Frame Work
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Frame Work
Results Framework Matrix
| Program Development Objective: To improve quality of care, strengthen the management of NCDs and injuries and reduce inequities in reproductive and child health services in TN. | |||||||||
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| These results are at | Program Level | ||||||||
| Program Development Objective Indicators | |||||||||
| S.No | Indicator Name | DLI# | Unit of Measurement | Baseline | Cumulative Target Values | ||||
| YR1 | YR2 | YR3 | YR4 | YR5 | |||||
| 1 | Increased number of public facilities with quality certification (primary, secondary, and tertiary) Tertiary = medical colleges Secondary = District, Taluk, and non-Taluk hospitals Primary = PHCs and CHCs Priority districts: Ariyalur, Dharmapuri, Ramanathapuram, The Nilgris, Theni, Thoothukkudi, Tirunelveli, Tiruvannamalai, Virudhunagar |
2 | Number | Tertiary facilities with entry level NABH certification | Tertiary facilities with entry level NABH certification | Tertiary facilities with entry level NABH certification | Tertiary facilities with entry level NABH certification | Tertiary facilities with entry level NABH certification | Tertiary facilities with entry level NABH certification |
| 0 | 0 | 0 | 2 | 4 | 7 | ||||
| Secondary facilities with NQAS certification | Secondary facilities with NQAS certification | Secondary facilities with NQAS certification | Secondary facilities with NQAS certification | Secondary facilities with NQAS certification | Secondary facilities with NQAS certification | ||||
| 0 | 34 of which 9 are in the priority districts | 34 of which 9 are in the priority districts | 54 of which 13 are in the priority districts | 54 of which 13 are in the priority districts | 75 of which 15 are in the priority districts | ||||
| Primary facilities with NQAS certification | Primary facilities with NQAS certification | Primary facilities with NQAS certification | Primary facilities with NQAS certification | Primary facilities with NQAS certification | Primary facilities with NQAS certification | ||||
| 0 | 11 of which 3 are in the priority districts | 71 of which 13 are in the priority districts | 141 of which 30 are in the priority districts | 221 of which 50 are in the priority districts | 300 of which 60 are in the priority districts | ||||
| 2 | Improved scores in quality dashboard for primary, secondary, and tertiary facilities | % | NA – to be established after quality dashboard is established | To be established | To be established | To be established | To be established | To be established | |
| 3 | Increased screening in public sector facilities for cervical and breast cancers | % | Cervical Cancer: 15.8% Breast Cancer: 19.5% | Cervical Cancer: 18% Breast Cancer: 22% | Cervical Cancer: 21% Breast Cancer: 24% | Cervical Cancer: 24% Breast Cancer: 26% | Cervical Cancer: 27% Breast Cancer: 28% | Cervical Cancer: 30% Breast Cancer: 30% | |
| 4 | Increased share of adults with hypertension or diabetes whose blood pressure or blood sugar are under control | 3 | % | NA – to be established after STEPS is implemented in 2019 | --- | NA – to be established after STEPS is implemented in 2019 | --- | Hypertension under control: 3 percentage point increase from baseline Diabetes under control: 6 percentage point increase from baseline | |
| 5 | Improved provision of quality trauma care services | 4 | Number % | # of trauma centers using trauma registry: 0 % of surgical ED admissionsa: 6.7% % of IFT calls as a % of total 108 system calls: 41.1% |
1 trauma center % of surgical ED admissions: 6.7% % of IFT calls: 41.1% |
11 trauma centers % of surgical ED admissions: 8% % of IFT calls: 38% |
24 trauma centers % of surgical ED admissions: 10% % of IFT calls: 35% |
39 trauma centers % of surgical ED admissions: 12% % of IFT calls: 32% |
54 trauma centers % of surgical ED admissions: 15% % of IFT calls: 30% |
| a % of surgical emergency department (ED) admissions in Group A and B facilities who received surgery within 6 hours of admission in the same institution | |||||||||
| 6 | Increased utilization of reproductive & child health services in priority districts | 5 | % | Full ANCa: 28.8% Fully immunizedb: 57.9% mCPRc: 38.5% |
--- | --- | Full ANC: 36.3% Fully immunized: 65.4% mCPR: 41.5% |
--- | Full ANC: 41.3% Fully immunized: 70.4% mCPR: 43.5% |
| a. Full antenatal care (ANC): Pregnant women receiving at least four ANC visits, at least one TT injection, and taken IFA tablets or syrup for 100 or more days b. Full immunization: Children 12-23 months receiving vaccinations against tuberculosis, diphtheria, pertussis, tetanus, polio, and measles c. Modern contraceptive prevalence rate (mCPR). Modern methods include male and female sterilization, injectables, intrauterine devices (IUDs/PPIUDs), contraceptive pills, implants, female and male condoms, diaphragm, foam/jelly, the standard days method, the lactational amenorrhoea method, and emergency contraception. |
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| Intermediate Indicators | |||||||||
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| S.No | Indicator Name | DLI# | Unit of Measurement | Baseline | YR1 | YR2 | YR3 | YR4 | YR5 |
| 1 | Implementation of quality improvement interventions in primary, secondary, and tertiary care facilities | 1 | Number | Numberof primary, secondary, and tertiary level facilities implementing at least 1 endorsed quality improvement initiative from the list of evidence-based interventions specified in the QoC Strategy: 0 Number of primary, secondary, and tertiary facilities reporting on quality dashboard quarterly: 0 |
--- | Number of facilities implementing at least 1 endorsed quality improvement initiative from the list of evidence-based interventions specified in the QoC Strategy: Primary: 142 Secondary and tertiary:62 |
Number of facilities implementing at least 1 endorsed quality improvement initiative from the list of evidence-based interventions specified in the QoC Strategy: Primary: 284 Secondary and tertiary:124 Number of facilities reporting on quality dashboard quarterly: Primary: 190 Secondary and tertiary: 83 |
Number of facilities implementing at least 1 endorsed quality improvement initiative from the list of evidence-based interventions specified in the QoC Strategy: Primary: 427 Secondary and tertiary:186 Number of facilities reporting on quality dashboard quarterly: Primary: 380 Secondary and tertiary: 166 |
Number of facilities implementing at least 1 endorsed quality improvement initiative from the list of evidence-based interventions specified in the QoC Strategy: Primary: 570 Secondary and tertiary:248 Number of facilities reporting on quality dashboard quarterly: Primary: 570 Secondary and tertiary: 248 |
| 2 | Piloting of patient experience questionnaire for secondary & tertiary care facilities | % | 0% | --- | --- | 5% | 7% | 10% | |
| 3 | Implementation of updated social and behavior change communication (SBCC) strategy | Text | N | N | Y | Y | Y | Y | |
| 4 | Increased share of primary and secondary facilities with at least one staff trained on mental health | % | 0% | --- | 5% | 20% | 30% | 40% | |
| 5 | Establishment of suicide hotline | Text | N | N | Y | --- | --- | --- | |
| 6 | Better equipped ambulance system to improve pre-hospital care - number of ATLS ambulances providing Level 1 care | Number | 64 | 75 | 100 | 125 | 150 | 164 | |
| 7 | Improved capacity of trauma care providers - number of emergency department providers that received Level 3 (BTLS) and Level 4 training (ATLS) | Number | Level 3: Nurses – 165 Doctors – 100 Level 4: Nurses – 0 Doctors – 0 |
Level 3: Nurses – 1500 Doctors – 700 Level 4: Nurses – 150 Doctors – 70 |
Level 3: Nurses – 3000 Doctors – 2000 Level 4: Nurses – 300 Doctors – 200 |
Level 3: Nurses – 5000 Doctors – 3500 Level 4: Nurses – 500 Doctors – 350 |
Level 3: Nurses – 7000 Doctors – 5000 Level 4: Nurses – 700 Doctors – 500 |
Level 3: Nurses – 9000 Doctors – 6000 Level 4: Nurses – 900 Doctors – 600 |
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| 8 | Strengthenedcontent, quality, accessibility, and use of data for decision making | 6 | Text | Conceptual Model and Operational Plan for a strengthened and integrated Health Management Information System (HMIS): N | Conceptual Model and Operational Plan for a strengthened Health Management Information System (HMIS) covering all data sources, data users and data channels including integration with electronic medical records and patient tracking for NCDs: Y | Detailed data model and detailed design specifications completed: Y | Contract awarded for development of integrated HMIS, and key modules (electronic health record and reporting) piloted in at least 1 primary, 1 secondary, and 1 tertiary facility in a district: Y | Integrated system implemented in all the health facilities of at least one district: Y | Integrated system implemented in all the health facilities in 9 districts: Y |
| 9 | Strengthenedcoordination, integration, performance-based management, learning, and other cross-cutting functions for better results | 7 | Text | Policies/Strategies Adopted: N | Development and Adoption of TN Health Policy/ Strategy for Vision 2030: Y Development and adoption of an Environment Strategy for the Health Sector in Tamil Nadu: Y | Operational research program launched with 1 annual call for research proposals issued and selected proposal awarded: Y (ii) Deploying e-procurement system in TNMSC and 20% of value of total contracts of TNMSC under the Program done through e-procurement: Y |
1 annual call for research proposals issued and selected proposalawarded: Y | (i) 1 annual call for research proposals issued and selected proposal awarded | (i) 1 annual call for research proposals issued and selected proposal awarded (ii)Development & adoption of performance-based incentive strategy for PHCs: Y |
| 10 | Increased transparency and accountability through citizen engagement (voice, agency and social accountability) | 8 | Text % Number | Districts conducting Health Assembly: 0% State Health Assembly: 0 |
Districts conducting Health Assembly: 0% State Health Assembly: 0 |
Districts conducting Health Assembly: 10% State Health Assembly: 1 |
Districts conducting Health Assembly: 20% State Health Assembly: 1 |
Districts conducting Health Assembly: 40% State Health Assembly: 1 |
Districts conducting Health Assembly: 60% State Health Assembly: 1 |