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সেবার মানের দৃশ্যমান উন্নয়ন সাধনের...

Background The Management Information System (MIS) unit of the Directorate General of Health Services (DGHS) has launched a...

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সেবার মানের দৃশ্যমান উন্নয়ন সাধনের স্বীকৃতিস্বরুপ বিভিন্ন সরকারী হাসপাতাল ও স্বাস্থ্য ব্যবস্থাপকের অফিস পেলো স্বাস্থ্যমন্ত্রী জাতীয় পুরস্কার ২০১৮

Background

The Management Information System (MIS) unit of the Directorate General of Health Services (DGHS) has launched a performance management initiative for improvement of health services in the public health sector. The Government of Bangladesh has taken the initiative to measure performance, to rank and to reward the different tiers of health facilities since 2014. The World Health Organization (WHO) has been providing technical assistance in the conceptualization and development of the initiative which are aligned with the health systems building blocks and the results chain analytical frameworks. An online system for measurement and scoring is now accessible to all through a real time dashboard. Different partners such as UNICEF, icddr,b and Health Information System Program (HiSP) Bangladesh have been supporting the initiative along with WHO.

The initiative is being supported by WHO Country Office in Bangladesh under the biennium 2018-2019 under the Health System Strengthening program, which follows the principles of 6 health systems building blocks of WHO, viz., (i) health services; (ii) supplies of medicines, equipment, and technologies; (iii) health workforce; (iv) health financing; (v) health information system; and (vi) leadership and governance.

The incentive to the participating hospitals was the Health Minister National Award to be accorded to the best performing hospitals and health managers. Certain areas, which commonly do not require external interventions, have been chosen for making visible change. These areas include cleanliness, staff punctuality, placement of appropriate display boards and patient guidance signs, good behavior with patients, improving laboratory services, waste management, reducing weighting time at the outpatient department, improvement of overall hospital service, updating data in the online reporting systems, holding monthly staff meeting and follow-up of the decisions made in the past meetings, etc. The Health Minister National Award was first introduced in 2014 under WHO biennium 2013-2014. This report is on this ranking of the government hospitals for 2017.

Procedure of hospital ranking for 2017

A total of 68 public health facilities were nominated both physical assessment and patient satisfaction survey out of 511 public health facilities in the country which was carried out to see the actual situation and validation of data.

Out of 68, 44 Upazila health complex (UHC), 17 district hospital (DH), three medical college hospital (MCH) one specialty post-graduate institute & hospital (SpH) have been short listed on the basis 60% score out of 100 (aggregated scores of on-line and onsite). No district hospital was short listed due to attain minimum 60% score of (combined score of online and onsite). 34 assessors (Government officials from different departments, such as, MIS; Medical Education; and Hospital & Clinics; Community based health services; officers from respective divisional health offices and development partners and WHO) during the month of November and December 2017.

In physical verification visits, assessors checked and verified 243 indicators for UHC, 260 indicators for DH, 265 indicators for medical college hospital (MCH), and 244 indicators for specialty post-graduate institute & hospital (SpH). Separate patient satisfaction survey on outdoor and indoor patients was also done. The physical verifications were “joint assessments” between the external evaluators and local authorities and supervisors; the evaluation sheets have been countersigned by the local and supervising authorities on both the completed checklists and survey questionnaires.

HSS core committee

A meeting was held on 05-Feb-2018 at the MIS resource center, DGHS. Director, MIS Dr Ashish Kumar Saha was the chair of the meeting. The preliminary results of Health Minister’s National Award 2017 result was presented to the meeting including the description of shortlisting and compilation of the final score according the category of awards. The members of the committee reviewed the total process of scoring mechanism and the list of health facilities in each category. The members recommended the result as acceptable and finally endorsed it.


 

A. Result 2017 (National Award)

 

Table 1. Category of award: Upazila Health Complex (Top 5)

Facility name

District

Division

Total Score

Facility score (100)

PAT (150)

PST (50)

Rank

Chowgacha Upazila Health Complex

Jessor

Khulna

240.51

69.45

146.30

24.76

1

Keshabpur Upazila Health Complex

Jessor

Khulna

240.38

68.46

146.91

25.00

2

Wazirpur Upazila Health Complex

Barisal

Barisal

232.90

66.68

140.74

25.48

3

Iswardi Upazila Health Complex

Pabna

Rajshahi

229.18

65.08

139.81

24.29

4

Kumarkhali Upazila Health Complex

Kustia

Khulna

227.57

65.96

138.27

23.33

5

 

Table 2. Category of award: District Hospital (Top 5)

Facility name

District

Division

Total Score

Facility score (100)

PAT (150)

PST (50)

Rank

Narsingdi 100 bed district hospital

Narsingdi

Dhaka

236.39

63.94

147.69

24.76

1

Narsingdi district hospital

Narsingdi

Dhaka

235.51

66.41

144.81

24.29

2

250 beded general hospital

Jessore

Khulna

230.11

67.99

137.60

24.52

3

Pabna 250 bed general hospital

Pabna

Rajshahi

228.04

63.61

139.90

24.52

4

Kurigram district hospital

Kurigram

Rangpur

226.18

62.75

139.62

23.81

5

Table 3. Category of award: Medical College Hospital (Top 3)

Facility name

Division

District

Total Score

Facility score (100)

PAT (150)

PST (50)

Rank

Shaheed Suhrawardy Medical College Hospital

Dhaka

Dhaka

220.97

60.00

138.11

22.86

1

M Abdur Rahim Medical College Hospital

Rangpur

Dinajpur

211.53

61.99

126.51

23.04

2

Dhaka Medical College Hospital

Dhaka

Dhaka

208.35

66.11

121.70

20.54

3

 

 

 

Table 4. Category of award: Specialty post graduate Institute hospital

Facility name

Division

District

Total Score

Facility score (100)

PAT (150)

PST (50)

Rank

National Institute of Neuroscience & Hospital

Dhaka

Dhaka

198.14

63.29

113.42

21.43

1

 

Table 5. Category of award: Community Health Services (Top 5)

Facility name

District

Division

Total Score

Rank

Amtali Upazila

Barguna

Barisal

91.68%

1

Bamna Upazila

Barguna

Barisal

91.45%

2

Monpura Upazila

Bhola

Barisal

90.57%

3

Wazirpur Upazila

Barisal

Barisal

89.46%

4

Ramgarh Upazila

Khagrachari

Chittagong

88.86%

5

 


 

B. Result 2017 (Divisional Award)

 

Table 6. Category of award: Upazila Health Complex

Facility name

District

Division

Total Score

Facility score (100)

PAT (150)

PST (50)

Rank

Lalmohan Upazila Health Complex

Bhola

Barisal

218.48

63.19

131.48

23.81

Champion

Banaripara Upazila Health Complex

Barisal

Barisal

209.36

61.14

123.46

24.76

Runner Up

Saharasti Upazila Health Complex

Chandpur

Chittagong

219.36

64.59

130.25

24.52

Champion

Patiya Upazila Health Complex

Chittagong

Chittagong

200.28

67.30

109.88

23.10

Runner Up

Sibpur Upazila Health Complex

Norsingdi

Dhaka

205.52

64.51

123.15

17.86

Champion

Dhamrai Upazila Health Complex

Dhaka

Dhaka

200.66

67.43

108.95

24.29

Runner Up

Kotchadpur Upazila Health Complex

Jhenaidah

Khulna

223.19

64.98

134.88

23.33

Champion

Shailkupa Upazila Health Complex

Jhenaidah

Khulna

221.54

64.02

133.95

23.57

Runner Up

Nandail Upazila Health Complex

Mymensingh

Mymensingh

213.69

67.26

125.00

21.43

Champion

Kazipur Upazila Health Complex

Sirajganj

Rajshahi

207.57

60.67

128.09

18.81

Champion

 


 

 

Table 7. Category of award: District Hospital (Divisional Champion)

Facility name

District

Division

Total Score

Facility score (100)

PAT (150)

PST (50)

Rank

Pirojpur District Hospital

Pirozpur

Barisal

225.82

69.72

130.38

25.71

Champion

Moulvibazar 250 bed district hospital

Moulavibazar

Sylhet

224.17

62.85

138.46

22.86

Champion

Lakshmipur District Hospital

Laxmipur

Chittagong

222.26

64.80

132.69

24.76

Champion

Jhenaidah District Hospital

Jhenaidah

Khulna

220.87

67.10

130.67

23.10

Champion

Panchagarh District Hospital

Panchagarh

Rangpur

206.04

66.36

120.87

18.81

Champion

Tangail District Hospital

Tangail

Dhaka

202.78

63.89

123.17

15.71

Champion

 

Table 8. Category of award: Community Health Services (Divisional Champion)

Facility name

District

Division

Total Score

Tarail Upazila

Kishoreganj

Dhaka

87.36%

Shyamnagar Upazila

Satkhira

Khulna

87.17%

Durgapur Upazila

Netrokona

Mymensingh

87.16%

Debiganj Upazila

Panchagharh

Rangpur

85.71%

Patharghata Upazila

Barguna

Barisal

85.03%

Biswambarpur Upazila

Sunamganj

Sylhet

84.95%

Kazipur Upazila

Sirajganj

Rajshahi

84.72%

Raipur Upazila

Lakshmipur

Chittagong

80.08%

 

 

 

Table 9. Category of award: Civil Surgeon Office (Top 5)

Office

District

Division

Total Score

Rank

Civil surgeon office

Jessore

Khulna

85.65

1

Civil surgeon office

Chuadanga

Khulna

84.48

2

Civil surgeon office

Panchagarh

Rangpur

82.21

3

Civil surgeon office

Jhenaidah

Khulna

81.64

4

Civil surgeon office

Narsingdi

Dhaka

79.51

5

 

 

Table 10. Category of award: Divisional Health Office (Champion and Runner up)

Office

Division

Total Score

Rank

Divisional health office

Khulna

73.51

1

Divisional health office

Rajshahi

68.17

2

 

Performance measurement

Health system is a set of interconnected parts that must function synergistically broadly to secure more equitable and sustained improvement across health services and better health outcome. The initiative, through the cycle of assessment and measurement and finally rewarding, was an attempt to effectively managing and strengthening interactions of six health system building blocks (WHO’s health system framework); and ultimately promote improved health, responsiveness, social and financial risk protect and improved efficiency. The tools for physical verification used to measure how much the facility is ready to deliver required services safely with quality and with minimum waste of resources; what are the drivers of good performance and where is the weakness to develop health workforce and other key resources; mobilize and allocate finances, and ensure leadership and governance. The conducted patient exit survey has documented the extent of the health facility service meeting the expectation of the population.

The full mark for evaluation was 300. This was divided into four components -

Table 11.

Tools of measurement

Scores

Percentage

Online

80

26.70

Onsite monitoring

20

06.70

Physical assessment tool (PAT)

150

50.00

Patient satisfaction tool (PST)

50

16.60

Total

300

100.00

Ranking and awards for 2017

Three categories of awards proposed: a) national and divisional award for top ranking or best health facility b) national awards and divisional awards for top ranking community health services c) national awards for top ranking civils surgeon and divisional office.

The facility awards have been calculated upon aggregation of the scores across all four tools. For community health service one year data from community clinics and field were collected from DHIS2 and average score was calculated. Civil surgeon office data has been be estimated from the average scores of online, onsite and community health service of duration of 12 month for the facilities under his jurisdiction. Similar estimation has been done for divisional office.

A total of 50 awards and certificates have been proposed according to the top scores in national and divisional category. The awards for community health services have been proposed for national and divisional category. The best civil surgeon office and divisional office and top tertiary hospital and specialized post graduate institute have been proposed for national award.

Table 11. National awards

Health facility

Number of awards

Top three medical college hospital (MCH)

03

Top one specialty post-graduate institute & hospital (SpH)

01

Top five district hospital (DH)

05

Top five upazila health complex (UHC)

05

Community health service (CHS)

05

Divisional health office (DHO)

02

Civil surgeon office (CSO)

05

Table 12. Divisional awards

Health facility

Number of awards

Top eight   district hospital (DH)- one from each division

08

Top 16 upazila health complexes (UHC)- two per division

16

Based on the final score, the ranking of all the physically verified hospitals in each category has been made. The ranking for year 2017 has been made as follows:

Name of short-listed facilities

Division

District

Code

Type

Name of facility

Barisal

Barisal

10001966

UHC

Banaripara Upazila Health Complex

Barisal

Barisal

10001997

UHC

Wazirpur Upazila Health Complex

Barisal

Bhola

10002002

DH

Bhola District Hospital

Barisal

Bhola

10002006

UHC

Charfession Upazila Health Complex

Barisal

Bhola

10002015

UHC

Lalmohan Upazila Health Complex

Barisal

Pirojpur

10002067

DH

Pirojpur District Hospital

Chittagong

Chandpur

10000727

UHC

Saharasthi Upazila Health Complex

Chittagong

Chittagong

10000740

UHC

Boalkhali Upazila Health Complex

Chittagong

Chittagong

10000756

MCH

Chittagong Medical College Hospital

Chittagong

Chittagong

10000802

UHC

Patiya Upazila Health Complex

Chittagong

Comilla

10000875

UHC

Daudkandi Upazila Health Complex

Chittagong

Comilla

10000914

UHC

Titas Upazila Health Complex

Chittagong

Lakshmipur

10001001

DH

Lakshmipur District Hospital

Dhaka

Dhaka

10000033

MCH

Dhaka Medical College Hospital

Dhaka

Dhaka

10000064

UHC

Dhamrai Upazila Health Complex

Dhaka

Dhaka

10000069

UHC

Dohar Upazila Health Complex

Dhaka

Dhaka

10017210

SpH

National Institute of Neuro Sciences & Hospital

Dhaka

Dhaka

10000080

UHC

Nawabganj Upazila Health Complex

Dhaka

Gazipur

10000144

UHC

Kaliganj Upazila Health Complex

Dhaka

Kishorgonj

10000243

DH

Kishorganj 250 Bed District Sadar Hospital

Dhaka

Munshiganj

10000328

DH

Munshiganj District Hospital

Dhaka

Narsingdi

10000453

DH

Narsingdi 100 Bed Zilla Hospital

Dhaka

Narsingdi

10000452

DH

Narsingdi District Hospital

Dhaka

Narsingdi

10000461

UHC

Shibpur Upazila Health Complex

Dhaka

Rajbari

10000505

UHC

Baliakandi Upazila Health Complex

Dhaka

Rajbari

10000508

UHC

Goalanda Upazila Health Complex

Dhaka

Rajbari

10000518

UHC

Pangsha Upazila Health Complex

Dhaka

Rajbari

10000536

DH

Rajbari District Hospital

Dhaka

Tangail

10000647

DH

Tangail 250 Bed District Hospital

Khulna

Bagerhat

10001701

UHC

Fakirhat Upazila Health Complex

Khulna

Chuadanga

10001719

UHC

Alamdanga Upazila Health Complex

Khulna

Chuadanga

10001723

DH

Chuadanga District Hospital

Khulna

Jessore

10001737

UHC

Abhoynagar Upazila Health Complex

Khulna

Jessore

10001741

UHC

Bagherpara Upazila Health Complex

Khulna

Jessore

10001744

UHC

Chowgacha Upazila Health Complex

Khulna

Jessore

10013096

DH

Jessore 250 bed General Hospital

Khulna

Jessore

10001759

UHC

Jhikargacha Upazila Health Complex

Khulna

Jessore

10001760

UHC

Keshabpur Upazila Health Complex

Khulna

Jessore

10001763

UHC

Monirampur Upazila Health Complex

Khulna

Jhenaidah

10001771

UHC

Harinakunda Upazila Health Complex

Khulna

Jhenaidah

10001776

DH

Jhenaidah District Hospital

Khulna

Jhenaidah

10002213

UHC

Kaliganj Upazila Health Complex

Khulna

Jhenaidah

10001780

UHC

Kotchandpur Upazila Health Complex

Khulna

Jhenaidah

10001785

UHC

Moheshpur Upazila Health Complex

Khulna

Jhenaidah

10001790

UHC

Shailkupa Upazila Health Complex

Khulna

Khulna

10001824

UHC

Paikgacha Upazila Health Complex

Khulna

Kushtia

10001848

UHC

Kumarkhali Upazila Health Complex

Khulna

Satkhira

10001928

UHC

Shyamnagar Upazila Health Complex

Mymensingh

Mymensingh

10000404

UHC

Nandail Upazila Health Complex

Rajshahi

Bogra

10001111

MCH

Shaheed Ziaur Rahman Medical College Hospital

Rajshahi

Joypurhat

10001289

UHC

Akkelpur Upazila Health Complex

Rajshahi

Joypurhat

10001303

UHC

Khetlal Upazila Health Complex

Rajshahi

Naogaon

10001394

DH

Naogaon District Hospital

Rajshahi

Naogaon

10001402

UHC

Patnitala Upazila Health Complex

Rajshahi

Pabna

10001482

UHC

Iswardi Upazila Health Complex

Rajshahi

Pabna

10001484

DH

Pabna 250 bed General Hospital

Rajshahi

Sirajganj

10001624

UHC

Belkuchi Upazila Health Complex

Rajshahi

Sirajganj

10001633

UHC

Kazipur Upazila Health Complex

Rangpur

Dinajpur

10001193

UHC

Birganj Upazila Health Complex

Rangpur

Dinajpur

10001224

UHC

Ghoraghat Upazila Health Complex

Rangpur

Dinajpur

10002288

MCH

M Abdur Rahim Medical College Hospital

Rangpur

Kurigram

10001317

DH

Kurigram District Hospital

Rangpur

Panchagarh

10001506

UHC

Debiganj Upazila Health Complex

Rangpur

Panchagarh

10001514

DH

Panchagarh District Hospital

Sylhet

Maulvibazar

10002096

UHC

Barlekha Upazila Health Complex

Sylhet

Maulvibazar

10002116

DH

Moulvibazar 250 bed District Sadar Hospital

Sylhet

Sylhet

10002195

MCH

Sylhet MAG Osmani Medical College Hospital

*Individual facility score is above 200 (total score 300) for all except SpH. CHS, CSO and DHO have been calculated by taking one year average scores of online data + community health services report to UHC (ANC-1, exclusive breast feeding , BCG coverage , fully vaccinated child , % of CC reporting )