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  1. HEALTH PLANNING Professor Syed Amin Tabish FRCP (London), FRCP (Edin.), FAMS, MD (AIIMS) Postdoc Fellowship, Bristol University (England) Doctorate in Educational Leadership (USA)
  2. Responsibilities of a Doctor  Patient Care: Disease Prevention, Health Promotion, Medical care with advanced technology  Some level of teaching competence with professionalism  Research
  3. Pressures of Changes  Knowledge Explosion  Technological Advances  Information Superhighway (Internet/World Wide Web)
  4. Roles of Physician  Medical Expert (clinical decision- maker)  Communicator / Educator  Collaborator (team leader)  Manager/Leader: managing resources  Health advocate  Scientist/Scholar  Professional: to provide high quality care with honesty & compassion
  5. What are the responses  A New Curriculum: Outcome- based, community-based  New Educational strategies: PBL, SDL, Integrated learning, task- based learning, Core curriculum & student-selected components  New Curriculum models: Communication skills, preparation for practice, team work, EB practice
  6. Health Planning  During the 20th century, the expectation of life in all parts of the world has been transformed  Concerns for efficient use of health resources  Importance of health planning widely recognized
  7. Planning  Deciding how resources should be allocated  Determining how to implement these decisions  Judicious health planning is crucial
  8. Planning  A method of trying to ensure that the resources available now and in future are used in the most efficient way to obtain explicit objectives
  9. Planning  A system of making decisions about how an organization will use its resources in the future  It involves making of choices  Requires possibility of real alternatives  Resources are limited
  10. Important components  Where are we going? – Objectives  With what? – Resources  How? - (efficient implementation)  When? – (future)
  11. Health care  Public Health Services (environmental sanitation)  Personal Preventive Services (immunization)  Personal Curative Services (hospitals, health centres)
  12. PLANNING SPIRAL  Situational Analysis  Priority Setting  Option appraisal  Programming & budgeting  Implementation & monitoring  Evaluation
  13. Situational Analysis  Assessment of present situation  Examine the current & projected health situation, the demographic pattern, and present & future health needs
  14. Situational Analysis  Looks at the general socioeconomic & provision of non-health services & infrastructure  Analysis the infrastructure of health sector & the pattern of services provided
  15. Situational Analysis  Examines the current & future resources of the health sector in terms of both financial resources & real resources (personnel, equipment, buildings, etc.)  Analysis the efficiency & effectiveness within which the health sector operates
  16. Situational analysis  General country characteristics  Health Status Needs  Health Service availability  Policy & political environment
  17. Demographic information  Absolute size & distribution of population  Vital statistics (births, deaths, fertility)  Population growth rate  Age & sex structure
  18. Priority Setting  Determination of goals, objectives & targets of the organization  Ensuring that the priorities are set are feasible within the social & political climate
  19. Option Appraisal  Generation and assessment of various options for achieving each of the set objectives and targets  Appraisal info: effectiveness, efficiency, equity, acceptability, feasibility, resource availability
  20. Programming & Budgeting  Translate the results of the earlier decision into a series of programmes each with a budget and resources  Option chosen  Budgetary info  Resources
  21. Implementation & Monitoring  Transforming the broad programs into more specific times and budgeted sets of tasks and activities  Involves the drawing up of a more operational plan of a work  Monitoring of the implementation of activities
  22. Implementation Management info at service provision stage:  Utilization of services  Cost  Constraints
  23. Evaluation Provides the basis for the next situational analysis
  24. Primary Health Care The Alma-Ata Declaration (1978) endorsed PHC as the key to achieving HFA goal National Rural Health Mission
  25. Essential Components of PHC  Education concerning prevailing health problems and methods of prevention & control  Promotion of food supply/nutrition  Safe water & basic sanitation  MCH/RCH
  26. Components of PHC (contd)  Immunization  Prevention & control of locally endemic diseases  Treatment of common diseases  Provision of essential drugs
  27. Equity Emerging Issues in HC:  Equal health  Equal access to health care  Equal access to HC according to need  Equal utilization of HC according to need  Planning requires identification of disadvantaged groups and address their needs
  28. Approach to planning  A clear definition of equity  A clear process for involving communities in decision making about strategies to improve their health  A clear process for involving other sectors in health- promotive strategies
  29. Approaches to planning Management structures consistent with the principles of PHC Criteria for assessing the appropriateness of approaches chosen
  30. Data Collection/Information  Surveys  Vital registration  Treatment records  Notifiable diseases return  Management reports & return  Informed opinion (meeting with individuals/groups)  Information from other ministries, institutions, agencies
  31. Information on Health Needs Basic requisite for a plan Medically perceived Health Needs:  Morbidity rates  Mortality rates  Disability rates  Antenatal care Community perceived Health Needs:  Service deficiencies
  32. Information of Services/Resources  Socioeconomic situation & infrastructure  Socioeconomic & cultural characteristics  Geographical & topographical characteristics  Infrastructure  Services provided by other sectors (education, water, sanitation, agriculture, public works)
  33. Information (contd.) Health Services  Service facilities (hospitals, beds)  Service utilization (occupancy rates, immunization)  Service gaps (areas not covered by basic facilities; projected service gaps)
  34. Health service organizational arrangements  The degree of centralization of decision making  Opportunities for community participation in decision making  Linkage between sectors
  35. Resources  The resources currently deployed in the health sector The resources likely to be available in future  Financial resources (budget)  Personnel  Building, land, equipment & vehicles  Efficiency, effectiveness, equity of current services
  36. Setting Priorities First Stage:  Involves the production of a macro situational analysis setting out the key information at national level Second stage:  Discussion by a national-level planning group, involving representatives of major health related sectors
  37. Priority Setting (contd.) Third stage:  The development of local- level situational analysis by local level health & other professionals & community representatives
  38. Priority Setting (contd) Fourth Stage: The review of these policies by National Health Planning Unit Priority setting involves a combination of technique & judgement
  39. Human Resource Planning  To ensure that there is the right number of personnel with the appropriate skills available in the right place at the right time  Health facilities are highly labour intensive  50-70% of the health budget spent on human resources
  40. Human Resource Planning  Supply of HR: available personnel  Demand for HR: funded requirement for personnel  An equilibrium (Balance) situation is required: where Demand & Supply are equal for each set of staff for each year
  41. Human Resource Planning  Estimating projections of each side of the supply & demand equation  Estimate demand for each category (ideally for a decade)
  42. HR Planning (contd)  Estimation of the present & future supply of each category of health professionals  Comparison of demand & supply  Establishment control  Development of training plan
  43. Human Resource Planning  Demand should be based on the plans for service implicit in the broader sectoral plan  Planning system should be sustainable  Ensure that the planning function will continue despite broader organizational changes
  44. HR Planning (contd.) Disciples required in planning include: economics, sociology, social epidemiology, community development, operations research, law
  45. Creating a structure for success A carefully organized and well-defined planning structure is essential Planning process for success
  46. Creating a structure for success There are several options for developing steering committees, advisory committees, and other structures to carry out planning work and involve people in the process.
  47. SWOT Worksheet  SWOT is an examination of a group’s internal strengths and weaknesses, as well as the environment’s opportunities and threats. It should be used in the beginning stages of decision making and strategic planning.
  48. SWOT  Strengths What are your state’s particular strengths? Do you do something particularly unique? What could be an asset in developing objectives for your state plan?  Weaknesses Where is your state lacking? What do others seem to accomplish that you cannot? What could limit your state planning efforts?
  49. Identifying & securing Resources “It takes a village to raise a child (or develop a state plan).”  Identify resources needed to develop state plan  Identify existing internal resources  Develop budget # Identify potential external resources, including potential donated resources
  50. Resources (contd.)  Plan to integrate the plan into state planning, budgeting, and programming processes  Develop staff and technical support plan  Secure identified resources and develop alternative resources if necessary
  51. Ask the right questions early  What is the scope of the state planning process? ► What does the state want to accomplish through this process? ► Why should taxpayers or others fund the development of the state plan? ► What will it take to support the planning initiative?
  52. Plan for the future  Don’t forget to plan for the future— it’s not over when the plan is released ► Identify resource needs to carry out a ten-year plan to monitor progress, publish periodic reviews, and sustain activities ► Keep a wish list ready for future funding (e.g., resources for a business companion document, a special health disparities consortium, or other ideas generated planning)
  53. Align the planning structure with goals
  54. THANK you Very much
  55. Health Service Providers(1)  Ministry of Health (MOH)  King Faisal Specialist Hospital & Research Center (KFSH&RC)  Ministry of Defense (MODA)  Ministry of Interior (SFH)  National Guard (NGHA)  Universities Hospitals  Private Sector
  56. Current Status (1)  Ministry of Health (MOH)  195 hospitals  1760 PHCC 20 are running different HIS & no connection between them 40 has a connection to MOH WAN but does not have HIS A system has been developed in-house for PHCC’s and applied in 9 of them which has connectivity The system can be accessed remotely by dialup
  57. Current Status (2)  King Faisal Specialist Hospital  2 hospitals (1 in Riyadh & 1 in Jeddah) The most advanced EMR in the country
  58. Current Status (3)  Ministry of Defense (MODA)  25 hospitals  150 clinics (10 are running different HIS & not connected to each other) 137 are connected to the nearest hospital
  59. Current Status (3)  Ministry of Defense (MODA)  25 hospitals  150 clinics (10 are running different HIS & not connected to each other) 137 are connected to the nearest hospital
  60. Current Status (4)  Ministry of Interior (SFH)  1 hospital  30 +- clinics (hospital is running HIS) Simple system in clinics & not connected to the hospital
  61. Current Status (5)  National Guard (NGHA)  4 hospitals  60 clinics ( 4 hospitals are connected through ASP model + 25 clinics)
  62. 1/27/2023 The 4th Regional conference on e-Health 62 Current Status (6)  Universities Hospitals  4 hospitals 2 are running the same HIS through connectivity Others are running different HIS
  63. 1/27/2023 The 4th Regional conference on e-Health 63 Current Status (6)  Universities Hospitals  4 hospitals 2 are running the same HIS through connectivity Others are running different HIS
  64. Public Input