NMI (Non-monetary Incentive) Scheme to improve provider behavior Presenters: Ms. Grishma Shrestha, Social Franchising Manager Mr. Pawas Rai, Sector Office Manager 2 nd Global SF Conference 23 rd Oct 2014

OK Franchise Network  Women’s Health Program  Since 2009  Network of service providers  Private clinic adjoining a pharmacy  Balanced Counseling and IUCD services  400 approx. in 50 districts (out of 75)

Why NMI?  Motivation  IUCD – “not profitable” -Limited to one product -Time-consuming but limited income  Turnover  Complains -“Support not adequate” -“No sterilization equipments” -Incomplete recording and reporting – “time-consuming” -QA, community-level activities – “No time”

Process – Development & Implementation Need assessment – Issues & Needs Eligibility Criteria, Scoring Criteria & Rewards Scoring & Redemption Mechanism - Forms & Formats IEC Materials – Brochure, Scoring Sheet System/MISOrientation Monthly Scoring & Notification MonitoringEvaluationImprove

Eligibility and Scoring Criteria  Certified  Minimum of 50 IUCD insertions Scoring Criteria  Points - several criteria -QA Assessment scores -Participation in Bhalakusari (community) meetings -Record-keeping and reporting -Display of IEC materials -Behavior Rewards

Scoring Mechanism  Monitored - field staffs  Monthly  Reward points - observations & MIS data  Maximum points  Multiple rewards

Impact of NMI in 2013 Improved indicators  Fewer complaints  Improved QA score - from 91.3% to 94.4%  Increased % of providers attending Bhalakusari (community) meetings - from 6% to 18%  Improved display of IEC materials  Increased productivity - average IUCD insertion per provider - from 3.1 to 5.1 Successful in motivating providers

Challenges  Key motivator - monetary but against policy -Appealing non-monetary rewards  Behavior change – not easy & takes time -Monthly notify – points -Continuous motivation – improve performance and earn better scores

Applicable to other SF Programs?

Next steps Lesson learnt – Include facility owners