You are on page 1of 4

Section 5

Introduction to Strategic Management


Health policy reforms, even ones that have been approved, decreed, or signed into law, will not necessarily be implemented as intended without the impetus and guidance of policy champions. The policy process, as explained and diagrammed in the introduction to this toolkit (Section 1, especially Figure 1.1), includes the following stages: policy formulation and legitimation, constituency-building, resource mobilization, implementation design and organizational structuring, and progress and impact monitoring. However, proposed reforms are not likely to progress through these stages without someone managing or shepherding them. For those who want to participate in and further the process of health sector reform, strategic management provides an effective approach. Strategic management is a process for developing and enacting plans to reach a long-term goal that takes into account internal variables and external factors. Strategic management encompasses an integrated, future-oriented managerial perspective that is outwardly focused forward-thinking performance-based (see Kiggundu 1996). Strategic managers identify long-range targets, scan their operating environments, evaluate their organizations structures and resources, match these to the challenges they face, identify stakeholders and build alliances, prioritize and plan actions, and make adjustments to fulfill performance objectives over time. Brinkerhoff (1991 and 1994) characterizes strategic management as looking out, looking in, and looking ahead. Looking out means exploring beyond the boundaries of your organization to set feasible objectives, identify key stakeholders, and build constituencies for change. Looking in implies critically assessing and strengthening your systems and structures for managing personnel, finances, and other essential resources. Finally, looking ahead entails melding your strategy with structures and resources to reach your policy goals, while monitoring your progress and adjusting your approach as needed.

5-2

Policy Toolkit for Strengthening Health Sector Reform

Balancing strategic managements outward-, inward-, and forward-looking functions helps you develop a vision and a strategy for where and how to move health sector reform forward. Balancing these different perspectives is the essence of managing strategically (Brinkerhoff 1991). Strategic management comprises five key facets: goal-setting, analysis, strategy formation, strategy implementation, and strategy monitoring (see Figure 5.1). These are the integral elements that, when applied together, distinguish strategic management from less comprehensive approaches, such as operational management or long-term planning. Strategic management is an iterative, continuous process that involves important interactions and feedback among the five key facets, which are explained in more detail in Table 5.1.

Figure 5.1. Facets of Strategic Management

*RDOVHWWLQJ 6WUDWHJ\ 0RQLWRULQJ

$QDO\VLV

6WUDWHJL. 0DQDJHPHQW
6WUDWHJ\ ,PSOHPHQWDWLRQ 6WUDWHJ\ )RUPDWLRQ

Introduction to Strategic Management

5-3

Table 5.1. Five Facets of Strategic Management


*RDO6HWWLQJ
*RDOVHWWLQJ HQDEOHV \RX WR DUWL.XODWH \RXU YLVLRQ LGHQWLI\ ZKDW QHHGV WR EH D..RPSOLVKHG GHILQH VKRUW DQG ORQJWHUP REMH.WLYHV DQG UHODWH WKHP WR ZKDW \RXU RUJDQL]DWLRQ QHHGV WR GR $ PLVVLRQ VWDWHPHQW VXPPDUL]HV \RXU SXUSRVH DQG JRDOV LQ WHUPV HDVLO\ XQGHUVWRRG E\ ERWK VWDII DQG H[WHUQDO VWDNHKROGHUV $QDO\VLV JXLGHV \RX WR .ROOH.W DQG .RQVLGHU LQIRUPDWLRQ VR WKDW \RX IXOO\ XQGHUVWDQG \RXU VLWXDWLRQ $VVHVV H[WHUQDO HQYLURQPHQWV DQG LQWHUQDO VLWXDWLRQV WR LGHQWLI\ WKH VWUHQJWKV DQG ZHDNQHVVHV RI \RXU RUJDQL]DWLRQ DQG WKH RSSRUWXQLWLHV DQG WKUHDWV \RX ID.H DV \RX VHHN WR UHD.K \RXU JRDOV 7R GHWHUPLQH D VWUDWHJ\ \RX UHIOH.W SULRULWL]H GHYHORS RSWLRQV DQG PDNH GH.LVLRQV 5HYLHZ WKH UHVXOWV RI WKH DQDO\VHV LGHQWLI\ WKH LVVXHV WKDW \RX DQG \RXU LPSOHPHQWLQJ SDUWQHUV QHHG WR DGGUHVV DQG SULRULWL]H WKHP LQ WHUPV RI WKHLU XUJHQ.\ DQG PDJQLWXGH 8VH WKHVH UHVXOWV WR GHVLJQ DOWHUQDWLYH VWUDWHJLHV DQG SODQV WKDW DGGUHVV WKH NH\ VWUDWHJL. LVVXHV 7R LPSOHPHQW \RXU VWUDWHJ\ DVVHPEOH WKH QH.HVVDU\ UHVRXU.HV DQG DSSO\ WKHP 3XW WKH .KRVHQ SODQV LQWR SUD.WL.H PDUVKDO WKH UHVRXU.HV DQG .RPPLWPHQWV QH.HVVDU\ IRU PRYLQJ DKHDG WDS H[LVWLQJ .DSD.LW\ DQGRU EXLOG QHZ .DSD.LW\ DQG VHHN WR D.KLHYH UHVXOWV 0RQLWRULQJ DOORZV \RX WR .KH.N \RXU SURJUHVV WRZDUG D.KLHYLQJ \RXU JRDOV DQG DVVHVV ZKHWKHU DQ\ .KDQJHV LQ WKH HQYLURQPHQW QH.HVVLWDWH DOWHUDWLRQV WR \RXU VWUDWHJ\ 0RGLI\ SODQV DQG D.WLRQV WR DGMXVW WR WKH LPSD.W RI .KDQJHV LQ WKH RSHUDWLQJ HQYLURQPHQW (IIH.WLYH PRQLWRULQJ DOORZV \RX WR UHD.W DQG DQWL.LSDWH 0RQLWRULQJ DOVR IHHGV ED.N LQWR DQDO\VLV VWUDWHJ\ GHVLJQ DQG LPSOHPHQWDWLRQ LQ WKH LPPHGLDWH WHUP DQG LQWR JRDOVHWWLQJ RYHU WKH ORQJHU WHUP

$QDO\VLV

6WUDWHJ\ )RUPDWLRQ

6WUDWHJ\ ,PSOHPHQWDWLRQ

6WUDWHJ\ 0RQLWRULQJ

As mentioned, you can use strategic management to help move health sector reforms through the various stages in the policy process. The framework of the policy stages can help you determine your location in the policy process and identify tasks to be done. By applying a strategic management approach to each subsequent stage of the policy process, you can further implementation of health sector reforms. Consider each stage of the policy cycle from a strategic perspective, balancing the looking-out, looking-in, and looking-ahead issues. In so doing, you can effectively integrate a strategic management approach into the policy cycle. As an example, Figure 5.2 illustrates how you might strategically manage your reforms through the policy formulation and legitimation stage.

5-4

Policy Toolkit for Strengthening Health Sector Reform

Figure 5.2. Strategic Management of One Stage of the Policy Process


3ROL.\ 3ROL.\ )RUPXODWLRQ DQG )RUPXODWLRQ DQG /HJLWLPDWLRQ /HJLWLPDWLRQ
6WUDWHJ\ 0RQLWRULQJ

*RDOVHWWLQJ

$QDO\VLV

3URJUHVV,PSD.W 3URJUHVV,PSD.W 0RQLWRULQJ 0RQLWRULQJ

&RQVWLWXHQ.\ &RQVWLWXHQ.\ %XLOGLQJ %XLOGLQJ

6WUDWHJL. 0DQDJHPHQW RI 3ROL.\ )RUPXODWLRQ DQG /HJLWLPL]DWLRQ

,PSOHPHQWDWLRQ ,PSOHPHQWDWLRQ 'HVLJQ DQG 'HVLJQ DQG 2UJDQL]DWLRQDO 2UJDQL]DWLRQDO 6WUX.WXULQJ 6WUX.WXULQJ

5HVRXU.H 5HVRXU.H 0RELOL]DWLRQ 0RELOL]DWLRQ

6WUDWHJ\ ,PSOHPHQWDWLRQ

6WUDWHJ\ )RUPDWLRQ

6WUDWHJL. 0DQDJHPHQW RI 3ROL.\ )RUPXODWLRQ DQG /HJLWLPDWLRQ


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
SULPDU\ OLQNDJH VH.RQGDU\ OLQNDJH