Planning and evaluation presentation

Planning and
Evaluation
Dr. Ritu Randad
28/09/2021
1

Content
 Introduction
 Uses of planning
 Types of health planning
 Steps in planning process
 Evaluation
1. Criteria used in evaluation of dental services
2. Types of evaluation
3. General steps in evaluation
 Conclusion
 References 2

Introduction
It has been rightly said that most of the human history has been a result of accidents and blind
decisions. When a crisis occurs, the solutions are immediate and involve minimal efforts rather than
considered and thoughtful planning. The need to develop over ability to predict, plan and thus prevent
the same crisis from happening should be the highest priority.
G. Gluck, W. Morganstein, Jong’s Community Dental Health, 5th edition, Mosby, 2002
3

What is planning
 Banfield defined planning as “a plan is a decision about the course of action”.
 Jong defined planning as “a plan is a systematic approach to defining the problem, setting
priorities, developing specific goals and objectives and determining alternative strategies and a
method of implementation.”
4

Uses of planning
 To match limited resources with many problems.
 Eliminate wasteful or duplication of expenditures.
 Develop best course of action and accomplish a defined objective.
5

Principles of planning
 At most basic level: planning aims to guide choices so that decisions are made so that desired
outcomes are derived.
It provides an opportunity to be proactive in decision-
making rather than constantly reacting to pressures and
demands.
It enables priorities to be set.
It identifies where resources can be directed to have the
highest impact.
B. Daly, P. Batchelor, E. Treasure, R. Watt, Essential of Dental Public Health, 2nd edition, Oxford publications, 2013
6

Types of health planning
Identification and
resolutions of
problems
Designing of the
course of action
Coordination of
efforts and
activities
Allocation of
resources
Development of
blue print or
proposal
Design of standard
operating
procedures
Increases the
availability,
efficiency,
productivity
and
effectiveness
GIVEN BY Spiegel
and associates in
1978
7

options
Decisions of
policy
Available
resources
implementation
evaluation
Identification of
needs
RATIONAL PLANNING
MODEL BY McCarthy
1982
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Assessment of need: identifying the oral health problems and
concerns of the population
Identifying the priorities: agreeing the target areas for action
Developing aims and objectives: to reach the aims
Assessing the resources: identifying the range of resources
available to facilitate implementation of the plan
Implementation: turning plans into action
Evaluation: measuring the changes resulting from the plan
B. Daly, P. Batchelor, E. Treasure, R.
Watt, Essential of Dental Public Health,
2nd edition, Oxford publications, 2013
9

Strategic planning
flow chat
10

Planning and
implementation
strategy flowchart
 Data can be obtained by various
techniques like questionnaires,
clinical examinations or through
personal communications.
 Factors that the planner should
consider are no. of individuals,
the extend and level of severity
and attitudes of the individual’s
to be surveyed.
11

Steps in planning and evaluation
1. Identify the problem
2. Determining the priorities
3. Development of program goals, objectives and activities
4. Resource identification
5. Identifying the constraints
6. Identify alternative strategies
7. Develop implementation strategy
8. Implementation
9. Monitoring
10. Evaluation
12

IDENTIFY THE PROBLEM
 Conduct a need assessment
Needs is defined as “deficiencies in health that calls for preventive, curative, and eradication of
measures”- WHO 1971.
13

Needs assessment
 Evaluates the effectiveness of program. Done by obtaining the baseline information over
time, measuring the amount of progress is achieved in solving the specific problem.
 reasons for need assessment:
1. Defines the problem
2. Identifies the extend and severity
3. Provides a profile for the community to ascertain the cause for the problem
4. Helps in evaluating the effectiveness of the program
14

Population profile
1. No. of individuals in the population
2. Geographical distribution of the population
3. Rate of growth
4. Population density and degree of urbanization
5. Ethnic backgrounds
6. Diet and nutritional levels
7. Standard of living
8. Amount and types of public services
9. Public and private school system
10.General health profile
11.Patterns and distribution of diseases.
Once the needs has been assessed, the
information should be analysed before the
priorities are determined.
15

DETERMINING THE PRIORITIES
 “Priorities determination is a method of imposing people’s values and judgements of what is
important onto the raw data”.
 It is used to rank the problems according to the severity and helps to utilize the resources
tactically.
 If the priorities are not set and determined then program may not serve the people in need.
16

High risk priorities groups
 Pre school and school age children
 Mentally and physically challenged persons
 Chronically ill or medically compromised persons
 Elderly persons
 Expectant mothers
 Low- income minority groups (rural and urban)
When setting priorities the
planner must ask:
1. How serious is the problem?
2. What percent of the
population is being affected?
17

DEVELOPMENT OF PROGRAM GOALS AND
OBJECTIVES
 Program goals are broad statements on the overall purpose of the program to meet a defined
problem.
 Program objectives are more specific and described in a measurable way the desired end result of
program activities.
18

 Objectives should have
1. what: the nature of the situation or condition to be attained
2. Extend: the scope and magnitude of the situation or condition to be attained
3. who: the particular group or portion of the environment in which attainment is desired
4. where: the geographic area of the program
5. when: the date and day of the desired situation or condition intended to exist.
19

Program activities
 Includes 3 components to bring out desired outcomes:
What is it
going to be
Who will be
doing it
When will it
be done
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RESOURCE IDENTIFICATION
 Implies the selection of resources needed for the
activities, like personnel, equipment, money,
skills needed or required for implementation of
the program.
 Balance has to stuck with that is required and
what is available.
Some criteria commonly used to determine the
resources:
1. Appropriateness: most suitable resources
to get the job done
2. Adequacy: the extend or degree to which
the resources would complete the job
3. Effectiveness: how capable the resources
are at completing the job
4. Efficiency: the cost and amount of time
spent.
21

IDENTIFYING CONSTRAINTS
 “road blocks” or “obstacles” to achieving a certain goal or objective.
 Identifications of the constraints should be done at the early stages of the planning
procedures, so that
1. one can modify the design and
2. create a more practical and realistic plan.
22

 Constraints can be results of :
 Attitudes of professional organizations
 Lack of funding
 Restrictive governmental policies
 Inadequate transportation services,
 Labour shortages and
 Population’s socioeconomic characteristics.
23

 One of the best ways to identify constraints is to bring together a group of concerned citizens
together who might be involved in or will be affected by the project.
 A group that is similar to local politics and structures can not only identify the constraints by
also provide with alternative solutions and strategies to meeting the goals.
24

ALTERNATIVE STRATEGIES
 It is needed to have multiple alternative strategies so that out of that number at least one may be
considered acceptable. The no of alternatives should be at hand
Presence of
existent constraints
and resources
Alternative
strategies
Help achieve the
objectives
25

 The alternative strategies will help decide the most suitable plan individually or in
combination
 The preventive measures considered should be cost effective, as well as practical to
implement, the planner would then choose the measure that has the best interest and
alternatives.
26

DEVELOPING AN IMPLEMENTATION
STRATEGY
 An implementation strategy for each activity is complete when the following questions have been
answered:
1. WHY: the effect of the objectives to be achieved.
2. WHAT: the activities required to achieve the objective
3. WHO: individuals responsible for each activity
4. WHEN : chronologic sequence of activities
5. HOW: materials, media, methods and techniques to be used
6. HOW MUCH: a cost estimate for the materials to be used and time.
27

 To develop an implementation strategy, planners must know what specific activity they want
to do. The most effective method is to work backward to identify the events that must occur
before initiating the activity.
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IMPLEMENTATION
 The process of putting the plan into action is called as IMPLEMENTATION.
 The process involves individuals, organizations and community. Only through the team work
between individual and the surrounding environment can the implementation be successful.
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The pilot phase: whose development works on trial and error basis
The controlled phase: where the model of a program is run under the regulated
conditions to judge its effectiveness.
The actualization phase: where the model of a program is subjected to realistic
operating conditions
The operation phase: program is ongoing part of the structure,.
30

Rules for implementation
1. Specify clearly the activity
2. Be sure someone is responsible for the whole activity and coordinate with people who will
carry out different tasks.
3. Identify all the preparatory steps before doing that activity
4. List steps in order in which they will be occur
5. Check for missing steps
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6. Determine when each step should begin and end
7. Consult with organizations affected by the activities, potential problems etc.
8. Specify the resources and their source
9. Specify what constraints must be addressed.
10.Make sure all people involved know that they are expected of and when.
32

MONITORING
 Refers to the maintenance of an ongoing watch over the activities of an healthy service.
 Monitoring is not only about watching but also using the observation as basis for continual
modifications of the goals, plans and aims.
33

Input data
• Financial/
budgetary
reports, personnel
available,
transport records,
equipment and
supplies
purchased.
Process data
• Specific activities
carried out in
completing the
program
• The sequence in
which they will be
carried out and
their timing.
Output data
• Services or goods
provided (as the
proportion of
target population
served)
34

EVALUATION
 Evaluation measures the degree to which the objectives and targets are fulfilled and the
quality of the results are obtained.
 It measures the productivity of available resources in achieving clearly the defined
objectives.
 It makes possible the reallocation of priorities and resources on the basis of changing
health needs.
- WHO 1967
Jill Mason, Concepts in Dental Public Health, Wolters Kluwer Company, 2005
35

 Evaluation is defined as “the collection and analysis of information to determine program
performance”.
 Concerned- final outcome and factor related to it.
Final outcome
Determine the value
of program and to
make sure the
program was carried
out as thought
Direct result-
assess the
changes made
due to the
program
Indirect result- it is not
practicable to measure
directly the changes
made
Whether all the
objectives and
performance was
fulfilled.
36

Criteria used for evaluating dental services
(WHO-1972)
Effectiveness- have the
stated objective being
met
Efficiency-cost of
manpower and finance
to outcome
Appropriateness-
acceptance and
priority reflect in
interpretation of needs
Adequacy- coverage
of target population
and services available
37

 EFFECTIVENESS: “the ration between the achievement of the program activity and the desired
level which, during the planning process, the planner had proposed would result from the
program”.
1. Resources-
2. Activities-
3. Objectives
38

 EFFICIENCY :”the result that might be achieved by expenditure of a specific amount of
resources and the result that might be achieved through a minimum of expenditure.(WHO 1974)
 It is a measure of the resources spent (money, personnel, material and time) in the process of
providing the health care program.
39

 APPROPRIATENESS: decided by lay decision makers. They will weigh up whether the
problem defined by the program personnel is a problem for the community.
 There are 2 levels at which the evaluation of appropriateness can be carried out:
1. aim and objectives of the program are appropriate.
2. strategy of the program is appropriate.
40

 ADEQUACY: a measure of adequacy is the extend to which the population in need was
covered by the services, or the extend to which the services covered the various aspects of the
underlying problems.
41

Types of evaluation
1. Based on time duration
 Formative and summative evaluation
2. Based on fulfilment of objectives
 Effective, efficiency and impact evaluation
3. Based on the output
 Process, relevance evaluation
42

Formative evaluation
 “the internal evaluation of program”. It is an examination of the activities of a program, as
they are taking place. Usually carried out to aid the development of a program at its early
phase.
 Used primarily by the program developers and program staff members as to whether they
are workable or whether changes should be made to improve the activities.
43
C. Pine, R. Harris, Community Oral Health, 2nd edition, Quiescence publications, 2007.
PILOT PHASE AND
CONTROL PHASE

Summative evaluation
 Judges the merit of worth of a program after it has been in operation. It is an attempt to
determine whether a fully operational program is meeting the goals for which it has been
developed.
 Aimed at program decision makers, who will decide as to program continues or is
terminated and also at decision makers from other programs who might be considering
adoption of the program.
44
ACTUALIZATION
PHASE AND FINAL
OPERATIONAL PHASE

Relevance evaluation
A. What Problem is being addressed?
B. How adequate is the problem defined?
C. Level of services associated with problem
D. Accurate information of problem
E. Adequate is the program defined?
F. Program appropriate to problem
G. Identification of the ones needing the services
45
Activities
Whether the program is
needed
The program is targeting its
efforts on the individuals in
need

Process evaluation
 Refers to “ efforts made to assess the extend to which the program implementation
compiles with the program plan.”
 The assessment of program helps in making early adjustments and decision concerning
with the continuation and expansion of the program.
46
Management
process.

Questions around which the process
evaluation can be conducted :
 Recommendations might help logically follow :
1. Terminate the project
2. Reorganize the project
3. Fine tune the project
4. Process as the program implemented.
47

Effective evaluation
 Refers to “whether the program results meet the predetermined objectives”. The
emphasis on immediate outcomes and whether outcomes meet the activities
set by planners.
48
Sr. number Questions
1. Did the program meet its stated objectives?
2. Were the providers satisfied by the effects of the program activities?
3. Were the program beneficiaries were satisfied by the effects of program activities?
4. Was the problem reduced or eliminated as result of the program

Impact evaluation
 Refers to “ the long term outcomes of the program”. (long lasting effect on
the ultimate problem)
 It is an expression of the overall effect of a program on health status and
socio-economic development.
49

Efficiency evaluation
 Attempts to relate the results obtained from a specific program to the
resources expended to maintain the program.
50
Question related to efficiency evaluation
include
Dishonest evaluation can be of different types
Do program benefits exceeds the costs
initiated?
Eyewash- appraisal limited to good parts
Are program benefits more or less costly
per unit of outcome
Whitewash- covering up the failure by avoiding
objectives
Submarine- aimed without knowing the worth of the
program,
Postponement ploy- need to seek facts in hope that
crisis will be over by the time the facts are known.

General steps in evaluation
 DETERMINING WHAT IS TO BE EVALUATED:
51
Evaluation of the structure Evaluation of the process Evaluation of the outcome
Evaluate the structure,
manpower, resources meet
the standard accepted by
the experts as good.
• Process of Medical care,
problems of recognition,
diagnostics, treatment,
management and
prevention.
• Compared with the
predetermined standard.
Concerned with the end
result. Persons using the
services experience the
measurable benefits or not.

ESTABLISMENT OF STANDARDS AND
CRITERIA
 Standards and criteria should be established, so that they can be compared.
 Important to determine how well, the desired objectives have been achieved.
1. STRUCTURAL CRITERIA
2. PROCESS CRITIERA
3. OUTCOME CRITERIA
52

PLANNING THE METHODOLOGY
 A pre set format should be prepared for the gathering the desired information.
 Standards and criteria should be included at the planning stage.
53

GATHERING THE INFORMATION
 The type and amount of information required will depend on the purpose of the
evaluation.
 Health related socio-economic policies, plans as well as the extend, scope and use of
health services, services and institutions.
54
Include political, cultural, administrative, environmental and economic factors
influencing the health situation as well as mortality and morbidity status.

ANALYSIS OF RESULTS
 Analysis and interpretation of data and feedback should be done at the
shortest feasible time. (to the concerned people)
 Opportunities- for discussing the evaluation.
55

TAKING ACTION
 True productivity- actions to be designed for support, strengthen or modify
the services involved, needs to be undertaken.
 Demands- shifting priorities, revising objectives or develop new programs or
services to meet the previous unidentified needs.
56

RE-EVALUATION
 Evaluation is an ongoing /continuous process.
 Aimed- render health services more relevant, effective and efficient.
57

CONCLUSION
 A PLAN CAN PLAY A VITAL ROLE IN HELPING TO AVIOD MISTAKES AND
RECOGNIZE HIDDEN OPPORTUNITIES. PLANNING HELPS IN FORECASTING
THE FUTURE.
 IT BRIDGES BETWEEN WHERE WE ARE AND WHERE WE WANT TO GO.
58

Name of the article Level of evidence Results Conclusion
Hooper P
, Boulange C,
Arciniegas G, Foster S,
Bolleter J, Pettit C.
Exploring the potential for
planning support systems
to bridge the research-
translation gap between
public health and urban
planning.
3a Evaluation results
indicated the Urban
Check PSS helped in four
key areas: visualisation of
how the neighbourhood
would change in response
to a proposed plan;
understanding how a plan
could benefit the
community; Communicate
and improve
understanding health of
planning and design
decisions that positively
impact health outcomes
The use of health-impact
PSS have the potential to
be transformative for the
translation and application
of health evidence into
planning policy and
practice, providing those
responsible for the policy
and practice of designing
and creating our
communities with access
to quantifiable, evidence-
based information about
how their decisions might
impact community health.
59

REFERENCES
 G. Gluck, W. Morganstein, Jong’s Community Dental Health, 5th edition, Mosby, 2002
 Jill Mason, Concepts in Dental Public Health, Wolters Kluwer Company, 2005
 B. Daly, P. Batchelor, E. Treasure, R. Watt, Essential of Dental Public Health, 2nd edition, Oxford
publications, 2013
 C. Pine, R. Harris, Community Oral Health, 2nd edition, Quiescence publications, 2007.
 K Park, Textbook of Preventive and Social Medicine, 23 rd edition, Bhanot, 2012
60

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