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1. Health Planning in Developing Countries: An Overview Regional Consultative Meeting on Strategic Planning in Health
November 21-24, 2004
2. Presentation Outline Principles and rationale for strategic planning
Strategic Planning: Process and product
Planning for human resources
Issues and challenges for strategic planning in EMR
3. Four Fundamental Questions of the Planning Process
4. What is Strategic Planning?
Strategic planning is a process of setting agreed priorities and direction for the health sector in the light of given resource constraints
Source: Andrew Green (2003)
5. Why Strategic Planning? Means of giving content to the leadership function of the Ministries of Health;
Process for developing intersectoral collaboration for health development;
Means for constructive public-private partnership;
Means for streamlining donor assistance; and
Means for bringing about institutional change
6. Rationale for strategic planning ?Wants and needs outstrip resources?
Scarcity and Choice ? The Basis for Planning
Appraisal of alternatives
Rationing of resources
Introducing discipline and minimizing external influences
7. Strategic choices facing the Public Health Sector
8. The Planning Cycle
9. Process for Developing a Strategic Plan
10. Strategic Planning Process: Values and Contextual Factors Values and Principles
Community participation, Privatization
Analysis of the contextual factors
Social and economic policies
Political and administrative setup
Donor influence and assistance
State of the health system
11. Strategic Plan: Product General statement of health sector priorities with no set period ? Health Sector Strategy, Health Policy
?Organic? document with inbuilt process for updating according to circumstances, information, analysis and resource availability ? Rolling plans
?Finished? product with set periods of implementation of 5-15 years, objectives, targets, strategies, risks and assumptions, and allocated resources
12. Is Strategic Planning a Technical or a Political Activity? Technical ? Planning tools and techniques essential to develop a plan document
Political ? Planning is about introducing a systematic change, views and perceptions of stakeholders
13. Major Types of Plans Strategic vs. Operational Plan
Project vs. Program Plan
Investment vs. Operational Plan
Physical vs. Human Resource vs. Financial Plan
Macro- vs. Micro-plan
14. Links between strategic and operational plans Strategic plan- Outlines the direction an organization is intending to follow, with broad guidance as to implications for service action ? WHAT?
Operational plan - Activity plan detailing precise timing, methods and modes of implementation ? HOW?
15. Characteristics of Strategic and Operational Plans
16. Strategic Planning Tools Planning guidelines and frameworks
Logframe, ZOPP, others
Burden of Disease
National health accounts
Resource allocation formulae
Population, BOD, income poverty
Certificate of Needs
17. Planning for Human Resources Almost 2/3rd of the regular health budget of the government is spent on human resources;
Are there right number of personnel, with the right skills, at right place and at the right time?
Inadequate no. of trained and/or available personnel
Over trained and unemployed
Inappropriate use of trained personnel
Migration of personnel
Unproductive and demoralized staff
18. Why is Planning for Human Resources deficient? HR planning require medium to long term strategies;
HR planning is attached the same status as planning for any other activity;
Lack of unit or body for planning for HR within or outside the MOH
Lack of accurate data on HR
Lack of consideration of the HR needs of the private health sector
19. Health Planning: Issues and Challenges in the EMR Technical
Lack of capacity ? individual, institutional
Weak or absent planning units
Inadequate contextual analysis
Weak health information system
Poor operationalization of plans
Insufficient monitoring and evaluation
20. Health Planning: Issues and Challenges in the EMR Political and Administrative
Lack of political commitment
Priorities set by political agenda
Donor driven initiative
Planning outside MOH
Planning only for the public sector
21. Criteria for Assessing the Planning System Purpose and role of the planning system clear and appropriate
Planning system based on explicit values
Decision making structures of planning system
Open and transparent
Balance between central & local decision making
Balance between technical and political decision making
Planning for health instead of health care only
22. Criteria for Assessing the Planning System ?contd.
Balance between long-term direction with short term flexibility
Adequate information base for planning
Standard planning tools available and used
Planning unit adequately resourced, technically sustainable
Donor assistance program managed well
23. Conclusions or Questions? What do we know of the current status of health planning in countries of the EMR?
strengths and weaknesses;
What experiences can we share in the EMR on aspects of health planning and its tools?
How can we give momentum to improved human resource planning in countries of the EMR?
What will it take for the national governments and WHO to strengthen strategic planning in the Region?
Thank you for your attention!