Health Policy and Administration (HPAd 201)

Planning as a Management Function

July 21, Saturday, 3:00 PM 5:00 PM Auditorium Francisco S. Cruz, MD., MPH.

Health Policy and Administration (HPAd 201) 6th Session

At the end of the session, the graduate students should be able to: 1. Discuss the concepts in health planning ; 2. Define elements in health planning; 3. Enumerate types of health plan; 4. Discuss the different approaches to planning and 5. Discuss examples of health planning models. Session No. 6 Plan 3:00 Review of TQM and Health Management Fundamentals 3:15 Health Planning Concepts 3:30 Elements of Health Planning in the context of program and project plans 3:50 Types of health plan 4:00 Approaches to health planning 4:10 Health planning models 4:40 LGU Scorecard 4:55 Preparing for the Next Session: Implementation Phase of Management

Health Policy and Administration (HPAd 201) Session: Review of 5th session

Total Quality Management : rationale, definition and main thrust, quality health care Systems Approach

Management Cycle: POSCORBE and PIE

The Cost of Poor Quality

The tip of the iceberg

The rest of the iceberg

Insufficient funds

Dissatisfied patients

Frustrated workers
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Total Quality Management

Refers to activities that establish the objectives and requirements for quality.

Quality Management System

A set of coordinated activities to direct and control an organization in order to continually improve the effectiveness and efficiency of its performance.

Main Thrust
Defining the processes which will result in the production of quality products and services not detecting the defective products and services after it has been done.
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Quality Management System

1. Enables an organization to achieve its goals and

objectives set up in its policy and strategy

2. Provides consistency and satisfaction in terms of

methods, materials, equipment, etc. and interacts with all activities of the organization beginning with identification of customer requirement and ending with their satisfaction at every transaction interface.

Universal Dimensions of Quality Care

Efficacious Safe Efficient Accessible Satisfying Affordable Socially acceptable

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Systems Framework

Inputs

Process

Outputs

Outcome

Public Health Management Course

Health Policy and Administration (HPAd 201) Session: Review of 5th session
Management Cycle: Planning, Implementation and Evaluation (PIE) and Planning, Organizing, Staffing, Coordinating, Reporting, Budgeting and Evaluation (POSCoRBE) Objectives->Strategies->Targets->Activities

Management and clientele/population: Inputs ->Processes--->Outputs Outcomes Impact

Health Policy and Administration (HPAd 201) 6th Session: Health Planning Concepts
A management dictum (If you fail to plan, YOU PLAN TO FAIL) A major part of the management cycle (commitment) A logical sequencing of evidence-based, analytical thinking (process) A road- map of priorities, strategies, activities, resources and commitments (document) A product of multi-level consultations, inputs from M&E (formative/summative) and forecasting (formulative) and management policies A blue print for lower level/regional/sub-regional/subnational/micro development and implementation (WHO Global polio eradication plan, DOH CMNCHN plan) An advocacy strategy and tool (MDGs)

Health Policy and Administration (HPAd 201) 6thSession: Elements of Health Planning
The objectives of what is being planned: Goal or over-all objective (MDGs, eradicate wild poliovirus transmission, attain universal health care); specific objectives (90% FIC, 100% growth monitoring of pre-schoolers, immediate referral of all suspected dengue cases to tertiary hospitals); targets (master-listing of all pregnant women, # of mobilized BHWs on healthy heart diet)

The approach, or strategy, for reaching the objectives: approach - PHC, community organizing and empowerment, PPP, sustainable development, human rights approach; strategies disease surveillance, health promotion and education, social mobilization and advocacy, social marketing, program/project management, logistics management, provision of quality services (DOTS, vaccination, vector control), M&E, networking and referral

Health Policy and Administration (HPAd 201) 6thSession:

Elements of Health Planning The activities or services required to achieve the objectives and targets; inherent and integral to the approach or strategies including unit responsible The obstacles that may hamper activities and solutions/mitigating activities (ZOPP, logical framework analysis; SWOT analysis) Others: introduction (historical perspective, purpose and rationale of the plan, scope and time-frame), proponents and clientele, required resources and monitoring & evaluation component

Health Policy and Administration (HPAd 201) 6th Session: Types of Health Plans
Program, Project and Area-based Strategic, Directional, Operational, Action Plan, Implementation Plan, Annual Plan, Physical Plan, WFP Component Plans: Communication plan, Logistics plan, Training plan, Social Marketing plan, Social Mobilization and Advocacy plan, Monitoring and Evaluation plan Long-term/Medium Term/ Short Term

Health Policy and Administration (HPAd 201) 6th Session: Approaches to Health Planning

Approaches to Health Planning Population-based (clientele focused) Institution-based (OD/HRD/Facility enhancement) Program and project Multiple needs vs. limited resources Various options and conflicting priorities Coping with change and advancement (IT) Rational decision making Policy implementation Budget is the best manifestation

Health Policy and Administration (HPAd 201) 6th Session: Health Planning Models

ZOPP: Objectives Oriented Project Planning Planning methodology with instruments and procedures Situation analysis, problem identification-prioritizationanalysis, objective setting (with alternatives), resource mobilization and scheduling, risk analysis and M&E. Highly participatory requiring teamwork, visualization and facilitation. Consultations with evidenced-based information among stakeholders. Planning in a structured process.

Health Policy and Administration (HPAd 201) 6th Session: Health Planning Models

LFA: Logical Framework Approach/Analysis Management tool in the design, monitoring and evaluation of international development projects LFA project design methodology (process) and log frame document (product: matrix) Better and easier control of project management team Goal (Impact) ---->Purpose---->Outputs (results, deliverables) --->Strategic Activities Narrative Summary, Objectively Verifiable Indicators, Means Of Verification and assumptions/risks

Health Policy and Administration (HPAd 201) 6th Session: Health Planning Models
Kalusugan Pankalahatan (Universal Health Care) Execution Plan (DOH Order 2011-0188) Rationale: low NHIP coverage; poor access to quality HF services by marginalized sectors (equity in health); risk of not attaining health MDGs Major strategies: rapid expansion in NHIP membership; upgrading HFs; prioritization of service delivery and resources targeting the poorest of the poor in selected LGUs Support strategies: budgetary re-allocation and creation of operational and technical/administrative clusters

Health Policy and Administration (HPAd 201) 6th Session: Health Planning Models

Provincial Investment Plan on Health (PIPH) Annual operation plan by program, project, sector Matrix : horizontal - program/project description, unit responsible, schedule, expected outputs, funding source (DOH, PLGU, MLGU, PDAF, others), PS, MOE, CO, Premium. Vertical: service delivery (public health programs, surveillance), health facility enhancement, health regulations, health care financing, good governance, HHR initiatives and HIS Prepared by PHO and approved by governor

LGU Scorecard
The performance indicators in the LGU Scorecard are a

subset of the Performance Indicator Framework (PIF) of the ME3. The performance indicators measure basic intermediate outcomes and major outputs of health reform programs, projects and activities (PPAs). There are 46 performance indicators in the LGU Scorecard categorized in two sets (Set I and Set II).
Reference: JUAN ANTONIO A. PEREZ III, M.D., MPH
Officer In-Charge-Director IV Bureau of Local Health Development Department of Health
Bureau of Local Health Development

PROGRAM PROJECT ACTIVITIES

I. FINANCIAL RISK PROTECTION = 6 INDICATORS PHIC Enrolment (1) Availment of PHIC Benefit Packages (1) Accred. to PhilHealth for: OPB, MCP & TB DOTS (3) II. EFFICIENT HEALTH SECTOR SPENDING = 6 INDICATORS Publications of: Annual Budget , Previous Year Statement of Receipts & Expenditures and Annual Procurement Plan or Procurement List (3) Provl Health Budget, Municipal Health Budget & MOOE allocated to Health (3)

III. HEALTH FACILITY ENHANCEMENT PROGRAM = 7 INDICATORS

Ave Length of Stay in Hosp (1) Bed Occupancy Rate (1) Hospital Gross Death (1 Hosp Bed to Pop. Ratio (1) Client Satisfaction Rate (1) Blood Collection in Catchment Areas (1)

IV. INTERNAL MANAGEMENT AND SUPPORT = 3 INDICATORS Doctor to Pop Ratio (1 ) Nurse to Pop Ratio (1) Midwife to Pop Ratio (1) Magna Carta for Health Staff (1)

V, POLICY STANDARDS DEVELOPMENT & REGULATION SCALE-UP PUBLIC HEALTH INTERVENTIONS FOR MDGs= 15 INDICATORS
Filariasis (1) Schistosomiasis (1) Facility Based Deliveries

Principle of Health Administration Preparing for the Next (7th) Session

Reading Materials for July 28, 2012 Principles and Practice in Health Administration Volumes I and II Total Quality Management Readings in Health System Management