Marie Stopes Society

Overview

Marie Stopes Society (MSS) is a social enterprise that provides comprehensive reproductive health services for people throughout Pakistan. Their ultimate aim is to increase access to reproductive health information and services that empower women, men, young people and families to lead healthier lives. MSS is one of the leading Global Partners of Marie Stopes International (MSI), a non-profit organization based in the UK with more than 35 partners around the world.

MSS is registered under the Societies Act of Pakistan in 1990 and it opened its first clinic in Karachi in 1992. It is established as a unique social business organization, applying modern marketing and management techniques to the achievement of social ends and contributing towards national poverty reduction, MSS services are accessible to approximately 70 million people in the country.

MSS provides a full range of reproductive health services, including information, counseling, family planning services, maternal and child healthcare through 85 well equipped clinics throughout Pakistan. These centers provide high quality services through a ‘client-centered’ approach. The Karachi centers have achieved ISO 9000:2001 standards where standardized quality services are ensured in all the centers through strict and formalized monitoring systems.

MSS has a more than 1,900 people (as of May 2014) forming committed, professional teams with the resolve to fulfilling MSS’s vision and mission of improving the reproductive health of people in Pakistan. Of its total people capital, MSS boasts of fully trained, qualified 952 service providers, working tirelessly across hard-to-reach communities in union councils and tehsils of 73 districts to provide client-focused reproductive health information and services to underserved women, men, couples and young people.

Situation

MSS undergoes an annual QTA by Marie Stopes International to assess and score foundational quality issues of clinical governance, infection prevention management, standard of services, procurement of commodities and client satisfaction to ensure all service provision adheres to international clinical practices.

In MSS, Reproductive Health Franchise Project (RHF) is carried out where Quality Assurance process is followed by QA staff when performing extensive Quality Scans at Franchises/Clinics in field through manually filled scan registers.  The Quality Scans are filled manually in QA Scan Registers by doctors in field.

RHF project has 13 districts nationwide (might scale up to 20% more in couple of years). Each district has approximately 10 clinics and each clinic is observed 4 times per annum and every time a detailed Quality Scan registers is filled by visiting doctor manually. The QA register has 7 knowledge areas and each of them includes 30-60 questions/indicators, which makes approximately 280 questions as a grand total. Scores from 0-2 and N/A are marked against each question and total questions scores are summed up and then a total score is extracted for each knowledge area. Finally, total score of all 7 knowledge areas is summed up and then aggregated percentage/score is extracted for that Quality visit.

Moreover, Action Plan is documented by visiting doctor against areas that need improvement. The same Quality Scan process is performed 4 times per annum (minimum). In addition to 4 scheduled scans, there are also follow up scans that are conducted as per need, following the same process. A full year performance history is maintained by doctors in shape of manual reports. At the end of each scan performed, doctors return to district offices and electronically populate registers in an MIS system.

As a matter of fact, manual systems put pressure on people to be correct in all details of their work at all times, the problem being that people are not perfect. With manual systems, the level of service is dependent on individuals and this puts a requirement on management to run training continuously for staff to keep them motivated and to ensure they are following the correct procedures.

It can be all too easy to accidentally switch details and end up with inconsistency in data entry or in hand written orders. Productivity is usually lower, particularly in routine or operational situations such as transaction processing which becomes slower where large volumes of data need to be dealt with.

It takes more effort and physical space to keep track of paper documents, to find information and to keep details secure.  When mistakes are made or changes or corrections are needed, often a manual transaction must be completely redone rather than just updated.  With manual or partially automated systems information often has to be written down and copied or entered more than once.  The response speed of the manual system is slow compared to the automated system.

Systemization can reduce the amount of duplication of data entry. Reporting and checking that data is robust can be timely and expensive.  This is often an area where significant money can be saved by automation.

Approach

RHF Quality Assurance department required a system for their doctors to perform Quality scans electronically, shifting from the current manually filled Scan registers since a number of problems had been faced by them.

There are two solutions that have been provided to RHF. Firstly, a custom built application that could be installed on portable devices which could be Android tablets, smart phones, etc. The application offers the currently used Quality Scan registers in electronic form.

Secondly, the development of a new module in the existing MIS application (.NET) which could enable the doctors to electronically fill Quality Scan registers using directly the web application.

In addition to it, the solutions are operated in such manner that either doctors fill quality scans over tablets and synchronize the data directly in the existing MIS Quality module or populate quality data by accessing MIS application via front end.

Moreover, the application enables the doctors to populate data scans in offline mode considering GPRS/EDGE/Wi-Fi connectivity on site will be mostly unavailable. Thus, each entry while populating Quality scan gets auto saved in memory, just in case the device becomes unusable or unresponsive.

The solution enables the doctors to carry the devices while they are on a clinic visit and perform Quality scan by populating scores in the application which was deployed on tablet or phone, summarized from listing all questions or indicators that were marked with N/A. Then, the score sheet is required at the end of each scan. Besides, the action plan form needed at the closure stage of scan will be electronically filled by visiting doctors and clinic authorized personnel will sign it.

In addition to 4 quarterly scans, unlimited number of follow up scans can be easily carried out through this approach. Upon returning to district office or wherever they get data connectivity via EDGE/GPRS/Wi-Fi, synchronization will be run, which will update the web based MIS application database.

Finally, the reports will be maintained in the existing  MIS application which will include historical quality scans reports, historical quality scan trends, doctors performance reports, clinics performance reports, and schedule/calendar of upcoming scans to be done by doctors by districts.

Results

RHF experiences tremendous results having shifted from the manually filled scan registers to the automated systems. It can process information much more rapidly than human beings. An automated system’s response is faster and hence prevents mishaps and other risks.

Moreover, the problem of repetition has been resolved. An automated system can do the same job over and over again without the risks of error and inaccuracy which leads to the proper accomplishment of the duties. Automated systems are accurate and follow precise instructions without error.

As a result, MSS remains committed to provide highest quality reproductive health services to women and couples across peri-urban, rural and remote communities of Pakistan.

Moreover, MSS scored above 97% Quality Technical Assistance audit score also known as the QTA score for maintaining highest clinical standards and providing quality services across all its service delivery channels including 82 Behtar Zindagi Centres, 14 Outreach teams, 1 Mother and Child Health Centre and over 300 Suraj social franchises.

Today, MSS Pakistan provides reproductive health information and services to some 40 million persons across the country. The quality, dedication and ability of its team members are central to its continued growth and success.

Conclusion

In the present world of rapid technological changes, there is an urgent demand for the very best quality products or services that can only be supplied by a high level of productivity which requires automated systems and processes.

There is no doubt that manual tasks take time. They have to be performed linearly by humans who are prone to errors and who are unable to consistently perform to the highest standards.  Process automation reduces the time it takes to achieve a task, the effort required to undertake it and the cost of completing it successfully.

Automation not only ensures systems run smoothly and efficiently, but that errors are eliminated and that your best practices are constantly leveraged. It reduces the number of tasks you and your employees would otherwise need to do manually.

In a nutshell, the success of the sustained businesses is dependent on their competitive advantages. Automation frees up the time to work on items that add genuine value to the business, allowing a business to be more innovative and increasing their employees’ levels of motivation.

 

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