GUIDELINE TO
USE CHECKLIST
FOR TRACKING FACILITIES FOR IMPLEMENTATION OF NRHM/RCH-II
Background
Under the current Government of India’s maternal health policies and programmes, there are various facilities and services available from health facilities at various levels. To understand district and state specific progresses on selected interventions and to bring a clearer understanding of barriers to community level implementation of policies related to health systems, checklist/ questionnaire designed by the White Ribbon Alliance for Safe Motherhood, India (WRA India) which are used to collect information collected under the policies and schemes for effective tracking of policy and drawing accountability for effective functioning of health facilities and the service providers.
Why Checklists are used
In one such effort, WRA India has devised, promoted, and provided checklists to enable systematic tracking of the implementation of national policies and programs at the health facilities from sub-centre to district hospital .
Checklists were developed for a social assessment of the progress of policies under the national RCH policies. The checklist specifically references health facilities at all levels, provision for services of Auxiliary Nurse Midwives (ANMs) and implementation of the national schemes like Janani Suraksha Yojana [1](JSY), and Janani Shishu Suraksha Karyakram (JSSY).
Checklists are used because
• Maternal mortality and morbidity is high
• Safe Motherhood is a matter of right
• State has to provide Quality Maternal Health Care
• Plans and programmes must be in place
• To strengthen monitoring and supervision
• To address low progress in MMR reduction
• To collect evidences for making changes
What kind of information is collected
Checklists are based on provisions under,
– Government health policies and programs like National Rural Health Mission (NRHM) in India
– India Public Health Standard (IPHS) from Sub-Centre to Dist. Hospital Level
Checklists are focused on
– Community awareness on entitlements
– Stakeholders’ participation
– Status of health facility
– Implementation and Policy Gaps
Checklists are used at;
– Community & Sub-centre level
– Block/ Sub-district level
– District level
What is role of WRA member/Civil Society in collecting information
• Civil society can facilitate changes and make things happen
• Civil society needs to monitor the implementation of policies and program
• Checklists bring new gaps for civil society intervention
• Checklists open up space for participation and dicsussion
• Checklists helps in gathering baseline information
• Checklists are the starting point of advocacy
What you need to know first?
• The existing entitlements
• The envisaged services
• The plans and the policy regulating services
• The status of facility (Declared or functional)
• What the question in checklist aspires?
• Who is appropriate to respond?
• Is the response a fact?
• How to cross-check the responses
Methodology
• Collection of secondary information
• Formation of team of investigators/ data collection Team
• Training to investigators/ data collection team on how to use checklists
• Identification of facility and respondent
• Cross checking of responses
Analysis of Data
– All data collected can be tabulated in excel format assigning codes
– The data can be analyzed with simple statistical tools
– Findings to be documented with data tables/ graphs
How to use the findings?
The findings were collated, and the report was shared with all the stakeholders including policy makers and media. The findings and recommendations have been instrumental in state specific advocacy on safe motherhood.
• Disseminate findings starting from the community to top policy makers
• The findings should be shared with health facility itself, then with media and elected representative.
• Use the findings in advocacy on improving maternal health services
• Use this finding as baseline and measure changes happen
• Use the checklists agin after regular interval of time eg. 6-8 months
• Analyse the changes
• Provide recommendations
Next Steps -
• It should be a beginning and not end
• It never costs much to local civil societies
• Make constant visit to facility
• Interact with the respondents on regular basis
The checklists aim to strengthen accountability at facilities and health service providers and build on gaps to promote safe motherhood. Checklists are for rapid monitoring of the maternal health services and situations in local health facilities. The quality of services provided is assessed at the district hospital, first referral units and primary health centers and sub-centres using checklists and individual interviews of beneficiaries.
[1] A maternity benefit scheme for monetary assistance for institutional deliveries