Mitanin Program - Nipccd

Project Name:
Efficiency Criteria
Human Resource
Efficiency
Mitanin Programme
Format 3: Efficiency and Expandability
Performance Improvement
Community Level Health and Nutrition Functionaries
BACKGROUND INFORMATION
EFFICIENCY OF THE INTERVENTION (COMMUNITY LEVEL HEALTH & NUTRITION FUNCTIONARY)
Numbers Efficiency Factors
The program requires an additional cadre 1. Are the people required for improving
of supervisors (20:1) and trainers (200:1). performance a scarce resource or are they easily
and a pool of 25 state level trainers. In available? (yes indicates reduced efficiency) No.
addition, it requires functional health The state level resource persons are drawn from
system for referral support and medical the exisiting system and the rest are from
supplies
community
2. Does it require involvement/ recruitment of people
who are not already existing with the programme or
is the resource internally present? (externally
sourced HR indicates reduced efficiency) People
from within the system and from community
3. Is there consistency between human resource
competence and the job they are handling?
(incidences such as Nurse Midwives doing clerical
work indicates HR inefficiency) Consistent
Materials Efficiency The Mitanins carried a kit of medical and 1. Has the intervention increased the numbers of
non-medical supplies, which was materials with CLHNF? There is no information on
replenished through the existing channels this in the available documents
of the public health systems. The 2. Has the change in materials with CLHNF reduced
available documents do not present the the materials load at level above? (no indicates
consumption patterns of the medical as reduced efficiency): Not applicable
well as non-medical supplies.
3. Is the CLHNF overstocking or understocking?
what is the evidence of stock-out with CLHNF?
(overstocking, understocking or stock-out indicates
material inefficiency): Supplies are replenished from
sub-centre. Evaluation by CHC indicates an
inadequate supplies with Mitanins
Comments

Time Efficiency Mitanin initiative was planned as a 60
months programme. 18 months for pilot
phase (selection, training and deployment
of Mitanin) and the remaining 42 months
for intervention and their work in
community
Technology Efficiency There is no information on this in the
available document
Financial Efficiency Annual programme cost per Mitanin (over
60,000 mitanins) is Rs. 3750. Annual
drug cost per Mitanin (over 60,000
mitanins) is Rs. 2300
1. Is it a quick action intervention for performance
improvement? The Intervention takes 1.5 years as
start-up time.
2. Does bringing in this performance improvement
take longer time out of CLHNF's routine work time?
In other words, did participation in integrating
performance improvement techniques hamper
CLHNF's work? Since the performance
improvement is done on the job review process, it
does not reduce the working hours. However, there
is no evidence to assess this
1. Does the intervention use easily available
gadgets and technology? (yes indicates improved
efficiency): NA
2. Are the gadgets and technology user-friendly to
CLHNFs? (yes indicates improved efficiency)NA
3. Are the gadgets portable? (yes indicates
improved efficiency) NA
4. Is the technology universally compatible with
other gadgets? (yes indicates improved
efficiency) NA
5. Are the gadgets energy efficient? Less use of nonrenewable
fuels and scarcely available energy
sources (yes indicates imrpoved efficiency) NA
1. Have DALYs and QALYs been calculated?: There
is no information on this in the available documents
2. If yes, does it show an improved cost per DALY/
QALY?: N.A
Sources of Information
1. Human Resource Efficiency: Outcome Evaluation of Mitanin, SHRC
2. Materials Efficiency: Outcome Evaluation of Mitanin, SHRC
3. Time Efficiency: Mishra JP, Mitanin Programme, Available at:http://www.cbhi-hsprod.nic.in/prin.asp?SF=25&KI=5&OT=1
4. Technology Efficiency: All available documents
5. Financial Efficiency: Mishra JP, Mitanin Programme, Available at:http://www.cbhi-hsprod.nic.in/prin.asp?SF=25&KI=5&OT=1
EXPANDABILITY (COMMUNITY LEVEL HEALTH & NUTRITION FUNCTIONARY)
EXPANDABILITY FACTORS EXPERT GROUP'S COMMENTS SOURCE

Relevance to the existing problem
Is this aspect of performance an issue of concern at national and state
levels?
Relevance of the performance improvement component in current
programs?
Transferability 1. Consistency (profile, job responsibilities) between the CLHNF under
study and those with health systems and WCD Department?
2. Is the solution consistent to existing infrastructure and human
resources?
3. Does the solution have multiple and complex components? How easy
is it to transfer?
4. Did the implementation of the model face resistance (from the
community, from the health workers', from the workers' union or the
health systems)?
5. What are the groups that are most likely to resist the integration of this
technique? Who are most likely to support it?
Robustness
Comment of the Expert Group:
Date of Review
1. Has this performance improvement technique been tried over a wide
range of population? Was it successful?
2. Has this technique been tried in EAG States? What was the success of
it?
3. How dependable is this technique on political support from highest
offices? Is it sustainable despite political change and change of office
bearers?
4. Are there funds available to initiate it on a larger scale? Are there
financial, technological, material and human resources available to
sustain it at scale?
Expert Group Member's Names: