Planning, Implementation & Evaluating

Health Promotion Program

Dr Nabeel ahmed

Assistant Professor
Department of
WHY MUST YOU STUDY MANAGEMENT
AS A MEDICAL DOCTOR

DOCTORS ARE CONSIDERED AS POOR

MANAGERS

AS A MEDICAL DOCTOR YOU ARE EXPECTED

TO LEAD A HIGHLY PROFESSIONAL TEAM OF
TRAINED HEALTH WORKERS

MEDICAL LOGISTICS AND RESOURCES ARE

SCARCE

HOSPITALS TODAY ARE COMPLEX

ORGANISATIONS
 DEFINITION

“Administration is the art and science of

guidance, leadership, and control of the
efforts of a group of individuals towards
some common goal.”
Management is the operational part of
administration.

It is defined as:
“ It is a set of interactive processes through which
the utilization of resources results in the
accomplishment of organization objectives.”

 It is a “conversion mechanism”
 A systems view of management:

Process

Inputs Outputs
Conversion
mechanism

Human resources Objectives

Non-human resources achievement
ADMINISTRATION MANAGEMENT

POLICY MAKING IMPLEMENTATION

PLANNING MONITORING

EVALUATION AND
DECISION MAKING
OPERATIONAL ASPECTS
 Management
consists of

Planning Reporting
Organization Budgeting
Staffing Supervising
Directing Evaluation
Coordinating
 Health Promotion
• The process of enabling people to increase control
over, and to improve, their health.
-The Ottawa Charter (WHO 1986)
• Health promotion aims to improve individual and
population-wide health outcomes.

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• Planning
• Implementation
• Evaluation

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 Pre-planning

• Prior to planning, it is important to do some pre-

planning.
• Pre-planning is preparation for planning.
• Pre-planning allows a core group of people (or
steering committee) to gather answers to key
questions that are critical to the planning process
before the actual planning process begins. It also
helps to clarify and give direction to planning, and
helps stakeholders avoid confusion as the planning
progresses.
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 Pre-planning process
Important preconditions are:
1.Government interest
2.Legislation
3.Organisation for planning
4.Administrative capacity

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Planning a health promotion program

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 Planning
• Is a multistep process that begins after doing pre-
planning.
• Plan is a blueprint for taking action. It consists of 5
major elements-
– objectives
– policies
– programmes
– schedules
– budget

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 Terminology
• An OBJECTIVE (point) is a planned end-point of all
activities.It is either achieved or not achieved.
• A TARGET often refers to a discrete activity such as
the number of blood films collected or vasectomies
done; it permits the concept of degree of
achievement.
• GOAL is defined as the ultimate desired state
towards which objectives and resources are
directed. Unlike objectives and targets, goals are not
constrained by time or existing resources nor are
they necessarily attainable.
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• A PROGRAMME is a sequence of activities designed to
implement policies and accomplish objectives. It gives
a step-by-step approach to guide the action necessary
to reach a predetermined goal. Program must be closely
integrated with objectives.
• A SCHEDULE is a time sequence for the work to be
done.
• PROCEDURES are a set of rules for carrying out work
which, when observed by all, help to ensure the
maximum use of the resources and efforts.
• POLICIES are the guiding principles stated as an
expectation, not as a commandment.
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 Planning models for health promotion
1. The Generalized Model
2. PRECEDE-PROCEED
3. MAPP
4. MAP-IT
5. SMART (Social Marketing Assessment and Response
Tool)
6. SWOT (Strengths, Weaknesses, Opportunities, Threats)
7. Healthy Communities (or Healthy Cities)
8. The Health Communication Model
9. Intervention Mapping
10. Healthy Plan-It 16
Steps involved in planning a program.
The Generalized Model

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 Assessing needs
• The process of identifying, analyzing, and prioritizing
the needs of a priority population is referred to as a
needs assessment.
• Other terms-community analysis, community
diagnosis and community assessment.
1. Collection of facts
2. Identification of needs
3. Analysis of needs
4. Prioritization of needs

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 planning

implementation inputs process output effects impact needs

Monitoring and
evaluation
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 Setting goals and objectives

Types of objectives

• Process Objectives
• Impact Objectives
• Outcome Objectives

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 Setting goals and objectives

• Process Objectives
-the daily tasks, activities, and work plans that lead
to the accomplishment of all other levels of objectives
- focus on such things as program resources
(materials, funds, space); appropriateness of
intervention activities; priority population exposure,
attendance, participation, and feedback; feedback from
other stakeholders such as the funding and sponsoring
agencies; and data collection techniques

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• Impact Objectives -3 different types
- learning objectives,
- behavioural objectives, and
- environmental objectives.
These objectives describe the immediate observable
effects of a program (e.g., changes in awareness,
knowledge, attitudes, skills, behaviour's, or the
environment) and they form the groundwork for
impact evaluation

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• Outcome Objectives
- the ultimate objectives of a program and are aimed
at changes in health status, social benefits, risk
factors, or quality of life. “They are outcome or
future oriented”
-If these objectives are achieved, then the program
goal will be achieved.
-Commonly written in terms of reduction of risk,
physiologic indicators, signs and symptoms,
morbidity, disability, mortality, or quality of life
measures. 23
 SMART objectives
• Specific – What exactly are we going to do, with or
for whom?
• Measurable – Is it measurable & can we measure it?
• Achievable/Realistic – Can it be done in the
proposed timeframe / in this political condition /
with this amount of money?
• Relevant/Appropriate – Will this objective lead to
the desired results? Will address the needs of the
target population?
• Time-framed – When will this objective be
accomplished? When can the achievement be
measure?

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Elements of a Well-Written Objective

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Implementation of health promotion
program

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 Defining Implementation

• “the act of converting planning, goals, and

objectives into action through administrative
structure, management activities, policies,
procedures, regulations and organizational actions of
new programs”

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 Phases followed in implementing a
program

(1) adoption of the program

(2) identifying and prioritizing the tasks to be
completed
(3) establishing a system of management
(4) putting the plans into action, and
(5) ending or sustaining a program.

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 Resources

• Resources include the “human, fiscal, and technical

assets available” to plan, implement, and evaluate a
program.
• The quantity or amount of resources needed to plan,
implement, and evaluate a program depends on the
scope and nature of the program

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 Resources

• 3 Ms-man-power, money, material.

Manpower
- medical and paramedical personnel
- other key personnel as epidemiologists, trained
health educators, data operators and statisticians
- ‘supportive manpower” as political leaders,
administrative authorities and peers who would
support the program

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 Money
-funds / finances which will be required for development
of health education material, training material,
communications and transport, purchase of health
educational and medical equipment, payment of
salaries, etc.
-The source of finances could be government (public
funds) or funds generated by voluntary / non-
governmental organizations.

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Material
-refers to technical equipment, expendables and logistics.
-availability of class-rooms, lecture halls, buildings,
electricity, announcement systems, projection systems as
slide / overhead projectors, computers, LCD projectors,
posters and charts for exhibitions and mobile panels for
posters; models.
-equipment pertaining to “logistics” as vehicles for
transportation of target population, petrol, generators
etc.
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 Evaluating
Health Promotion Programs

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 Evaluation

• Defined as the process of determining the value or

worth of a health promotion program or any of its
components based on predetermined criteria or
standards of acceptability identified by stakeholders.
• To establish that a health promotion program has
achieved the desired outcomes, evaluation must
take place to measure relevant changes in
populations, individuals or their environments.

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 Types of evaluation

• Formative evaluation
• Impact evaluation
• Outcome evaluation
• Summative evaluation
• Process evaluation

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• Formative evaluation
- “Any combination of measurements obtained and
judgments made before or during the
implementation of materials, methods, activities or
programs to control, assure or improve the quality of
performance or delivery”
-Data derived from formative evaluation help revise
intervention components (content, methods, and
materials) as well as instrument and data collection
procedures.
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• Impact evaluation
- Focuses on “the immediate observable effects of a
program, leading to the intended outcomes of a
program; intermediate outcomes” .
- Measures of awareness, knowledge, attitudes, skills,
and behaviour's yield impact evaluation data.
-Impact evaluation is associated with behavioural
impact or change.

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• Outcome evaluation
-Focuses on “an ultimate goal or product of a
program or treatment, generally measured in the
health field by mortality or morbidity data in a
population, vital measures, symptoms, signs, or
physiological indicators on individuals”
-Outcome evaluation is long-term in nature and
generally takes more time and resources to conduct
than impact evaluation. Ultimately, it makes a
determination of the effect of a program or policy on
its beneficiaries.
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• Summative evaluation
- “Any combination of measurements and judgments
that permit conclusions to be drawn about impact,
outcome, or benefits of a program or method”
-Are done at the conclusion of a program to provide
a conclusive statement regarding program effects”

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• Process evaluation
-“Is used to monitor and document program
implementation and can aid in understanding the
relationship between specific program elements and
program outcomes”.
- The purposes are to “identify the key components
of an intervention that are effective, to identify for
whom the intervention is effective, and to identify
under what conditions the intervention is effective” .
-It also evaluates the “extent to which a program is
being implemented as planned” .
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 Reasons why programs are evaluated:

1. To determine achievement of objectives related to

improved health status
2. To improve program implementation
3. To provide accountability to funders, the community,
and other stakeholders
4. To increase community support for initiatives
5. To contribute to the scientific base for community
public health interventions.
6. To inform policy decisions

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Framework for Program Evaluation

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• “Planning an effective program is more difficult than
implementing it. Planning, implementing, and
evaluating programs are all interrelated, but good
planning skills are prerequisite to programs worthy of
evaluation”

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 References

1.JF.McKenzie, BL.Neiger, R.Thackeray, Planning, Implementing,and

Evaluating Health Promotion Programs A Primer,6th Edition,Pearson
Publication,2013
2.Park K,Preventive and Social Medicine,21stedn.Bhanot
Publications,2011.

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