How motivation can fix public systems | Abhishek Gopalka
New Section
The speaker introduces the concept of improving public healthcare in Rajasthan, India, emphasizing the importance of motivation in driving change within the health system.
Prioritizing Citizen Motivation
- Motivation is identified as a crucial factor for change within the healthcare system.
- Human desire to shine in society is highlighted as a key motivator.
- The focus shifts towards leveraging citizen involvement to trigger motivation for healthcare transformation.
Transforming Public Health System
The dire state of Rajasthan's public health system is outlined, emphasizing the need for accountability and citizen-centric approaches to drive improvement.
Accountability Crisis in Healthcare
- Neonatal mortality rate in Rajasthan is significantly higher than that of developed countries like the UK.
- Lack of accountability leads to patient distrust and loss of faith in the public health system.
- A case study illustrates how systemic failures impact individuals seeking healthcare services.
Introducing Data-driven Accountability
- Data-driven reviews are implemented to enhance accountability but yield no significant changes.
- Recognizing the dilution of accountability to citizens, a shift towards involving citizens through promises is proposed.
Citizen Promises for Change
The strategy of utilizing citizen promises to enhance accountability and motivate positive change within the public health system is introduced.
Implementing Citizen Promises
- Drawing inspiration from commercial strategies, citizen promises are displayed at PHCs to ensure service delivery.
- Elected representatives play a role in promoting these promises within communities, fostering accountability and transparency.
- Public commitment drives improvements such as increased doctor availability and enhanced patient visits.
Enhancing Administrative Support
Addressing challenges related to resource allocation and administrative support within the healthcare system through innovative strategies.
Administrative Empowerment
- Resource constraints hinder doctors' efforts; administrative officers lack motivation for support.
New Section
In this section, the speaker discusses the implementation of a three-tiered ranking system inspired by soccer leagues to motivate districts to improve their performance.
Implementing a Three-Tiered Ranking System
- The rankings were designed not only to impact the best- and worst-performing districts but also to motivate every district.
- The three-tiered ranking system generated excitement and competition among districts striving to be exemplars.
- Combining the coffee shop strategy with public competition led to a more motivated public health system focused on improving citizen health.
- Example from Ajmer district where passionate doctors discussed ideas for better team support, showcasing motivation in action.
- Doctors utilized innovative approaches like up-skilling health workers and using WhatsApp creatively to enhance performance.
Performance Improvement in Rajasthan's Public Health System
This section highlights the significant improvement in Rajasthan's public health system due to motivational strategies and transparency.
Transforming Rajasthan's Public Health System
- Motivated teams eagerly accepted support, emphasizing the importance of addressing motivation challenges before resource allocation.
- Rajasthan showed remarkable improvement in rankings, saving thousands of newborn lives annually through reduced neonatal mortality rates.
- The approach used in Rajasthan is not limited to the state; it emphasizes triggering motivation through citizen involvement.