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Currently, the monitoring of activities at the health centers and camps is largely manual, requiring health workers to maintain and submit written records of the activities they undertake on a day to day basis to their supervisors. This results in additional compliance load on them and the duplication of their efforts.
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Hence, improving the MEL mechanism, potentially through the introduction of digitized platforms, can help automate checks to gauge the implementation of SoPs as well as identify common loopholes in SoP adoption, forming a basis for their modification.
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Additionally, putting in place effective feedback mechanism is essential to allow healthcare workers and other actors to suggest improvements to the working of health centers, a mechanism which is currently missing on-ground. This may not be feasible for outdoor camps and other health initiatives in the short run, however piloting digitized MEL mechanisms activities at established centers may give insights on how to extend these to camps, etc. in the long run.
Improve and digitize monitoring and feedback systems at health centers and camps to ensure accountability, efficiency and revision of SoPs
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We have to carry out patient registration twice – once on a physical register and then again on the e-Sanjeevani teleconsultation platform. The initial registration on the physical register is a record for our supervisor so they can monitor our work and results in the duplication of our efforts.
Health centers and camps do not have strong monitoring and feedback mechanisms in place which results in inability of supply-side actors to identify, undertake or suggest improvements to the functioning of these centers and camps.
Case in Point
While interacting with ANMs and conducting observations of health and wellness centers in Bihar, we realized that there are limited avenues for health workers to provide inputs/ feedback on the functioning of the health and wellness centers, with them mostly relaying their grievances to supervisors.
Additionally, we heard from ANMs that current reporting mechanisms require them to maintain a physical record of the activities they undertake, which sometimes results in the duplication of their efforts (see quote on previous slide).
