Health Project Development and Management

Definition of Key terms

• A project is an organized, time-limited, one-off
effort towards a defined goal, which requires
resources,
• It is traditionally described as having a ‘3D’
objective (e.g. Rosenau 1998): to meet
specifications, to finish on time and to do it
within budget.

1
 Definition…
• There are two essential elements of modern project
management.
• A large set of tools and techniques for planning
and coordinating the multiple inputs required
for major projects.
• The role of the project manager and the project
team.

2
 Definition…

• In human service organizations, project management

methods are used for four basic purposes:
• The development of new services, programs or
technologies;
• To improve existing services, care processes, work
practices or service delivery models;
• The implementation of new organizational
structures or systems; and
• The construction, installation and/or
commissioning of new equipment and facilities.

3
 Definition…
• A project is a temporary organization.
• We have a vision of a future state we wish to
achieve, and we need resources to do work to
deliver it.
• So we create a new organization within which
those resources can work.
• That organization will have only a temporary
existence, being disbanded when the new state is
achieved.

4
 Definition…
• Program
• A structured process of managing multiple ongoing
projects within an organization.
• The focus of Program Management is the alignment
of ongoing projects with the goals of the
organization
• Projects vs Programs
o While there is some overlap between program
planning and design methods, and project
management, there are some differences
• projects have a definite beginning and end
whereas programs continue perhaps for many
years and often evolve and develop
5
Definition…

• Portfolio
• Simply a collection of programs.
• Portfolio management is about selecting a
combination of programs that will give the
organization the most optimized profits at the
lowest risk.

6
Definition…
• Project Office
• An administrative function of a project.
• A Project Office does not only provide key support
to the project manager but also liaises with the
Program Management Office to ensure that its
project adopts the most current project
management standards implemented by the
PMO.
• Program Management Office (PMO)
• An operation center that not only governs and
supports projects from initiation to completion,
but also plays an important role in improving an
organization’s project management capabilities

7
The Functions of Project Management
• The project entails work, and that scope of work
must be managed.
• We assemble the resources into a temporary
organization which must be managed.
• In order to deliver the desired benefit, the asset
must function in certain ways, and at required
levels of performance.
• Therefore, the performance, or quality, of the
asset must be managed.
• But to deliver a quality asset the work of the
project must also meet certain quality
standards. Quality needs to be managed.

8
 The Functions of Project…
• In order for the project to be of value to both the
client and contractor, it must cost less than the
value of the benefit. Thus cost needs to be managed.
• This involves managing the consumption of all
resources, including people and material, not just
money.

• Time needs to be managed for several reasons.

• In order for the work of the project to take place
effectively and as efficiently as possible, the input
of the various resources needs to be coordinated.

9
 The Functions of Project…
• Also there will be a time value associated with the
benefit from the asset.
• The later it is delivered, the less its value, so the
timing of the work needs to be managed to
deliver the asset within a time frame that will
give the desired benefit.

• There are seven functions of project management:

managing the scope, project organization, the
stakeholders, quality, cost, time, and risk.

10
 Management of the Project
• There are two components of the management
approach:
• The project life cycle:
• the stages we go through from the initial germ
of an idea that there is some change we can
make to improve performance to the point
where we have an operating asset providing
benefit.
• The management process:
• the management steps we follow at each stage
to deliver that stage.

11
The project management life cycle

12
 Management Process
• The management process is the management cycle
that is followed to implement the work of each
stage. There are five basic processes:
• Planning the work
• Organizing the resources
• Implementing by assigning work to people
• Controlling progress
• Managing and lead

13
The management process …

14
Step Management Process
Perceive the problem Identify the opportunity for providing benefit to the
organization
Gather data Collect information relating to the opportunity
Define the problem Determine the value of the opportunity and its potential
benefits
Generate solutions Identify ways of delivering the opportunity and associated
benefits
Evaluate solutions Identify the cost of each solution, the risk, and expected
benefit
Select a solution Choose the solution that gives the best value for the
money
Communicate Inform all parties involved of the chosen solution

Plan implementation Complete a detail design of the solution and plan

implementation
Implement the solution Authorize work, assign tasks to people, undertake the
work, and control progress
Monitor performance Monitor results to ensure the problem has been solved
and the benefit obtained
 Levels of management
• A project is fractal:
– each component of a project is a mini-project in its
own right; it is a temporary organization to which
resources are assigned to deliver beneficial change,
the beneficial change in that case being a
component of the main project.

• There are three fundamental levels over which a

project is managed:

16
 Levels of management…
• The integrative level:
• The desired performance improvement is identified,
and the facility (output) required to deliver it is
defined through quantitative and qualitative
objectives.

• Areas of work and categories of resource required

to undertake them are defined, and basic
parameters or constraints determined for time
scales, costs, benefits, and performance.

• Any risks and assumptions are stated.

17
Levels of management…

• The strategic or administrative level:

• Intermediate goals or milestones required to
achieve the objectives are defined.
• The responsibility of organizational units,
functions, and disciplines for work packages is
defined.
• Work packages are scheduled in the project, and
budgets developed.
• A stable plan which remains fixed throughout
the project is created.

18
 Levels of management…

• The tactical or operational level:

• The activities required to achieve each milestone

are defined, together with the responsibilities of
named people against the activities.

• Changes are made at this level within the

framework provided at the strategic level.

19
20
21
P LA N N I N G

• Major undertakings
• Identifying a specific issue, target group and
focus for a program
• Designing the program
• Developing the action plan

22
Identifying a specific issue, target group and focus for a
program

23
 A. Conducting consultations

• Consulting with people from within and outside the

organisation who know about the health issue and
the individuals who are affected by it.
Consulting with key people
Have consultations been conducted to gather
information on:
• The nature of the perceived issue(s)?
• Who is most affected by the issue(s)?
• How to contact and engage communities involved?
• The types of programs that have been attempted
and how successful or unsuccessful they have
been?

24
B. Gathering information about the issue

• Collecting and analysing data and information about

the problem from a variety of sources.
Reviewing the relevant information
• The type of information may include:
• Demographic information
• Literature about the effectiveness of previous
programs
• Mortality and morbidity data
• Social and economic factors

25
C. Examining the organisational context

Considering the organisational context in which the

project will operate.
• Current policies from relevant government and
non-government agencies
• Local councils annual reports
• Overall priorities of the Local Health Service
• Other programs operating elsewhere in the Local
Health Service
• Likely stakeholders in this program

26
D. Analysing the information and making a Judgement
• Making a judgement about all this information in
order to select a health issue, target group, setting or
focus for a program.
Analysing the issue
– Relationships between the various factors which
contribute to the health issue
– Which factors is it possible to influence? Which
factors are amenable to intervention?
– What does this analysis imply for the kind of
strategies which may be effective in redressing the
issue?
– Is more information required to further understand
the issue? If so, how can it be obtained?

27
 Analysing the information…

Selecting the focus of the program

• What best meets the needs of the:
• Target group
• Stakeholders
• Funding body
• Organisational environment?
• Will the focus of the program be:
• A single issue; a set of issues;
• A setting; a service characteristic; an
environmental /organisational issue?

28
Designing the program

29
Planning 2 involves:
• Converting the analysis of the issue into a draft
plan (strategies)
• Developing roles with key people
• Reviewing available sources
• Ensuring the program is realistic and achievable

30
A. Converting the analysis of the issue into a draft
plan
• What is the range of potential strategies which could
achieve the possible objectives?
• Are the potential strategies a mixture of:
• Developing personal skills
• Strengthening community action
• Creating supportive environments
• Building healthy public policy
• Reorienting health services?
• Are the objectives “SMART”?
• Is there a logical relationship between the program
goals, objectives and strategies?
• Will the strategies enable the goals and objectives to
be achieved?
31
B. Developing roles with key people

• The role of every stakeholder?

• Would a committee or working party be useful?
• Are there any potential stakeholders who might not
support the program?
• Can the stakeholders offer any resources “in kind”?

32
 C. Reviewing available sources
• How many staff are needed to conduct the program?
What skills do they require?
• How much money is required for the program? Is
this funding available? If not, what are the
alternatives?
• What resources are available in the community to
support the program? What skills or resources can
the target group offer?

33
D. Ensuring the program is realistic and achievable

• Are there significant gaps between the resources

required to achieve the objectives and those
available?
• What are the opportunity costs for conducting the
program?
• What are the short/long term benefits of
proceeding with the planned program?

34
Developing the action plan

35
A. Planning for the organisation of tasks
• Tasks required to implement each strategy
• Sequence of these tasks
• Who will perform these tasks?
• What quality control measures will be used to
ensure the program progresses as planned?
• At what intervals will the progress of these tasks
be reviewed?
• What are the indicators of success for completion
of key tasks?

36
B. Constructing a time frame
• What tasks need to be completed before other
tasks are started?
• What are the most critical tasks?
• Is there enough time allocated to complete these
tasks?
• Is the overall time frame for the program
realistic?

37
C. Developing a communication strategy

• Does the program plan include a communication

strategy?
 This involves decisions about:

• the type of information to be conveyed,

• to whom,
• when they require the information and
• what format is most suitable.

38
 IMPLEMENTATION

• Major undertakings
– Ensuring quality implementation of the program
– Following up additional opportunities
– Effectively documenting and communicating the
program’s progress

39
Ensuring quality implementation of the program

40
 A. Implementing the action plan
• Is the list of tasks outlined in the action plan being
used to guide implementation?
• Is the program running on, or close to, the time
frame?
• If there are delays, how are they to fit the overall
program?
• Is the program on, or close to, budget?
• If not, what changes need to be made and how
will they affect the direction of the program?

41
 B. Ensuring effective communication
• Maintaining clear roles and responsibilities
• Are the individuals involved clear about what the
program is trying to achieve? Is this evident in
their work?
• Are the people involved communicating effectively
with each other, the target group and the
stakeholders?
• Providing feedback to people involved with the
program

42
C. Contingency planning and action
• Assessing the situation and making changes
• Are there problem(s) or delays with a particular
aspect of the program?
• What are the options for overcoming, minimising or
avoiding the problems or delays?

43
Following up additional opportunities

44
A. Identifying opportunities to raise the program’s role

• Have any opportunities occurred as a

result of the program's implementation, or
circumstances in the wider community,
which could raise the program's profile?

45
B. Maintaining support for the program
• Have any changes occurred in the organisational or
wider environment which reinforce the importance
of the issue being addressed by this program?

• Have any changes occurred which could weaken

management/external support obtained for the
program during the planning phase?

46
C. Identifying opportunities to broaden the impact of the
program

• Policy development
• Reorientation of services
• Strengthening community action

47
Effectively documenting and communicating the
program’s progress

48
A. Documenting the program’s progress

• Has the following information been documented?

• Goals, Objectives, Strategies, Action Plan
• Baseline data about the issue and target group
• Performance Indicators
• Evaluation methods
• Has a system been set up to record the program’s
progress?

B. Communicating the program’s progress

• Are the Districts Health Services/other equivalent
executives, stakeholders and target groups being
kept informed of the program’s progress?

49
EVALUATION

• Major undertakings
 Developing the evaluation plan
 Assessing the program’s results
 Communicating the evaluation results and
recommendations

50
Developing the evaluation plan

51
 Developing the evaluation plan involves:

• Clarifying the purpose of the evaluation.

• Selecting the scale and scope of the evaluation.
• Determining the methodology.
• Planning implementation of the evaluation.

• Establishing protocols and quality control

measures to ensure the evaluation produces are
valid and reliable results.
• Planning analysis of the data.
• Planning distribution of the evaluation findings.

52
Assessing the program’s results

53
Assessing the program’s results

• Measuring the results in relation to each

objective and performance indicator.
• Analysing the data for patterns, trends,
consistencies and inconsistencies.
• Interpreting the results to determine how they
can be attributed to the program and/or to
other factors.

54
 Communicating the evaluation results and
recommendations

• Reporting the findings of the evaluation to

stakeholders and other interested parties.

• Publishing results and conclusions in refereed

journals or presenting them at conferences.

• If appropriate, disseminating the results and

conclusions to the public through the mass
media, in newsletters, and/or at seminars.

55
 Sustainability

• Major undertakings
 Assessing the value of continuing the
program
 Marketing the program so that others can
use it
 Establishing structures which help others to
apply the program

56
Assessing the value of continuing the
program

57
 Assessing the value of continuing…

• Deciding whether or not the program should be

discontinued, ongoing or repeated.

• Determining what changes the program will need to

continue successfully.

• Deciding whether the benefits of modifying the

program outweigh the associated costs.

58
Marketing the program so that others
can use it

59
 Marketing the program...

• Determining who may be interested in - or able to

sustain – the program.

• Determining what could motivate others to

sustain the program.

• Deciding how these circumstances could be

created or enhanced to encourage others to take
up the program.

60
Establishing structures which help others to apply
the program

61
 Establishing structures…

• Determining what form of support organisations

will require to successfully sustain the program.

• Determining how this support will best be offered.

62
 Tips
• You cannot always achieve your objectives in one
step
• You must continually adapt your plan in response to
changing circumstance
• You cannot plan the detail, you can only plan the
strategy
• Even still it is possible to achieve an accurate
forecast of the cost and duration of the project
• The winners are the most competent team, with the
best strategic plan, who respond best to the
conditions actually encountered

63
Term paper… Writing a project proposal

• Assume that you are a member of the PHC of JU and your

team comprises
• health systems manager, health economist,
communication specialist, epidemiologist, biostatistician
etc
• And let one of you be the head of Jimma Zonal health
department
• Write a full project proposal to be submitted to the
International Development Research Centre (IDRC), Canada
 Problem: to be decided by the team

64
Term paper…Writing a project proposal

a. Project Title
b. Project Overview
c. Background Information/Statement of the Problem
d. Project Detail
a. Goals and Objectives
b. Clientele
c. Methods
d. Staff/Administration

65
Term paper…

5. Available Resources
6. Needed Resources
a. Personnel
b. Facilities
c. Equipment/Supplies/Communication
d. Budget (with justification)
7. Evaluation Plan (use logfram)
8. Appendices
 Don’t miss detailed CV of the principal investigator and
shorthand CV of all other research team members

66