Strategic Management- BRAC TB Program

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  • Women with Serious illness feared abandonment- wrong belief

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  • 1. BRACs Tuberculosis ProgramPioneering DOTS Treatment for TB in Rural Bangladesh By- POWER WALL
  • 2. FRAMEWORK Situation AnalysisConflict StrategyManagem Formulati ent on BRAC Strategic Strategic Control Implemen tation
  • 3. 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
  • 4. 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)
  • 5. 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
  • 6. EXTERNAL ANALYSISSOCIAL ECONOMIC53%- literacy rate (Bangladesh) GDP per capita in PPP(07)- 117850% - Poverty rate,BPL Population-5 million Government expenditure on health-Female population restriction from working outside 7.2% (07)Social Myth & wrong belief about TB International donor agenciesMyth about government and private facilities Inflation200 million TB patients registered every yearglobally- 3,40,000 in B’deshReduced access to healthcare-women Dual Infection of TB-HIVPOLITICO-LEGAL TECHNOLOGICAL Stability of government- National TB programme Information & CommunicationInternational relations- World Bank, WHO support Technology-E-health, mhealth,Tax laws Telemedicine advances for diagnostic andLabor laws Treatment Electronic Health Records
  • 7. INTERNAL ANALYSISMARKETING OPERATIONSTie up with private practitioner and Smear positive- approachmedical colleges Research and evaluation divisionTie ups with garment districts- exportprocessing zonesIndividual factory ownersPrisonsHUMAN RESOURCE FINANCE Involving traditional doctors and mid Government Fundingwives with social legitimacy Global FundShasthya sebika program 10 % profit margin for volunteersPerformance based incentivesTraining programs
  • 8. SWOT ANALYSIS STRENGTHS WEAKNESSESCommunity based delivery system Drop outsVillage health volunteers-shasthya Loss to follow upsebikas Case detection rateUnique incentives Understanding of DOTS administrationOwned Laboratory facilities by shebikasReferral Linkages Lack of human resourceBond System Low success rate in womenStandardisationBRAC-NTP partnershipFinancially stableOPPORTUNITIES THREATSSupport of Govt. policies Socio-cultural barriersMore service delivery points Geographic inaccessibilityCatchment area- 30 million people Resistance from district level officialsMDR-TB diagnostic lab Duplication of programmeQuality assurance centersCapacity BuildingAwareness programs
  • 9. TOWS MATRIXInternal strengths Internal Weakness + + External Opportunities External Opportunities 16 13 External Threats External Threat + + Internal Strengths Internal Weakness 13 10
  • 10. STRATEGIES1) Related Diversification Laboratories Doctors Group Chest Clinics Home based Care Ambulatory Care2) Market Penetration Awareness campaigns Art workshops
  • 11. Space profile for BRAC’s Tuberculosis in Rural Bangladesh 5 financial strength 0, 4.3 4 Aggressive Profile 3 2 industry strengthcompetitive 1 advantage 0 -3 -2 -1 0 1 2 3 4 3.44, 0 -2.25, 0 -1 -2 0, -2.2 -3 Environmental stabilityAn organization whose financial strength is a dominating factor in the industrysegment
  • 12. Strategic Alternatives for Aggressive profiles Related diversification Vertical Integration Product development Market Development
  • 13. VISIONBRAC’s Vision is to make sustainableimprovement in the quality of life for thepoor by working with the community andfocusing on increasing autonomy.
  • 14. MISSIONBRACs mission is to work towards Preventionand Treatment of Tuberculosis by providingstandard and sustainable services which areaccessible and affordable
  • 15. GOALThe Goal of BRACs is to Combat HighPrevalence of Tuberculosis.
  • 16. 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
  • 17. • 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.
  • 18. Strategic ControlFrameworkInvolve Think TankEstablish standardsMeasure and compare performanceDetermine reasons for deviationCorrective action
  • 19. Conflict ManagementInterpersonal conflict- Due to miscommunication, Intense work , overlapping tasks , compensation.Solution-By clearly defining job responsibilities with least overlapping of tasks. Proper mode of communication
  • 20. Who moved my cheese?• Abreast with Technology- ICT• Slow continuous process• Simulation Exercises