Download - Basic concepts of health planning
BASIC CONCEPTS OF HEALTH PLANNING
IntroductionPlanning is making current decisions in the light of their future effects.
Health planning is a process culminating in decisions regarding the future provisions of health facilities and services to meet health needs of the community.
Types of health planning Based on time frame
1. Short term planning (generally 1-3 years) Meeting needs as defined by current trends Using available resources and re-allocation of resources
2. Medium-term planning (5-10 years) Modify demands Recognize new needs Obtain new resources
3. Long-term planning (10-20 years) Select a desired future Design a way of reaching it
Based on hierarchy of goals
1. Health policy planning
Long term health goals
2. Health programme planning
Medium term objectives
3. Operational health planning
More specific & localised
Main characteristics Policy linkage- problems, priorities, directions and strategy
Future orientation- Analysis of past, assessment of present, projection and action towards future
Multidimensionality- epidemiology, demography, medicine, economics, administration, social science
Multisectoral approach- Health, education, environment, social service
Team work- sharing of experience, resources, knowledge
Rationale for health planning
Cope with major health issues in a sustainable manner. Ensure effective coordination and avoid unnecessary
duplication Promote optimum utilization of resources Ensure equitable distribution of health resources and
services Facilitate monitoring and evaluation of health services
Steps of preparing a plan1. Situation analysis2. Problem identification, prioritizationAnalysis3.Set goals, objectives and targets4. Determination and analysis of strategies5. Major activities6. Finance and budgeting7. Monitoring and evaluation
1. Situation analysis
A methodology to assess where we are now?.
A comprehensive analysis of the past & present situation in terms of a selected number of variables.
Identify & assess achievements & limitations of the past and ongoing health interventions.
Information needs for situation analysis
Demographic data Epidemiological data
(morbidity/mortality) Health services data Vital statistical data Socio-economic data
Methods of collecting data
Existing data- published, routine
Surveys- qualitative , quantitative
2. Problem identification,prioritization and analysis
A problem is difficulty or obstacle seen to exist between a present situation and a desired future objective
A perceived gap between what it is and what it should be.
Problem has to be analysed for It’s magnitude Causes consequences
The task of prioritization involves analysis, assessment and grading of problems in order of relative importance.
Criteria for ranking health problems
MagnitudeSeverityFeasibilityCost of interventionPolitical commitment
Different methods to prioritize 80:20 rule Urgent and important model Nominal group technique Modified delphi technique
Problem analysis tools
Cause and effect diagrams Fishbone analysis Problem tree
Define the problem
Problem tree
Fish bone analysis/Ishikawa diagram
3.Set goals, objectives and targets
Goals--- a broad and future oriented statement of the desired condition
objectives—intended result of a successful activity/programme, should be SMART
Targets---quantified statement of desired change in a key indicator over a given time period in a specified geographic area
4. Determination and analysis of strategies A strategy denotes a broad line of action
to be undertaken at different levels of administration in and outside the sector in order to achieve the desired goals and objectives.
To implement a strategy, a variety of activities with specific outcomes are needed for a specific time duration.
In order to identify program/project strategies, it is first necessary to examine internal and external data related to your program.
Internal data
Internal data describe the current status of your program and how it operates, gathered from your situational analysis
External data
External data describe the population that the program serves and the environment in which your program operates.
Use these internal and external data to conduct a SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis of the program.
Environmental analysis
Internal External
Favourable Strengths Opportunities
Unfavourable Weaknesses Threats
Environment
Effect
Program strengths
Program strengths are the elements internal to the health program that facilitate reaching the program goals
Program weaknesses
Program weaknesses are internal elements that are barriers to reaching the program goals
Program opportunities
Program opportunities are aspects of the external environment that facilitate reaching program goals
Program threats
Program threats are aspects of the external environment that are barriers to reaching program goals
Use the results of SWOT analysis to determine the best approaches of the program to meet its stated goals. These approaches are the strategies
5. Major activities
Identify the major activities for each selected strategy.
Determine their sequence and timeframe
Prepare a plan of action including activities, time frame and responsibility
6. Finance and budgeting
Estimate financial requirements for the necessary resources: Physical, Material, Human resources etc.
A detailed description of the costs of the project should be prepared.
The budget should cover the whole project period year-wise.
List each strategy and the activities associated with it List the materials and equipment required for each activity List operating costs under appropriate heads such as
personnel, communication, transport, etc.
Contributions made by the organization such as manpower, equipment or buildings should be stated explicitly.
Summary capital cost by items Recurrent cost by items
7. Monitoring and evaluation
Monitoring
Regular ongoing process to ensure that operations are proceeding as planned and on schedule
Monitoring tools- Schedules- Activity designs- Progress reports- Gannt charts -etc.
Evaluation
A systematic way of learning from experience and using the lesson learned to improve the current activities and promote better planning by careful selection of alternative for future actions
Input evaluation Process (Audit) evaluation Efficiency (output) evaluation Cost efficiency evaluation Effectiveness (out come) evaluation Impact evaluation
Relevance and the adequacy of each components are considered in evaluation
Item Monitoring Evaluation
Frequency Regular/ongoing episodicMain action Keeping track AssessmentBasic purpose Improving efficiency Improve effectivenessFocus Inputs, outputs,
process outcomes, work plans
Effectiveness, relevance, efficiency, impact, sustainability
Source of information Routine databases, field visits, stakeholder meetings, output reports
SurveysSpecial studies
Conducted by Project manager, funders etc
External evaluator
Some technical terms
Project Vs Programme
Definition of a ProjectA project is a temporary entity established to deliver specific (often tangible) outputs in line with predefined time, cost and quality constraints
Definition of a ProgrammeA program is a portfolio comprised of multiple projects that are managed and coordinated as one unit with the objective of achieving (often intangible) outcomes and benefits for the organization.
Efficient Vs Effective
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