A hypothetical proposal on human resource retention in rural area

1. PRACTICAL SKILL DEVELOPMENT IN DEVELOPING THE
HYPOTHETICAL PROJECT PROPOSAL ON SUSTAINIBILITY OF
HUMAN RESOURCE FOR HEALTH
SIRJANA TIWARI
Master of Public Health
School of Health and Allied Sciences
Faculty of Health Sciences, Pokhara University
Kaski, Nepal
2018

2. PRACTICAL SKILL DEVELOPMENT IN DEVELOPING THE
HYPOTHETICAL PROJECT PROPOSAL ON SUSTAINIBILITY OF
HUMAN RESOURCE FOR HEALTH
SIRJANA TIWARI
ROLL NO: 17690006
A PSD Report Submitted In partial fulfillment of the requirements for
the Degree of Master of Public Health (MPH), II Year, III Semester,
health project management (PSD612)
Master of Public Health Program
School of Health and Allied Sciences
Faculty of Health Sciences
Pokhara University Kaski, Nepal
November 2018

3. i
APPROVAL
Ms Sirjana Tiwari has prepared the hypothetical project proposal entitled
SUSTAINIBILITY OF HUMAN RESOURCE FOR HEALTH using MS
Project Management. The report has been prepared and presented for the partial
fulfillment of the requirement for the degree of Master of Public Health (MPH)
and forwarded for final evaluation.
Prof. Naveen Shrestha
Date 11/24/2018
This report has been reviewed and
Accepted
Accepted with condition
Not accepted
External Examiner
1. Name……………………Signature……………………………. Date…………
2. Name………………… Signature……………………Date……….
ChirinjiviAdhikari Dr. Damaru Prasad Paneru School seal
MPH Coordinator Director
SHAS, PU

4. i
DECLARATION
To the best of my knowledge and belief I declare that this project proposal on"
SUSTAINIBILITY OF HUMAN RESOURCE FOR HEALTH is the result of
my own PSD and contains no material previously published by any other person
except where due acknowledgement has been made. This PSD report contains no
material, which has been accepted for the award of any other degree or diploma in
any university.
Signature: ....................................................
Name: Sirjana Tiwari
Roll No: 17690006
Date: November 2018

5. ii
ACKNOWLEDGEMENT
I am as being MPH (PHSM) student of 2017 batch of SHAS, PU is greatly
thankful to our Dean Dr. Khem Raj Joshi for allowing us to embrace such an
opportunity to learn.
I gratefully acknowledge the contributions of Dr. Damaru Prasad Paneru, Director
of School of Health and Allied Sciences, Mr. Chiranjivi Adhikari, Program
Coordinator of MPH for providing this opportunity to develop my practical skills.
I would like to express my special gratitude and thanks to Professor Naveen
Shrestha for his cooperation and guidance throughout the PSD.
My thanks go to my class friend Prabin Sharma for helping me to learn Microsoft
Office Project.
Sirjana Tiwari
2017 Batch
PU SHAS

6. iii
EXECUTIVE SUMMARY
Introduction
Project in a new endeavor with specific objective to create a unique product,
service or result. Project Management is the skills, tools and management
processes required to undertake a project successfully. A project proposal is a
detailed description of a series of activities aimed at solving a certain problem.
Objectives
Develop the skills required in the field of project management, design the project
and develop the proposal
Method
Search engines like Google scholar, PubMed, Google chrome were searched for
relevant information on project, its management, proposal development and the
literatures related mental health training methodology to enhance the quality of
care.
Field visit was done to ISER-N and Himalayan Eye Hospital to compare the
theoretical and practical aspect of project cycle and management.
MS office project software was used to develop the project activities of
hypothetical project and proposal was developed.
Conclusion and Recommendation
Understanding of the theoretical and practical aspect of the project is developed.
For the successful project each cycle of the project must be followed. The
activities in the project must be planned rationally and go in synchronous order.
The project must be developed as per the need of the implementing area for its
success.
This type of activities for our practical skill development is very useful and I
would like to recommend for its continuation.

7. iv
Table of Contents
DECLARATION........................................................................................................ i
ACKNOWLEDGEMENT.......................................................................................... ii
EXECUTIVE SUMMARY....................................................................................... iii
CHAPTER I: INTRODUCTION.................................................................................1
1.1 Background ......................................................................................................1
General Objective ...................................................................................................2
Specific Objective...................................................................................................2
CHAPTER II: LITERATURE REVIEW......................................................................2
2.1 Literature search methods and strategies .............................................................2
2.2. Literature Review.............................................................................................2
CHAPTER III: METHODOLOGY..............................................................................4
3.1 Method.............................................................................................................4
3.2 Project techniques and tools ...............................................................................4
3.5 Steps and strategy..............................................................................................4
3.6 Ethical issues ....................................................................................................5
CHAPTER IV: RESULT............................................................................................6
6.1. Conclusion.......................................................................................................7
6.2. Recommendations ............................................................................................7
6.3. Lessons learned................................................................................................7
REFERENCES...........................................................................................................8
ANNEX I...................................................................................................................9
Interview guideline .................................................................................................9
Annexes II...............................................................................................................10
Field Visit report I: Institute of Social and Environmental Research Visit Report ......10
Field Visit report II: Himalayan Eye Hospital, Pokhara ...........................................11
Annexes III: Sustainability of human resource for health a hypothetical proposal..........13

8. 1
CHAPTER I: INTRODUCTION
1.1 Background
It's a temporary endeavor undertaken to create a unique product, service or result. A project
is temporary in that it has a defined beginning and end in time, and therefore defined scope and
resources.
A project consists of a concrete and organized effort motivated by a perceived opportunity when
facing a problem, a need, a desire or a source of discomfort (e.g., lack of proper ventilation in a
building). It seeks the realization of a unique and innovative deliverable, such as a product, a
service, a process, or in some cases, a scientific research. Each project has a beginning and an
end, and as such is considered a closed dynamic system. It is developed along the 4 Ps of project
management: Plan, Processes, People, and Power (e.g., line of authority). It is bound by the triple
constraints that are calendar, costs and norms of quality, each of which can be determined and
measured objectively along the project lifecycle. Each project produces some level of formal
documentation, the deliverable(s), and some impacts, which can be positive and/or negative.
Project management, then, is the application of knowledge, skills, tools, and techniques to
project activities to meet the project requirements.
It has always been practiced informally, but began to emerge as a distinct profession in the mid-
20th century. The Project Management Body of Knowledge identifies its recurring elements:
Project management processes fall into
five groups:
1. Initiating
2. Planning
3. Executing
4. Monitoring and Controlling
5. Closing
Project management knowledge draws on
ten areas:
1. Integration
2. Scope
3. Time
4. Cost
5. Quality
6. Procurement
7. Human resources
8. Communications
9. Risk management

9. 2
10. Stakeholder management
A project proposal is a technical proposal, often called a "Statement of Work,” is a persuasive
document. Its objectives are to 1. Identify what work is to be done 2. Explain why this work
needs to be done 3. Persuade the reader that the proposers (you) are qualified for the work, have
a plausible management plan and technical approach, and have the resources needed to complete
the task within the stated time and cost constraints. What makes a good proposal? One attribute
is appearance. A strong proposal has an attractive, professional, inviting appearance. In addition,
the information should easy to access. A second attribute is substance. A strong proposal has a
well-organized plan of attack. A strong proposal also has technical details because technical
depth is needed to sell your project. Remember: A proposal is a persuasive document.
1.2. Rationale
Project management involves planning and organization of a company's resources to move a
specific task, event, or duty towards completion. It typically involves a one-time project rather
than an ongoing activity, and resources managed include personnel, finances, technology, and
intellectual.
Health Project Management requires the set of skills, tools and management processes. To
develop the skills required for successful designing of project, developing the proposal and the
management of the developed project this PSD was undertaken.
1.4. Objectives
General Objective
 Develop the skills required in the field of project management, design the project and
develop the proposal.
Specific Objective
 Review relevant literatures regarding the project management
 Visit the different project implementing organizations
 Develop the skill in running the MS office project software
 Design project life cycle of hypothetical project
 Develop the hypothetical project proposal

10. 2
CHAPTER II: LITERATURE REVIEW
2.1 Literature search methods and strategies
Literatures related to project, project designing, project proposal and literatures related to the
retention of human resource for health were searched and reviewed form the various sources like
PubMed, Research Gate, Google Scholar, Google search engine.
2.2. Literature Review
As the part of a commercial banking, human resources management must be prepared to deal
with the effects of the changing world at work. This means understanding the implications of
globalization, technology changes, workforce diversity, labor shortages, changing skill
requirements, technology changes, workforce diversity, labor shortage, changing skill
requirements, continuous improvement initiatives, the contingent workforce, decentralized work
sites, and employee involvement.( Burke, R.J. and Ng, E., 2006)
A systematic and structured approach to the support and supervision of health workers can
strengthen the human resource management function at the district and health facility levels and
may help address the current crisis in human resources for health in sub-Saharan Africa by
improving health workers’ motivation and retention.( Mathauer, I. and Imhoff, I., 2006)
Trends such as population growth, demographic and epidemiological transition as well as ageing
of the health workforce are increasing demand for health and social care which is projected to
create 40 million new jobs by 2030, mostly in middle-and high-income countries.Despite the
growth in jobs, there will be a projected shortage of 18 million health workers to attain and
sustain the health related SDGs primarily in low- and middle-income countries.( Rasmussen, B.,
Sweeny, K. and Sheehan, P., 2015)
The health workforce is a crucial pillar in every health sector and Sierra Leone has long suffered
from health worker shortages. In the aftermath of the Ebola Virus Disease outbreak, the
importance of investing in Sierra Leone’s health workforce is more evident than ever. Since then,
the Ministry of Health and Sanitation has made significant efforts to rebuild the health sector,
with a focus on improving maternal and child health. Strengthening human resources for health
(HRH) has been a core component of this work and it is now a central theme in the plan that

11. 3
outlines the President’s Recovery Priorities (PRP) for the near future. These priorities include
immediate investments to expand and strengthen the nursing and midwifery workforce, as well
as the community health workforce, and to improve overall training quality.( Wurie, H., Witter,
S. and Raven, J., 2016). Project management is important because it ensures what is being
delivered, is right, and will deliver real value. Kerzner, H 201
Project is a unique process, consist of a set of coordinated and controlled activities with start and
finish dates, undertaken to achieve an objective confirming to specific requirements, including
the constraints of time cost and resource.(ISO10006). Three major dimensions that define the
project performance are scope, time, and resource. These parameters are interrelated and
interactive. The relationship generally represented as an equilateral triangle. Project success is a
widely studied and discussed phenomenon of project management. Whilst certain success criteria
and success factors are common across different project types, there are unique criteria and
factors that apply only to specific projects. Cserháti, G. and Szabó, L., 2014

12. 4
CHAPTER III: METHODOLOGY
3.1 Method
Firstly the particular PSD activity was selected as per the discussion with the subject teacher.
For this PSD primary and secondary data sources were used to collect the relevant information
on project management.
Primarily: Field Visit to ISER-N and Himalayan eye hospital were done to compare the
theoretical aspect and the practical aspect of the Project designing and implementation as well
for the proposal development.
Secondarily: Using the various web based search engine like Google scholar, Google Chrome,
Research Gate different information about the project management, proposal development were
searched.
3.2 Project techniques and tools
Field visit
Interview schedule
3.5 Steps and strategy
Field Visit
 Coordination was done with the facilitator before visit by the subject teacher
 Introduction of every participants in the session was done.
 Tula Ram Shinjali Project Manager and DrHridaya Raj Devkota Research Officer were
facilitator in ISERand Medical Superintend DrIndramanMaharjanin Himalayan Eye
Hospital and Facilitator Professor Naveen Shrestha SHASPU.
 Objectives of visit were explained by Professor Naveeen Shrestha.
 The concept of individual project of the students was then shared in ISER
 The research area of ISER and Himalayan Eye Hospital were shared.
 Theoretical background of project life cycle was explained by DrHridaya Raj Devkota
comparing with actual project life cycle of ISER.
 Interaction was continuous throughout the visit.

13. 5
 Note taking was done of the discussion was done at both visit.
Project development
For developing hypothetical project on sustainability of human resource for health our Prof
Naveen Shrestha sir had first discussed project, project management, proposal development
along with it he also provided information on using the MS project management software for
planning our individual projects. The field of interest was shared in the class and developed
individual idea of project. Then the literature review was ongoing either in selecting the topic of
project and developing each activities of the project in MS Project Management Software.
3.6 Ethical issues
The organizations visited were pre informed and their permission was taken prior to visit.

14. 6
CHAPTER IV: RESULT
Interview Schedule for the field was developed and kept in the annexes in this report.
For accomplishing this PSD activity field visit on different NGOS were done, report of which is
kept in the annexes
Hypothetical project Named Sustainability of human resource for health was developed in MS
project management software.
Hypothetical project proposal was developed which is kept in annexes.

15. 7
CHAPTER V: CONCLUSION, RECOMMENDATIONS AND LESSONS LEARNED
6.1. Conclusion
Creating hypothetical project proposals play great role on understanding theoretical aspect of
project development. The project proposal includes its scope, bound with certain time, cost and
quality. A successful project has its trained human resource with leading motivated project
manager. A project in real field should mitigate risk as soon as possible with developing and
coordinating with its stakeholders.
6.2. Recommendations
Development of hypothetical proposal is further recommended for the continuation in future.
6.3. Lessons learned
 Review for the initiation of projects
 Review input requirements (i.e. plans, deliverables, activities, tasks, decisions and related
variables).
 Review benchmarks and analysis criteria for project evaluation
 Lessons learned reporting methodologies i.e. documentation of project plan and
incorporated into the "institutional body of knowledge for how to pleased technical and
financial support.
 Learn on how to run MS office project software i.e. like defining and arranging activities,
keeping the time frame, defining working days and holidays, rolling up of the project.
 Learn how to prepare project budget.

16. 8
REFERENCES
 Burke, R.J. and Ng, E., 2006. The changing nature of work and organizations:
Implications for human resource management. Human Resource Management
Review, 16(2), pp.86-94
 Buykx, P., Humphreys, J., Wakerman, J. and Pashen, D., 2010. Systematic review of
effective retention incentives for health workers in rural and remote areas: Towards
evidence‐ based policy. Australian Journal of Rural Health, 18(3), pp.102-109.
 Dolea, C., Stormont, L., Shaw, D., Zurn, P. and Braichet, J.M., 2009. Increasing access to
health workers in remote and rural areas through improved retention. In First expert
meeting to develop evidencebased recommendations to increase access to health workers
in remote and rural areas through improved retention. Geneva: World Health
Organization.
 https://www.pmi.org/about/learn-about-pmi/what-is-project-management
 http://writing.engr.psu.edu/workbooks/proposal_guidelines.pdf
 Mkoka, D.A., Mahiti, G.R., Kiwara, A., Mwangu, M., Goicolea, I. and Hurtig, A.K.,
2015. “Once the government employs you, it forgets you”: Health workers’ and
managers’ perspectives on factors influencing working conditions for provision of
maternal health care services in a rural district of Tanzania. Human resources for
health, 13(1), p.77.
 OECD (2015a). Health at a Glance 2015: OECD Indicators, OECD Publishing
(http://dx.doi.org/10.1787/health_glance-2015-en).
 Uduma, O., Galligan, M., Mollel, H., Masanja, H., Bradley, S. and McAuliffe, E., 2017.
The impact of a human resource management intervention on the capacity of supervisors
to support and supervise their staff at health facility level. Human resources for
health, 15(1), p.57.
 World Health Organization, 2017. National health workforce accounts: a handbook.
Wurie, H., witter, S. and Raven, J., 2016. Fighting a Battle’: Ebola, Health Workers and
the Health System in Sierra Leone. Liverpool: ReBUILD.

17. 9
ANNEX I
Interview guideline
Institution Activities Questions
ISER N Orientation and discussion
regardingISRE-n
Discussion about the practical aspect of
project management.
-Can you tell about ISER-N
-List of the projects implemented
by ISER-N
-Does the project on ISER-N
follows the theoretical life cycle
of the project?

18. 10
Annexes II
Field Visit report I: Institute of Social and Environmental Research Visit Report
Submitted to: Naveen Shrestha, professor ,Pokhara University
Submitted by: Sirjana Tiwari, MPH 3rd Semester.
Field Visit Date: 4th June , 2018
Field Visit Venue: Institute for social and environmental research – Nepal (ISER-Nepal)
Amarsing Choke Pokhara.
Objectives: Main objective/s of this field visit is/are to:
To explain project management
To evaluate how research project were run
To examine the process of research project
To analyze research project life cycle in practical way.
Activities:  Introduction with different section i.e. Health and environment
section and staffs
 Orientation
 Presentation on life cycle of ISER-Nepal project
 Presentation on Major research area of Social research program
(Migration study and mental health) , agricultural productivity
and women participation,
 Tea-Program
 ISER-Nepal Photograph and video demonstration
 Sharing Working Experience in ISER-Nepal on Co-ordination
with university of Michigan & Berkly USA, Pro. Michel bed,
with Manipal Teaching hospital and with main office Bharatpur-
15, phulbari chitwan.
LessonLearned: ISER-N has completed many projects till date and has been successful in
maintaining the standard / quality of the data collection, analysis and
reporting. From our field visit on ISER-N we have gained expertise
experience and knowledge on social and environmental research project
management on
 Need Identification, Planning and designing
 Fund Generation
 Fitting own and donor strategies
 Implementation of projects
 Monitoring and evaluation of projects in terms of relevance,
efficiency, effectiveness, impact and sustainability.
Conclusion: This project visit gives us opportunity to learn theory versus Practical
work in research project management.

19. 11
Recommendations: Being a public health graduated Our field visit is fruitful in research
project management. Instead we are going to specialize in health service
management so, it would be better if we get chance to visit health service
management (NGO, INGO and government) project.
Field Visit report II: Himalayan Eye Hospital, Pokhara
Submitted to: Naveen Shrestha, professor , Pokhara University
Submitted by: Sirjana Tiwari, MPH 3rd Semester
Field Visit Date: 8th June 2018
Field Visit Venue: Himalayan Eye Care Foundation
Objectives: Main objective/s of this field visit is/are to:
 To explain project management
 To evaluate how small project were run in HEH
 To examine the process of HEH project
Activities:  Introduction between we students, Teacher from PU and HEH
staffs (Medical director Dr. Indra man Shreshta and Bam Dev
Gautam
 Orientation Program
 Short description about establishment, funding, financial
autonomous and HEH network in Nepal.
 Short discussion on Patients flows, relevant research area for
exploration, co-ordination between different donor partners and
intervention project lunched on community people and
government school children at rural area of Nepal.
LessonLearned: Service Area: Gandaki, Dhaulagiri and Karnali zone on 3 million
population on
 Preventive & Curative Service
 Creating awareness and decreasing incidence of preventable
blindness
 Improving people’s treatment seeking behaviors
 Making Eye Care Service accessible to the people who are
living underneath the line of poverty
 Extending services by developing manpower and infrastructure
Conclusion: Himalayan Eye Hospital provides hospital based and community based
preventive and curative service mainly on western and mid western
part of Nepal.

20. 12
Recommendations: Sufficient time would be better to get enough idea on Project
management (proposal submission, contract to the donor, Surgical Eye
Camps, School Eye Health Programme, mobile and static Screening
Camps, Radio Eye Health Programme) of Himalayan Eye Hospital.

21. 13
Annexes III: Sustainability of human resource for health a hypothetical proposal
PROJECT INTRODUCTION
Despite improvement in overall health outcomes over last two decades, there are persistent
systemic issues that need to be addressed to ensure equitable access to quality health services for
all people and communities in Nepal. These issues include an inefficient administration, which
poses additional challenges for the transition from a unitary government to federalism,
insufficient social health protection, and a deficient urban healthcare system that has not kept
pace with Nepal’s rapid urbanization. The quality, availability and, in part, also the acceptance of
health care services are still low for a larger part of the population.
The introduction of federalism has brought tremendous changes to Nepal and will have
implications for the implementation of the NHSS in the coming months and years. Service
delivery, particularly in health care, is expected to face significant challenges. As per the
constitution, a wide range of political, administrative and financial functions will devolve to the
7 newly-created provinces and 745 local governments. The constitution has defined the
governance structure and functions mandated to the local level, including the delivery of basic
health services. The development of standards and policies, management of hospitals, regulation
of medicines, response to outbreaks and disasters, and international cooperation will remain with
the federal and provincial governments. The federal government will also play a supporting role
in enhancing the capacity of local and provincial governments. The roles and functions of the
health sector will be spread across the three levels. S2HSP is already cooperating with the new
administrative units and providing technical support to the government during this transition to
ensure the continued provision of health services.(GIZ scholarship documents)
PROJECT OBJECTIVES AND EXPECTED OUTCOME
General objectives
 To improve the sustainability of skilled Human resource for Health
Specific objectives
 To improve availability of human resources for health at all levels with a focus on rural
retention and enrolment

22. 14
 To conduct a needs assessment to develop training programmes to equip health workers
with administrative and human resource management skills.
 To support on the introduction of mentoring and coaching approaches at the place of
work for both clinical and managerial aspects
 To establish cooperation with the private sector to add on the simulation based education
of midwives students and SBA/ASBA trainees at public and private universities to
overcome training deficiencies of pre-service education programmes.
DESCRIPTION OF PROJECT ACTIVITIES
1. Office setup
1.1.1. Notice in newspaper for house rent
1.1.2. Contract with house owner
1.1.3. Consultation with co-operatives
1.1.4. Creation of Project Logo
1.1.5. Creation of project brochure in English and national language
1.1.6. Creation of project website
1.1.7. Project planning
2. Situational analysis
2.1. TOR
2.2. RFP
2.3. Contracting and agreement
3. Project objectives
4. Identify stakeholders
5. Formulate project team( Define project manager and other staff)
6. Arranging meetings and writing the minutes
7. Budget formulation
8. Maintaining the project website;
9. Maintaining project documentation;
10. Maintaining contact with the sponsors
11. Identify target group
12. Project management procedures

23. 15
6.1. Project work plan
6.2. Outcomes, outputs and deliverables
7. Resource planning
6.1. Human resource planning: the project team formulation plan
6.2. Planning for required equipments
6.3. Leadership
6.4. Co-ordination
6.5. Financial plan
8. Evaluate planning
8.1. Identification of evaluation needs in consultation with stakeholders;
8.2. definition of evaluation questions;
8.3. formulation of appropriate indicators to evaluate the quality of the implementation
process and the effects
8.4. Operationalization of the indicators (the way in which they will be measured).
9. Planning of dissemination
9.1. Content of intervention: message
9.2. Audience of intervention
9.3. Purpose of intervention
9.4. Method of intervention
9.5. Total time of intervention
10. Implementation of project
10.1. Develop intervention package
10.2. Co-ordination with MoH
10.3. Intervention package formulation
10.4. Take the inform consent
10.5. Test intervention
10.6. Develop test plans
10.7. Develop training manual
10.8. Develop training design
10.9. Conduct training
10.10. Describe purpose

24. 16
10.11. Identify ultimate purpose
10.12. Consider budget allocation
10.13. Manage the work plan within schedule timetable
10.14. Monitor budget
10.15. Manage risk/Outputs and deliverables/Roles and responsibilities/Relationship to
other work packages
10.16. Coordination with development partner
11. Project evaluation
11.1. Prepare for field study
11.2. Formulate evaluation questions, indicators and targets through survey
11.3. Collect primary data on
11.4. Process evaluation: accuracy and timeliness of project implementation
11.5. Performance indicators: level of participation on the project, user satisfaction,
efficiency, take-up,
11.6. Effect evaluation: achievement of the objectives
11.7. Analyze data
11.8. Report evaluation findings
12. Dissemination of project result
12.1. Following purpose of dissemination with considering appropriate language
12.2. Dissemination method: publications/ conferences and workshops/ collaborative
events/website/ e-mails

25. 17
IMPLEMENTATION PLAN AND TIME FRAME (6MONTH-1YEAR) (GHANT
CHART)
Project Name: Sustainability of Human Resource for Health
Company Name: school of health and allied science
Project start date: September 2018 Project end date: May 2019
Activities/date Sep Oct Nov Dec Jan Feb Mar Apr May
Office setup
Situational analysis
Project objectives formulation
Stakeholders analysis
Formulate project team( Define project
manager and other staff)
Budget formulation
Maintaining the project website
Identify target group and inform for
training
Resource planning
Implementation of project
Project evaluation
Dissemination of project result and
handover project

26. 18
RISK TO SUCCESSFUL IMPLEMENTATION
 Lack of Senior Management Involvement
 Unrealistic schedules
 Unrealistic Expectations
 Scope Creep
 Lack of beneficiaries/client Involvement
 Inexperienced Project Managers
 Delay in tender process and contract negotiation and project goal implementation.
 Service Level Agreement with the supplier (not signed)
 Lack of Resources/ inappropriate use of resources
 Missing the target groups
 Expecting the Software to Fix All the Issues
 Failure existing technology
 Lack of appropriate training and support from the management that don't take the personal
development of employees seriously
 Lack of Communication to Various Stakeholders
MONITORING AND EVALUATION PLAN AND INDICATOR
LOGICAL FRAMEWORK ANALYSIS
Data –information-knowledge- decision
Narrative summary Objectively verifiable
indicators(Indicator+ target)
Means of
verification
Important
assumption(Ris
k have been
considered)
Goal -To improve the -health workforce to population Source Unabated

27. 19
/obje
ctive
(1)
sustainability of skilled
Human resource for Health
ratio
-health workforce to health
service/program ratio
- Ratio of nurses to physicians
-Percentage of generalist
physicians
-Specialized birth care
workforce
-geographical distribution of
health worker
-age,sex ,education distribution
of health worker
- expenditure on health
workforce education
-Health workforce
unemployment and vacancy rate
- Expenditure on health
workforce relative to total
health expenditure
-occupational health and safety
policy( working hour, working
condition, benefits, working
environment, security)
-HURIS
-general
administrat
ion of
Nepal
-HR
information
from
different
NGOS and
INGOS
efforts by
government and
Development
Partners, to
recruit and
retain health
professionals
Proje
ct
purp
ose
-To improve availability of
human resources for health
at all levels with a focus on
rural retention and
-Changes in salaries,
allowances and incentives
-Measurable change in staff
morale, motivation and job
-Annual
report of
governmen
t of Nepal
-
Existing human
resources, skills
and knowledge

28. 20
enrolment
- To conduct a needs
assessment to develop
training programmes to
equip health workers with
administrative and human
resource management
skills
satisfaction
-Degree of equity of salaries,
incentives and allowances
between health sector
employers
Degree of satisfaction of health
workers related to living
conditions
-Proportion of health workers
receiving training
-Changes in recruitment
procedures to address retention
-NDHS
survey
-MICS
-Annual
performanc
e
evaluation
report of
each
gov/NGO/I
NGO
-journal
articles
=Personnel man
agement,
motivation
systems and
incentives
-Perception
of leadership,
hierarchy and
authoritative
relationships
-Organizational
risk tolerance
-Project
stakeholders an
d organizational
stakeholders
Outp
uts/r
esult
s
-improve job satisfaction
and engagement and
reduce turnover
-correctly performing
specific tasks improved
-declined poor patient flow
or high administrative
workload
-critical awareness on
functioning of health
services
- empowered to implement
-Proportion of health workers
satisfied with the working
environment and working
conditions
-Proportion of health workers
receiving increase in salary;
degree of equity
-Proportion of health workers
satisfied with housing, transport
and security
- Proportion of health workers
satisfied with access to
-Annual
report of
governmen
t of Nepal
-NDHS
survey
-MICS
-Annual
performanc
e
evaluation
report of
- particular
background
characteristics
of health
workers
-diversity if
health
workforce
(socioeconomic,
culture,
language,
religion)
-political

29. 21
change
-improved provider-patient
relations and reduced
waiting times
-increase in hospital
income and outpatient
numbers
education and training
- no of applications for health
sector vacancies
each
gov/NGO/I
NGO
-journal
articles
ideology
-incentives of
workplace
-government
policy,rules and
regulation on
HRH
-organization
risk tolerance
- formal and
informal comm
unication
channels
-HMIS
Input
/acti
vities
For education
-enroll students with a rural
background in education
programmes for various health
disciplines
-Locate health professional
schools, campuses graduates are
more likely to work in rural
areas.
-Expose undergraduate students
to rural community experiences
-Revise undergraduate and
postgraduate curricula to
For education
-Proportion of rural health
workers trained
-Proportion of training
programmes, that are
competency-based
-Proportion of recruitment
of rural health worker from
graduates school in their
local area.
For regulatory
-no of HR management
-HURIS
-general
administrat
ion of
Nepal
-HR
information
from
different
NGOS and
INGOS
-Budget of
Nepal
governmen
-Inexperienced
Project
Managers
-Delay in tender
process and
contract
negotiation
-Delays related
to project goal
implementation
-Service Level
Agreement with
the supplier (not
signed)

30. 22
include rural health topics
Regulatory
compulsory service
requirements in rural and
remote areas accompanied with
appropriate support and
incentives
-Provide scholarships, bursaries
or other education subsidies
agreements of return of service
Financial Incentives
hardship allowances
grants for housing
free transportation
paid vacations
Professional support and
living condition
-Workplace sanitation,
electricity, telecommunications,
children schools
-use tele health to serve remote
people
-Adopt public recognition
measures such as rural health
days, awards and titles at local,
national and international levels
-adopt an updated electronic
functions decentralized
according to policy
- no of education
scholarship to the rural
services
Financial
-% increase in allowances
-Proportion of eligible staff
receiving allowance
-# of additional allowances
effected
-% increase in equal
incentives
- # of additional incentives
-% of Discrepancy between
salaries of government and
non government health
worker.
Professional Support and
living condition
-Proportion of health
workers trained
-TNA carried out
-No of districts
determining training needs
-Proportion of health
centres with access to
t
-HR
planning
and
performanc
e appraisal
system of
Nepal
governmen
t.
-inappropriate
use of resources
-Missing the
target groups

31. 23
attendance system public services
-Proportion of training
programmes, that are
competency-based
-Proportion of health
workers with subsidized
housing
- Proportion of health
workers in rural areas with
access to communication
-Proportion of health
workers provided with
duty-transport
SUSTAINABILITY OF RESULTS ACHIEVED
Regular monitoring and evaluation
Feedback mechanism
Transparent reward and punishment system
Promotion in every year as per performance
Bonus distribution on the basis of hierarchy
and working time
Benefit and welfare facilities
On the job and off the job training:
internship, apprentice, team work,
Refreshment training
Emotional attachment
Responsibility as well as authority
distribution

32. FINANCIAL DETAIL (INCOME/EXPENDITURE)
Activities Budget
office setup $500,000
Labor( current staff salary) $300,000
Career development training (including
related travel expenses) 250000
Books/dues/subscriptions/infrastructure 200000
Travel 10000
Consulting Services 20000
Benefit plan administrators
Health insurance review
Job evaluation and compensation review
Employee attitude survey
Software, equipment, office supplies(
HURIS update, computer, printer,
training material) 10000
HRIS lease and upgrades
Employee Relations 50000
Teambuilding/social events
Service awards
Totals 1,340,000