NATIONAL HEALTH

PLANNING
INTRODUCTION
 The increasing demand for medical
and health care services, in the face of
limited resources, has brought out the
need for careful planning of health
services.
 Planning is considered essential if
higher standards of health and health
care are to be achieved.
PURPOSE OF PLANNING

 To match the limited resources with

many problems;
 To eliminate wasteful expenditure or
duplication of expenditure;
 To develop the best course of action to
accomplish a defined objective
PLANNING
 Every country has its own plan for national
development.
 The purpose of national planning is to achieve a
rapid, balanced economic and social
development of the country as a whole.
 The national development plan of a country is a
combination of sector plans which comprise the
following sectors, viz.food and agriculture,
education, health and family planning, industry,
transport and communications, housing, power,
social welfare etc.
 All these sectors compete for national
resources.
NATIONAL DEVELOPMENT
PLANNING
“As a continuous, systematic, coordinated,
planning for the investment of the
resources of the country(men, money and
materials) in the programmes aimed at
achieving the most rapid economic and
social development as possible.”
HEALTH PLANNING
 It is a part of national development planning.
 Health planning is necessary for the economic
utilization of material, man-power and financial
resources.
 The purpose of health planning is to :
 improve the health services
 meet the health needs and demands of the
people.
NATIONAL HEALTH
PLANNING –DEFINITION:
 “As an orderly process of defining
community health problems,identifying
unmet needs and surveying the resources
to meet them,establishing priority goals
that are realistic and feasible and
projecting administrative action to
accomplish the purpose of the proposed
programme.
 TERMINOLOGIES
 HEALTH NEEDS &DEMANDS:

“Deficiencies in health that call for

preventive,curative,control or eradication
measures.”
 The need for medical care, safe water supply,
adequate nutrition,immunization,family planning
are all community health needs.
RESOURCES:
The term “resources” widely used in health
planning implies the manpower, money,
materials, skills, knowledge, techniques
and time needed or available for
performance or support of action desired
towards specified objectives.
 OBJECTIVE: is precise-it is either achieved /not
achieved. It is planned end-point of all activities.

 TARGET: refers to a discrete activity such as the

number of blood films collected or Vasectomies done;

 GOAL: is defined as the ultimate desired state towards

which objectives and resources are directed.
 A goal is usually described in terms of :
 -what is to be attained
 The extent to which it is to be attained.
 -the population or section of the environment involved.
 -the geographic area in which the proposed programme will
operate;
 -the length of the time required to attain the goal.
 PLAN-is blue print to take action.
 It consists of five major elements- objectives,
policies, programmes, schedules and budget.
 A Programme is a sequence of activities
designed to implement policies and accomplish
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 an commandment.
PRE-PLANNING:(preparation
for planning)
 The important pre conditions are :
 A)government interest: Any plan for the health
and welfare of a country must be based on a
strong political will as manifested by clear
directives or policies given by the political
authority.
 B)legislation: The social and health policies
formulated may have to be translated into
legislation.
 (E.G) enactments of the medical termination of
pregnancy act,1971 by the Indian Parliament to
protect the health of the mothers
 C)organization for planning: There should be
organizational structure for the preparation of the
various parts of the plan. The planning
commission in India serves this function. It is
composed of full-time planners who are advised
by the representatives and technical experts in
the field of socio economic development as well
as political leaders.
 D)administrative capacity: for proper coordination
of activities and implementation of the plan at all
levels. For the health plan, administrative capacity
is vested in the state and the central ministries.
 PLANNING CYCLE
 Planning may be defined as a process of
 analyzing a system, or defining a problem,
 assessing to which the problem exists as a need,
 formulating goals and objectives to alleviate or
ameliorate those identified needs,
 examining and choosing from among alternative
 initiating the necessary action for its implementation
and
 monitoring the system to ensure proper
implementation of the plan and
 evaluating the results of intervention in full filling the
stated objectives.
1.Analysis of the health situation
 The first step in health planning is analysis of the
situation.
 It involves the collection,assessment ,interpretation
of information in such a way as to prepare a clear
picture of the health situation
 The analysis and interpretation of the below given
data brings out the health problems,health needs
and health demands of the population.
Minimum essential
requirements for health planning
 The population-its age and sex structure
 Statistics of mortality and morbidity
 The epidemiology and geographical distribution of
different diseases.
 Medical care facilities such as hospitals,health and other
health agencies-both public and private
 The technical manpower of various categories
 Training facilities available.
 Attitudes and beliefs of the population towards its cure
and prevention.
 2.establishment of objectives & goals:
 Objectives and goals are needed to guide efforts.
Unless objectives are established, there is likely to be
haphazard activity, un-economical use of funds and
poor performance.
 Objectives must be established at all levels, at upper
levels, objectives are general; at successively lower
levels, they become more specified and detailed.
 Objectives may be short term or long term.
 In setting these objectives, time and resources are
important factors.
 Objectives are not only a guide to action, but also a
yard stick to measure work after it is done.
3.Assessment of resources
 The term resources implies the man
power,money,materials,skills,knowledge
and techniques needed or available for the
implementation of the health programmes.
 These resources are assessed and a
balance is struck between what is required
and what is available,or likely to be
available in terms of resources.
4.Fixing priorities
 Once the problems,resources and objectives have been
determined,the next most important step in planning is
establishment of priorities in order of importance or
magnitude,since the resources always fall short of the
total requirements.
 In fixing priorities,attention is paid to financial
constraints,mortality and morbidity data,diseases which
can be prevented at low cost,saving the lives of younger
people in whom there has been considerable social
investment;
 Once the priorities have been established,ALTERNATIVE
PLANS for achieving them are also formulated and
assessed in order to determine whether they are
practicable and feasible.
5.Write-up of the formulated
plan:
 The next major step is the preparation of the detailed plans or
plans.
 The plan must be complete in all respects for the execution of
a project.
 For each proposed health programme,the
resources(inputs)required are related to the results(outputs)
expected.
 Each stage of the plan is defined and costed and the time
needed to implement is specified.
 The plan must contain working guidance to all those
responsible for execution.
 It must also contain a “built-in” system of evaluation.
6.Programming & Implementation
 Plan execution depends upon the existence of
effective organization.
 It is at the implementation stage that
shortcomings often appear in practice.
 The main considerations in the implementation
stage include:
 -definition of roles and tasks
 -the selection, training, motivation and
supervision of the manpower involved.
 Organization and communication
 The efficiency of individual institutions such as
hospitals or health centers.
7.Monitoring
 Monitoring is the day-to day follow up of activities
during the implementation to ensure that they are
proceeding as planned and are on schedule.
 It is the continuous process of observing,
recording, and reporting on the activities of the
organization or project.
 Monitoring, thus, consists of keeping track of
course of activities and identifying the deviations
and taking corrective action if excessive
deviations occur.
8.Evaluation
 It measures the degree to which the objectives and
targets are fulfilled and the quality of the results
obtained.
 It measures the productivity of the available
resources in achieving clearly defined objectives.
 It measures how much out put or cost effectiveness
is achieved.
 It makes possible the reallocation of priorities and
of resources on the basis of changing health needs.