Health planning Dr A.T.Kannan


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Itis basically a lecture for UGS in a medical school as apart of their syllabus on Health administration as a part of Community medicine

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Health planning Dr A.T.Kannan

  1. 1. Health Planning
  2. 2. Health Planning: The orderly process of defining community health problems, identifying unmet needs & surveying the resources to meet them, establishing priority goals that are realistic & feasible & projecting administrative action to accomplish the purpose of the proposed program
  3. 3. Plan: A blue print for taking action. It consists of five elements: • Objectives: planned end point of all activities • Policies: guiding principles stated as an expectation & not as a commandment. It is defined as the setting, adjustment & maintenance of social & economic priorities for development • Program: A sequence of activities designed to implement policies & accomplish objectives • Schedule: a time sequence of the work to be done • Budget
  4. 4. Planning may be defined as • A process of analyzing a system or defining a problem • Assessing the extent to which the problem exists as a need • Formulating the goals & objectives to alleviate or ameliorate those identified needs, examining & choosing from among alternate intervention strategies, initiating the necessary for its implementation, monitoring the system to ensure proper implementation of the plan & evaluating the results in the light of stated objectives
  5. 5. Need for planning: planning & management is essential to maximize the use of available resources& achieve the defined & expected objectives • To match the limited resources with many problems • To eliminate wasteful expenditure & duplication of expenditure • To develop the best course of action to accomplish the defined objectives
  6. 6. Importance of planning: • It provides direction • It provides a unifying framework of decision making throughout the org • Helps to reveal future opportunities & threats • Prevents piecemeal decision • Facilitates control (ensuring that activities conform to plan, involves a cycle in which standards are set, performance is measured relative to these standards & deviations are identified and controlled)
  7. 7. Types of planning: • Directional or policy planning: a framework of intent & philosophy within which the program proceeds • Administrative & managerial planning: overall implementation of policies, mobilization & co ordination of resources in terms of men, material & money in time frame • Operational planning: actual delivery of services or programs to the people. Includes participatory planning. Produces info about local conditions, needs & attitudes & develops a commitment towards the program
  8. 8. Types of plans: • Descriptive: stated in words descriptively, what is to be accomplished • Budget: stated in financial terms • Strategic plan: long term plans( 5-10yrs) • Operational plan: short term- day to day activities
  9. 9. Pre-planning: preparation for planning. Preconditions are: • • • • Government interest Legislation Organization for planning: Planning commission Administrative planning: for proper coordination of activities & implementation of plan at all levels. Central & state health ministries serve this function
  10. 10. Steps involved in planning proces • Forecast & develop the planning premise: determine the basic assumptions upon which the plan will be built. Forecast of economic activity & technological breakthrough are a vital source of planning premise • Define specific objectives • Develop & test alternatives • Decide on the course of action – Plan formulation – Plan execution – Plan evaluation
  11. 11. Plan Formulation: steps involved are: • Assessment of the situation & fact finding: what the situation is & what it could be. Useful info are • • • • • • • • • • Topographical & physical cond Agricultural procedures Demographic profile Cultural beliefs & attitudes Socio economic status Health status Health facilities available Availability of technical manpower Training facilities Info about the community: social institutions, literacy levels, socially disadvantaged groups & map of the area
  12. 12. • Assessment of health needs & demands: health needs – deficiencies in health that call for preventive, curative, control or eradication measures. Experience from the past will help to project the situation & to establish future needs of the population • Establishment of goals & objectives: to avoid haphazard activities & wastage of scarce resources. Provides an overall criteria for measuring performance. Depends on available resources. At higher levels obj are general but at successively lower levels they become more specific & precise. Must be relevant, feasible & measurable
  13. 13. • Assessment of resources: direct & indirect allocation to be assessed at initial stages & ways to bridge the gap b/w required & available resources decided • Establishment of priorities: foll parameters to be taken into consideration • • • • • • • Size of the problem Needs Resources Expected impact Acceptability Political & community interests & pressures Preventability
  14. 14. • Identification of possible interventions: guided by: • Feasibility: Technical, operational & administrative by undertaking pilot project or experience of the intervention elsewhere • Economic considerations: cost benefit & cost effectiveness analysis • Collateral benefits: gives benefit other than the one for which it is intended can be preferred
  15. 15. Time framing (Phrasing): prepared in 4 phases: • Lead time: • To develop procedures • To secure necessary equipments, materials & supplies • To secure required personnel • Initial trial period: • To experiment or test the program • To conduct tentative evaluation & consultation • To modify the plan, if required • Peak load of adjustments: • To implement the plan • To provide extra resource, manpower, materials etc for peak situations • Evaluation & re-planning: • Whether they helped in attaining the objectives. If not, replan the program
  16. 16. • Write up of formulated plan: preparation of the detailed report of complete plan in all respects for its execution. Plan should be communicated to the concerned persons • Plan execution: it is at the implementation stage that shortcomings often appear in practice. Main considerations at this stage include: • Definition of roles & tasks • Selection, training, motivation & supervision of the manpower involved • Organization & communication • The efficiency of individual institutions such as hospitals or health centers
  17. 17. Monitoring & Evaluation • Monitoring: implies day to day supervision & follow up of activities to ensure that they are proceeding as planned & on schedule. Continuous process of observations, discussions, meetings, recording & reporting of the various activities & as such whenever there is any deviation corrective steps can be taken immediately • Evaluation: measures the degree to which objectives & targets are fulfilled & quality of services obtained, the productivity of available resources in achieving the clearly defined objectives. Measures how much output or cost effectiveness is achieved
  18. 18. Challenges • Correct assesment of situational analysis – Use of Indicators- Epidemiological, Service Utilisation,Social determinants • Prioitisation- Assignment of Priorities • Resource allocation and Justification • Development Of End Point Indicators In a timely Phased manner • Lack Of managerial capablities for majoity in the health system