Best health care planning ppt

1. 1
HEALTH CARE PLANNING AND
STRATEGIC MANAGEMENT
Getachew Weldeyohannes (MPH, PhD)
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2. Brain storming
What was your previous understanding regarding
planning process?
Do you think that planning should be part of
your day to day activity?
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3. 3
Session Objectives
 At the end of this session the trainees will
be able to:
 Defining planning
 Identify unique features of health services
planning
 Describe the types of planning
 Explain the steps of planning
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4. 4
What is planning?
 Planning means determining the organization’s
goals and defining the means for achieving them.
 Using Plans to Achieve Goals
 Goals specify future ends; plans specify today’s
means.
 A plan helps a manager organize resources and
activities efficiently and effectively to achieve
goals
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5. Planning….
Planning helps to answer six basic questions:
 What needs to be accomplished?
 When is the deadline?
 Where will this be done?
 Who will be responsible for it?
 How will it get done?
 How much time, energy, and resources are
required to accomplish this goal? 5

6. What is health services planning?
 A process that appraises the overall
health needs of a geographic area or
population and determines how these
needs can be met in the most
effective manner through the
allocation of existing and anticipated
future resources.
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7. Purposes of planning
 Gives an organization a sense of direction
 Focuses attention on objectives and results
 Establishes a basis for teamwork
 Helps anticipate problems and cope with
change
 Provides guidelines for decision making
 Serves as a prerequisite for other management
functions
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8. Attributes of planning
Futuristic
 anticipate the future
 what is required and
 how it will be accomplished
Decision making
 determine what is to be done, when, where, how, and
for what purpose.
 choosing among the alternatives.
 Resource allocation.
Continuous and dynamic Why?
 because planned activities are affected by internal and
external factors 8

9. Definition of terms
 Define the following terms and mention your
organization practice ?
 Mission
 Vision
 Goal
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10. Definition
 Mission
 Describes an organization's reason for existence.
 A mission statement should answer the following
questions:
 What is our fundamental purpose?
 Who do we work for?
 What do we do?
 Why do we do
 what we do? 10

11. Mission…..
 When developing the mission, the following
should be emphasized:
 The purpose for which the organization exists;
 The target population to which its services are
aimed;
 The services and/or products offered
 The scope of the activities of the organization.
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12. Characteristics of mission
 Mission statements identify the scope of
operations in terms of service and market.
 Mission statements should underscore the
uniqueness of the organization.
 Mission statements are enduring/stable.
 Missions are broadly defined statements of
purpose.
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13. Example of a mission statement:
 Yekatit 12 Hospital medical college strives to
provide preventive, promotive, curative and
rehabilitative health services to the people of
Addis Ababa city and its surroundings so that the
people lead a healthy and prosperous life.
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14. Definition…
 Vision-Where we want our organization to
be in the future
 Organization’s future intent
 The “picture of the future
 Usually one sentence:
 Can include a high-level strategic result (goal)
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15. Vision…..
Vision must;-
 Be compelling (forceful)
 Be inspiring (stimulating)
 Make people want to join the Organization
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16.  Goal Is a long-range specified state of
accomplishment toward which programs are
directed.
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17. Definition…
 Objective- achieving a measured amount of
progress toward a goal.
 It must include a specification of: what, how much,
when, who, and where
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18. Objective must be SMART
 Specific: Clearly written to avoid different
interpretations;
 Measurable: To allow you to monitor and
evaluate progress toward achieving the result;
 Appropriate/attainable: To the scope of your
program or work activities, so that you can
influence or make changes;
 Realistic: Achievable within the time allowed;
 Time bound: With a specific time period for
completion 18

19. Purposes of good objectives
 Serving as targets,
 Acting as measuring sticks,
 Encouraging commitment, and
 Strengthening motivation.
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20. Example of objectives….
 To increase use of voluntary counseling and
testing (VCT) services in one district by 50% (to
an average of 80 clients per month) among youths
by the end of 2019.
 To streamline the intake process for new clients
in our clinic so that, by the end of 2019, the
prescreening process takes an average of 10
minutes for each clients.
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21. Types of Plans
 Three major types of plans (strategic, tactical, and
operational) plus on additional- contingency plan can help
managers achieve their organization’s goals.
1. Operational plans
 A plan that a manager uses to accomplish his or her day to
day job responsibilities. These goals are called operational
goal or objective.
 Scheduling work hours, deciding what work will be
done and by whom…
 Can be a single-use plan or an ongoing plan
 Used by First-level managers 21

22. Cont…
2. Tactical plans
 Concerned with what the lower level units within each
division must do, how they must do it, and who is in charge at
each level. These goals are called tactical goals or objectives.
 Used by Middle-level managers.
3. Strategic plans
 Is an outline of steps designed with the goals of the entire
organization as a whole in mind.
 Includes developing the organizations mission, vision, goal,
objective, and major policy areas. These goals are called
strategic goals or objectives.
 It is a framework and sets dimensions for the lower level
planning.
 Used by Top-level managers. 22

23. Cont…
4. Contingency plans
 It involves identifying alternative courses of
action that can be implemented if and when
the original plan proves inadequate.
 Roots because of the dynamic environment
and changing circumstances.
 Operational Tactical Strategic plans
 Time frame (span): short long term
 Scope: narrow wide
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24. Strategic planning
 Strategy: Goal-directed decisions and actions in which
capabilities and resources are matched with the
opportunities and threats in the environment.
 Strategy bridges the gap between “where we are” and
“where we want to be”
 Strategic planning
 Is a management tool to help an organization do a better
job
 Is the ongoing process of ensuring a competitively
superior fit between the organization and its ever-
changing environment 24

25. Elements of strategic plan
 When doing planning managers need to address the
essentials of sound planning
 Organization vision
 Organizational mission
 Identify and analyze opportunities
 Objectives
 Priorities
 Course of action to achieve goals
 Resources needed.
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26. Planning Approaches
 Top-down the two commonly
 Bottom-up Approaches discussed
approach
 A three steps approach involving both Top-
down and Bottom-up approaches
 Adapted from the Woreda-based Health Sector
Planning Approach of the health sector
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27. Top-Down Approach
 In multilevel organizations
 Actual planning happens centrally
 Targets allocated to lower level organizations
 Lower level organizations are expected to execute what is
planned for them
 In single level organization
 Planning performed by senior managers
 Lower level managers and workers have little or no
influence on what is being planned 27

28. Top-Down Approach
 Advantages
 Aligns plans with expectations of funding agencies
 Makes standardization easy
 Cost-effective if successful
 Easy to evaluate implementation and results
 Disadvantages
 Doesn’t consider variations between settings at lower levels
 Difficult to engage partners and target groups
 Difficult to change even if it isn’t working
 Lack of ownership at lower levels 28

29. Bottom-up Approach
 Planning decisions are made at the lowest levels
 Targets passed on to each next higher level for
aggregation
 Central organization or senior management levels
approve what is already planned at lower levels
 A larger number of employees are involved
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30. Bottom-up Approach…..
 Advantage
 Easier to involve partners
 Possibility to use free resources
 Easier to engage target group and identify their needs
 Easier to adapt to differing needs of different organizations
Easy to obtain ownership and commitment at lower levels
 Disadvantage
 Take staff time and costs
 No full control if target population participate and influence
planning decisions
 More difficult to evaluate 30

31. Steps of planning process
 Step1 - SITUATIONAL ANALYSIS
 Gives improved understanding of the current situation
from various perspectives
 Answers the question “where are we now?”
 Two major aspects regarding the current situation
need to be described
 Identification of health and health related needs of
the community
 Available resources
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32. Contents of situational analysis
1. Population characteristics and Area
characteristics
2. Policy and political environment
3. Review of past implementation experience
4. Reviewing the Mission
5. Stakeholders Analysis
6. Assess Internal and External Environment
(SWOT Analysis)
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33. Stakeholders Analysis
 A “stakeholder” is considered any person,
group or organization that can place a claim
on the organization’s attention, resource, or
services, or is affected by what the organization
does or the service it provides.
 The organization need comprehensive list of
both internal and external
constituents/stakeholders and identify their
expectations.
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34. Stakeholder analysis worksheet
Stakeholde
r group or
individual
What are
they most
interested
in?
What is
their
biggest
concern?
What do
we need to
do to get
their
support?
34

35. Assess Internal and External Environment
(SWOT Analysis)
 It is a method that helps to identify the ways of bridging
the gap by analyzing the organization’s situation.
 Strengths (S) and Weaknesses (W) are internal factors over
which the organization has some measure of control.
 Opportunities (O) and Threats (T) are considered to be
external factors over which the organization has essentially
no control.
 SWOT analysis helps to identify issues that must be
addressed in the strategic plan
 It is evidence-based, not just opinion gathering
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36. Cont…
Strengths:
 Qualities that enable organizations to accomplish mission and to
make success sustained
 Two major categories: resources and capabilities
 It determine the organization’s competitive strength /weapons
 Helps to answer “What should the organization’s business be?”
Weaknesses:
 Factors that prevent organizations from accomplishing mission and
achieving their full potential
 Negative influences on the organizational success and growth
 They are controllable. They must be minimized and eliminated.
 Human resources, financial management, infrastructure,
technology….. 36

37. Cont…
Opportunities:
 Are positive trends in the external environment
 Arise when an organization can take benefit of
conditions in its environment to plan and execute
strategies that enable it to become more successful.
Threats:
 Are negative trends in the external environment
 Arise when conditions in external environment
jeopardize the reliability and success of the
organization.
 Threats are uncontrollable.
 Rivals, substitute services, purchasers, suppliers,
government regulations… 37

38. 38
Step 2 - PROBLEM PRIORITIZATION
Why do we need to prioritize problems?

39. 39
Prioritization cont…
 While analyzing problems:
 Define clearly what the problem is
 Find all possible causes of the problem
Eg. What are the possible causes of high diarrheal
disease incidence?
 Inadequate water supply
 Unsafe water supply
 Poor sanitary conditions
 Inappropriate infant feeding practice, etc

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Prioritization cont…
 Environmental problems
 Poor sanitary conditions
 Poor housing conditions
 Inadequate and unsafe
water supply
 Air pollution and so on
 Diseases/health problems
 Malaria
 TB
 HIV/AIDS
 TB
 Socio-economic problems
 Low per capita income
 Low literacy rate
 Cultural and religious
beliefs and values
 Health services problems
 Inadequate distribution
of health services
 Poor quality and
quantity of drugs
 Old medical equipments
 Lack of qualified
personnel
Grouping of problems
 Grouping of identified problems allows managers to design interventions
for groups of activities.
Examples:

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Prioritization cont…
How can we prioritize problems?

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Prioritization cont…
 Magnitude of the problem
 the public health burden imposed by the problem
 Degree of severity
 consequent suffering, death and disability
 Feasibility:
 cost effectiveness
 social acceptability
 local sustainability
 Government concern
 political acceptability with consideration of equity
 Multi-sectoral approach
 consistency with government plan and budgetary system
 Community concern
 how much does it relate to community perceived health needs?
 Ranking is then done by using criteria on 5 point scale
- very high (5), high (4), moderate (3), low (2) and very low (1)

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Step 3 - SETTING OBJECTIVES AND
TARGETS
 Describing the desired direction of a service definition
in terms of measurable parameters
 Answers the question “where do we want to go?”
 “If you don’t know where you are going, any road will
get you there.” Lewis Carroll
Importance
 Clear statement of objectives enables:
 to decide how to achieve them
 improves efficiency by avoiding unnecessary investments
 to evaluate how effective one is in achieving and reaching
objectives

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Step 4 - IDENTIFYING POTENTIAL
OBSTACLES & LIMITATIONS
 Situations that may prevent the achievement of each
objectives & targets
 The limitations may be :
 Resources
 Human – lack of interest/skill
 Equipment – not available/Expensive
 Money - lack of budget
 Time - people may not have time
 Information - needed for implementation not timely/well processed
 Environmental obstacles
 Geographical features like lakes, rivers, mountains
 Climate – affect the nature of health problems
 Technical difficulties
 Social factors - taboos, traditions

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OBSTACLES cont…
 There are three groups of Obstacles
1. Obstacles that can be removed
2. Obstacles that can be reduced or modified
3. Obstacles that can’t be changed

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Step 5 - DESIGNING STRATEGIES
 Strategies are the tactics or techniques that should be
devised or adopted & utilized to facilitate the
achievement of objectives & targets.
 Strategies are ways of achieving objectives & targets
 Potential strategies often include
 Technology to be applied
 Procedures to be used
 Defining the role of communities and other
sectors

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STRATEGIES cont…
 For each chosen strategy, the corresponding
activities to be undertaken & the resources needed
should be detailed.
 What is to be done?
 Who will do the activities?
 Which resources are needed?
 How? (procedures for technical, administrative,
community workers, contribution of other sectors)
 When to do it? (beginning, end)
 Where the work will be done?
 How would the activity be monitored and evaluated

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Step 6 - WRITING UP THE PLAN
 Purpose
 To request funds or resources from the government
or other funding agencies
 To be used as a guide for implementation
 For monitoring & evaluating the implementation
process by all concerned

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WRITING UP cont…
 The following need to be included in the
plan document:
 Summary of main points
 Introduction
 General background
 Statement of the problem)
 Objectives and targets
 Strategies
 Activities and the Gantt chart

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WRITING UP cont…
– Resource requirement
• The type and number of resources needed
• How each of the resources are going to be
utilized
– Monitoring & evaluation
• Mention how monitoring and evaluation is to
be performed
– By whom?
– When?
– Indicators of effectiveness should be decided before
implementation

51. Home Take Assignment
 Considering your organizational/institutional
data as a base line, Prepare a hypothetical
strategic plan for your institution taking into
account the steps of planning into
consideration
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