Performance Indicators

The progress of the project will be monitored on the basis of a set of performance indicators. The indicators are classified into two broad groups:

• Process Indicators
• Outcome Indicators

Process Indicators: The project will initiate a series of activities under each component, such as civil works, service delivery, training, manpower recruitment and development, disease surveillance, HMIS, IEC, etc. The process indicators will judge the actual progress of each activity in quantitative terms against the project target.

Outcome Indicators: These indicators will measure the overall impact of the project due to expected changes in hospital outputs and improved efficiency of the system. These indicators include disease profile, morbidity and mortality rates, case fatality ratio, patient’s satisfaction, awareness of people regarding availability of services, and so on. The indicators will be assessed at regular intervals so that problems can be identified, solved, and necessary changes brought about during the implementation phase. These will also provide useful data for further analysis and studies.

Process Indicators:

• Number of centers providing comprehensive emergency obstetric care operationalized
  Declining trend of out-referrals in the CEmONC centers

• Number of centers providing neonatal care operationalized
  Declining trend of out-referrals in the CEmONC centres

• Number of counselors appointed in health facilities in tribal areas

• Number of facilities with staffing according to norms

• Number of counseling centers for NCD established at district hospitals

• Protocols developed for management for NCD

• Cases registered and managed as per protocol

• Increased number of women being screened for cervical cancer

• Number of identified trauma care centers operationalized

• Development of standard treatment protocols and recording/reporting forms

• Training in the use of protocols

• Carry out and evaluate (mid-term and end-line independent, before and after assessments) training in the following areas:

  • Rational use of drugs

  • Management training

  • Health care waste management

  • HMIS

  • Equipment maintenance

  • QOC

  • Referral

  • Service provider behavior change

• Number of MOUs with NGOs for facilitating service utilization by Below poverty line (BPL) population at project hospitals

• Increase in utilization by BPL of project facilities as measured by increases in:

  1. Out Patient(OP) and In Patient(IP)/month

  2. Bed Occupancy Rate(BOR)

  3. Bed Turn Over Rate(BTOR)

  4. Average Length of Stay(ALOS)

• Baseline survey of health service utilization, expenditure, and satisfaction

• Baseline quality of care evaluation

• Implementation of a field tested and coherent paper-based hospital HMIS

Outcome Indicators:

• Total in-patient utilization (considering both the public and private sector) by the poorest 40% of the population increased (as measured by an asset index).

• Improved quality of care in public hospitals, as measured by a series of indicators (including management of indicator conditions, patient outcomes, and quality control mechanisms) and implementation of a regulation / accreditation system to improve quality of care in private sector hospitals

• CEmONCs should handle more than 50% of complicated deliveries for women belonging to SC/ST concurrently meeting the standards of quality of care.

• Reduced case-fatality rate among the SC/ST population for maternal admissions in CEmONC hospitals

• Reduced ratio of neonatal deaths per total of neonatal admissions and hospital live births in CEmONC hospitals

• Increased utilization of primary and secondary services by tribal groups.

• Decreased road traffic accident case fatality rate

• Improving trend in indicators of quality of care

• Increased patient satisfaction with care

• Short and medium term measures for health care waste management implemented at project facilities

• PPP with NGO/private partners for transportation and final waste disposal

• Rigorous evaluation of 14 PPPs completed in terms of measured gains in access, quality and cost- effectiveness

• Upgradation and repairs of project facilities completed according to plan

• Increased number of laboratory tests, x-rays and other diagnostics at project facilities

• Reduction in equipment downtime

• Availability of staff according to norms at project facilities

• Reduction in doctor absenteeism as recorded in supervisor’s logbook