Planning Process, Policies, Political Process vis a via Nursing Process

Introduction: Every country has its own plan for national development. The purpose of national planning is to
achieve a rapid and at the same time a balanced economic and social development of the country as a whole.

Definition: According to WHO “A health plan is a predetermined course of action that is firmly based on nature
and extent of health problems, from which are devised priority goals.”

“Health Planning has been defined as the orderly process of defining community health problems, identifying unmet
needs and surveying the resources to meet them, establishing priority goals that are realistic and feasible, and
projecting administrative actions to accomplish the purpose of the proposed programme.”

Purposes of health planning: The purpose is to meet the health needs and demands of the people.

Health Needs have been defined as, deficiencies in health that call for preventive, curative, control or eradication
measures.

Health needs include need for medical care, safe water supply, adequate nutrition, immunization, family planning
etc.

Resources: It implies to manpower, money, material, skills, knowledge, technique and time needed or available for
the performance or support of action directed towards the specified objectives.

Objectives, Targets and Goals: They are used to describe the end results of planning. Setting clear cut
objectives, targets and goals are important elements in planning.

An Objective is precise, it is either achieved or not. Objective is planned end point of all activities.

A Target often reers to a discrete activity. It is the concept of degree of achievement.

Goal is defined as the ultimate desired state towards which objectives and resources are directed. Unlike objectives
and targets, goals are not constrained by time or existing resources; nor are they necessarily attainable. Goals are
generally broad and are usually described in terms of

• What is to be attained

• Extent to which it is to be attained

• The population or section of the environment involved

• The geographic area in which the proposed programme will operate

• Length of time required for attaining the goal

Plan: planning results in the formulation of a plan. A plan is a BLUE PRINT for taking action. Plan consists of five
major elements:

• Objectives

• Policies

• Programmes

• Schedules

• Budget

Objectives: This is the statement of desired changes in behavior or state of excellence, expected as a result of
particular programme or activity.
Policies: written statement of the terms of a contract of insurance. It’s a plan of action, statement of ideals etc.
proposed or adopted by a government or political party or an organization.

Programmes: An organized order of performances of events. It is a sequence of activities designed to implement

policies and accomplish objectives. It gives a step by step approach to guide the action necessary to reach a pre-
determined goals. It must be closely integrated with objectives.

Schedule: It is a program of work to be done or of planned events. It is a time sequence for the work to be done.

Budget: It is a concrete precise picture of the total operation of an enterprise in monetory terms.

Pre planning: It is the pre-preparation for planning. The important pre-conditions are:

• Government Interest

• Legislation

• Organization for Planning

• Administrative Capacity

The Planning Cycle:

Tabulate, Analyze, Gather Health

interpret Data
Formulate health
Problems
No Assign priorities among
problems

Evaluate results , Goals achieved?

Formulate individual priority
Goals satisfactory?
problems for planning solutions

Collected data Yes Define programme objectives

for Evaluation and how to measure

Assign priorities among

Operate
objectives
Programme
 Design alternative programme
Initiate Integrated
to solve problems
Programme

Orient and train Select best programme

personnel (feasibility, cost/ effective

Combine programme,
Plan implementation of
develop integrated plan
integrated programme
Planning is the broad foundation upon which much of the management is based. The steps in planning or planning
cycle include:

• Analysis of the Health Situation

• Establishment of Objectives or Goals

• Assessment of Resources

• Fixing Priorities

• Writing up of formulated plans

• Programming and Implementation

• Monitoring

• Evaluation

Analysis of the health situation: The items of data which are the minimum essentials for health planning
include:

a. The population, its age and sex structure.

b. Statistics of morbidity and mortality.

c. The epidemiology and geographical distribution of different diseases.

d. Medical care facilities such as hospitals, health centers and other health agencies both private and public.

e. Technical manpower of various categories.

f. Training facilities available.

g. Attitude and beliefs of people towards diseases, its care and prevention.

The analysis and interpretation of the above data brings out the health problems, the health needs and the health
demands of the population.

Establishment of objectives and goals: They are needed to guide efforts. Objectives must be established at all
levels, down to the smallest organizational level. In setting these objectives, time and resources are important
factors.

Assessment of resources: They are assessed and the balance is calculated between what is required and what
is available or likely to be available.
Fixing priorities: Once priorities have been set, alternate plans for achieving them are also formulated and
assessed to determine whether they are practicable and feasible. Alternate plans with great effectiveness are
choosen.

Writing up of formulated plan: The plan must be complete in all respects for the execution of a project. For a
health programme the resources required are related to the results expected. Also plan should contain methods for
evaluation or evaluation system. Central planning authority and government will consider modifications of the plan
relating to allocation of the resources.

Programming and implementation: The major considerations at the implementation stage include:

 Definition of roles and tasks.

 The selection, training, motivation and supervision of the manpower involved.

 Organization and communication.

 Efficiency of the individual institutions such as hospitals or health centers in implementing the plan.

Monitoring: It consists of keeping track of the course of activities and identifying deviations and tacking corrective
action if excessive deviation occurs.

Evaluation: Monitoring is confined to day to day or ongoing operations. Evaluation is concerned with the final
outcome and factors associated with it. A good planning will have built in evaluation to measure the effectiveness
and to detect deficiencies.

National Health Policy (NHP): Policy is the statement about the manner in which the given task is to be
performed. The National Health Policy is the statement enunciated by the Government of India about the manner in
which the tasks related to health and allied subjects have to be performed in view of the actual needs and priorities.
All subordinate agencies, state government and non official organizations concerned with health care are governed
by the NHP.

Formulated by the Ministry of Health, the National Health Policy was approved by Parliament in 1983.

Subsectors of National Health Policy:

• National Education Policy

• National Nutrition Policy

• National Population Policy

Elements of N.H.P. :

• Health awareness and community participation.

• Safe water and Basic sanitation through affordable technology.

• Correction of rural urban imbalance.

• Giving legislative support.

• Greater emphasis on correction of malnutrition.

• Provision for alternative health care.

• Emphasis on Indian system of Medicine.

Components of N.H.P. :

• Women welfare.
 • Child welfare.

• Rural development.

• Fuller employment.

• Reducing regional disparity.

The predominant areas stressed by N.H.P. are:

• Need to evolve 20 point program.

• Population stabilization.

• List of problems that needed urgent attention like Nutrition, Food Adultration, Water and Sanitation,
Immunization, MCH, School health and health awareness, occupational health.

• Mental health care.

• Rehabilitation of mentally retarded, deaf and dumb.

• Establishing health information system.

• Essential drugs.

• Health insurance.

N.H.P. Planning Process: Health Planning in India is the responsibility of Planning Commission. Health policy is
laid down by the “Central Council of Health and Family Welfare”.

Planning Commission: Planning commission was constituted in 1950. It constitutes :

• Chairman who is the Prime Minister of India.

• A deputy Chairman, the Finance Minister of India

• 4 members

• Several panels including a Health panel headed by the Advisor (Health)

Planning Commission works in two phases:

In the first phase: The planning commission prepares a draft plan of action of what is to be done in various
developmental areas for the succeeding five years. This is called the Draft Five Year Plan

In the second phase: The draft five year Plan is considered in depth by a body called the National Developmental
Council (NDC).

NDC comprises of Prime Minister of India, all cabinet ministers of the central government, Chief ministers of all
states and union territories and members of planning commission.

NDC revise the draft by carrying out addition and deletions. The revised version is the final draft. The role of NDC is
tom ensure cooperation between the centre and state governments in the matter of planning. The final Five Year
Draft is discussed and adopted by the Parliament.

Central Council of Health and Family Welfare (CCHFW) : CCHFW lays down Health Policy of the country. It
decides what needs to be done in the area of Family planning, population control, prevention of diseases, nutritional
promotion, medical education, professional training and research.
CCHFW is composed of Union Health Minister as chairman and the Health Ministers of all states and union territories
as members.

It meets once a year.

It considers proposals for new health legislations.

It determines how the central grants in aid are distributed among the states and union territories,

Finally it reviews the health work done in the previous year.

BIBLIOGRAPHY:

♦ Prabhakara G.N. Health Policy. 1st ed. Preventive and Social Medicine. New Delhi. Jay Pee Brothers Medical
Publishers. 2002. Pp- 213 – 14.

♦ Basavanthappa B.T. Public Health Administration and Policy. 1st ed. Nursing Administration. New Delhi. Jay
Pee Brothers Medical Publishers. 2002. Pp- 169 – 170.

♦ Basavanthappa B.T. Health Planning. 1st ed. Nursing Administration. New Delhi. Jay Pee Brothers Medical
Publishers. 2002. Pp- 224 – 227.

♦ Mary Lucita. Health Care Planning in India. 1st ed. Nursing: Services and Public Health Administration. Jay
Pee Brothers Medical Publishers. 2001. Pp- 313 – 324.

♦ www.pubmed.com

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