1. MAJOR STAKEHOLDERS OF
HEALTH CARE SYSTEM

2. STAKEHOLDER
SHAREHOLDER

3. DEFINITIONS
“Stakeholders are those entities in the
organization’s environment that play a
role in an organization’s health and
performance or that are affected by an
organizational action.”
“ Persons or groups who have vested
interest in the clinical decision and the
evidence that supports that decision,
referred to as stakeholders”
[ AHRQ ]

4. TYPES OF STAKEHOLDERS
* EXTERNAL STAKEHOLDERS
• provides inputs to
organization.

5. EXTERNAL STAKEHOLDERS
 Suppliers, patients, and financial community.
 The competitor.
 Special interest group

6. INTERFACE STAKEHOLDERS:
 Interface between organization and its environment.

7. INTERNAL STAKEHOLDERS
 almost entirely within the organization and its
environment.

8. PRIMARY STAKEHOLDERS:
 They are the beneficiaries or the targets of the effort
SECONDARY STAKEHOLDERS:
 those directly involved with or responsible for
beneficiaries or targets of the effort.
KEY STAKEHOLDERS:
 people who can devise, pass and enforce laws and
regulations

9. EXAMPLE: NRHM
state health mission.
district health mission.
chief block health officer.
Doctors,nurses,health workers etc at PHC and
sub-centre level.
ASHA, Anganwadi workers
MCH services
Mother and children

10. MAJOR STAKEHOLERS IN THE
HEALTH CARE SYSTEM
STAKEHOLDERS
Health care
providers
Public
NGO
Health
insurance
Hospital
administrators
& governing
bodies
Government

11. 1. GOVERNMENT
 Vision:
Availability of quality health care on
equitable, accessible, and affordable basis across
regions and communities with special focus on under
reached population and marginalized groups.

12. GOVERNMENT
Mission:
 primary, secondary and tertiary health care delivery
system.
 maternal and child health.
 decrease the incidence of communicable diseases.
 population stabilization.
 training.
 promote rational use of pharmaceuticals in the
country.

13. GOVERNMENT
 At central level
 Ensuring high levels of executive management
performance.
 Ensuring quality of patient care.
 Ensuring financial health of the organization.
 Formulating policies to guide decision making and
action.
 Making decisions regarding health.

14. GOVERNMENT
 At state level :
 Integrating health services.
 Emphasis on institutional autonomy and dependency.
 Plan health care programmes and drawing policies.
 Provision of medicines.
 At district level:
 managed by deputy commissioners, civil surgeons,
senior medical officers, and district public health nurse.

15. THE PUBLIC
Health as the
right………
2.PUBLIC

16. 3. HEALTH CARE PROVIDERS:
 Community health care professionals.
 Doctors of community health centre:

17. HEALTH CARE PROVIDERS
 Public health nurses:

18. HEALTH CARE PROVIDERS
 Health workers
 village health guides
 local dais
 Anganwadi workers:

19. HEALTH CARE PROVIDERS
 Hospital health care professionals:
1. Physician

20. 2. Nurses:
3. Pharmacists:

21. 3. Paramedical personnel:
4. Respiratory technologists.
5. Social workers.
6. Physiotherapists.

22. HOSPITAL ADMINISTRATORS AND GOVERNING
BODIES

23. HOSPITAL ADMINISTRATORS AND
GOVERNING BODIES
 BOARD OF TRUSTEES:
• Mission development .
• Ensuring high quality care.
• Oversight of finance & staff.
• Selection & evaluation of CEO.
• Board self -evaluation and
education.

24. HOSPITAL ADMINISTRATORS AND
GOVERNING BODIES: CONTD
 The chief executive officer.
Runs institution efficiently, carrying out policies ,
addressing health care issues in the community.
 The chief finance officer.
Manages the finance,allocates adequate
funds according to the needs.
 The chief nurse executive.
Serve as clinical leaders and administrators.

25. NON-GOVERNMENTAL AGENCIES
FUNCTIONS:
Supplementing the work of
governmental agencies.
Pioneering.
Education.
Demonstration.

26. NON-GOVERNMENTAL AGENCIES:
 Indian red cross society,1920.
 Indian council of child welfare,1952.
 All India blind relief society,1946.
 Tuberculosis association of india,1939.
 Hindu kusht nivaran sangh,1950.
 The Kasturba memorial fund,1994.
 Professional bodies.

27. HEALTH INSURANCE
 Central government health scheme.
 Out-patient care.
 Hospitalization facilities.
 Supply of drugs.
 Lab and x-ray facilities.
 Emergency department.
 Family welfare services.
 Antenatal, natal and postnatal services.
 ESI SCHEME:

28. MANAGEMENT OF STAKEHOLDER
RELATIONSHIP

29. STEPS IN THE MANAGEMENT OF
STAKEHOLDERS
diagnose each
stakeholder
classify each
stakeholder
relationship
formulate
generic
strategies
implement
strategies and
evaluate
identify type of
stakeholder

30. STEPS IN THE MANAGEMENT OF
STAKEHOLDERS
 Identify type of stakeholder:
identify the major stakeholder and recognizes the
function depicted to them .
 Diagnose each stakeholder relationship:
1. Stakeholder potential for threat:
2. Stakeholder potential for co-operation:
 Classify each stakeholder relationship:
 Mixed blessing stakeholder relationship.
 Supportive stakeholder relationship.
 Non-supportive stakeholder relationship.
 Marginal stakeholder relationship.

31. STEPS IN THE MANAGEMENT OF
STAKEHOLDERS
 Formulate strategies to reduce stakeholder’s
potential to threat:
 Collaborate cautiously in the mixed blessing
relationship.
 Involve trustingly in the supportive relationship.
 Defend pro-actively in the non-supportive
relationship.
 Monitor efficiently in marginal relationships.
 Implementation of strategies and evaluation

32. STAKEHOLDER ANALYSIS
Stakeholder analysis/ stakeholder
mapping is a way of determining who
among stakeholders can have the
most positive or negative influence
on an effort, who is likely to be most
affect by the effort, and how you
should work with stakeholders with
different levels of interest and
influence.

33. STAKEHOLDER ANALYSIS
Need to identify and analysis stakeholders
 It puts more ideas on the table.
 It includes varied perspectives from all sectors and
the elements of community affected.
 It gains support for the effort from all stakeholders
by making them as integral part of development,
planning, implementation and evaluation.
 It saves you from being blindsided by concerns you
didn’t know about.
 It increases credibility of your organization.

34. STAKEHOLDER ANALYSIS