TED@BCG Mumbai
Abhishek Gopalka: How motivation can fix public systems
Abišek Gopalka (Abhishek Gopalka): Kako motivacija može popraviti javne sisteme
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Kako popraviti loše javne sisteme? Podstaknete takmičarski duh ljudi. U govoru o tome kako ljude motivisati na promene, strateg javnog sektora Abišek Gopalka govori o tome kako je pomogao da se poboljša zdravstveni sistem Radžastana, države u Indiji koja je dom više od 80 miliona ljudi, koristeći moć transparentnosti i javne odgovornosti. „Motivacija se ne javlja tek tako,“ kaže Gopalka. „Nešto mora da se promeni da bi vas nateralo da vam bude stalo.“
Abhishek Gopalka - Public sector strategist
BCG's Abhishek Gopalka advises governments on innovative approaches to deliver better outcomes for citizens. Full bio
BCG's Abhishek Gopalka advises governments on innovative approaches to deliver better outcomes for citizens. Full bio
Double-click the English transcript below to play the video.
00:13
Take a minute
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Hajde na trenutak
00:14
and think of yourself
as the leader of a country.
as the leader of a country.
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zamislite da ste vođa neke zemlje.
00:18
And let's say one
of your biggest priorities
of your biggest priorities
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I recimo da je jedan
od vaših najvećih prioriteta
od vaših najvećih prioriteta
00:21
is to provide your citizens
with high-quality healthcare.
with high-quality healthcare.
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da svojim građanima pružite
visokokvalitetnu zdravstvenu zaštitu.
visokokvalitetnu zdravstvenu zaštitu.
00:26
How would you go about it?
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Kako biste to uradili?
00:27
Build more hospitals?
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Da li biste izgradili više bolnica?
00:29
Open more medical colleges?
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Otvorili više medicinskih fakulteta?
00:31
Invest in clinical innovation?
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Ulagali u kliničke inovacije?
00:35
But what if your country's health system
was fundamentally broken?
was fundamentally broken?
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Ali šta ako je zdravstveni sistem
u vašoj zemlji suštinski poremećen?
u vašoj zemlji suštinski poremećen?
00:39
Whether it's doctor absenteeism,
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Bilo da se radi o odsustvu lekara,
00:41
drug stock-outs or poor quality of care.
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nedostatku lekova
ili lošem kvalitetu nege.
ili lošem kvalitetu nege.
00:45
Where would you start then?
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Odakle biste počeli?
00:48
I'm a management consultant,
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Ja sam konsultant u menadžmentu,
00:50
and for the last three years,
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i protekle tri godine
00:52
I've been working on a project
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radim na projektu
00:54
to improve the public heath
system of Rajasthan,
system of Rajasthan,
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poboljšanja sistema
javnog zdravlja u Radžastanu,
javnog zdravlja u Radžastanu,
00:57
a state in India.
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državi u Indiji.
01:00
And during the course of the project,
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Za vreme trajanja ovog projekta,
01:02
we actually discovered something profound.
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otkrili smo nešto vrlo značajno.
01:06
More doctors, better facilities,
clinical innovation --
clinical innovation --
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Veći broj doktora, bolje ustanove,
kliničke inovacije -
kliničke inovacije -
01:11
they are all important.
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sve to je bitno.
01:13
But nothing changes
without one key ingredient.
without one key ingredient.
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Ali ništa se ne menja
bez jednog ključnog sastojka.
bez jednog ključnog sastojka.
01:18
Motivation.
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Motivacije.
01:21
But motivation is a tricky thing.
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Ali motivacija je nezgodna stvar.
01:23
If you've led a team, raised a child
or tried to change a personal habit,
or tried to change a personal habit,
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Ako ste predvodili tim, odgajali dete
ili pokušali da promenite ličnu naviku,
ili pokušali da promenite ličnu naviku,
01:29
you know that motivation
doesn't just appear.
doesn't just appear.
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znate da se motivacija ne javlja tek tako.
01:33
Something has to change to make you care.
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Nešto mora da se promeni
da bi vas nateralo da vam bude stalo.
da bi vas nateralo da vam bude stalo.
01:37
And if there's one thing
that all of us humans care about,
that all of us humans care about,
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A ako postoji nešto
do čega je nama ljudima stalo,
do čega je nama ljudima stalo,
01:42
it's an inherent desire
to shine in front of society.
to shine in front of society.
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to je urođena želja
da zablistamo pred društvom.
da zablistamo pred društvom.
01:47
So that's exactly what we did.
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Zato smo upravo to uradili.
01:50
We decided to focus on the citizen:
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Rešili smo da se fokusiramo na građane:
01:54
the people who the system
was supposed to serve in the first place.
was supposed to serve in the first place.
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ljude kojima je sistem
prvenstveno namenjen da služi.
prvenstveno namenjen da služi.
01:59
And today, I'd like to tell you
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Danas bih hteo da vam ispričam
02:02
how Rajasthan has transformed
its public health system dramatically
its public health system dramatically
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kako je Radžastan drastično transformisao
svoj sistem javnog zdravlja
svoj sistem javnog zdravlja
02:07
by using the citizen
to trigger motivation.
to trigger motivation.
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tako što je iskoristio građane
da podstakne motivaciju.
da podstakne motivaciju.
02:12
Now, Rajasthan is one
of India's largest states,
of India's largest states,
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Danas je Radžastan
jedna od najvećih država Indije,
jedna od najvećih država Indije,
02:17
with a population of nearly 80 million.
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sa populacijom od skoro 80 miliona.
02:20
That's larger than the United Kingdom.
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To je više nego u Ujedinjenom Kraljevstvu.
02:24
But the similarities probably end there.
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Ali tu verovatno svaka sličnost prestaje.
02:28
In 2016, when my team was called in
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Godine 2016, kada su moj tim pozvali
02:31
to start working with the public
health system of Rajasthan,
health system of Rajasthan,
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da počne da radi na sistemu
javnog zdravlja u Radžastanu,
javnog zdravlja u Radžastanu,
02:35
we found it in a state of crisis.
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našli smo ga u stanju krize.
02:39
For example, the neonatal
mortality rate --
mortality rate --
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Na primer, stopa neonatalnog mortaliteta -
02:42
that's the number of newborns who die
before their first month birthday --
before their first month birthday --
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to je broj novorođenčadi koja umre
pre nego što napuni mesec dana -
pre nego što napuni mesec dana -
02:48
was 10 times higher than that of the UK.
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bila je 10 puta veća nego u UK.
02:53
No wonder then that citizens were saying,
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Nije ni čudo što su građani govorili:
02:55
"Hey, I don't want to go
to a public health facility."
to a public health facility."
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„Hej, neću da idem
u zdravstvenu ustanovu.“
u zdravstvenu ustanovu.“
02:58
In India, if you wanted to see a doctor
in a public health facility,
in a public health facility,
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U Indiji, ako biste hteli da odete
kod lekara u ustanovi javnog zdravlja,
kod lekara u ustanovi javnog zdravlja,
03:03
you would go to a "PHC,"
or "primary health center."
or "primary health center."
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išli biste u „PZC“
ili „primarni zdravstveni centar“.
ili „primarni zdravstveni centar“.
03:08
And at least 40 patients
are expected to go to a PHC every day.
are expected to go to a PHC every day.
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Predviđeno je da najmanje 40 pacijenata
svakoga dana dolazi u PZC.
svakoga dana dolazi u PZC.
03:14
But in Rajasthan,
only one out of four PHCs
only one out of four PHCs
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Ali u Radžastanu
samo jedan od četiri PZC-a
samo jedan od četiri PZC-a
03:18
was seeing this minimum
number of patients.
number of patients.
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primi taj minimalni broj pacijenata.
03:21
In other words, people
had lost faith in the system.
had lost faith in the system.
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Drugim rečima, ljudi
su izgubili veru u sistem.
su izgubili veru u sistem.
03:27
When we delved deeper,
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Kada smo zašli dublje,
03:29
we realized that lack of accountability
is at the core of it.
is at the core of it.
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shvatili smo da je nedostatak
odgovornosti u srži svega toga.
odgovornosti u srži svega toga.
03:35
Picture this.
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Zamislite ovo.
03:37
Sudha, a daily-wage earner,
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Sudha, nadničarka,
03:39
realizes that her one-year-old daughter
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shvata da njena godinu dana stara ćerka
03:42
is suffering from
uncontrollable dysentery.
uncontrollable dysentery.
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boluje od uznapredovale dizenterije.
03:46
So she decides to take the day off.
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Zato reši da uzme slobodan dan.
03:48
That's a loss of about
350 rupees or five dollars.
350 rupees or five dollars.
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To je gubitak od oko 350 rupija
ili pet dolara.
ili pet dolara.
03:53
And she picks up her daughter in her arms
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Podiže ćerku u naručje
03:56
and walks for five kilometers
to the government PHC.
to the government PHC.
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i pešači pet kilometara do državnog PZC-a.
04:00
But the doctor isn't there.
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Ali doktor nije tamo.
04:03
So she takes the next day off, again,
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Zato ona ponovo uzima slobodan dan
04:06
and comes back to the PHC.
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i vraća se u PZC.
04:09
This time, the doctor is there,
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Ovoga puta je doktor tu,
04:11
but the pharmacist tells her
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ali joj farmaceut saopštava
04:13
that the free drugs
that she's entitled to have run out,
that she's entitled to have run out,
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da je nestalo besplatnih lekova
na koje ona ima pravo,
na koje ona ima pravo,
04:16
because they forgot
to reorder them on time.
to reorder them on time.
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jer su zaboravili da ih naruče na vreme.
04:19
So now, she rushes
to the private medical center,
to the private medical center,
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Tako ona sada juri
u privatni medicinski centar,
u privatni medicinski centar,
04:22
and as she's rushing there,
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i dok žuri tamo
04:23
looking at her daughter's condition
worsening with every passing hour,
worsening with every passing hour,
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i gleda kako se stanje njene ćerke
pogoršava sa svakim satom,
pogoršava sa svakim satom,
04:28
she can't help but wonder
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ne može da se ne zapita
04:30
if she should have gone
to the private medical center
to the private medical center
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da li je trebalo da odmah ode
u privatni medicinski centar
u privatni medicinski centar
04:32
in the first place
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04:33
and payed the 350 rupees
for the consultation and drugs.
for the consultation and drugs.
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i plati 350 rupija za pregled i lekove.
04:40
No one is held accountable
for this incredible failure of the system.
for this incredible failure of the system.
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Niko ne snosi odgovornost
za ovaj neverovatan neuspeh sistema.
za ovaj neverovatan neuspeh sistema.
04:48
Costing time, money
and heartache to Sudha.
and heartache to Sudha.
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A to Sudhi oduzima vreme i novac
i povređuje je.
i povređuje je.
04:55
And this is something
that just had to be fixed.
that just had to be fixed.
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To je prosto moralo da se popravi.
04:59
Now, as all good consultants,
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Kao svi dobri konsultanti,
05:02
we decided that data-driven reviews
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odlučili smo da prikazi
zasnovani na podacima
zasnovani na podacima
05:05
had to be the answer
to improve accountability.
to improve accountability.
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moraju biti odgovor
za poboljšanje odgovornosti.
za poboljšanje odgovornosti.
05:09
So we created these fancy
performance dashboards
performance dashboards
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Tako smo napravili
sofisticirane table učinka
sofisticirane table učinka
05:13
to help make the review meetings
of the health department
of the health department
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kako bi inspekcijski sastanci
odeljenja za zdravlje
odeljenja za zdravlje
05:16
much more effective.
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postali mnogo efikasniji.
05:19
But nothing changed.
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Ali ništa se nije promenilo.
05:21
Discussion after discussion,
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Rasprava za raspravom,
05:23
meeting after meeting,
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sastanak za sastankom,
05:26
nothing changed.
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ništa se nije menjalo.
05:29
And that's when it struck me.
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Tada mi je sinulo.
05:31
You see, public systems
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Vidite, javnim sistemima
05:33
have always been governed
through internal mechanisms,
through internal mechanisms,
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se oduvek upravljalo
kroz unutrašnje mehanizme
kroz unutrašnje mehanizme
05:36
like review meetings.
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kao što su inspekcijski sastanci.
05:39
And over time,
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Vremenom,
05:41
their accountability to the citizen
has been diluted.
has been diluted.
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njihova odgovornost
prema građanima je oslabila.
prema građanima je oslabila.
05:45
So why not bring the citizen
back into the equation,
back into the equation,
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Pa zašto ne bismo vratili
građane u jednačinu,
građane u jednačinu,
05:49
perhaps by using the citizen promises?
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možda pomoću obećanja građanima?
05:52
Couldn't that trigger motivation?
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Zar to ne bi moglo da pokrene motivaciju?
05:56
We started with what I like to call
the coffee shop strategy.
the coffee shop strategy.
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Počeli smo nečim što volim
da zovem strategijom kafića.
da zovem strategijom kafića.
06:01
You've probably seen
one of these signs in a coffee shop,
one of these signs in a coffee shop,
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Verovatno ste videli
neki od ovih znakova u kafiću
neki od ovih znakova u kafiću
06:05
which says,
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koji kaže:
06:06
"If you don't get your receipt,
the coffee is free."
the coffee is free."
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„Ako ne dobijete račun,
kafa je besplatna.“
kafa je besplatna.“
06:11
Now, the cashier has no option
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Sada kasir nema izbora
06:14
but to give you a receipt each time.
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nego da vam svaki put da račun.
06:18
So we took this strategy
and applied it to Rajasthan.
and applied it to Rajasthan.
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Uzeli smo tu strategiju
i primenili je na Radžastan.
i primenili je na Radžastan.
06:23
We worked with the government
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Radili smo sa vladom
06:25
on a program to revive 300 PHCs
across the state,
across the state,
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na programu oživljavanja
300 PZC-a širom zemlje,
300 PZC-a širom zemlje,
06:31
and we got them to paint very clear
citizen promises along the wall.
citizen promises along the wall.
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i rekli smo im da po zidu nacrtaju
vrlo jasna obećanja građanima.
vrlo jasna obećanja građanima.
06:37
"We assure you that you will have
a doctor each time."
a doctor each time."
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„Uveravamo vas da će vas doktor
primiti svaki put.“
primiti svaki put.“
06:42
"We assure you that you will get
your free drugs each time."
your free drugs each time."
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„Uveravamo vas da ćete svaki put
dobiti svoje besplatne lekove.“
dobiti svoje besplatne lekove.“
06:46
"We assure you
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„Uveravamo vas
06:47
that you will get
your free diagnostics each time."
your free diagnostics each time."
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da ćete svaki put dobiti
besplatno dijagnostikovanje.“
besplatno dijagnostikovanje.“
06:51
And finally, we worked
with elected representatives
with elected representatives
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I najzad, radili smo
sa izabranim predstavnicima
sa izabranim predstavnicima
06:54
to launch these revived PHCs,
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na pokretanju tih oživljenih PZC-a,
06:57
who shared the citizen promises
with the community
with the community
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a oni su pred zajednicom
iznosili obećanja građanima
iznosili obećanja građanima
07:01
with a lot of fanfare.
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uz mnogo pompe.
07:04
Now, the promise
was out there in the open.
was out there in the open.
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Sada je obećanje stajalo na otvorenom.
07:08
Failure would be embarrassing.
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Neuspeh bi bio sramotan.
07:12
The system had to start delivering.
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Sistem je morao da počne
da ispunjava obećanja.
da ispunjava obećanja.
07:16
And deliver it did.
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I tako je i bilo.
07:18
Doctor availability went up,
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Doktori su bili više dostupni,
07:21
medicines came on hand,
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lekovi su bili pri ruci,
07:23
and as a result,
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i, kao rezultat toga,
07:24
patient visits went up by 20 percent
in less than a year.
in less than a year.
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broj poseta pacijenata se povećao
za 20 procenata za manje od jedne godine.
za 20 procenata za manje od jedne godine.
07:30
The public health system
was getting back into business.
was getting back into business.
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Sistem javnog zdravlja
bio je ponovo u akciji.
bio je ponovo u akciji.
07:36
But there was still a long distance to go.
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Ali još je ostalo preći dug put.
07:38
Change isn't that easy.
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Sprovesti promene nije tako lako.
07:41
An exasperated doctor once told me,
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Jedan ogorčeni doktor mi je jednom rekao:
07:44
"I really want to transform
the maternal health in my community,
the maternal health in my community,
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„Zaista želim da transformišem
zdravstvenu zaštitu majki u zajednici,
zdravstvenu zaštitu majki u zajednici,
07:48
but I just don't have enough nurses."
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ali prosto nemam dovoljno
medicinskih sestara.“
medicinskih sestara.“
07:51
Now, resources like nurses
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Resurse kao što su medicinske sestre
07:53
are actually controlled
by administrative officers
by administrative officers
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zapravo kontrolišu
administrativni službenici
administrativni službenici
07:57
who the doctors report to.
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kojima doktori podnose izveštaj.
07:59
And while the doctors were now motivated,
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I mada su lekari sada bili motivisani,
08:02
the administrative officers
simply weren't motivated enough
simply weren't motivated enough
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administrativni službenici jednostavno
nisu bili dovoljno motivisani
nisu bili dovoljno motivisani
08:06
to help the doctors.
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da pomognu doktorima.
08:09
This is where the head
of the public health department,
of the public health department,
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Ovde je šef odeljenja za javno zdravlje,
08:12
Ms. Veenu Gupta, came up
with a brilliant idea.
with a brilliant idea.
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gđica Vinu Gupta,
došla na briljantnu ideju.
došla na briljantnu ideju.
08:16
A monthly ranking of all districts.
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Mesečno rangiranje svih okruga.
08:20
And this ranking would assess
the performance of every district
the performance of every district
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A to rangiranje bi procenjivalo
učinak svakog okruga
učinak svakog okruga
08:24
on each major disease
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vezan za svako veće oboljenje
08:26
and each major procedure.
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i svaku veću proceduru.
08:29
But here's the best part.
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Ali evo šta je najbolji deo.
08:30
We made the ranking go public.
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Rangiranja su javno objavljivana.
08:33
We put the ranking on the website,
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Okačili smo rangiranja na veb-sajt,
08:35
we put the ranking on social media,
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stavili ih na društvene mreže,
08:38
and before you knew it,
the media got involved,
the media got involved,
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i za tren oka su se angažovali mediji
08:41
with newspaper articles
on which districts were doing well
on which districts were doing well
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sa novinskim člancima
o tome kojim okruzima ide dobro,
o tome kojim okruzima ide dobro,
08:44
and which ones weren't.
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a kojima ne.
08:47
And we didn't just want the rankings
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Nismo samo hteli da rangiranja
08:49
to impact the best-
and the worst-performing districts.
and the worst-performing districts.
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utiču na okruge sa najboljim
i najgorim učinkom.
i najgorim učinkom.
08:52
We wanted the rankings
to motivate every district.
to motivate every district.
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Želeli smo da rangiranja
motivišu svaki okrug.
motivišu svaki okrug.
08:57
So we took inspiration
from soccer leagues,
from soccer leagues,
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Zato smo preuzeli inspiraciju
od fudbalskih liga
od fudbalskih liga
09:00
and created a three-tiered ranking system,
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i napravili sistem
rangiranja sa tri nivoa,
rangiranja sa tri nivoa,
09:04
whereby every quarter,
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pri čemu biste svakog kvartala,
09:06
if a district's performance
were to decline,
were to decline,
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ako se smanji učinak okruga,
09:09
you could get relegated to the lower tier.
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mogli da padnete na niži nivo.
09:12
But if the district's performance
were to improve,
were to improve,
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Ali ako se učinak okruga poboljša,
09:15
you could get promoted
to the premiere league.
to the premiere league.
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možete biti unapređeni u premijer ligu.
09:19
The rankings were a big success.
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Rangiranja su ostvarila veliki uspeh.
09:22
It generated tremendous excitement,
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Stvorila su ogromno uzbuđenje,
09:24
and districts began vying with each other
to be known as exemplars.
to be known as exemplars.
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a okruzi su počeli da se međusobno nadmeću
kako bi se utvrdili kao uzorni primeri.
kako bi se utvrdili kao uzorni primeri.
09:30
It's actually very simple,
if you think about it.
if you think about it.
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To je zapravo vrlo jednostavno,
ako razmislite o tome.
ako razmislite o tome.
09:33
If the performance data
is only being reviewed by your manager
is only being reviewed by your manager
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Ako podatke o učinku
pregleda samo vaš menadžer
pregleda samo vaš menadžer
09:38
in internal settings,
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u internim uslovima,
09:40
it simply isn't motivating enough.
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to jednostavno ne motiviše dovoljno.
09:43
But if that data is out there,
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Ali ako su podaci o tome predstavljeni
09:46
in the open, for the community to see,
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na otvorenom, tako da zajednica
može da ih vidi,
može da ih vidi,
09:49
that's a very different picture.
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stvari su sasvim drugačije.
09:52
That just unlocks a competitive spirit
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To oslobađa takmičarski duh
09:55
which is inherent
in each and every one of us.
in each and every one of us.
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koji je urođen svima nama.
09:59
So now, when you put these two together,
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Kada spojite ta dva,
10:02
the coffee shop strategy
and public competition,
and public competition,
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strategiju kafića i javno nadmetanje,
10:06
you now had a public health system
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dobili ste sistem javnog zdravlja
10:09
which was significantly more motivated
to improve citizen health.
to improve citizen health.
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koji je znatno motivisaniji
da poboljša zdravlje građana.
da poboljša zdravlje građana.
10:15
And now that you had
a more motivated health system,
a more motivated health system,
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I sada kada imate
motivisaniji sistem zdravstva,
motivisaniji sistem zdravstva,
10:19
it was actually a system
that was now much more ready for support.
that was now much more ready for support.
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to zapravo postaje sistem
koji je mnogo spremniji da pruži podršku.
koji je mnogo spremniji da pruži podršku.
10:23
Because now, there is a pull
for the support,
for the support,
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Jer sada postoji sila
koja navodi na podršku,
koja navodi na podršku,
10:25
whether it's resources,
data or skill building.
data or skill building.
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bilo da se radi o resursima,
podacima ili razvijanju veština.
podacima ili razvijanju veština.
10:30
Let me share an example.
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Izneću jedan primer.
10:32
I was once at a district meeting
in the district of Ajmer.
in the district of Ajmer.
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Jednom sam bio na okružnom
sastanku okruga Adžmer.
sastanku okruga Adžmer.
10:37
This is one of the districts
that had been rising rapidly
that had been rising rapidly
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To je jedan od okruga
koji je brzo napredovao
koji je brzo napredovao
10:40
in the rankings.
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na rang-listama.
10:42
And there were a group
of passionate doctors
of passionate doctors
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Tu je bila grupa strastvenih doktora
10:44
who were discussing ideas
on how to better support their teams.
on how to better support their teams.
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koji su razmatrali ideje
o tome kako da bolje podrže svoje timove.
o tome kako da bolje podrže svoje timove.
10:49
One of the doctors
had up-skilled health workers
had up-skilled health workers
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Jedan od lekara je dokvalifikovao
zdravstvene radnike
zdravstvene radnike
10:52
to tackle the problem of nurse shortages.
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da bi rešio problem
nedostatka medicinskih sestara.
nedostatka medicinskih sestara.
10:56
Another doctor was using WhatsApp
in creative ways
in creative ways
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Drugi doktor je koristio Votsap
na kreativne načine
na kreativne načine
10:59
to share information and ideas
with his frontline workers.
with his frontline workers.
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da bi delio informacije
i ideje sa svojim radnicima.
i ideje sa svojim radnicima.
11:04
For example,
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Na primer,
11:05
where are the children
who are missing from immunization?
who are missing from immunization?
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gde su deca koja su
propustila vakcinaciju?
propustila vakcinaciju?
11:09
And how do you convince the mothers
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I kako ubediti majke
11:11
to actually bring their children
for immunization?
for immunization?
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da dovedu decu na vakcinisanje?
11:14
And because their teams
were now significantly motivated,
were now significantly motivated,
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A pošto su njihovi timovi
sada bili značajno motivisani,
sada bili značajno motivisani,
11:18
they were simply lapping up the support,
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prosto su jedva dočekali podršku,
11:20
because they wanted to perform
better and better.
better and better.
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jer su hteli da postignu što više.
11:26
Broken systems certainly need
more resources and tools.
more resources and tools.
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Lošim sistemima svakako treba
više resursa i alata.
više resursa i alata.
11:32
But they won't drive much impact
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Ali to neće imati mnogo uticaja
11:35
if you don't first address
the motivation challenge.
the motivation challenge.
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ako se najpre ne pozabavite
problemom motivacije.
problemom motivacije.
11:39
Once the motivation tide begins to shift,
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Kada plima motivacije počne da se menja,
11:43
that's when you get the real returns
off resources and tools.
off resources and tools.
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tada zgrćete pravi dobitak
od resursa i alata.
od resursa i alata.
11:50
But I still haven't answered
a key question.
a key question.
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Ali i dalje nisam odgovorio
na ključno pitanje.
na ključno pitanje.
11:53
What happened to the performance
of Rajasthan's public health system?
of Rajasthan's public health system?
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Šta se dogodilo sa učinkom
sistema javnog zdravstva u Radžastanu?
sistema javnog zdravstva u Radžastanu?
11:58
In 2016, when our work began,
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Godine 2016, kada smo počeli sa radom,
12:01
the government of India and the World Bank
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vlada Indije i Svetska banka
12:05
came out with a public health index.
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prikazali su indeks javnog zdravlja.
12:08
Rajasthan was ranked 20th
out of 21 large states.
out of 21 large states.
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Radžastan je bio na 20. mestu
od 21 velike države.
od 21 velike države.
12:14
But in 2018,
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Ali 2018. godine,
12:16
when the next ranking came out,
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kada je objavljena sledeća rang-lista,
12:18
Rajasthan showed
one of the highest improvements
one of the highest improvements
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Radžastan je pokazao
jedno od najboljih poboljšanja
jedno od najboljih poboljšanja
12:21
among all large states in India,
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među svim većim državama u Indiji,
12:23
leapfrogging four positions.
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skočivši za četiri mesta.
12:26
For example, it showed
one of the highest reductions
one of the highest reductions
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Na primer, pokazao je
jedno od najvećih smanjenja
jedno od najvećih smanjenja
12:29
in neonatal mortality,
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neonatalnog mortaliteta,
12:31
with 3,000 additional newborn lives
being saved every year.
being saved every year.
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pri čemu se svake godine spasi
dodatnih 3 000 novorođenčadi.
dodatnih 3 000 novorođenčadi.
12:37
Typically, public health transformations
take a long time, even decades.
take a long time, even decades.
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Transformacije u javnom zdravstvu
obično traju dugo, čak decenijama.
obično traju dugo, čak decenijama.
12:44
But this approach had delivered results
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Ali ovaj pristup je ostvario rezultate
12:46
in two years.
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za dve godine.
12:50
But here's the best part.
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A evo najboljeg dela.
12:52
There is actually nothing
Rajasthan-specific about what we learned.
Rajasthan-specific about what we learned.
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U ovome što smo naučili nema ničeg
što posebno važi samo za Radžastan.
što posebno važi samo za Radžastan.
12:57
In fact, this approach
of using the citizen to trigger motivation
of using the citizen to trigger motivation
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Zapravo, ovaj pristup korišćenja građana
za pokretanje motivacije
za pokretanje motivacije
13:02
is not even limited
to public health systems.
to public health systems.
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nije čak ni ograničen
na sisteme javnog zdravlja.
na sisteme javnog zdravlja.
13:06
I sincerely believe
that if there is any public system,
that if there is any public system,
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Iskreno verujem da,
ako postoji neki javni sistem,
ako postoji neki javni sistem,
13:11
in any country,
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u bilo kojoj zemlji,
13:13
that is in inertia,
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koji je u stanju inercije,
13:15
then we need to bring back the motivation.
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moramo uvesti motivaciju.
13:18
And a great way to trigger the motivation
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A sjajan način za pokretanje motivacije
13:21
is to increase transparency
to the citizen.
to the citizen.
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jeste povećanje
transparentnosti za građane.
transparentnosti za građane.
13:26
We can do this with education
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To možemo primeniti u obrazovanju,
sanitarnim merama,
sanitarnim merama,
13:28
and sanitation and even
political representation.
political representation.
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pa čak i sa političkim predstavnicima.
13:32
Government schools can compete publicly
on the basis of student enrollment.
on the basis of student enrollment.
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Državne škole se mogu javno takmičiti
na osnovu upisa učenika.
na osnovu upisa učenika.
13:38
Cities and towns,
on the basis of cleanliness.
on the basis of cleanliness.
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Veći i manji gradovi
to mogu na osnovu čistoće.
to mogu na osnovu čistoće.
13:41
And politicians on the basis
of a scorecard
of a scorecard
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A političari na osnovu rezultata
13:43
of how exactly they're
improving citizen lives.
improving citizen lives.
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koji tačno pokazuju
kako poboljšavaju živote građana.
kako poboljšavaju živote građana.
13:49
There are many broken systems
out there in the world.
out there in the world.
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Mnogo je loših sistema u svetu.
13:53
We need to bring back their motivation.
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Moramo im vratiti motivaciju.
13:56
The citizen is waiting.
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Građani čekaju.
13:59
We must act today.
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Moramo nešto preduzeti danas.
14:02
Thank you very much.
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Mnogo vam hvala.
14:03
(Applause)
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(Aplauz)
ABOUT THE SPEAKER
Abhishek Gopalka - Public sector strategistBCG's Abhishek Gopalka advises governments on innovative approaches to deliver better outcomes for citizens.
Why you should listen
BCG's Abhishek Gopalka is a Managing Director and Partner in the New Delhi office, with more than 11 years of experience working with governments, foundations, international institutions, NGOs and private sector.
Gopalka has deep expertise in large-scale transformation of public delivery systems to drive citizen outcomes, with a focus on public health and education. He has worked across multiple geographies, including India and the US.
Gopalka holds an MBA from the Ross School of Business (University of Michigan, Ann Arbor) and a B.E. in Computer Science from R.V. College of Engineering (Visvesvaraya Technological University), Bangalore.
Abhishek Gopalka | Speaker | TED.com