STAKEHOLDER MEETING

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STAKEHOLDER MEETING

• Selecting Interventions to Improve Utilization of
  the IUD

City, Country Date
(Note Photos have been removed to keep the file
size manageable.)
Insert MOH logo
Insert Project logo
Insert USAID logo
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Introductions

• As we go around the room, say
• Your name
• Your position
• Where you work

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Meeting Objectives

• Share and discuss results of performance
  assessment data results
• Discuss performance gaps and analyze root causes
  of the performance gaps
• Identify and select interventions to address
  performance gaps

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Agenda
Day 1Date

• Welcome and opening remarks
• Review of PIA and results of stakeholders
  workshop desired performance statements
• Presentation of assessment data results
• Break
• Actual performance and performance gaps
• Lunch
• Overview of root cause analysis
• Group work conduct root cause analysis

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A Quick Reminder of Performance Improvement
Approach
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What is Performance?

• The tasks that people do and the results of those
  tasks

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What is Performance Improvement?

• A step-by-step methodology for finding out what
  is needed to ensure good performance, and
  delivering it

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Factors Influencing Performance
Organizational Support Using Performance Factors

• Job expectations
• Performance feedback
• Environment and tools
• Motivation and incentives
• Skills knowledge

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PI Framework
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OBTAIN AND MAINTAIN STAKEHOLDER AGREEMENT
CONSIDER INSTITUTIONAL CONTEXT MISSION GOALS ST
RATEGIES CULTURE CLIENT AND COMMUNITY PERSPECTI
VES
DEFINE DESIRED PERFORMANCE
PERFORMANCE GAP
FIND ROOT CAUSES WHY DOES THE PERFORMANCE GAP
EXIST?
SELECT INTERVENTIONS WHAT CAN BE DONETO CLOSE
THE PERFORMANCE GAP?
IMPLEMENTINTERVENTION
DESCRIBE ACTUAL PERFORMANCE
MONITOR AND EVALUATE PERFORMANCE
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Define Desired Performance

• What the organization would like to see happening
  - what the providers should be doing
• Is defined by stakeholders through consensus
• Use specific, measurable terms

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Desired Performance Statements
Note insert desired performance statements
developed at stakeholder agreement meeting
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OBTAIN AND MAINTAIN STAKEHOLDER AGREEMENT
CONSIDER INSTITUTIONAL CONTEXT MISSION GOALS ST
RATEGIES CULTURE CLIENT AND COMMUNITY PERSPECTI
VES
DEFINE DESIRED PERFORMANCE
PERFORMANCE GAP
FIND ROOT CAUSES WHY DOES THE PERFORMANCE GAP
EXIST?
SELECT INTERVENTIONS WHAT CAN BE DONETO CLOSE
THE PERFORMANCE GAP?
IMPLEMENTINTERVENTION
We are Here
DESCRIBE ACTUAL PERFORMANCE
MONITOR AND EVALUATE PERFORMANCE
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Actual Performance Statements

• Actual performance measured with same indicators
  as desired performance
• One actual performance statement for each desired
  performance statement

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Data Collection Methodology

• Describe methodology, sample size, and tools used

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Performance Data

• Present text, tables, and figures of performance
  data collected via facility audits, provider and
  client interviews, provider observations, and any
  other methods used

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Performance Factor Data

• Present the information gathered regarding the
  performance factors/ quality assurance and
  management elements, such as information on
  supervision, job expectations, motivation,
  knowledge and skills, etc.

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Do you have any questions or comments?
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OBTAIN AND MAINTAIN STAKEHOLDER AGREEMENT
CONSIDER INSTITUTIONAL CONTEXT MISSION GOALS ST
RATEGIES CULTURE CLIENT AND COMMUNITY PERSPECTI
VES
DEFINE DESIRED PERFORMANCE
We are Here
PERFORMANCE GAP
FIND ROOT CAUSES WHY DOES THE PERFORMANCE GAP
EXIST?
SELECT INTERVENTIONS WHAT CAN BE DONETO CLOSE
THE PERFORMANCE GAP?
IMPLEMENTINTERVENTION
DESCRIBE ACTUAL PERFORMANCE
MONITOR AND EVALUATE PERFORMANCE
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What is a Performance Gap?
Desired Performance
Actual Performance _____________________________
______________ GAP
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Performance Gaps
Note insert the actual percentages determined
via data collection and present the corresponding
Gap for each desired performance statement or
indicator
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Prioritize Performance Gaps

• We cannot work on every gap at once
• Resources are limited
• We need to focus our efforts for greater success
• Must define criteria for prioritizing gaps
• Largest gaps
• Critical area of performance
• Place in priority order (1, 2, 3, .)
• Lets discuss.

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OBTAIN AND MAINTAIN STAKEHOLDER AGREEMENT
CONSIDER INSTITUTIONAL CONTEXT MISSION GOALS ST
RATEGIES CULTURE CLIENT AND COMMUNITY PERSPECTI
VES
We are Here
DEFINE DESIRED PERFORMANCE
PERFORMANCE GAP
FIND ROOT CAUSES WHY DOES THE PERFORMANCE GAP
EXIST?
SELECT INTERVENTIONS WHAT CAN BE DONETO CLOSE
THE PERFORMANCE GAP?
IMPLEMENTINTERVENTION
DESCRIBE ACTUAL PERFORMANCE
MONITOR AND EVALUATE PERFORMANCE
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Root Cause AnalysisMultiple Whys
3 Ws
Why?
Why?
Why?
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Root Cause Analysis Technique

• For each gap, ask why is this occurring?
• For each answer, ask why again?
• Chart multiple answers if they come up
• Keep asking why? until no more answers are
  available
• Stop when you have to say I dont know
• The root cause is the lowest-level cause
  you can do something about.

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Gap Supervisors are not making appropriate
number of supervision visits
Root Cause Analysis Example
Did not know how many visits were expected
No transport
Have no job description
Not in their training
No one told them
No funds
No ones job to tell them
Did not request funds
No one developed a Job description
Did not know how to complete the funding request
form
Have no supervisor
No support system for them
Were not trained
Example Ghana, 2000
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Remember the Performance Factors

• Organizational Support Using Performance Factors
  
• Job Expectations
• Performance Feedback
• Physical Environment and Tools
• Motivation and Incentives
• Skills and Knowledge to do the job
• Note Categorizing root cause by performance
  factor helps us to better identify the
  appropriate interventions for addressing the root
  cause

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Group Work

• In your group begin by reviewing assessment
  results related to your assigned gap.
• Conduct root cause analysis for the performance
  gaps. Ask why-why-why for each gap.
• Choose a facilitator for your group and write the
  multiple why trees on flipchart paper so your
  whole group can see.
• Identify the root causes for each gap by placing
  a star () by it.
• You will have 60 minutes. Then we will present
  and discuss.

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STAKEHOLDER MEETING
Welcome to Day Two!

• Selecting Interventions to Improve Utilization of
  the IUD

City, Country Date
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Agenda
Day 2Date

• Presentation of root cause analysis group work in
  plenary
• Overview of steps for intervention selection
• Group work brainstorm and select interventions
• Break
• Presentation of group work on intervention
  selection in plenary
• Conclusion and next steps

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Plenary Root Cause Analysis

• Lets share your groups work!

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OBTAIN AND MAINTAIN STAKEHOLDER AGREEMENT
PNA
CONSIDER INSTITUTIONAL CONTEXT MISSION GOALS ST
RATEGIES CULTURE CLIENT AND COMMUNITY PERSPECTI
VES
DEFINE DESIRED PERFORMANCE
We are Here
PERFORMANCE GAP
FIND ROOT CAUSES WHY DOES THE PERFORMANCE GAP
EXIST?
SELECT INTERVENTIONS WHAT CAN BE DONETO CLOSE
THE PERFORMANCE GAP?
IMPLEMENTINTERVENTION
DESCRIBE ACTUAL PERFORMANCE
MONITOR AND EVALUATE PERFORMANCE
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Select InterventionsThe Steps

• Define intervention criteria
• Make a list of criteria for judging possible
  interventions, some examples include
• Affordable
• Feasibly
• Timely
• Brainstorm possible interventions
• Generate as many possibilities as you can
• Do not evaluate them yet

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Select InterventionsThe Steps

• Prioritize and select interventions
• Compare each intervention to criteria list
• Cross out those that do not meet the criteria
• Prioritize the interventions
• Select the best intervention to fix the root
  cause in question
• Aim for one intervention per root cause (if
  possible)

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Define Intervention Criteria

• Make a list of criteria for judging possible
  interventions
• Identify must criteriathose criteria that are
  absolutely essential
• Prioritize the other criteria

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What will be our Criteria?

• Ideas?
• Lets discuss

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Group Work

• For each root cause identified earlier,
• Brainstorm possible interventions
• Compare interventions to selection criteria
• Select the interventions you propose to address
  each root cause
• Record your interventions on flip chart paper
  using the table format.
• You will have 60 minutes. Then we will present
  and discuss.

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Presentation Format
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Group WorkDefine Action Plans

• For each intervention your group selected,
  identify the
• Activities/steps
• Responsible person
• Timeline
• Use the following table format and record your
  action plan on flipchart paper.
• You have 60 min. Then we will present and
  discuss.

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Action Plan Format
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Next Steps

• Add next steps as appropriate