sound policy and plan formulation. 2 policy and planning key messages policy process is messy, but...
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2Policy and planning
Key messagesKey messages
Policy process is messy, but there are elements of good practice you can use.
1. Sound processes
2. Realism
3. Comprehensive and balanced content
4. Linkage with health programs
5. Linkage with medium-term and subnational plans
Policy dialogue needs a range of skills
3Policy and planning
Policy dialoguePolicy dialogue
Policy dialogue includes analysis and advice that is:
accurate, timely and well informed
politically astute, and
based on broad consultation
4Policy and planning
Good policy adviceGood policy advice
is grounded in the big picture
focuses on the ‘customer’
comes from a strong analytical foundation
rests on a substantial evidence-base
appreciates the value of engagement, and
builds-in systematic evaluation
5Policy and planning
Policy dialogue skillsPolicy dialogue skills
More than technical expertise. Specific skills needed in:
rigorous problem identification identifying options applying analytical frameworks, and preparing clear advice.
Broad skills needed in: relationship building, negotiating, influencing, and aligning governance, strategy, policy, management
and service delivery.
6Policy and planning
Policy process and planning are messyPolicy process and planning are messy
Bottom-up participatory planning cycle
CSO
CSO
CSONGO
NGO
GHIpartners
5 year plan
Annual Review
Annual Review
Annual Review
Annual Review
Political priorities
partners
Lobbies
Elections
Programmes
Private sector 5 year plan
Government plan
Operational plan disease x
Civil service reform
Idealised planning processes
Real-life planning processes
Idealized
Real-life
7Policy and planning
Good policy and planning practice Good policy and planning practice
1. Sound processes
2. Realism
3. Comprehensive and balanced content
4. Linkage with health programs
5. Linkage with medium-term and subnational plans
Ref - A framework for national health policies, strategies and plans June 2010
8Policy and planning
1. Sound processes in all steps1. Sound processes in all steps
Situation analysis
Implementation & monitoring
Evaluation & feedback
Plan formulation
Priority setting
Costing & budgeting
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2. Realism:2. Realism:
… the people who will implement the plans are involved in the planning decisions
… plans are within the sector’s resources, capacities, and constraints
… plans address the concerns of the implementing and middle management of the health sector
… plans have political commitment and buy-in of stakeholders with competing interests
Plans are more likely to be implemented if: … Plans are more likely to be implemented if: …
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3. Comprehensive and balanced content3. Comprehensive and balanced content
A national health plan should address
i. Vision, values, goals, inter-sectoral approaches
ii. A robust situation analysis
iii. Possible policy directions for: improving health equity making services people-centered protecting and promoting the health of communities
iv. A comprehensive strategy, with associated costs, to respond to challenges and implement the plan
v. Financing and management arrangements, audit, procurement and monitoring arrangements
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4. Linkage with programs - coherence4. Linkage with programs - coherence
Coherent health planning is more than the sum of programme plans such as MCH, TB, HIV …
Coherence requires:
Inclusive policy dialogue
each programme’s concerns are reflected in the national health plan
programme plans are based on realistic assessments of their use of shared system resources
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4. Linkage with programs - coherence4. Linkage with programs - coherence
Coherence means:The relative priorities of the different programmes are set
in line with the BoD and overall sector priorities
The objectives of the different programmes are consolidated to assist implementation of service delivery
The use of shared system resources by different programmes is within the capacity of relevant levels
Programme monitoring requirements: • are included in the routine health information system,
and/or • monitoring labour & costs are feasible
13Policy and planning
How does a clinic nurse cope without coherence?
DEVELOPMENT PARTNERS
NATIONAL
AIMAG
SOUM
HEALTH CENTRECLINIC or NURSE STATION
COMMUNITY
WHO UNICEFGIZ
EPICancer
TB
ORAL HEALTH
RH
OTHERS
HAC
World Bank
DFIDADB
GFATMUNFPA
Under funded
Too much information
Too many trainings
HIV/AIDSDiabetes
Inadequate logistics
Too many requirements
Understaffed
Conflicting priorities
Too many meetings
orld Vision
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5. Linkage with medium term & subnational plans 5. Linkage with medium term & subnational plans
Medium Term Expenditure Framework consists of:– top-down multi-year projection of resource envelope
(funds available)– bottom-up multi-year cost estimates for programmes
(funds needed)– Trade-offs: the political / administrative process to
reconcile the two
Linkage with operational plans depends on the level of detail in the national strategic plan, and autonomy or decentralization at different operational levels.
15Policy and planning
More than the sum of programme plans such as MCH, TB, NCDs …
Blueprints won't work
It is not only the "plan”. The process is as important!
… but the process is usually messy…
This is why inclusive policy dialogue is key
Idealized
Bottom-up participatory planning cycle
CSO
CSO
CSONGO
NGO
GHIpartners
5 year plan
Annual Review
Annual Review
Annual Review
Annual Review
Political priorities
partners
Lobbies
Elections
Programmes
Private sector 5 year plan
Government plan
Operational plan disease x
Civil service reform
Idealised planning processes
Real-life planning processesReal-life
Planning is messyPlanning is messy
16Policy and planning
1.Sound processes
2.Realism
3.Comprehensive and balanced content
4.Linkage with health programs
5.Linkage with medium-term and sub-national plans
Good policy and planning practice Good policy and planning practice