A ppt for third first MBBS part 1 students on planning and management

1. Planning and Management
Dr. Shyamsundar J Raithatha
Head, Extension Programmes Department
Assistant Professor, Community Medicine
H M Patel Center for Medical Care and Education
Karamsad – 388325
shyamjr@charutarhealth.org

2. Outline

Class 1 : Introduction
– What is planning, management, leadership,
administration ?
– Planning Cycle

Class 2: Time management

Class 3: Programme Evaluation

3. Class 1: Introduction

What is Administration, Management, Leadership ?

Planning cycle

4. Administration

The activities that relate to running a company, institution,
or other organization

Implementing decisions/strategies

Maintenance – Implementation

Used interchangeably with management

5. Management

Coordination of the efforts of people to accomplish goals
and objectives by using available resources efficiently
and effectively

Getting things done efficiently

Goals are predecided – strategies formed and
identified

Used interchangeably with leadership at times

6. Leadership

Leaders set direction and help themselves and others to
do the right thing to move forward through motivation and
inspiration

Defining goals

Transformation

7. Example

8. Leadership Management
Administration

9. Planning
The process of setting goals, developing strategies,
and outlining tasks and schedules to accomplish
the goals

First step of management

10. Planning
Deciding in advance

What to do ?

How to do ?

Who is to do it ?

11. Planning Cycle

12. Steps in a planning cycle

13. Example of a planning cycle for TB
Step 1: Assess need
Burden of TB
- Prevalence, Mortality

14. Example of a planning cycle for TB
Step 1: Assess need
Burden of TB
- Prevalence, Mortality
Step 2: Identify &
Prioritise
Treatment of cases
Step 2: Identify &
Prioritise
Treatment of cases
Step 2: Identify &
Prioritise
Treatment of cases

15. Example of a planning cycle for TB
Step 1: Assess need
Burden of TB
- Prevalence, Mortality
Step 2: Identify &
Prioritise
Treatment of cases
Step 2: Identify &
Prioritise
Treatment of cases
Step 2: Identify &
Prioritise
Treatment of cases
Step 3: Goals and
Objectives
70% Detection rate,
85% cure rate

16. Example of a planning cycle for TB
Step 1: Assess need
Burden of TB
- Prevalence, Mortality
Step 2: Identify &
Prioritise
Treatment of cases
Step 2: Identify &
Prioritise
Treatment of cases
Step 2: Identify &
Prioritise
Treatment of cases
Step 3: Goals and
Objectives
70% Detection rate,
85% cure rate
Step 4: Develop
Strategy
DOTS

17. Example of a planning cycle for TB
Step 1: Assess need
Burden of TB
- Prevalence, Mortality
Step 2: Identify &
Prioritise
Treatment of cases
Step 2: Identify &
Prioritise
Treatment of cases
Step 2: Identify &
Prioritise
Treatment of cases
Step 3: Goals and
Objectives
70% Detection rate,
85% cure rate
Step 4: Develop
Strategy
DOTS
Step 5: Implement
Pilot and scale up

18. Example of a planning cycle for TB
Step 1: Assess need
Burden of TB
- Prevalence, Mortality
Step 2: Identify &
Prioritise
Treatment of cases
Step 3: Goals and
Objectives
70% Detection rate,
85% cure rate
Step 4: Develop
Strategy
DOTS
Step 6: Monitor and
Evaluate
Indicators – Detection
rate, Cure rate
Step 5: Implement
Pilot and scale up

19. Goals, Objectives and Targets

20. Example
An oral cancer prevention and care programme is being implemented in Anand
district with the purpose of reducing the burden of oral cancer in the district. Two
approaches are followed for achieving the purpose viz. Reducing the tobacco
addiction prevalence in the community and early detection of cancer through
screening. Several activities will be undertaken as listed below

Education of school children on hazards of tobacco

Creation of tobacco free zones in the community

Providing de-addiction facilities at health centers

Organising screening camps in villages for oral cancer

Providing diagnostic facility through biopsy for those identified as screen
positive at the health centers

Helping the patients identified as oral cancer to reach a cancer hospital –
Government hospital for poor patients and other hospitals for affording patients

21. Example: Cancer Programme
Reduce the
burden of oral
cancer in Anand
district
Reducing the prevalence
of tobacco addiction Education of school
children on tobacco
Tobacco free zones
De-addiction facilities
Early detection and
treatment of cancer
Screening camps for cancer
Biopsy for confirmatory
diagnosis at centers
Referral of diagnosed
patients to cancer centers

22. Example: Cancer Programme
Reduce the
burden of oral
cancer in Anand
district
Reducing the prevalence
of tobacco addiction Education of school
children on tobacco
Tobacco free zones
De-addiction facilities
Early detection and
treatment of cancer
Screening camps for cancer
Biopsy for confirmatory
diagnosis at centers
Referral of diagnosed
patients to cancer centers
Objective
Objective
Goal
Target
Target
Target
Target
Target
Target

23. Goals, Objectives and Targets
Goal: Ultimate desired state towards which all objectives and
resources are directed
Objective: A planned end-point of all activities
Target: An indicator which describes a specific number of a
discrete activity

24. Time Management

25. What do you understand by time management ?

26. What is Time Management ?

Multitasking

Being continuously busy – ensuring every second is used
properly

Working extremely hard

Achieving more in limited amount of time

Using to-do lists

27. What is Time Management ?

Multitasking

Being continuously busy – ensuring every second is used
properly

Working extremely hard

Achieving more in limited amount of time

Using to-do lists

28. Time Management
“Working smarter to enhance your effectiveness”

Prioritization – First things first

Sharpening the saw

29. Why time management ?

Limited life time

Many things to achieve

The Last Lecture – Randy Pausch

30. Prioritization – First Things First
Video

31. Prioritization – First Things First

33. Prioritization – First Things First

34. Prioritization – First Things First

35. Sharpen the saw

36. Sharpen the saw

37. Sharpen the saw

38. Some homework for you !

39. Some homework for you !
Step 1: Take one hour out of your routine and go to place
where you can sit alone and think. It can be a library, your
room, terrace, garden, .. any thing where you can be alone
and talk with your mind and think yourself. Take a
notebook (hard/soft) with you.

40. Some homework for you !
Step 2: Imagine that you are celebrating your 71st birthday. You
have invited your friends, family members, relatives, colleagues,
students, teachers, sub-ordinates, etc... all those whom you have
known in the last 70 years. Everybody is happy and wishing you
on your birthday. Now you ask them to say a few words about
yourself – like how you have been with them – a feedback on you,
etc.
--> Now take the notebook and start writing down as to what you
would like them to say about you. What words would you like
them to use for you?

42. Thank you !
“Imagination is more important than
knowledge.”
- Albert Einstein

43. Programme Evaluation

44. What is programme evaluation ?
A systematic assessment of the effectiveness of
processes and/or outcomes of a program with
the intent of furthering its development and
improvement

45. Example of a planning cycle for TB
Step 1: Assess need
Burden of TB
- Prevalence, Mortality
Step 2: Identify &
Prioritise
Treatment of cases
Step 2: Identify &
Prioritise
Treatment of cases
Step 2: Identify &
Prioritise
Treatment of cases
Step 3: Goals and
Objectives
70% Detection rate,
85% cure rate
Step 4: Develop
Strategy
DOTS
Step 5: Implement
Pilot and scale up

46. Evaluation of health services
Health Programme - <Add images>
Health facility – Hospital / Heath center / clinic

47. Types of Evaluation
Formative
Summative

48. Types of Evaluation

49. Types of Evaluation
Formative: Evaluation is done before the beginning of the
programme or during the implementation of the programme to
improve the delivery of the programme
– Structure
– Process
Summative: Evaluation is done at the end of the programme to
assess the extent to which the programme was effective in
achieving its objectives
– Outcome

50. What is to be evaluated ?

Structure: Facilities, Equipment, Manpower and organisation meet a standard

Example – NABH, NAAC, IPHS

Process - Output

The way in which an activity is being carried out

Target achievement

Outcome
– The end result of activities – objectives

Impact

Goal achievement

51. Programme Indicators
Example – Diagnosis and treatment of malaria by ASHA
workers as a part of the Malaria control programme
Output Indicators No. of blood smears collected by ASHA workers
No. of patients administered anti-malarial treatment
Outcome Indicators Percentage of fever cases underwent malaria
testing
Percentage of malaria cases received treatment
Impact Indicators Malaria mortality rate

52. Elements of evaluation
1. Relevance
2. Adequacy
3. Accebility
4. Acceptability
5. Effectiveness
6. Efficiency

53. Elements of evaluation
1. Relevance – Appropriateness of the service – Whether the
service is needed at all from the perspective of location,
time and person
Eg: Kala Azar treatment facility may not be required in
Gujarat
2. Adequacy - Whether the service is available in adequate
quantity
Eg: Vaccine demand of a PHC/SC

54. Elements of evaluation
3. Accessibility: The extent to which a service is usable.
– Physical – Distance, availability of transport
– Economic – charges
– Cultural – Caste/Language barrier
4. Acceptability:
Eg: Screening for cervical cancer by male doctors

55. Elements of evaluation
5. Effectiveness – Degree of attainment of the objectives
and targets of the programme, service or institution in real
life situation
Eg – Cure rate in RNTCP
6. Efficiency – How well are the resources ( money, men,
material and time) are utilised to achieve a given
effectiveness
– Eg – Cost effectiveness

56. Methodology of evaluation
Quantitative – Surveys, Experiments, Case Control studies,
etc.
Qualitative – Focus Group Discussions, In-depth interviews,
observations, etc.

57. Assignment
What is cost effectiveness analysis ?
What is cost benefit analysis ?