Emerging Project Lessons
It’s important to recognize the training needs of VHCs, clinical staff, and project staff and partners:
- A dedicated implementation team training is invaluable to ensure commitment and focus on a very complex project multiple components. CARE has had some staff turnover and observed gaps in skills as the project has unfolded, and then moved to try to address these. One 2 day team building session was held in June. It has been important to create a team spirit between the field staff at the hub clinic and Yavatmal and the referral center in Nagpur, as well as to the project management oversight in Hyderabad, and the software vendor in Bangalore and the research partner in Chennai.
- Targeting capacity building is necessary depending on gaps observed (clinical operations, insurance concepts, project management, etc.) In particular, for many, insurance is very new, and they need sufficient training and exposure to the concept. Insurance is not a core competency of CARE, so this must be built.
Contingency plans should be considered for all key inputs to the project: technology, insurance literacy, clinical staff and clinic operations, VHC hiring and training, etc. Without these in place, and constant oversight, project delays can be more likely. The delays documented with respect to the HHD and the development of an insurance literacy program demonstrates this point.
Development of systems and procedures to handle servicing of non-insured clients requires separate consideration(e.g. what kind of registration is needed for clients who do not have an identification card?). The HHD generates a unique identification number even for non- insured clients. Because all encounters and transactions get recorded, it can be possible to analyze even follow up visits and understand the health seeking behavior and costs of non-insured clients, and to use the data to support appropriate conversion to insurance at a later date.
Establishing a new distribution channel may sound like a good solution to increase enrolment, but developing a financially viable channel is another matter. On the surface, the potential outreach of the Dairy Cooperative Society in Yavatmal District was attractive – but CARE could not offer an incentive payment rich enough to interest this prospective partner.
Date of last Learning Journey update: April 2012