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India is Asia's second largest country after china. It lies in the South part of Asia. India shares its border with China, Pakistan, Bhutan, Bangladesh, Burma & Nepal. Total area is 3,287,590 sq. km. The country's coastline is worth of 4350 miles. The climate of India is tropical in south and temperate in the northern part. Main religions are Hindus (80%), Muslims (13%), Christians (2%), others (5%).
Population* of India
With 1,014,003,817 people, India is emerging the world's second largest populated country according to 2001 census. Now we can compare with the most populous country of the world.
65 years &above
*Source census of India 2001
In this scales, children in India is tend to be more than as compared to the world's populous country. So the need for care of children is to be raised according to the need. The latest measures show that India will overtake China's population in 2020 by estimation.
Literacy rate of India
As the population is high, education remains to be constraint in all states of India except Kerala. If we consider the literacy in India, it is improving and getting more help from the government. The census of the 2001 reveals of the scales that are improving.
The measures show the facts about the literacy in India of census 2001, however this can be used to measure the child problems as scales reveals the fact that the literacy is rated above 7 years of age who know to write and read their names at least in one language. In future this level of literacy increases and reflects in education positively, especially in Kerala.
Economic Status of India
India is the 12th largest economy of the world and 4th largest on the 'Purchasing Power Parity' (PPP). In 21st century, India will be an emerging power which the nation is capable of economic power with human resources and of knowledge base. The prediction of the economists is that it will be the leading economies by 2020. But the trend is to be affected, if the waves of inflation have an impact with the economy of India. India's per capita income is 128th in PPP and 139th in nominal. The GDP of the economy is based on Service industry (54%), Agriculture (28%) and industries (18%) of the total economic status of India.
Major sources of Income
Agriculture, services, industries are the main sources of GDP in India. So in the future, according to the population increase, as the measures shown ahead and also the country grows more in economic terms due to rising inflation, and increasing literacy shoots up education standards.
In India, the health status varies from state to state, depending upon the lifestyle, traditions, society etc. As the 2001 measures shows of increasing population and increasing economic returns, the health status is also to be geared up. However the increasing population will still be a constraint to achieve success in this field. But however, it adversely helps the man power the requirements for the healthcare needs of the nation. Hence the measures showing the facts can be taken for the estimation.
Life Expectancy Rate
It has been increasing in India due to advanced healthcare system and the quality of it. However, the measures show the figures of 64.1 years for males and 65.8 years for females in the country. In Kerala state of India, the life expectancy rate at birth is 73 years, and it will change according to the states depending on the culture, beliefs, tradition etc. As the trend goes on the value we have obtained is reflected positively during the future.
Infant mortality rate
*Source National Health System Profile 2005
The graph shows the declination of the infant mortality rate of the state as well as the nation's mortality rate. This current trend shows the declination of the mortality rate of Kerala which is compared to National mortality rate.
Major Health Issues
Major diseases in India includes dengue fever which is most reflected in the tropical climates, Kala Azar in Bihar district, filariasis and Roll back Malaria. But if we look on to children the main diseases are ARI, Diarrhoea, and malnutrition. The common diseases which we can see are the spreading diseases. Spreading diseases such as hepatitis and chicken pox are also seen in children. Other diseases of which the children are affected are of chronic pneumonia, diarrhoea, viral infections and dengue fever, convulsions, cardiac problems, PUO, etc.
The chronic diseases are often less as compared to the considerable amount of infectious diseases. The patient who comes with infectious diseases is cared in isolation wards.
The Indian healthcare system is widely known over the world for its inadequacy of professional hands, but on the other hand the same is world famous for its practitioners and quality professionals all over the world who works abroad. Indian healthcare system is one of the developing systems in all levels during the present times. The basis of this system is the funding type to the system.
In India the external assistance for the system is low of up to 1-3%, but the majority of the healthcare is funded or occupied by the private holdings. The public healthcare system is a three tier system which accompanies Sub centre for 5000 population, PHC for 30000 populations, community health centre for 100000 populations. The system getting external assistance for this system which 10-20% is sponsored by WHO. The objective that set by the system in 2003 is to achieve an acceptable standard of good health among general population of the country. However, there are also charity oriented healthcare systems in there which offers a great value to the nation's health.
OVERVIEW OF HEALTHCARE ORGANISATION
The organisation started in 1952 and the paediatric department started in 1969. The organisation is a non-profit funding organisation which runs by the Archdiocese of Trichur. The organisations motto of "service with love" is widely known in the district as well in the nearby districts and it is reflected in the paediatric segment. The low costs for the treatment with quality care services gave the organisation an ethical status and hence known as "poor man's hospital" throughout the area. The organisation also does several charity oriented service as well.
The hospital's vision is to "service with love" and it is spread to the all religion groups irrespective of cast and creed. Its approach towards healthcare is that to ensure the promotive, preventive, curative and rehabilitative health care to all, to the poor and disadvantaged irrespective of cast and creed. It also enhances the quality health within the affordable rates. They also aim to the principles and ethical value of human life and dignity in their sector. Hence their objective is to 'serve the people with love irrespective of cast and creed and irrespective of rich or poor in an affordable rate with the quality service' is stated on the website of the organisation.
Jubilee Mission Medical College & Research Institute [JMMC & RI] the above mentioned organisation is boasting of 1500 beds in overall gave the 120+ beds for the paediatric department. The department also acquired an Intensive care unit for the serious patients with well qualified staff and medical officers all round the clock. It consists of more than ten doctors of which have completed more than ten years experience in the department. Dr. Johny Vincent, Dr. Sunny George, Dr. Vinod Jacob Cherian are the main doctors of the department. And additions to this, there are more than 25 doctors who serve the department in a day. The people who comes there are mostly poor, from far places within the district and also from nearby districts. The clients from other state often visit the hospital. However rich people also afford a good treatment at less cost with pay rooms. The level of standards of living of patients often makes problems in the busy department. Due to the busy environment, the staff had to work more than their shift, according to busy nature. We can see how the paediatric department in this reputed organisation tends to cope with the health status of the children with their objectives.
The factors that affecting the organisation and that cannot be controlled by the organisation is said to be the macro-environment of the organisation. Here we can see how the paediatrics department have an impact with macro-environment surrounding it.
Political factors are the factors affecting the organisation influencing the politics. It may affect the organisation directly or indirectly. It may also reflect the influence of the politics whether it may be positive or negative according to the decisions. The paediatric department doesn't have any direct impact to the politics except child care issues. But the politic wave is reflected in the department, due to increase tax for the equipments, basic pay level to the staff set by the government, etc.
In future, the politics only waves the influence on the political issues not on the department. To overcome this factor, they have to change their strategic decision and objectives according to the changing situation of politics.
The economical factors are the terms that are related to the money. However the money spinning in the market get fluctuations in this sector and it is said as 'deflation' and 'inflation' in whole. The organisation's funds are mainly from the NRI (non-resident Indians) and from other charity organisation outside the country. It is now suffering from lack of sufficient funding due to recession. They are in the way to implement the cardio-thoracic department which links with paediatric department, but they have to drop it off due to the lack of sound financial support.
This trend continues to 2-3 years period; however they have to find the promotion for the department and thus can organise the funds for the expenditure.
The social factors are that related to the cultural tradition and beliefs of the local people. It can also includes the way of practices and the local systems of living influences the social changes and they will affects the paediatric department. One example is, the parents will not allow to cannulise the child saying reason as the child doesn't needs it. But somehow the medical professionals have to suffer owing that reason if anything happens to the child.
Due to the increasing level of literacy and other education programs in the country during the past 2-3 years and continuing, socially the people will develops. So the department have to compete for quality along with price in the future.
The technical matters are said to be technology deficits. The establishment of new level of technologies is to be updated in the every form of the care level to gain the success and outstanding quality. In the organisation there are lot of technical deficits. Due to the summer the electricity board will execute a 30 minutes load shedding that will adversely affects any emergency situation in the department.
MCKINSEY'S 7S FRAMEWORK
McKinsey's 7S model mainly aims to the value based management. This model will help to achieve how to analyse the situations within the department to outline the SWOT of it. In the picture as shown above the 7s is the analysing factors of an organisation. It is stating as below:-
Now we can analyse this factors in the paediatric department of the JMMC & RI.
Factor 'Strategy' means that the decisions or any type of measures opted for the long term business, which is covered with ethical ways to get optimum outcome with the other shared values within the organisation.
Factor 'structure' means that the way of structuring the department to other departments or linked to the central information store, where the details or other information about the client is assessable from the other part of the organisation within least time consumable.
This factor means that the daily routine of the department is gaining any sorts of advantage to the organisation. The daily routines and procedures are implemented is more focused whether it is of prime importance.
The style of behaviour of the managers is reflected in this factor. It also shows how the system and other factors are interlinked to the clients to have easy access.
It shows the capability of the staffs and their requirement per clients.
It discriminates the skills that are having with the employees is worthy if it.
This is the main factor for the organisation in which the all other factors are to be united to gain the central assess from or within the organisation.
Objective of the organisation
Setup of the organisation
Discussions for improvement
Ethically motivated managers
In terms of ethics
In terms of strategy
In terms of structure
In terms of system
In terms of style
In terms of staff
In terms of skills
In terms of quality
Paediatric department has its own values which can be assessed to strengths and weaknesses. It is use to extract the opportunities and strengths. Based on the chart above, we can summarise the SWOT table of Paediatric department of JMMC & RI.
SWOT OF PAEDIATRIC DEPARTMENT OF JMMC & RI
The paediatric department has the strategy which helps for the long term vision which actually shows their objective of what they are going to do is a main strength. Strength of the department is the procedure timing and the routine adjusting capability of the department. Various works are carried out in the timing with the procedures going on another side by the free oriented staff. And by that way the department saves money as well as man power to the department. The skills of the department are remarkable; the doctors are experienced with more than 10 years with proficient rated among the state. The nursing staff and other related staffs are trained inside the campus with huge amount of 'live' experience during their trainee period which reflects when they were once in the position.
The weaknesses include the structure of the organisation. The lack of right decision making at the right time is reflected in the department for angry behaviours of the by the parents in some occasions. However there are issues, there is no response to discuss the way for improving it, lacks a major evaluation which can be useful if analysed. The other weakness includes the workload to the staff. It is not to be done as they are the factors that we can give the care to the clients. If the workload continues, then it may come out as a threat for the department.
The system can be improved by applying rest to the staffs and other medical professionals. It can helps in improving the level of standard of the service provided and hence reduces the threat of falling number of staffs. The style of the department is to be changed, that means the motivation to the employees by the motivated managers can improve the support provided for the staffs and once they feels secure on their job, the threat can be reduced. The weak structure for the organisation can be assessed to be an opportunity because if the structure increases, probably the other resources will get develop and can have a competitive future within the sector.
The structure posses the threat for the organisation if continues to be same. The technology deficit which is a hurdle for the department will be a major threat if not cared. The system for the monthly rota is to be done well with correct level of rest for the medical professionals. If not doing so, the falling out of staff will cause a threat for the department. The most reasons behind the falling of departmental can be assumed to be as lack of support. It is to be cared individually, by appraising systems etc and so on. The demanding power of staffs can be assessed as another threat, which they strike of will affect service quality and quantity.
The describing of events or series of what action to be done systematically is known as scenario. The scenarios may vary according to the purpose of events. When we chose the scenario planning in healthcare sector, we can usually divide it into three.
Low end scenario
The low level of getting into the business is known as low level scenario.
Medium end scenario
The medium level of getting through the business is medium level scenario
High end scenario
The high level of success in the business is high level scenario.
In this part we are going to see how the scenarios are explained in the paediatric department of JMMC & RI. These are the likely things going to happen during the future 5-10 years of time depending upon the balance mix of evaluation of PESTEL and Mckinsey's 7S framework model.
LOW END SCENARIO OR WORST SCENARIO
The department gets worst when if they are not focusing the threats and opportunities of the department. Department will go worst if structure of the organisation remains the same for 2 more years. The rotas of the staffs are also to be concentrated, if not, the falling off staffs will lead to worsen the situation of business. The department will be affected or get worst if they are not making the right decisions with favourable to structure, style and staff evaluation & adequate rest to them. This will worsens if they are not taking any actions for the above stated reasons.
Alternatively the situation may get worsened if the political trick tumbles according to economic recession during the future.
MEDIUM END SCENARIO OR LIKELY SCENARIO
The paediatric department however gets likely scenario when concentrating the issues within the department more than the macro-environment. The focusing of opportunities rather than threats is tending to be medium way of attaining success during the 5 - 10 years of time. The alternative evaluation of politics during the phase will give some advantage to get advanced in the future. As the current trend continues the way for to achieve the success during the future is mainly based on the decision which comes prime importance for political issues with the analysing of defects in the department.
HIGH END OR BEST SCENARIO
The department can be changed to one of the valuable, good, competitive form by using the appropriate use of mixing the analysing factors that we have seen above. That is we have to use the right structure, style, and usage of staff in accordance to the change that is occurring in the political changes in the area. The evaluation of staff in accordance to system and structure of the department within the economic withhold of the department. And more to that the raising standards of ethics through educational camps and other charity works which will works as a promotional event to get more develop.
CONCLUSION & RECOMMENDATIONS
If we consider any type of business of any kind, the success for it is to work hard. At the present situation, population and educational standards increases in the nation. And it tends to continue for the future. In the future, the key element for success is to offer the 'services with quality' in the provided sector which should be ahead of the other service providers to make profits. And in healthcare sector the profit is explained as health. And the hard working is in vain if we are not using the right analysing of the factors which affects on the success of the department.
The gaining of this profit is thus achieved by actually using the mix of emphasising the questions such as what, where, when and how. In this study about the paediatric department of JMMC & RI, we can conclude as follows
The department can implement high standard of structure to the department which helps other factors of success, to enhance modification and reach high standards. And this should be delivered in emphasis to 'service quality' that is to be enhanced to the future as the major objective.
The objective of 'service quality' thus evolves during and in the future is thus promoted by the educational camps in the rural areas with ethical strategy to get promote itself, as well as to gain social standard which alternatively affects the nation's growth and health standards.
The growth of nation and health status will affects in the political measures adopted for the country, which reflects the economic level of the country alternatively, which every country is now looking for; in the middle of 'recession'.
And to gain the 'service quality', the patient care should reach the patients difficulties and it also should be in the achievable price. Other factor that is to gain is the 'value' of the service which can be got through the ethical strategy. And for to continue 'service quality' throughout the future, high performance with stability and the feedback from the patients is also to be done along with the above stated conclusions.