Health Planning and management

Objectives and Goals

Objective: is planned en – Point of all activities

◦ Is precise ANS SPECIFIC Q

◦ Is either achieved not achieved

◦ Is concerned with the problem itself

Target: A discrete activity which helps measure the extent of attainment of objectives

◦ Is a concept of degree of achievement Q

◦ Is a concerned with the factors involved in a problem

Your Objective in this institute

IS TO GET

PASS SCORE

Health Planning

Goal Ultimate desired state towards which objective and resources are directed

◦ Is not constrained by time or existing resources

◦ Is not necessarily attainable

◦ Shows all or none phenomenon

Goal

MY GOAL IN LIFE

IS TO GET

“PADMASHRI”

Mission: Is a description of fundamental principle of existence of programme

◦Is usually time bound

◦Is a statement of purpose

NRHM 2005-2017

Mission Indradanush 2015-2020

Impact: Is an expression of the positive

effect of a programme, service or

institution on the overall health

development and on related social and

economic development

Impact

Your performance will have a strong

impact on this institute.

Planning Cycle

Planning cycle consists of following steps ( Mnemonic : GOAL –

AORPPIME )

◦ Pre-planning: Government interest, Organization for planning,

Administrative capacity ,Legislation

◦ Step 1: Analysis of health situation

◦ Step 2: Objective and goals establishment

◦ Step 3: Resource assessment

◦ Step 4: Prioritization

◦ Step 5: Plan formation

◦ Step 6: Implementation

◦ Step 7: Monitoring

◦ Step 8: Evaluation

Health Committees in India

BHORE COMMITTEE,1946Bhore Committee (1946):

Health Committees in India

Bhore Committee (1946): Health survey and

Development Committee Q

◦ Short term measure: 1 PHC per 40,000 population,

30 beds, 3 subcenters and 2 medical officers

◦ Long term measure (3 Million Plan Q): Primary

health units with 75 – bedded hospitals per health units

with 2,500 beds

◦ Secondary health units with 650 beds

◦ Regional health units with 2500 beds.

◦ Prepare Social Physicians (3 months training in

preventive and social medicine in medical education)

Mudaliar Committee(1962):

Health survey and planning committee Q

◦ 1 PHC per 40,000 population maximum

◦ Constitution of All India Health Service

CHADAH COMMITTEE,1963

Chadah Committee (1963):

Constituted to study

arrangement necessary for

Maintenance phase of

National Malaria Eradication

Programme (NMEP) Q

◦ 1 Basic Health Worker per

10,000 population

Health Committess in India

Mukherji Committee (1965):

◦ Delink malaria activities from family planning

Mukherji Committee (1966):

◦ Basic Health Service should be provided at block level Q

Jungalwalla Committee (1967): Committee on Integration of Health

Services

◦ Equal pay for equal workers

◦ No private practice

Kartar Singh Committee (1973):

Kartar Singh Committee (1973): Constituted on Multipurpose

Workers under Health and Family Planning Q

◦ ANMs to be replaced by Female Health workers.

◦ Basic health workers, Malaria surveillance workers, Vaccinators,

Health education assistants and family planning health assistants

be replaced by Male Health Workers

Shrivastava Commitee (1975)

Shrivastava Commitee (1975):Group on Medical Education and

Support Manpower

◦ Create Brand of Para – professional and semi – professional

health workers from with in the community

◦ Development of Referral Services Complex

◦ Reorientation of Medical Education (ROME) scheme Q

◦ Village Health Guide scheme Q Community health worker

scheme

◦ “3 Tier rural health infrastructure “

◦ Panchayat, Panchayat Samiti ,Zila parishad

Planning commission in India

Set up by Govt of India

Consists of

Chairman

Deputy chairman

5members

3 Major divisions: Q

General secretariat

Technical divisions

Programme advisers

Millennium Development Goals

(MDGs) In September 2000, 189 countries adopted UN Millennium

Declaration. Millennium Development goals place health at the heart of development and represent commitments by governments

Baseline Year for MDGs: 1990

Deadline Year for MDGs: 2015 Q

There are 8 MDGs

◦ Goal 1 : Eradicate extreme poverty and hunger

◦ Goal 2 : Universalize primary and education

◦ Goal 3 : Gender equality and women empowerment

◦ Goal 4 : Reduce child mortality

◦ Goal 5 : Improve maternal health

◦ Goal 6 : Combat HIV/AIDS, malaria and other disease

◦ Goal 7 : Ensure environmental sustainability

◦ Goal 8: Develop global partnership for development

Millennium Development Goals (MDGs)

3 out of 8 goal, 8 out of 18 targets required to achieve them and 18

out of 48 indicators of progress are directly health related

◦ Goal 4, 5 and 6 are directly health related

◦ Goal2 and 3 do not pertain to health

1

Health Management

Modern Management Techniques

Cost Benefit Analysis: A management technique where economic

benefits of any programme are compared with cost of that

programme

◦ The benefits are expressed in monetary terms Q

◦ The main drawback of this technique is that all benefits in field

of health cannot be expressed in monetary terms

Cost Effective Analysis: A management technique where benefits

are expressed in terms of results achieved, e.g., number of lives or

number of days free disease Q

◦ It is a more promising tool than cost benefits in the health field

◦ Most comprehensive indicator of CEA: Quality adjusted life

years (QALYs) gained

◦ Measurement of output in terms of results achieved Q

Network analysis

Plan service

Staff

Required

Equipment

Ordered

Staff

trained

Equipment

installed

start

providing

service

Health Management Network Analysis Q: Is the graphic plan of all events and activities to be

completed in order to reach an end objective. Two common types of

network techniques are

◦ Programme Evaluation and Review Technique (PERT): An arrow

diagram representing the logical sequence in which events must take

place Q

◦ Critical Path Method(CPM):Is a type of network analysis (the graphic

plan of all events and activities to be completed in order to reach an end

objective)

◦ The longest path of the network is called as critical path. If any activity

along the critical path is delayed, entire project will be delayed

System Analysis: Is a management technique of finding out cost-

effectiveness of the available alternative. Q

Zero Budget Approach: All budgets start

at zero and no one get any budget that he

cannot specifically justify on a year to

year basis

Cost accounting – Budget, resources,

financial allocation to various components

of a health program Q Is based on

cost control

Planning and allocation of people and

financial services

Pricing of cost reimburse

According to world health report

2000,India`s health expenditure is 5.2% of

GDP

Indian economic GDP growth for the

year 2003 is 7.8%

Questions

Q1. Comparison of cost effectiveness of available

alternatives is

◦ A.) Cost benefit analysis

◦ B.) Cost effectiveness analysis

◦ C.) Systems analysis

◦ D.) Network analysis

ANSWER

C

Questions

Q2. Measurement of output in terms of results achieved is

◦ A.) Cost benefit analysis

◦ B.) Cost effectiveness analysis

◦ C.) Systems analysis

◦ D.) Network analysis

ANSWER

B

Questions

Q3. A specific pre-planned activity is known as

◦ A.) Objective

◦ B.) Target

◦ C.) Goal

◦ D.) Impact

ANSWER

A

Questions

Q4. Not a feature of Cost accounting is

◦ A.) Cost control

◦ B.) Planning and allocation of people and financial services

◦ C.) Cost structure of program

◦ D.) Benefit expressed as results achieved

ANSWER

D

Questions

Q5. The 3 major divisions of Planning Commission are all

EXCEPT

◦ A.) Executive division

◦ B.) General secretariat

◦ C.) Technical divisions

◦ D.) Programme advisors

ANSWER

A

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