Planning Health Programmes

By:Alemayo E(BSC,MPH)

Nekemte,Oromia,Ethiopia
Planning Health Programmes

When you have studied this session, you should

be able to:
Explain the importance of planning in
healthcare management.
Describe the difference between strategic and
operational planning.
Describe the eight stages of operational
planning, as they relate to healthcare
management.

Health Service management By 2

:Alex
Planning
• Planning is the process of determining in
advance what should be accomplished – when,
by whom, how, and at what cost.
• Planning is forecasting and thinking about
things that may happen in the future.
• The planning process will help you to decide
what needs to be done to achieve health
improvements in your community

Health Service management By 3

:Alex
Planning…

Why healthcare planning is important:

1. you need a clear understanding of what needs to be
done and why you need to do it.
2. you can’t do everything at one time, so you will need
to prioritise and make decisions.
3. you may have limited resources that will prevent you
from doing everything, so you need to decide which
actions will bring most benefit in your work.
4. you need to communicate your intentions to others,
5. you need a guide for the day-to-day implementation
of your health work.
Health Service management By 4
:Alex
Types of planning

Strategic planning
Operational planning.

Health Service management By 5

:Alex
 Strategic planning

• It is the process of determining what the health

sector should be achieving in the future and how

it will carry out the actions necessary to bring
about those achievements.
• Top level managers develop strategic plans in

order to achieve their strategic goals.

Health Service management By 6
:Alex
Strategic plan…

• It covers the long term and the specific actions

to be taken in the next five to ten years.

• It is about the ‘bigger picture’ and it shows a

‘map’ of where the health sector is aiming to

be in the future.

Health Service management By 7

:Alex
Operational planning

• It refers to the action plans that guide your day-to-day

work.

• Without a strategic plan you don’t know where you

are going or why you are going there.

• But without an operational plan, it is likely that the

strategic plan will remain a distant dream and you

will not get thereHealth

anyway.
Service management By 8
:Alex
Operational plan…

• It is an instrument for implementing the strategic plan.

• It is developed by managers nearer the front line in order

to establish actions that are necessary for the achievement

of operational goals.

• It is short-term plans that cover time periods of up to one

year, so they are usually referred to as annual operational

plans.
Health Service management By 9
:Alex
Operational plan

An operational plan outlines important answers

to such fundamental questions as:
 What needs to be done?
 How will it be done?
 Who will do it?
 By when must it be done?
 What resources are needed to do it?

Health Service management By 10

:Alex
Steps of operational planning
Situational analysis

Problem identification and prioritization

Setting objectives

Strategy formulation

Identify and sequence activities

Identify resources

Prepare action plans and schedules

Monitoring
Health Service management By 11
:Alex
Situational analysis

 It is the stage where you need to:

 Gather reliable information about the causes of health

problems in the community, including from local

people who will benefit from any interventions.

 Identify the health situation of the community and

identify where affected population groups are located

geographically. Health Service management

:Alex
By 12
Situational….

 Discover what is currently being done to

resolve the identified needs and who is doing

it.

 Investigate how well identified needs have

been addressed in the past and consider how

you could collaborate with others in the

Health Service management By 13
community in order to address current needs.
:Alex
SWOT Analysis
• SWOT analysis is a tool that can help you

analyze situations more easily in your planning

process.

• SWOT stands for: S = Strengths, W =

Weaknesses, O = Opportunities, T=

Threats.
Health Service management By 14
:Alex
SWOT…

• Its purpose is to identify the internal strengths

and weaknesses of an organization or project,

and the external opportunities and threats the

organization or project faces.

• The best time to do a SWOT Analysis is after

you have reviewed progress and completed an

Health Service management By 15
environmental scan.
:Alex
Case Study: Do SWOT analysis
In village A community members and kebele leaders are concerned about

health issues and work closely with their Health Extension Practitioners.

Several health promoters have volunteered to work with the HEPs. Most

community members make their living from selling coffee which makes them

economically stronger than similar nearby villages and literacy rates are

higher than in neighboring villages. In summer there is frequent flooding and

it is also a malarial area. The Federal Ministry of Health has developed a five

year strategic plan for the health sector in this region. However, although the

Health Extension Practitioners are busy and work hard, they don’t have a

health plan and they don’t know how to measure their performance.
Health Service management By 16
Communication skills amongst
:Alex them are weak.
SWOT analysis of village A.

Health Service management By 17

:Alex
Problem identification

• A problem is a perceived gap between what

something is and what that thing should
ideally be.
• Gathering information about the root causes of
health problems is necessary to identify the
health problems that exist in the community.
• Information gathered should also include those
people who will benefit from the interventions.

Health Service management By 18

:Alex
Prioritization

• When you set priorities, you decide what is most

important to tackle first .

• One way to determine priority problems is to

apply a set of selection criteria that establish a

standard by which something can be measured.

Health Service management By 19

:Alex
Priority matrix
• Severity
• Magnitude
• Community concern
• Governmental concern
• Feasibility

Health Service management By 20

:Alex
Selection criteria for evaluating a health problem

 Does the problem:

 affect a large number of people e.g. malaria, AIDS?

 cause high infant mortality e.g. malnutrition, neonatal

tetanus?

 affect maternal health e.g. postpartum haemorrhage?

 affect rural development?

 cause great concern

Health Service management By
:Alex to the whole community?
21
Setting objectives
• In order to plan effectively you need to be clear about what

you and your work group are trying to achieve.

• You will need to review what needs to be done, and determine

your priorities.

• Objectives include the steps to be taken in pursuit of agreed

goals, such as those in the strategic plans set by the wider

health service.

• However, you need to base your objectives on the local

Health Service management By 22
:Alex
context and the capacity of your community.
Cont..

There are two important reasons for setting objectives:

 A clear objective is essential to create a definite plan.

 Setting objectives enables results to be evaluated.

When a programme has no stated or known

objectives its outcome cannot be evaluated.

 Example: To increase the number of families using

Health Service management By 23
insecticide treated bed nets by 50% in one year.
:Alex
SMART objectives

All objectives should be SMART, which stands for:

S = Simple or Straightforward (understandable by
everyone involved)
M = Measurable (the outcomes can be measured to
demonstrate that the
objective has been achieved)
A = Attainable (the outcome is possible to achieve)
R = Realistic (achievable with available resources)
T = Time-framed (achievable within the time).

Health Service management By 24

:Alex
Reviewing your objectives
 Case Study: Your SMART objective is to increase condom
use by 40% among couples in your community within one
year. You have chosen the strategy of training 15 peer
educators on how to use condoms consistently and correctly to
achieve this purpose. You met all your training targets and in
monitoring and evaluating the outcomes you found that
condom use among couples has increased by 55% after a year.
1. Are your objectives being met by the way that you have
chosen to tackle this problem in your community?
Health Service management By 25
YES :Alex
Case Study
Your SMART objective is to increase the uptake of contraceptive pills by 25%

within one year among the women of childbearing age in your village. You

chose the strategy of using outreach workers to distribute the pills from house

to house. In monitoring and evaluating the outcomes at the end of the year,

you found that most women in the community were not using the pills they

received.

1. Are your objectives being met by the way that you have chosen to tackle

this problem in your community, or should you redirect some

of your resources to offer more choice of family planning methods?

2. NO
Health Service management By 26
:Alex
Identify and sequence activities

This is the stage where you already know what

you are trying to achieve and need to list all
the activities and place them in the correct
sequence according to their importance and
timing.

Health Service management By 27

:Alex
Identify the resources

• This is the time when you have to consider

what resources will be needed to complete
your health project activities.
• The resources you need to carry out an action
plan include: budget, staff, accommodation,
power, equipment and materials, time, skill
and information

Health Service management By 28

:Alex
Prepare action plans and schedules

• You now need to develop a practical action

plan with respect to the objectives you have set

Health Service management By 29

:Alex
Example: Hygiene and sanitation plan
• The problem: Village J has no access to safe water and there is
a high rate of neonatal death from diarrhoea. The community
is difficult to reach because of poor roads.
• Objective :To provide health education on hygiene and
sanitation to 75% of mothers at household level.
• Strategy and activities: The work is to be done by model
households. The strategy is to train a Health Extension
Practitioner who will then train the model households.
• Resources :Health Extension Practitioner X will deliver
refresher training on hygiene and sanitation to households.
• Organisation :The training of model households will take
place in the village hall.
• Control: Each model household will keep a simple record of
the number of women Healthreached.
Service management By 30
:Alex
Monitoring

• It is a technique by which you can check that

everything is continuing to go according to plan.
• Monitoring, in the context of the action plan,
addresses questions such as:
 Are outputs being achieved within the timeframes?
 Are resources being efficiently and effectively used?
 Have you maximized the use of resources?
 Are you doing what you said you would do and if
not, why not?
 Are you collaborating with other services?
Health Service management By 31
:Alex
THANK YOU!

Health Service management By 32

:Alex