MANAGEMENT CYCLE

(ORGANIZATION AND MANAGEMENT IN HEALTH

EDUCATION)

YAIMIN
15-2-61734
MASTER OF ART IN EDUCATION HEALTH EDUCATION
THE MANAGEMENT CYCLE
The Management phases follow a
cyclical approach throughout the life
of the project. The cycle represents a
continuous process in which each
phase provides the foundation for the
next. These cyclic nature among the
design, implement and monitor
phases is repeated throughout the
life of the project
 The cycle allows for a constant, iterative
process by which the project is constantly
monitored and any required changes are
reflected in the plans, this repetitive cycle
continues until all project activities and
objectives have been delivered. The cycle
approach allows opportunities to review the
original project assumptions and plans, as
the project makes progress the initial
conditions could have changed making
necessary for the project to change course
or readjust the original plans.
 The management cycle
figure

Impleme
nt

Close
Initiate Plan Monitor

Adapt
Initiation
This phase is where an idea or a proposal is
authorized and funded as a project. It may
include some initial planning and estimating
to clarify its objective and scope. Usually
projects are started by an organization in
the form of a proposal or they are initiated
by a donor agency by a competitive bidding
process or a cooperative agreement. In
either case the organization makes a
decision to support the project proposal.
Initiation
During initiation a diagnostic and analysis of the
problem has been performed and it delineates the
strategies that the project will use to achieve its
benefits; additionally, the organization has identified
that the project is aligned with the organizations
strategies, mission and vision. Major outcomes or
decision from this phase is the acceptance of the
project concept and approval of the project
proposal. This decision is based on an organizations
programming principles and/or strategic objectives
and takes into consideration available resources,
local needs, and government/donor interest.
Initiation
Authorization of the project concept leads to
the development of a formal project
proposal; it includes the documentation that
supports the requirements of the funding
agency. In this phase the project may or may
not be approved or accepted, or may require
additional analysis or modifications to the
proposal; it is not unusual that the donor and
the organization engage in long negotiations
on the final budget of the project
Initiation
The approval of the project proposal
is done by the organization (if funds
are internal) or the donor when the
organization responds to a bidding
process such as the RFP (Request for
Proposal) or the RFA (Request for
Assistance); approval of the proposal
opens the project to start the second
phase of the project, Project Planning
Planning
Once the proposal is accepted and funds
have been approved the project is finally
ready to start. The first step is the
development of all project plans, this
phase includes two distinct components;
the development of plans that are
required as part of the proposal core
planning, and the plans to manage the
implementation of the project
facilitating planning.
Planning
Enabling plans or core planning includes
the detailed planning documents that
were initially produced as part of the
project proposal. The project managers
first task is to develop in more detail the
project plans including the detailed
project budget and schedule. Enabling
plans are the plans to manage the scope,
schedule, budget and quality of the
project
Planning
Facilitating Plans include the
development of plans to manage all
the other facilitating processes
required to manage the project,
these include: team, stakeholders,
information, risk, and contract
management plans
Planning
Detailed planning in many cases help discover
oversights or wrong assumptions made during the
initiation phase and the project proposal. It is not
unusual to find that a project proposal was designed
without incurring the appropriate feedback from the
project stakeholders, or that budget assumptions
were based on old data. This is the time the project
manager has to go in detail about each component
of the project and formulate the plans that will help
manage the project. Outputs from this process
include a formal project management plan that
authorizes the project to begin work.
Implementation
Implementation includes taking all necessary
actions to ensure the activities in the project plan
are completed and the outputs of the plan are
produced.
Implementation occurs once the final project
plans have been approved by the organization
and/or the donor agency. The project manager
starts by forming a team and the initial expenses
required by the project; these may include the
purchase of office equipment, vehicles, and other
goods and services required to start the project
Implementation
Implementation includes coordinating people and
other resources required to perform the project
plans and obtain the desired outcomes of the
project or phase, this phase also includes activities
such as providing project leadership, developing
the project team, verifying project scope, assuring
quality, producing progress reports, procuring the
necessary resources and taking corrective action.
Outputs from this phase are the project
deliverables, progress reports and communications
to stakeholders.
Monitoring
Monitoring is about measuring the
progress of a project against its
objectives, looking at deviations from the
plan and taking corrective steps to put
the project back on track. Monitoring
runs across al project phases of the
project life cycle. Traditionally the focus is
on monitoring the four project constraints
of scope, schedule, budget and quality.
Monitoring
Project monitoring begins with planning
and ends with evaluation, having a
thorough involvement of each step in the
process. Each project should be assessed
for the appropriate level of control
needed and find an equilibrium that can
give the benefits without increasing
work; too much control is time
consuming, too little control is too costly.
Monitoring
Monitoring is the constant check on the
project to see if it is doing the right things
at the right time within the given resource
restrictions. Project monitoring is an
important element of the project that
keeps it on-track, on-time, and within
budget. Monitoring also looks for new
opportunities that may have risen since
the project started and that may improve
the chances to achieve the project goals.
Monitoring
Monitoring helps verify if the intervention of
the project is producing the desired effects
or benefits, it helps identify unexpected
consequences, establishes a discipline that
helps monitor how the situation and the
context of the project are evolving, and how
the initial assumptions of the project have
changed, which contributes to the regular
adjustments of the interventions to ensure
the project is a success.
Adapting
This phase refers to the process by
which the project manager adapts its
project management methods and
determines what works best for the
project. It also refers to the changes
that need to be incorporated in the
original processes, approaches,
strategies and methods planned to
deliver the project interventions
Adapting
Adapting is taking corrective actions. It
uses inputs from the monitoring phase
that informs what needs to be changed
or modified. The original assumptions
under the project was first planned
usually change and this phase helps
make the necessary changes. Adapting
involves the analysis of the changes
required and its impact and relevance to
the project and its constraints
Adapting
Adapting also refers to the process by
which project members learn from the
experience they gain in the project. This
process gives rise to increasing
productivity over time and to economies of
scale. The adapting phase incorporates a
lessons learning approach throughout the
project cycle; it is through a feedback loop
of experience, learning and practice, that
the project can improve its interventions
Adapting
Modifying the project and making the
necessary changes should occur at
the end of each project delivery, as
each delivery provides an
opportunity to reflect on the success
or failures and provides important
lessons that need to be incorporated
on the next project deliverable.
Closing
The closing phase of the project is when
the project has achieved the planned
objectives and all deliverables have been
produced. There could be instances that a
project is closed before all deliverables
have been completed, this could be
caused by changes in organizational
strategies, unavailability of funds or
security conditions that make project
work impossible
Closing
During closure the project ensures
that all administrative tasks have
been completed including all
contracts, staff is reassigned to other
projects and the project lessons
learned is developed. All project
documentation is properly cataloged
and its access made available to the
organization and the donor
Closing
which usually may include audit
evaluations, donor evaluation, or
internal evaluations conducted by
the organization or the project.
Health needs concept
The concept of health needs is one of key concepts
in public health. From the public health standpoint, the
most important perspective on this concept is the
perspective of a population, or an individual
respectively. But along this perspective there exist
several other perspectives, which can be to the certain
extent similar, but also could be also very different. All
this enters an enormous confusion in its
understanding, and consecutively this concept seems
rather elusive. This confusion originates from the fact
that the concept of health needs is very difficult to
define exactly, like it is also very difficult to define
exactly the concept of health itself, since both
concepts are extremely complex entities
Health needs concept
Questions in health needs assessments:
What is the problem?
What is the size and nature of the
problem?
What are the current services?
What do patients want?
What are the most appropriate and
effective (clinical and cost) solutions?
What are the resource implications?
What are the outcomes to evaluate
change and the criteria to audit success?
 From the public health perspective is
very important to be aware of different
dimensions of health need of a
population/an individual, and how they
could be fulfilled. Public healths role is
to be advocate in fulfilling populations
health needs if they are legitimate and
justified, and to prevent fulfilling
unjustified health needs, especially if
their fulfilling would result in cutting
down fulfilling other justified health
needs.
 At the end we need to emphasize again that
health needs are not only what people can
benefit from health care system (this is
health care need), but also from wider social
and environmental changes. In meeting
health needs in such a comprehensive
meaning, health needs assessment is
extremely important public health task to be
done. It involves epidemiological, qualitative,
and comparative methods to describe health
problems of a population; identify inequalities
in health and access to services; and
determine priorities for the most effective use
of resources.
Health Organization
Strategic
In healthcare today, challenges surface almost daily in
terms of finance, reform, government mandates and
policy, technology, and customer satisfaction. It is
crucial that healthcare leaders step back and
continually assess the organizations strategic plan. In
fact, strategic thinking, assessing and modeling are
becoming requirements for an organization to survive
the turbulent healthcare climate
Strategic planning provides a roadmap to where the
company is going, and directions on how to get there. It
is used to guide all decisions, including those regarding
capital, technology, staff and other resources.
7 Steps to Strategic
Planning

Step 1 Review/Develop Vision & Mission

Although many organizations have created vision,
mission, goals and objectives, these elements need to
be reviewed on a continuous basis. The reason lies in
the ever changing environment and business
constraints forced upon organizations through
government, payors, competition, physicians, patients,
vendors etc. Each internal departments vision and
mission must be aligned and supportive of the overall
business strategy.The mission of an organization is the
reason it exists. Usually the mission takes the form of a
statement, which conveys a sense of purpose to the
employees, patients, physicians and the community.
The mission sets the tone for goals and objectives
7 Steps to Strategic
Planning
Step 2 Business and Operational Analysis
One of the key objectives of strategic planning is
to understand internal strengths and
weaknesses as well as external threats and
opportunities, i.e. a SWOT analysis. It is critical
to engage stakeholders from across the
organization and vendors as well to provide
their points of view. This involvement will not
only improve your plan, it will create
organizational ownership, which will be
important for executing and sustaining the plan.
7 Steps to Strategic
Planning
Step 3 Develop and Select Strategic Options
All possible strategies should be developed based on the
inputs. Then the list should be narrowed down to strategies
that are within the guiding priniciples of the organization.
Guiding principles identify the ground rules and
parameters that will inform decision making for your
organization. For example, will your organization consider
merging with or acquiring another organization to meet its
goals? Do you want to outsource certain functions? Another
decisionmaking criterion is your organizational capacity. For
example, if a goal is to increase revenue in orthopedics by
7%, are there enough physicians to support that increase in
volume? Do they specialize in the services that will meet
that goal?
7 Steps to Strategic
Planning
Step 4 Establish Strategic Objectives
This step narrows the list even more by
applying various models (financial, etc.) to
each strategy to determine the effect it will
have on the organization. This step is also
where key measures and timelines are
established or validated. Once the strategies
are tested in this way, it can be put together to
form the strategic plan. The plans components
should be specific, measurable, achievable,
realistic and timebound (SMART).
7 Steps to Strategic
Planning
Step 5 Strategy Execution Plan
Now a plan must be developed to implement
the chosen strategic options. To be successful,
you will need organizational ownership of the
plan, which includes not only executive
sponsorship, but also the active involvement of
all staff members. Communicate the plan to all
levels of the organization. Find champions in
all areas. Define what is in it for them. The
clear (SMART) goals and staff involvement in
the initial committees will help you now.
7 Steps to Strategic
Planning
Step 6 Establish Appropriate Budget and
Resource Allocation
Quite often, once the strategic assessment and
plan is complete, leadership may not be able to
allocate or assign appropriate funding, staffing
or other resources to specific initiatives. The
result of improper or inadequate budgets and
staffing usually ends with failed strategic
initiatives. It is critical to receive leadership
commitment on budget and resources before
execution of the strategic plan
7 Steps to Strategic
Planning
Step 7 Execution Review
One of the critical success factors for effective
strategy deployment is constant and ongoing
progress reviews. Appropriate reporting
mechanisms must be included in the
deployment. When issues, challenges, deviations
or obstacles are identified, decisions and
remediation are necessary some which may
even change the strategic direction. Therefore, it
is important to decide who is involved in the
review process, and what exactly is reviewed
 Types of health planning

Planning is making current decisions in the light

of their future effects.

Health planning is a process culminating in

decisions regarding the future provisions of
health facilities and services to meet health
needs of the community.
 Types of health planning
Based on time frame

1. Short term planning (generally 1-3 years)

Meeting needs as defined by current trends
Using available resources and re-allocation of resources

2. Medium-term planning (5-10 years)

Modify demands
Recognize new needs
Obtain new resources

3. Long-term planning (10-20 years)

Select a desired future
Design a way of reaching it
 Based on hierarchy of goals

1. Health policy planning

Long term health goals

2. Health programme planning

Medium term objectives

3. Operational health planning

More specific & localised

 Main characteristics
Policy linkage- problems, priorities, directions and strategy

Future orientation- Analysis of past, assessment of present,

projection and action towards future

Multidimensionality- epidemiology, demography, medicine,

economics, administration, social science

Multisectoral approach- Health, education, environment,

social service

Team work- sharing of experience, resources, knowledge

 Rationale for health
planning
Cope with major health issues in a sustainable
manner.
Ensure effective coordination and avoid
unnecessary duplication
Promote optimum utilization of resources

Ensure equitable distribution of health resources

and services
Facilitate monitoring and evaluation of health
services