1. The document defines stakeholders in the health care system as entities that affect or are affected by organizational actions. It identifies key stakeholders as government, health care providers, the public, hospital administrators, NGOs, and health insurance providers. 2. The roles and responsibilities of these stakeholders are described. The government oversees policy, funding, and administration of health services at central, state, and district levels. Health care providers deliver services. The public are beneficiaries of care. Hospital administrators and boards manage operations. NGOs supplement government work. Insurers provide coverage. 3. Effective stakeholder management involves identifying and classifying stakeholder relationships, formulating strategies, and evaluating outcomes. Stakeholder analysis

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
Government
Health care
providers
Public
STAKEHOLDERS
Hospital
administrators
& governing
bodies
NGO
Health
insurance

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
2.PUBLIC
Health as the
right………

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
identify type of
stakeholder
implement
strategies and
evaluate
classify each
stakeholder
relationship
formulate
generic
strategies

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