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Capacity Planning. Shita Dewi. Harding-Montagu- Preker Framework: Overview. Assessment. Strategy. Focus. Goal. PHSA Gather available information Identify additional needs In-depth studies. Distribution (equity) Efficiency Quality of Care. Private Sector. Grow. Harness.

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Harding-Montagu-Preker Framework: Overview





  • PHSA

  • Gather available information

  • Identify additional needs

  • In-depth studies

  • Distribution (equity)

  • Efficiency

  • Quality of Care

Private Sector




  • Hospitals

  • PHC

  • Diagnostic labs

  • Producers / Distributors


  • For-profit corporate

  • For-profit small business

  • Non-profit charitable

    Formal/ Informal




Source: Adapted from Harding & Preker, Private Participation in Health Services, 2003.


  • To introduce the basic concepts underlying capacity planning

  • To outline the key elements of capacity planning

  • To review the key steps for policy makers and managers to implement capacity planning in a mixed health system

Outline of session
Outline of Session

  • Introduction

  • Key findings from developed countries

  • Examples of capacity planning

  • Discussion


What is it?

  • Capacity planning is the process of organizing decisions and actions relating to the deliverability and distribution of health care.

    Why do it?

  • Capacity planning is of crucial importance, as it determines to a large degree how health care resources are spent by shaping health service priorities, delivery systems and structures.

    Who does it?

  • National, regional or local level authorities, reflecting the various tiers of government within health systems. The distinction between these levels is not always clearcut.

    What are the types of capacity planning?

  • Strategic capacity planning

  • Operational capacity planning

Health sector variations in developed countries
Health sector variations in developed countries

  • Health care capacity planning devolved to regional level

  • Active involvement of provider organizations in the planning process

  • The extent to which planning applies to both public and private (for-profit and not-for-profit) providers usually reflects whether private providers qualify for public reimbursement of the services they provide

Trends in capacity planning in developed countries
Trends in capacity planning in developed countries

  • Usingsystematized care pathways as a means of characterizing the provision of health care services, including their linkage and integration with capital investment.

  • Comprehensive planning systems and the use of new measures of hospital capacity.

  • The need for linkingthe operationof hospitals with flexible financingmodels.

Hospital capital investment
Hospital capital investment

  • Capital investment: spending money up front on new or modernized buildings, machinery and equipment

Challenges in hospital capital investment
Challenges in hospital capital investment

  • The long time periods involved in planning, financing, construction and operation

  • The need for health facilities to be able to respond to changing health care needs and medical technologies,

  • The asymmetry between the need for rapid changes to enable the delivery of optimal care and the slow pace of change infacilities from which care is delivered poses a major challenge to the long term sustainability and effectiveness of hospitals

Lesson learned from developed countries
Lesson learned from developed countries

  • The critical nature of systematized care processes

  • The importance of the “people factor”

    • involvement of health professionals in decision-making

    • the role of inspired leadership

  • The steadily-growing role of “marketization” in health care

    • including public–private partnerships

  • The tension behind deciding on the proper setting of care

  • The need to look at “whole-system” perspectives

  • The unsolved question of measuring the true capacity of a hospital

  • Questions

    • How can capacity planning, including private sector involvement, increase coverage or quality for a specific health delivery objective in your country?

    • What are some of the main institutional or capacity constraints in your country that impede implementing capacity planning that includes the private sector?

    • What could be done in your country to address these constraints?

    Key messages
    Key Messages

    • To participate in capacity planning, it is important to identify and acknowledge the ownership form of the health system: public, private or mixed.

    • In a mixed health system, it is important to take into account private sector capacity while planning health sector development.

    • Capital investment can play an important role in designing a purchasing scheme for the private sector.

    Background readings
    Background readings

    • Ettelt, S., Nolte, E., Thomsons, S., & Mays, N., (2007). Capacity planning in health care: reviewing the international experience. Euro Observer 9:1.

    • Rechel, B., Wright, S., Barlow, J. & McKee, M. (2010). Hospital capacity planning: from measuring stocks to modeling flows. Bulletin of the World Health Organization, 88632–636. doi:10.2471/BLT.09.073361.