Post on 17-Jan-2015
description
BRACs Tuberculosis ProgramPioneering DOTS Treatment for TB in Rural Bangladesh
By- POWER WALL
FRAMEWORK
BRAC
SituationAnalysis
StrategyFormulation
StrategicImplementati
on
Strategic Control
ConflictManagement
OVERVIEW• Bangladesh is bordered by India on all sides, Burma
(Myanmar) on the southeast and the Bay of Bengal to its south.
• 7 administrative divisions• Divisions are subdivided into districts (zila). There are
64 districts in Bangladesh, each further subdivided into upazila (subdistricts) or thana.
• Highest Population Density in 2001• 240,000 km roadway- 90% unpaved
HEALTH PROFILE
• Tuberculosis Prevalence – 391 Per 100,000 People
(2006)
• Maternal Mortality Ratio – 570 per 100,000
Population (2005)
• Infant Mortality Rate – 43 Per 1000 Population(2008)
• HIV prevalence – 100 Per 100,000 population (2005)
• Malaria Cases – 19 Per 1,000 People (2006)
HEALTH DELIVERY SYSTEM• Four Tier System
- Village ( Quacks, Other informal Health care Provider )- Union ( 1362 Sub centres )- UpZilla ( Sub district ) – 460 Upzilla Health Complexes- Zilla ( District ) – 59 Districts Hospitals
• There are 7 specialized Hospitals• Physician density-3 per 10,000• Nursing density- 3 per 10,000• Hospital beds- 4 per 10,000
EXTERNAL ANALYSISSOCIAL
53%- literacy rate (Bangladesh)50% - Poverty rate,BPL Population-5 millionFemale population restriction from working outsideSocial Myth & wrong belief about TBMyth about government and private facilities200 million TB patients registered every year globally- 3,40,000 in B’deshReduced access to healthcare-women Dual Infection of TB-HIV
ECONOMIC
GDP per capita in PPP(07)- 1178Government expenditure on health-7.2% (07)International donor agenciesInflation
POLITICO-LEGAL
Stability of government- National TB programmeInternational relations- World Bank, WHO supportTax lawsLabor laws
TECHNOLOGICAL
Information & Communication Technology-E-health, mhealth, Telemedicine advances for diagnostic and TreatmentElectronic Health Records
INTERNAL ANALYSISMARKETING
Tie up with private practitioner and medical collegesTie ups with garment districts- export processing zonesIndividual factory ownersPrisons
OPERATIONS
Smear positive- approachResearch and evaluation division
HUMAN RESOURCE
Involving traditional doctors and mid wives with social legitimacyShasthya sebika programPerformance based incentivesTraining programs
FINANCE
Government Funding Global Fund 10 % profit margin for volunteers
SWOT ANALYSIS STRENGTHS
Community based delivery systemVillage health volunteers-shasthya sebikasUnique incentivesOwned Laboratory facilitiesReferral LinkagesBond SystemStandardisationBRAC-NTP partnershipFinancially stable
WEAKNESSES
Drop outsLoss to follow upCase detection rateUnderstanding of DOTS administration by shebikasLack of human resourceLow success rate in women
OPPORTUNITIESSupport of Govt. policiesMore service delivery pointsCatchment area- 30 million peopleMDR-TB diagnostic labQuality assurance centersCapacity BuildingAwareness programs
THREATSSocio-cultural barriersGeographic inaccessibilityResistance from district level officialsDuplication of programme
TOWS MATRIX
Internal strengths + External Opportunities 16
Internal Weakness + External Opportunities 13
External Threats + Internal Strengths 13
External Threat + Internal Weakness 10
STRATEGIES
1) Related Diversification Laboratories Doctors Group Chest Clinics Home based Care Ambulatory Care
2) Market Penetration Awareness campaigns Art workshops
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4.3
Space profile for BRAC’s Tuberculosis in Rural Bangladesh
Environmental stability
competitive ad-vantage
Aggressive Profile
industry strength
financial strength
An organization whose financial strength is a dominating factor in the industry segment
Strategic Alternatives for Aggressive profiles
Related diversificationVertical IntegrationProduct developmentMarket Development
VISION
BRAC’s Vision is to make sustainable improvement in the quality of life for the poor by working with the community and focusing on increasing autonomy.
MISSION
BRACs mission is to work towards Prevention and Treatment of Tuberculosis by providing standard and sustainable services which are accessible and affordable
GOAL
The Goal of BRACs is to Combat High Prevalence of Tuberculosis.
OBJECTIVES• To this model 50% self sustainable by the year
2000• To Make 14 million women learn How to make ORS
by the year 1990.• To Train village Health volunteer to Provide basic
diagnostic and curative services• To reduce the prevalence of Tuberculosis in
Bangladesh to 300 per 100,000 population by 2005• To increase the number of Shasthya Sebika to
70000 by the year 2007
• To work in conjunction with Government for Tuberculosis programme .
• To increase the case detection rate to 90 % by the year 2007.
• To increase the treatment success rate to 95% by the year 2007.
Strategic Control
FrameworkInvolve Think TankEstablish standardsMeasure and compare performanceDetermine reasons for deviationCorrective action
Conflict Management
Interpersonal conflict- Due to miscommunication, Intense work ,
overlapping tasks , compensation.Solution-By clearly defining job responsibilities with
least overlapping of tasks. Proper mode of communication
Who moved my cheese?
• Abreast with Technology- ICT• Slow continuous process• Simulation Exercises