Name of Presenter: Gautam Mazumder Position/Company State Coordinator-PPM Project in West Bengal

1. PLANNED PREVENTIVE MAINTENANCE (PPM) IN WEST BENGAL Name of Presenter:Gautam Mazumder Position/Company State Coordinator-PPM Project in West Bengal GOPA-EPOS Consultants Kolkata, India

2. Context – Overview of the project PPM, a new concept, means regular preventive maintenance (routine checks and servicing) undertaken in a health facility by a PPM Team every 2-3 months interval based on a check-list of cleaning and maintenance activities Regular PPM activities keep the health facilities in good working condition and minimize major maintenance costs for buildings and equipment. PPM project undertaken in pilot phase by GOPA-EPOS Consultants under kfw funded Basic Health Project of the Government of West Bengal (GoWB) in selected rural health facilities in West Bengal The aim of the PPM pilot project was to test the PPM concept as a new model for institutionalization of PPM programme across the State

3. Type of PPP PPM undertaken in pilot phase in selected health facilities to test the concept as a new model for institutionalalization in the State under PPP After the initiation of the institutionalization in selected Sub Divisions (SD) [covering a number of RHs, BPHCs and PHCs], Agencies were selected based on eligibility criteria, expression of interest and bidding to undertake PPM activities in the allocated Sub Division using the pilot model Agreement with contractual terms, approved cost and SOPs was signed with the CMOH, GoWB of the concerned District The operating partner takes care of all the expenses to implement PPM programme in the allocated health facilities by complying with the SOPs and receives the approved cost at the end of the month on production of prescribed documents including photo documentation The Assistant Chief Medical Officer of Health (ACMOH), in-charge of the concerned Sub Division is the Nodal Officer on behalf of GoWB.

4. Partnership/Actors Involved During Pilot Phase (2007-2010) Health & Family Welfare Department, GoWB through GOPA-EPOS Consultants under kfw funded Basic Health Project After the initiation of institutionalization by GoWB through its own fund ( Jan 2011-ongoing) Public Partner Health & Family Welfare Department, GoWB Private Partners NGOs, CBOs / Private Sector Organizations with some experience in sanitary mart project or maintenance in health care Technical Support (initial phase of institutionalization) GOPA-EPOS Consultants under kfw funded Basic Health Project

5. Project Objective Test the PPM concept as a new model for improving the conditions of the rural health care facilities in West Bengal Sensitization and Capacity Building Initiatives on PPM programme Institutionalization of PPM programme across the State using the pilot model

6. Project Set-Up and Arrangements A. During the Pilot phase of PPM Project Consultation with the State level officials of GoWB on the concept, decide on the 3 Districts for piloting with duration of piloting, finalization of documents relating to check-list, reports etc. Consultation at the District level with the concerned authorities, People’s Representatives and other stakeholders on the PPM concept, decide on the health facilities (Rural hospitals, Block Primary Health Centers) for piloting as well as finalization of programme schedule. Deployment of PPM Supervisor and other personnel in each of the pilot District with office set up. Engagement of on site PPM Maintenance Team and providing necessary training before launch of PPM programme Arrangement of Tools and equipment for PPM activities

7. Project Set-Up and Arrangements (Continued) B. During institutionalization of PPM PPM sustainability document was prepared and approved by GoWB. Based on the experience of pilot phase, GoWB decided in principle to initially implement the programme in two SDs in two Districts with its own fund Finalization of Information Brochure, contractual terms with SOP and eligibility criteria for selection of the operating partner Selection of two Organizations followed by signing of contractual agreement Orientation workshop and Training before launch of PPM activities On site PPM programme started from February 2011 On site technical support for initial months provided from GOPA-EPOS under kfw funded Basic Health Project

8. Key Milestones Keeping health facilities functional by ensuring that building and equipment are kept in good working condition through regular PPM activities Reducing major maintenance costs Providing healthy and hygienic conditions for the staff and patients, thus helping to improve health care delivery in the State

9. Challenges and Mitigation Plans Challenges Making stakeholders understand the concept of PPM and the difference between PPM and Corrective Maintenance Initial resistance from the hospital staff for fear of outsourcing Involving concerned hospital staff in the cleaning activities between the two PPM programme Creating a multiskilled PPM Team Mitigation Plan Series of interactions with stakeholders explaining the benefits of PPM District and Block level workshops involving health staff and Panchayeti Raj Institution on site training with PPM Team for multiskilled concept

10. Progress to Date Pilot project undertaken in 103 health facilities in three Districts between 2008 & 2010 to test the concept as a new model 16 District level and 59 Block level workshops with health personnel and PRIs conducted with the help of fiction film, video documentation for onsite PPM work and Booklets on PPM. Sustainability Plan for PPM submitted based on which GoWB decided in principle to initially implement PPM with its own fund in two SDs in two Districts covering an average of 35 RHs, BPHCs and PHCs in each SD Consultants facilitated the process of preparation of documentation and selection of two Agencies for undertaking PPM work at operating cost approved by GoWB On site PPM work started from Feb 2011 under the training and technical support from GOPA-EPOS Consultants in the initial stages GoWB is in the process of rolling out the scheme in other Sub Divisions under National Rural Health Mission (NRHM)

11. Lessons Learnt/Best Practices Lessons Learnt Involving the concerned person in the health facility in the advance work plan for PPM and Feedback after PPM work in structured format Multi skilled PPM Team for efficient management of PPM work Best Practices Photo documentation before, during and after each PPM work Designing of Booklets with photos of onsite PPM work, Information Brochure, Agreement and SOPs for PPM institutionalization

12. PPM Activities