Health System Management Planning Quiz

Health Programme Planning-PHS303

• Instructor: DR JOHNSON ADEGBOYEGA OYENIYI
• Qualifications: MBBS, MPH, FWACP, Cert. Health Plan & Mang.

Background

• Course aims to prepare public health students and health science students to develop health programs addressing specific community needs.
• Course highlights critical planning issues, management functions, implementation processes, support systems, evaluation procedures, and health information format.
• Key skills include setting goals and objectives, defining strategies, assessing resources, and linking implementation with evaluation of outcomes.

Meaning of Planning

• Planning is a managerial activity involving familiarizing oneself with planning concepts.
• Different types of planning are used at various management levels to maintain a functional system.
• Understanding the planning cycle is crucial.
• SMART objectives (Specific, Measurable, Achievable, Realistic, Time-bound) are essential.
• Planning includes monitoring and evaluation of programs and projects.
• Pre-planning activities need to be considered before the commencement of planning.

Health Planning

• Presentation outline includes: definition, types of planning, reasons for planning, limitations of planning, planning cycles, and factors to consider during program implementation.

Meaning of Planning (cont.)

• Planning is the function within management that sets goals and outlines the actions needed to reach those goals.
• It involves selecting future courses of action and is related to other management functions like decision-making, organizing, leading, and controlling.
• External factors influence goals.

Importance of Planning

• Planning provides direction, ensuring clarity of objectives and actions for employees.
• Planning reduces potential risks by enabling managers to predict changes and develop strategies for dealing with them.
• Planning minimizes wasteful activities by organizing efforts and ensuring coordinated action.
• Planning facilitates decision-making by providing alternative plans.

Planning Process

• The planning process involves setting objectives, developing tasks to meet those objectives, defining resource needs, creating timelines, establishing tracking and assessment, finalizing the plan, and distributing it to the team.

Four Types of Planning

• Strategic planning, tactical planning, operational planning, and contingency planning.

Types of Planning (cont.)

• Top-level management typically plans for the entire organization.
• Middle-level management focuses on departmental plans.
• Lower-level management plans for daily operations.
• Contingency plans (Plan B) are for unexpected events.

Limitations of Planning

• Rigidity: Plans can be inflexible, hindering adjustments to internal or external changes (e.g., political, legal, economic).
• Inability to Adapt to Dynamic Environments: The changing environment makes it hard to forecast needs or trends, potentially hindering successful implementation.
• Reduced Creativity: Top-level management may dominate, limiting opportunities for input from lower levels..
• High Cost: Planning requires substantial time and resources, including meetings, consultant input, and feasibility studies.
• Time Consuming: A comprehensive planning process can delay implementation.
• Absence of Alternatives: Without alternative paths to consider, planning lacks rationale.

Planning Step

• Plan formulation, Execution, Evaluation, and Collaboration.
• Specialists across medicine, economics, sociology, statistics, and management are involved.

National Development Planning

• Every country has its own national development plan.
• The plan aims for rapid, balanced economic and social development.
• A national plan usually combines sectorial plans covering various areas like health, agriculture, education, industry, power, transportation, and communication.
• Plans often need coordination to use national resources effectively.

Health Planning

• Health planning is part of national development plans.
• It’s essential for optimizing the use of scarce material resources.
• It aims to improve health services.
• Defined as a process to identify community health problems, needs, and resources to formulate plans with realistic, feasible goals and action plans.

Module 2 Outline

• Planning cycle.
• Definition of planning.
• Planning for planning.

Steps in Planning

• 1) Health Need Assessment: Identify deficiencies in preventive and curative measures and control measures for water, nutrition, immunization, and family planning.
• 2) Resource Assessment: Determine manpower, money, material, skills, knowledge, and time.

Useful Terms

• Goal, objective, and target: End results of planning, with activities and precise targets.
• Procedure: Rules guiding work.
• Policies: Guiding principles, not commands.

Plan

• 5 major components: objective, policy, program, schedules, and budget.
• Programs are sequences of activities tied to the achievement of objectives.
• Schedules provide time frames.

Pre-Planning/Preparation for Planning

• Strong government interest, legislative support (including budget allocation), adequate organizational planning (and funding), and administrative capacity to implement and monitor a health program.

Planning for Community Health Services

• Assembling a community-based team, training members, and developing instruments/questionnaires are foundational.

Planning Cycle (cont.)

• Analysis of health situations.
• Establishing objectives and goals.
• Assessing resources.
• Prioritizing needs.
• Formulating a plan.
• Programming and implementation.
• Monitoring progress.
• Evaluating outcomes.

Diagram of Planning Cycle

• Diagram depicting the cyclical nature of planning, including analysis, goal setting, resource assessment, prioritization, plan development, implementation, monitoring, and evaluation.

Analysis of the Current Situation

• Population characteristics (age, sex, religion, sex ratio).
• Morbidity and mortality rates (overall and specific diseases).
• Epidemiology and geographic distribution of diseases.
• Existing healthcare facilities and resources.
• Healthcare staff training and availability.
• Community perceptions and awareness regarding the disease.

Establishment of Objectives and Goals

• Defining the desirable future state for the problem under consideration.
• Establishing standards against which the program's effectiveness will be assessed.

Assessment of Resources

• Available manpower, money, materials, and skills.
• Ensuring resources align with objectives.

Fix Priorities

• Prioritization based on magnitude, costs, saving lives, and political commitments.
• Assessing different strategies through cost-effectiveness analysis.

Write-up of Formulated Plan

• Detailing of steps, resources, outcomes, and timelines.
• Clear responsibilities designated.

Programming and Implementation

• Implementing the approved plan with careful organization.
• Identifying potential shortcomings and developing solutions.

Programming and Implementation (cont.)

• Defining roles, tasks, training personnel.
• Communication and motivation of staff.
• Ensuring institutions operate efficiently.

Monitoring

• Consistent daily tracking, recording, and reporting of progress toward meeting objectives and plans.

Evaluation

• Measuring the achievement of objectives.
• Assessing resource use.
• Identifying factors influencing success and failures.
• Possible actions based on evaluation results.

Evaluation (cont.)

• Continuing evaluation of the implemented program to determine if it’s successful.
• Based on evaluation results, decisions can be made to continue, modify, adjust objectives or abandon the program.

Evaluation (cont.)

• Evaluating program effectiveness to identify areas needing adjustment.

Evaluation Considerations

• Determining if outcomes meet stated objectives and if the resources were used effectively..

Elements of Evaluation

• Relevance: Appropriateness of the service (e.g. is it still needed).
• Adequacy: Amount of resources.
• Accessibility: Ease of accessing the service.
• Acceptability: Whether people find the service suitable.
• Efficiency: How well resources are used for the program.
• Effectiveness: Extent of impacting the problem.
• Impact: Overall effects on health and socioeconomic conditions

Evaluation Considerations (cont.)

• Importance of continual evaluation.
• The means of evaluation must be built into program design during the planning process.

Module 4-Decision Making

• Planning is a future course of action.
• Management encompasses decision-making, organizing, leading, and controlling in a coherent manner.
• Effective decision-making is key to achieving health program goals within a health system or program framework.

Decision Making

• Decision-making is the core of management.
• Manager competence is determined by the quality of their decisions..
• How many factors in a manager's environment are beyond control?
• How to make optimal decisions with time constraints, incomplete information, and conflicting objectives?

Level of Decision Making

• Short-time operational decisions: Routine, frequently recurring tasks (e.g., drug inventory, staff scheduling).
• Periodic control decisions: Monitoring effectiveness, including advertising, staff deployment, pricing.
• Strategic decisions: High-cost, long-term impact involving detailed analysis (e.g., new product introductions, organization expansion).

Responding to Environmental Changes

• Flexibility is necessary to respond to economic, legal, technological, and competitive factors.

Model

• Models are simplified representations of reality in management science for determining how factors impact each other.
• Models are used in the decision-making process.

System Analysis

• Decision-making using various analyses for efficient resource allocation, considering cost and effectiveness; applicable to entire systems (hospital systems, clinics).

Network Analysis

• Network diagrams show tasks and events for scheduling and monitoring projects efficiently, including PERT and CPM methods.
• PERT diagrams help identify critical tasks for efficient project completion.

Critical Path Method (CPM)

• CPM method identifies the longest sequence or critical path in a project.
• Any delays on a critical path delay the entirety of the project.

Planning-Programming Budgeting System (PPBS)

• Resource allocation method that ties activities to achieve program objectives through a zero-based approach.

Work Sampling

• Systematic observation and recording of activities, providing quantitative data on job types and time requirements.

Decision Making (cont.)

• Decisions require complete information from various sources.

Questions-PHS-303

• Definition of Health Program Planning in a health system.
• Importance of planning for health programs.
• Levels of Health System Planning with examples.
• Steps in Planning Health Programs during a posting.
• Pre-planning conditions to get funding.
• Factors to consider in a community health situation.
• Evaluation elements and reasons for evaluation.
• Cost-benefit analysis, cost-effectiveness analysis, and net-work analysis.
• Health program resource requirements.
• Priority setting during a community health program posting.