Two simple interventions produced the immediate results of reduced client wait times and dramatically improved information sharing efficiency at one MiFamilia center in Nicaragua.
Managua, Nicaragua. Set on the edge of the bustling Mercado Oriental, the largest open-air market in Central America, is the Delegación Oriental de MiFamilia. It is a small building on a relatively empty side street, providing an unusually quiet respite from the chaos of the market space. MiFamilia is the federal government ministry that provides social services to children, adolescents, women, and vulnerable population groups. The Delegación Oriental serves Districts 4, 5, and 6 of Managua, a population of more than 620,000 people who are among the most poor of Nicaragua’s capital and largest city.
In 2004, with funding from USAID, Management Sciences for Health (MSH) provided MiFamilia with technical assistance in leadership development and the implementation of a management information system. From March to August 2004, 16 delegations of MiFamilia were selected to participate, including Delegación Oriental. The leadership development included self-assessments and identifying areas to focus on improvements. “We realized when we returned that we needed to share this with everyone at the center—from the security guards to the directors,” Ms. Gloria Diaz, the General Director of the Delegación Oriental, explains. “We all needed to practice good leadership in order to improve the quality of our services.”
Through the program, the Delegación Oriental developed client surveys. They also put out feedback boxes and established a committee to analyze complaints in an effort to improve. A major complaint was the wait times. Many mornings, before counselors have even arrived, several people sit in the waiting room, hoping to expedite the visit. However, initial processing of clients often took more than a half an hour.
USAID also provided MiFamilia with a new information system, with MSH providing technical support. By enabling more electronic records and working together, the office redesigned the visitation process for clients. In just three months, Delegación Oriental reduced its total waiting time from an average of 30 minutes to 10 minutes. Overall feedback on services has also improved.
The system has also allowed the office to make progress in modernizing its operations. Ms. Ruth Ramirez, the deputy director, is responsible for reporting and other information sharing. “Before it was nearly impossible and very time consuming just to do the minimal reporting,” she explains. “Now we can generate population statistics and share them in a timely manner with high accuracy—we can show how many children have received services, in what category of service they needed, our operating cost on a per-client basis showing how small the investment is based on the number of people we serve, and information on the foster homes we work with.” Not only is the information system increasing and improving the quality of the information sharing between MiFamilia and others, but it is reducing the human resource requirements in providing that information. As a result, more resources can be dedicated to serving the population.
