Basic concepts of health planning

Planning 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.

1. Basic concepts of Health Planning

2. Introduction Planning is making current decisions in the light of their future effects . H ealth planning is a process culminating in decisions regarding the future provisions of health facilities and services to meet health needs of the community.

3. 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

4. Based on hierarchy of goals Health policy planning Long term health goals 2. Health programme planning Medium term objectives 3. Operational health planning More specific & localised

5. Main characteristics P olicy 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

6. 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

7. Steps of preparing a plan 1. Situation analysis 2. Problem identification, prioritization Analysis 3.Set goals, objectives and targets 4. Determination and analysis of strategies 5. Major activities 6. Finance and budgeting 7. Monitoring and evaluation

8. 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.

9. Information needs for situation analysis Demographic data Epidemiological data (morbidity/mortality) Health services data Vital statistical data Socio-economic data

10. Methods of collecting data Existing data- published, routine Surveys- qualitative , quantitative

11. 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

12. The task of prioritization involves analysis, assessment and grading of problems in order of relative importance. Criteria for ranking health problems Magnitude Severity Feasibility Cost of intervention Political commitment Different methods to prioritize 80:20 rule Urgent and important model Nominal group technique Modified delphi technique

13. Problem analysis tools Cause and effect diagrams Fishbone analysis Problem tree Define the problem

14. Problem tree

15. Fish bone analysis/Ishikawa diagram

16. 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

17. 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.

18. In order to identify program/project strategies , it is first necessary to examine internal and external data related to your program.

19. 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 ( S trengths, W eaknesses, O pportunities, and T hreats) analysis of the program.

20. Environmental analysis Internal External Favourable S trengths O pportunities Unfavourable W eaknesses T hreats Environment Effect

21. 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

22. 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

23. Use the results of SWOT analysis to determine the best approaches of the program to meet its stated goals. These approaches are the strategies

24. 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

25. 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.

26. Contributions made by the organization such as manpower, equipment or buildings should be stated explicitly. Summary capital cost by items Recurrent cost by items

27. 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.

28. 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

29. Item Monitoring Evaluation Frequency Regular/ongoing episodic Main action Keeping track Assessment Basic purpose Improving efficiency Improve effectiveness Focus Inputs, outputs, process outcomes, work plans Effectiveness, relevance, efficiency, impact, sustainability Source of information Routine databases, field visits, stakeholder meetings, output reports Surveys Special studies Conducted by Project manager, funders etc External evaluator

30. Some technical terms Project Vs Programme Definition of a Project A project is a temporary entity established to deliver specific (often tangible) outputs in line with predefined time, cost and quality constraints Definition of a Programme A 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. 

31. Efficient Vs Effective

32. Thank you