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Health Planning Basanta Chalise [email protected] 1 Basanta Chalise

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Basanta Chalise 1

Health Planning

Basanta [email protected]

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Concept • A blue print for taking actions.• Planning is the process of predetermining future.

It is the process of setting goals and choosing the actions to achieve those goals. It is looking ahead. It is the process of bridging the gap between where we are and where we want to be. It attempts to define the future road map of organization.

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Definition • According to Stephen P. Robbins, “Planning is

deciding in advance about what to do, how to do it, when to do it, and who is to do it. It provides the ends to be achieved”.

• According to Ricky Griffin, “Planning is setting an organization’s goal and deciding how best to achieve them”.

• According to Koontz and Weihrich, “Planning involves selecting missions and objectives and the actions to achieve them”.

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IMPORTANCE OF PLANNING

• Uncertainty Reduction• Goal Focus• Better Coordination• Efficiency Promotion• Environmental Adaptation• Commitment• Control

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CHARACTERISTICS OF PLANNING• Process

Planning is a continuous process. It is a systematic way of doing things and is involved in organizing, staffing, directing and controlling.

• Future-orientedPlanning anticipates future opportunities and threats. It decides in advance what is to be done in future.

• PervasivenessPlanning is pervasive in nature. It is the function of every manager but its nature and scope differ according to the level of managers.

• Goal-focusedPlanning is the process of setting goals and selecting the actions to achieve them. Actions are selected from among the alternatives.

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• Decision-orientedPlanning involves decisions at all levels of decisions. Since planning is the process of thinking before doing it involves decision making.

• Efficiency-oriented Planning is directed towards efficiency at all levels of management. Efficiency means greater output at least input. Alternatives are evaluated on the basis of efficiency.

• Time FrameShort term, medium term or long term

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TYPES OF PLANNING

• ACCORDING TO MANAGERIAL HIERARCHY

• ACCORDING TO THE USE

• ACCORDING TO FLEXIBILITY

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• ACCORDING TO MANAGERIAL HIERARCHY– Corporate Planning (Strategic Planning)

It is organization wide. It establishes overall corporate mission, goals and strategies. These are long-term plan for five or more years. They are prepared by top management and are based on analysis of environmental opportunities and threats. It is also called long term plan.

– Tactical Planning (Divisional Planning)tactical plans are prepared by middle level management and are of medium term (one to five years). They are based on the strength and weakness of each division. It is also called medium term plan.

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– Operational Planning (Unit Planning/Functional Planning)

It is concerned with planning of day – to -day operation. It is the action plan for each unit. It defines operational goals and specific actions for implementing tactical plan. Operational plan are prepared by lower level management and is of short-term (generally annual, quarter, month). It is also called short term plan

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• ACCORDING TO THE USE– Single Use Plan

They are developed to meet the needs of particular situation. They are prepared for non repetitive activities such as project planning, budget planning etc. They are used only once.– Standing Use Planning

They are developed for ongoing repetitive activities such as mission, goals, policies, procedures, rules etc. Such plans are used over a long period of time.

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• ACCORDING TO FLEXIBILITY– Specific Plan

They have clearly defined objectives. There is no ambiguity. There is no room for misinterpretation and misunderstanding. Specific procedures, specific budget and specific schedule of activities are specified to reach the objective.– Flexible Plan

They are also known as directional plan. They provide general guidelines. They do not provide specific objectives or specific course of action. They can be changed according to changes in the environment.

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PLANNING CYCLE (PIE CYCLE)

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• Planning Formulation (Planning)

Planning formulation is the first step of planning in which plan is formulated for the program. Plan is formulated carefully in written form giving particular attention to details. A plan is made in written form to be implemented. Planning formulation is the process of making the plan of action.

• Planning Execution (Implementation)In this step, the formulated plan is new executed in practice. This is the time of plan implementation. Implementation is the process of putting the plan of action into operation.

• Plan Evaluation Planning evaluation is the process of assessing the degree of success of a particular program and identifying the limitations and problems, which need timely treatment for further operation of the program. Plan evaluation is the process of determining the program appropriateness, effectiveness, efficiency and success.

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PLANNING CYCLE (STEPS OF PLANNING)

• Analysis of the Health SituationIt involves the collection, assessment and interpretation of information in such a way as to provide a clear picture of the health situation. The following data are minimum essential requirements for health planning:

o the population, its age, and sex distributiono Statistics of morbidity and mortalityo Epidemiology and geographical distribution of different

diseaseso Medical facilities like hospital, health centreso Technical man-power of various categorieso Training facilities availableo Attitudes and beliefs of the population towards disease, its cure

and prevention

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• Establishment of Objectives and GoalObjectives and goals are needed to guide efforts. Unless objectives are established, there is likely to be haphazard activity, uneconomical use of funds and poor performance.

Objective must be SMART: • S = specific• M = measurable• A = Achievable• R = Realistic• T = Time boundExample: By the end of 2015 90% of eligible children will

be vaccinated against target disease in Nepal.

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• Assessment of ResourcesThe term resources implies the manpower, money, materials, skills, knowledge and techniques needed or available for the implementation of health programme. These resources are assessed and a balance is struck between what is required and what is available or likely to be available in terms of resources.

• Fixing PrioritiesOnce the problems, resources and objectives are determined, the next most important step in planning is establishment of priorities in order of importance or magnitude. Since the resources always fall short of the total requirement. Once the priorities have been established, alternate plans for achieving them are also formulated and assessed in order to determine whether they are practicable and feasible.

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Criteria - In identifying priority problem• The magnitude of problem• Degree of Severity• Feasibility

- Effectiveness- Cost and social acceptability of intervention

• Community concern• Government concern and social acceptability

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• Write-up of Formulated PlanThe next step is the preparation of the detailed plan. The plan must be complete in all respects for the execution of a project. Each stage of the plan is defined and costed as the time needed to implement is specified. The plan must contain working guidance and a built in system of evaluation. The purpose of writing the plan is to request funds or resources for monitoring and evaluating the implementation process by all concerned

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• Programming and ImplementationOnce the health plan has been selected and approved by the policy making authorities, programming and implementation are begun.

• MonitoringThis consists of record keeping and reporting of the ongoing processes, (day to day activities). It should start from the beginning of the program. Registers are maintained, and records are summarized into monthly summary reports.

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• EvaluationThis is done at fixed times. Evaluation is done of the inputs, process and outcome. Outcome is short term and impact is long term. Indicators are used here.

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PLANNING METHOD• Top-down Planning

The central office or headquarters of an organization develops and provides guidelines including mission, economic and social objectives, financial assumptions, content of the plan and other special issues. The lower management follows these directions and prepares schedules of activities to meet these goals and objectives. There is a very little involvement of the lower level staffs in the formulation of plans or there is no consultation between the higher and lower level authority.

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• Bottom-up PlanningBottom-up planning operates just in the opposite manner as compared to the top-down planning. The lowest operating level informs the top management what they expect to do in the coming future. There is a two way flow of communication. There is a great deal of consultation between the superior and the subordinate regarding the goal fixation and plan formulation.

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Health Planning Process in Nepal

• Planning Process (Macro level)National Planning Commission (NPC) is the apex body for formulating development plans under the directives of the National Development Council. NPC prepares the draft of approach paper for the forthcoming development plan. A draft approach paper prepared and presented to the NDC for suggestions. NPC revise the approach paper according to the suggestions given by the NDC. The detailed plan document is prepared based on approach paper.

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• Planning Process (Micro level)Basic sectorial planning process is under taken by the respective development related ministries based on the plan document. NPC’s various sectorial task forces review the plan and present sectorial report. After the preparation of the detailed plan document, it is put forward to the cabinet for its approval. The plan is executed after the cabinet approval.

• District levelIn district level District Development Committee (DDCs) identifies their programmes and projects. DDC sends the plan to the ministry then to National Planning Commission (NPC). The ministry send the approved plan to DDC for implementation.

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Plan formulation (bottom up)

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Ad-hoc planning • Prepared it during epidemic or for special

health programs like health camps, awareness campaign etc.