Evaluation Report

Proposal for Improving Primary Healthcare and Health Education in Rural India

Submitted to
Dr. Farhana Haque

Submitted by
Farhana Habib
ID: 1211293

May 9, 2014School of Public Health, Independent University, Bangladesh

Background of the Project:

Indian Government and International funding agencies have always focused on Primary Health
Centers (PHCs) for giving healthcare solutions to the rural population of India. But, in 2000, they
were not as successful as expect for a variety of reasons. These PHCs lacked decent facilities,
proper equipment, and trained doctors. As a result, diseases were not being diagnosed at the
early stage. This caused major complications for the patients which could have easily been
treated if the disease was diagnosed earlier.As PHCs fail to provide its services, rural medical
care seekers are moving to urban hospitals. Thus, the load on these hospitals is increasing.
On another side, the PHCs are not being able to provide awareness about health education in
the rural communities where there is already poor awareness of health issues. As a result, there
is now an explosive increase in diseases like HIV/AIDS, Hepatitis-B & C etc. Thus, George
Foundation submitted this proposal to propose a solution that would ratify this problem
effectively and efficiently.
Objectives:
The core objective of the proposal is to Improve and enhance the services offered by Primary
Health Centers (PHCs) in the rural communities of India. In order to do so the broad objective
are:
Improve the diagnostic and treatment capacity of PHC
Improve the PHCs capacity to provide heath education
There are 5 short term objectives and 2 long term objectives of Improving diagnostic and
treatment capacity of PHCs. These short term objectives are:
1. To furbish the existing PHCs (land, building, equipment, and supplies) already set up by
the government
2. To ensure uninterrupted electricity in PHCs
3. To ensure a full time trained support stuff in PHCs
4. To ensure better diagnosis and treatment through software technology
5. To ensure a qualified doctors to be shared between 3 to 5 PHCs in a given area.
The Long term objectives are:
1. To connect the computer at different PHC to a central co-ordination or support center
within 3 years

2. Increase diagnostic capacity of PHCs through video consultation within 2010

In order to improve PHCs capacity to provide health education the implementing agency has
set 3 short term objectives. They are:
1. To increase the capacity for heath education within PHCs facility
2. To facilitate community programs in creating health awareness
3. To train and empower stuff in order to spread awareness about health

Project Action Plan:

To achieve each of these objectives, George foundation has proposed some action plan. They
are given below:
1. Improve the diagnostic and treatment capacity of PHC
The first short term objective is to furbish the existing PHCs facility already setup by the
government. To do so, the implementing agency wishes to furbish the existing PHCs with
simple, comfortable, and durable materials.
The second short term objective is to ensure uninterrupted electricity in PHCs. They propose to
use a solar panel and a diesel generator connected to batteries for uninterrupted electric
power for computers and laboratory equipments.
The third short term objective is to ensure a full time trained staff. Each PHCs will have a
paramedic, a nurse, a physicians assistant and a laboratory technician.
The next short term objective is to ensure a qualified medical doctor to be shared between 3 to
5 PHCs in a given area. As the doctor do not wish to work in rural areas, the agency is planning
to make working at PHCs more attracting and satisfying for the doctors.
The last short term objective is to ensure better diagnosis and treatment through software
technology. George foundation is planning to implement a software program called EDPS-2000.
In 2000, the only way to collect data and support the PHCs software was for a person to travel
center to center physically. The implementing agency wishes to connect the computers at
different PHCs to a central co-ordination or support center within 3 years,
Finally, they wish to increase diagnostic capacity of PHCs through video consultation within
2010. They anticipated that this technology would be available by that time.

They also planned to improve the PHCs capacity to provide health education. To achieve the
first objective of increasing the capacity for heath education within PHCs facility, they planned
to utilize the staff through poster and audio-visual demonstration.
The second objective was to facilitate community programs in creating health awareness. This
was to be done in collaboration with NGOs and social workers.
The final objective was to train and empower stuff in order to spread awareness about health.
Using the telephone link to the central facility, relevant training and educational material and
specific health instructions was to be periodically transmitted to the computers at all PHCs, and
the status of various educational programs was to be monitored.

Evaluation methodology:
The evaluation of the proposal is done on a four point scale. The scale is given below:
Unsatisfactory
0

Marginally
Satisfactory
1

Satisfactory

Good

The evaluation of these objectives was done based on the four following criteria. These are:
1. Technical Capacity: Here, it will be checked whether the implementing agency has the
relevant technical skills to perform the functions proposed and meet the objectives within its
stipulated timeline.

2. Relevance of Project: We will check, whether the proposed solutions in the proposal actually
solve the social issues.

3. Financial and operational feasibility: This will test whether the agency has the financial and
operational capacity in terms of physical facility, human resource backup etc to complete the
project successfully.

4. Project Transparency: This will check whether the systems and process discussed ensure
transparency and clarity so that the overall project is free from corruption.

The evaluation is given below:

Technical Capacity
Heading
Score
Proven Expertise in Healthcare facility Management
0
Findings:
No proof of technical competence given regarding healthcare facility management. The
only proof of any facility management is of a school called Santi Bhaban.
Proven expertise in managing grants
2
Findings:
Only two indications are given regarding their capability to utilize funds in the Project
Lead-free and Santi Bhaban by Dr. Abraham George.
Proven capacity to utilize proposed technology
3
Findings:
Some idea is given about competence with technology (Ie. Solar Panel, EDPS-2000)
Proven understanding of Healthcare Professionals
1
Findings:
EDPS-2000 has a list of doctors to refer to, suggesting that they have communication
and understanding with doctors in South India.
No clear indication as to how they will persuade the doctors into staying in the rural
areas.
Total Score on Technical Capacity (out of 12)
6

Relevance of Project
Heading

Score
1

Solution to problem of target group

Findings:
No specific idea about target group is given regarding their background.
300 diseases that can be diagnosed with EDPS-2000 are most commonly found in South
India. Although, success rate for some diseases are questionable (Appendix E)
Relevance to governments objectives
3
Findings:
Project suggests that the objective of the project has been set in coordination with the
Tamil Nadu Government.
Understanding and Managing of other stakeholders interests
1
Findings:
No stakeholder analysis is explicitly shown. No stakeholder other than the regional
government, target group and the organization are addressed..
Total Score on Relevance of Project (out of 9)
5

Financial and Operational Feasibility

Heading

Score
1

Understanding the problem

Findings:
Broad problems are identified without specifically mentioning the target groups
concerns. Data regarding the target groups current situation is not provided suggesting
that the agency has not analyzed it.
Proof of financial Feasibility
0
Findings:
Revenue generation model has no rationale.
No cost-benefit analysis is provided making it hard for the assessor to identify the value
of the project. Benefits are only identified with qualitative terms.
Proof of long-term sustainability
0
Findings:
Contingency plans are not provided. Also, future plans are vague. This makes it difficult
to understand the organizations sustainability chances.
Rational behind human resource plan
0
Findings:
Human resource plans are vague with no concrete data. Only data for computer
operator is given.
Total Score on Financial and Operational Feasibility (out of 12)
1

Project Transparency
Heading

Score
1

Clarity of Process
Findings:
All processes are not clearly indicated. Thus, some objectives are not believably
described and give an impression that they will not be fulfilled. For example, what will
happen if community members do not provide free labor for initial development?
Strength of self-evaluation
0
Findings:
There is no self-evaluation plan identified.
Dependability of governance
3
Findings:
The governance team stated is well defined and the process looks transparent.
Total Score on Project Transparency (out of 9)
4

Total Score on overall project (out of 42)

Percentage of points earned

16
38%

Result and Recommendation

Based on the evaluation, we can safely suggest against the proposal. Other that technological
know-how and governance structure it failed to impress on any other evaluation criteria. Thus,
the following recommendations are provided:
1. Only send a proposal that focuses on implementing the EDPS-2000 on PHCs rather than fully
furnishing the overall PHCs.
2. Provide proof of technical competence in terms of managing healthcare professionals and
healthcare facilities.
3. Give proof regarding how well they understand the target group and how well their solutions
solve the issues of the target group.

4. Provide a stakeholder analysis that addresses all key stakeholders including drug suppliers,
non-government medical practitioners in the given location, pressure groups etc.
5. Provide proof through proper analysis that the agency has fully understood the problem of
the target group.
6. Draw up a clear financial plan with feasible assumptions of revenue and expenses. It is
imperative that the agency provides rationale for all their projections and assumptions.
7. Clearly mention all realistic contingencies to foreseeable problems. Also, provide a exit plan.
8. Clearly mention a human resource plan with the necessary qualifications for each position. If
possible, give idea about the labor situation in the locality so that it is possible to see whether
there Is ample supply of qualified talent.
9. Clearly identify all major processes and how they will be monitored.
10. Provide a solid self-evaluation plan that can measure the efficiency and effectiveness of the
project.