An evaluation of Primary health care system in Kerala

The thesis entitled An Evaluation of Primary Health Care System in Kerala. The present study is intended to examine the working of primary health care system and its impact on the health status of people. The hypothesis tested in the thesis includes, a. The changes in the health profile require reallocation of resources of primary health care system, b. Rate of utilization depends on the quality of services provided by primary health centers, and c. There is a significant decline in the operational efficiency of the primary health care system. The major elements of primary health care stated in the report of AlmaAta International Conference on Primary Health Care (WHO, 1994)” is studied on the basis of the classification of the elements in to three: Preventive, Promotive, and Curative measures. Preventive measures include Maternal and Child Health Care including family Planning. Provision of water and sanitation is reviewed under promotive measures. Curative measures are studied using the disease profile of the study area. Collection of primary data was done through a sample survey, using pre-tested interview schedule of households of the study area. Multi stage random sampling design was used for selecting the sample. The design of the present study is both descriptive and analytical in nature. As far as the analytical tools are concerned, growth index, percentages, ratios, rates, time series analysis, analysis of variance, chi square test, Z test were used for analyzing the data. Present study revealed that no one in these areas was covered under any type of health insurance. Conclusion states that considering the present changes in the health profile, traditional pattern of resource allocation should be altered to meet the urgent health care needs of the people. Preventive and promotive measures like health education for giving awareness among people to change health habits, diet pattern, life style etc. are to be developed. Proper diagnosis and treatment of the disease at the beginning of the stage itself may help to cure majority of disease. For that, Public health policy must ensure the primary health care as enunciated at Alma- Ata international Conference. At the same time Public health is not to be treated as the sole responsibility of the government. Active community participation is an essential means to attain the goals.

MQFD: A Model for Synergizing TPM and QFD

This thesis presents the methodology of linking Total Productive Maintenance (TPM) and Quality Function Deployment (QFD). The Synergic power ofTPM and QFD led to the formation of a new maintenance model named Maintenance Quality Function Deployment (MQFD). This model was found so powerful that, it could overcome the drawbacks of TPM, by taking care of customer voices. Those voices of customers are used to develop the house of quality. The outputs of house of quality, which are in the form of technical languages, are submitted to the top management for making strategic decisions. The technical languages, which are concerned with enhancing maintenance quality, are strategically directed by the top management towards their adoption of eight TPM pillars. The TPM characteristics developed through the development of eight pillars are fed into the production system, where their implementation is focused towards increasing the values of the maintenance quality parameters, namely overall equipment efficiency (GEE), mean time between failures (MTBF), mean time to repair (MTIR), performance quality, availability and mean down time (MDT). The outputs from production system are required to be reflected in the form of business values namely improved maintenance quality, increased profit, upgraded core competence, and enhanced goodwill. A unique feature of the MQFD model is that it is not necessary to change or dismantle the existing process ofdeveloping house ofquality and TPM projects, which may already be under practice in the company concerned. Thus, the MQFD model enables the tactical marriage between QFD and TPM.First, the literature was reviewed. The results of this review indicated that no activities had so far been reported on integrating QFD in TPM and vice versa. During the second phase, a survey was conducted in six companies in which TPM had been implemented. The objective of this survey was to locate any traces of QFD implementation in TPM programme being implemented in these companies. This survey results indicated that no effort on integrating QFD in TPM had been made in these companies. After completing these two phases of activities, the MQFD model was designed. The details of this work are presented in this research work. Followed by this, the explorative studies on implementing this MQFD model in real time environments were conducted. In addition to that, an empirical study was carried out to examine the receptivity of MQFD model among the practitioners and multifarious organizational cultures. Finally, a sensitivity analysis was conducted to find the hierarchy of various factors influencing MQFD in a company. Throughout the research work, the theory and practice of MQFD were juxtaposed by presenting and publishing papers among scholarly communities and conducting case studies in real time scenario.