B.Lkhagva: Any problem can be solved if the public discusses it together
As part of the activities of MASAM Second Phase Project, we had planned to evaluate the Family Health Centers (FHC) through a questionnaire. However, our team discussed and came up with the idea that instead of evaluating the FHC only once, we should develop a methodology that can be used sustainably in the future, and that it could continue to be used even after the project is over.
As the Mongolian saying goes, "One twig does not make a fire, and one person does not make a family." It is also said that two heads think better than one. Therefore, Ch. Lkhagvasuren, who worked for 33 years in the education sector of Khuvsgul province (local coordinator of the Association of Parents of Disabled Children), J. Lkhagvasuren, who worked for 31 years in the health sector (Chairman of the Khuvsgul province association of the Mongolian Medical Specialist Association), together with me, B. Lkhagva, who worked in the field of finance and economics for 34 years, developed a new tool named "Good Clinic – Satisfactory Service’. This new social accountability tool aims to improve primary health care and services in Mongolia.
This methodology is unique in that it evaluates the material, psychological and governance environment of the FHCs and proposes solutions to the problems faced based on creative joint participation. For example, the tool helped the "Gurvan Gal" FHC of Murun Soum, Khuvsgul Aimag to solve its sewage problem.
At this FHC, the “Good Hospital-Satisfactory Service” method was tested and a multi-participatory evaluation was conducted. Therefore, as a result of the assessment of the material environment, it was assessed that this FHC needed to connect its sanitary fixtures to the sewage system first for them to work. After the evaluation, in order to solve the problem, the FHC approached the Health Department and the Governor’s Office of Khuvsgul, presented the evaluation developed according to the methodology, and by consulting and exchanging ideas with them, they were able to include more than 19,000,000 MNT in the 2023 budget of the province. As a result, doctors, employees and clients of the FHC now can have access to working sanitary fixtures. Most importantly, by using this method, employees realized that in the future, when problems are encountered, the FHCs can solve problems together and achieve better results thanks to multi-stakeholder participation.
Also, Dr. J.Sunjidmaa, Head of the FHC stated that the attitude of the management, and employees of the hospital were changed due to the use of the Good Clinic -Satisfactory Service tool. As a result:
• By evaluating the psychological environment, FHC staff can openly discuss their problems, understand each other, and become motivated to cooperate.
• FHC staff who are motivated, tried to provide better services to their clients.
• FHC staff have come to understand that the problems faced by the medical staff are not only medical, but also psychological.
• Together, they discovered how critical it is to assess the organization's governance environment and increase openness.
In order to improve our "Good Clinic -Satisfactory Service" tool, we have tested it in five FHCs of the Khuvsgul aimag, and as a result of this tool, each FHC has identified the issues they faced and solved diverse problems. Based on this experience, we have been working in organizing a training in Sukhbaatar, Darkhan, and Selenge, Orkhon provinces in order to localize the "Good clinic -Satisfactory service” tool to improve the primary health care services of FHCs in Mongolia within the local initiatives of the MASAM II project.