display of IEC material Display of signages and name of the facility 14

Mentoring & Quality Assurance (MQA) model Student’s Feedback Questionnair e Knowledge Assessment Tool MQA Checklist Key component s

Operational Aspects of MQA The Team: 1. State Nodal Officers (HWC/CCCH) 2. DPMU Team members 3. Jhpiego representatives

MQA- Toolkit

Summarizing MQA visit Report 1. Status of dashboard indicators: 14 dashboard indicators reflecting upon infrastructural preparedness, quality of education (theory & practical) and management practices 2. Key highlights: Includes a summary of best practices, innovative approaches being used by PSCs 3. Areas of concern: Issues at PSCs which need immediate attention

Mentoring and Quality Assurance – Dashboard

The Process: closing the loop

Promoting evidence based actions and accountability Initiation of clinical posting of JAN 2018 batch at Sundergarh PSC State feedback to PSCs with clearly delineated actionable

Effectiveness of MQA Model Availability of Study Materials Improvement in Training Infrastructure Jul-Sep'18 100% 93% 95% Apr-Jun'19 98% 100% 80% 60% 41% 40% 20% 98% Apr-Jun'19 98% 95% 40% 20% 17% 7% 0% 0% Avialability of adequate furniture LCD projector Flipchart Availability of Module 1 Module 2 Module 3 Log Book 22

Participants feedback during MQA Level of Satisfaction with Quality of Clinical Training Satisfied Not Satisfied 100% 83% 84% 80% Level of Satisfaction with learning Environment 100% 83% 60% 40% 17% 89% 84% 80% 60% 20% Not Satisfied 20% 16% 17% 20% 16% 11% 0% 0% Orientation to Variety of clinical Methods used Clinical staff various clinical experiences for clinical support the facilities by the during training is training are students in counsellors adequate appropriate achieving their learning objectives Self-study hours for theory Guidance from counsellors courses are well utilized for completion of and learning labs are being assignments is adequate used for demonstration and practice 23

Priority Areas for Support in next phase • Setting up a Rapid Response Unit for providing need-based, quality soft TA to additional states beyond direct intervention areas • Strengthening preventive, promotive and wellness component within HWCs • Institutionalize a system for Supportive Supervision • Recognizing and rewarding high-performing HWCs and CHOs, to ensure that staff are motivated and the momentum is accelerated • Integration of School Health Program within HWC initiative • Ensuring unfinished agenda of RMNCH+A and TB-free India through HWCs Work together for transforming India’s healthcare service delivery and ensuring the ultimate goal of providing quality, accessible and affordable healthcare for all

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