Program Planning

2.03 PROGRAM PLANNING Dr. Juangco || January 14, 2016

CMD

Transcribers: Javier, Justiniani, Kaluag, Kamiya, Kasan Editors: Wandering Samurai of Rivia

OUTLINE I. II. III. IV. V.

Planning models Types of program plan DOH program planning models Precede-Proceed Match

II. TYPES OF PROGRAM PLAN

VI. DOH-LGU VII. Other planning models VIII. Strategic planning IX. Mission X. Vision XI. Where are we now? XII. Strategic development

Legend:

Figure 3. Types of program plan. A perfect example of a long term program plan is the MDGs that started in 2000 and ended in 2015. Also, when there is a new Mayor, one of the tasks of a City Health Officer is to create a long term plan for the Mayor for the next three terms (one term is 3 years. An example of a medium term program plan is the National Objectives for Health which is a 5 year development program by the DOH. A short term program plan is what is usually done in the Health Office every year. During June or July, we do our Program Implementation Review to see if the targets and goals of last year were met, to identify good and bad practices during implementation, and to do the program planning for the following year. Why June or July? Because the budget hearing for the city or municipal council is held during August or September, and we need the program plan to back up our budget for the next year.

References:  Readings in Health System Management by Dr. Remigio Mercado  LGU Performance Program Planning Guidelines  LGU Health Planning Guidelines Objectives 1. To be able to identify the different models of program planning 2. To be able to explain how to perform a strategic plan 3. To draft a program plan based on the prioritized problem

I. PLANNING MODELS: BACKGROUND INFORMATION    

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Models serve as frames from which to build; provide structure and organization for the planning process Many different models Common elements, but different labels No perfect model – which is why there’s a new model every 2, 3 or 5 years. Strategic planning is the only one that’s still being used up to now. Can be used in entirety, parts, and combinations Three F’s of program planning help with selecting the appropriate model

III. DOH PROGRAM PLANNING MODELS      

PRECEDE-PROCEED MATCH MAPP LGU Health Planning LPP Planning Strategic Planning

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PRECEDE – Predisposing, Reinforcing, and Enabling Constructs in education/Ecological Diagnosis & Evaluation o Involves doing a situational analysis, finding out what is the problem in the community PROCEED – Policy, Regulatory, and Organizational Constructs in Educational & Environmental Development o Implementing the program, monitoring and evaluation

IV. PRECEDE-PROCEED

Figure 1. A generalized model for program planning.

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PRECEDE has five phases:

Figure 2. Three F’s of program planning: fluidity, flexibility, functionality. Fluidity means there should be a step by step process. It should also be flexible enough that when you go to the community and the program you’re doing is not applicable because of hitches or technical difficulties, you would be able to revise your program. Lastly, it should be functional, or appropriate, for the community.

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Phase 1: Social diagnosis Phase 2: Epidemiological diagnosis Phase 3:Behavioral and environmental diagnosis Phase 4: Educational and organizational diagnosis Phase 5: Administrative and policy diagnosis

PROCEED has four phases:  

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Phase 6: Implementation Phase 7: Process Evaluation

[CMD] 2.03 PROGRAM PLANNING – Dr. Juangco o

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Looking at how you are doing the program, if you are doing the program right, and if the people involved are doing at what they are supposed to do o Done during implementation Phase 8: Impact evaluation o What is the overall effect of the program in the community? o Example: EPI – How much did measles morbidity decrease in the community? o Done after implementation Phase 9: Outcome evaluation o Depends on your program goals and outcome indicators o Example: EPI – How many children were fully immunized? o Done after implementation

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Scorecards were too high and most cities and municipalities failed

VII. OTHER PLANNING MODELS A Systemic Approach to Health Promotion (Healthy People 2010) o Components: Goals, Objectives, Determinants of Health and Health Status Mobilizing for Action Through Planning and Partnerships o By the National Association of County and City Health Zopp-Zielorientierte Goal Oriented Program Planning Program Evaluation Review Technique Critical Path Method

Figure 5: PERT-CPM flowchart

REMEMBER: It is amazing what you can accomplish, If you do not care who gets the credit!

Figure 4. PRECEDE-PROCEED model

V. MATCH 

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Multilevel Approach to Community Health o Involves intra- and inter-sectoral collaboration o Community organizations and people’s organizations help in achieving program goals o Program planning includes not only the Health Office but everyone in the community Developed in the late 1980s Used by the US Government Applied when behavioral and environmental risk, and protective factors for disease and injury are known, and general priorities determined Includes ecological planning – levels of influence

Five phases 1. 2. 3. 4. 5.

Goal selection Intervention Planning (Objectives, target and actions) Program development (create program units or components) Implementation (adoption, implementation, maintenance) Evaluation (process, impact, and outcome)

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VI. DOH-LGU  

LGU Performance Program (LPP) Planning in 1998 LGU Health Planning Guidelines – developed by the DOH and DILG thru the National Health Planning Committee in 2001 o DILG had a scorecard of what is a successful city or municipality o Program plan is based on the scorecard Page 2 of 6

VIII. STARTEGIC PLANNING It is the process of determining where an organization intends to be in the future and how it will go there. It is a way of finding and then outlining the best possible path of moving toward that designation. Why? o To improve performance o To solve major organizational problem/s o To stimulate thinking and future direction o To build cohesion and teamwork How? o What might we do (in terms of environmental opportunity)? o What can we do (in terms of ability and power)? o What do we want to do (in terms of personal preference)? o What should we do (In terms of social responsibility)? Steps in the Strategic Planning Process 1. Where are we now?  Situation Audit 2. How did we get in this  Environmental Scan situation?  Research 3. What will likely happen if we continue as we are? 4. Where do we want to go?  Vision  Values 5. How do we get there?

 Goals  Strategic directions  Action plans

[CMD] 2.03 PROGRAM PLANNING – Dr. Juangco 6. How do we know we’re there?

 Monitoring

XI. Where Are We Now? 

Answers: o How did you get into your current situation? o What are the problems encountered? o What are the good things that you have? o What is successful in your organization? Usually done by SWOT analysis

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Figure 6: Strategic Planning Process

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IX. MISSION Answers the following questions: o What is the organization’s function? o Who are target customers? o How does the organization fulfill its function? o What specific geographical area will it serve? o What is the organization’s philosophy and values? o What is the preferred public image? DOH o To guarantee equitable, sustainable and quality health for all Filipinos, especially the poor, and to lead the quest for excellence in health. Cebu City Health Office o To ensure the highest standard of quality health services are provided to all specially the underserved through Primary Health Care Approach. o To ensure the delivery of Health Care services are provided in an integrated and convergent manner. o To ensure the continuous professional education and development of health workers. o To ensure the spiritual, moral, social and economic needs of health are met.

Figure 7. SWOT (Strength-Weaknesses-Opportunities-Threats/Challenges) Analysis. Usually involves the external and internal (belongs to your organization) environment.

Figure 8. Example of External Environment.

X. VISION 

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Vision Statement (what you foresee in the future/how do you see yourselves 5-10 years from now): o Is this what you envisioned in your most ambitious dreams? o Is this what you would like to become? o Will it provide inspiration to the members? o Will it provide a guide to where you want to go? o Will it prepare you for the future? DOH (Vision by 2030) o A global leader for attaining better health outcomes, competitive and responsive health care system, and equitable health financing. Cebu City o A responsive department guided by a highly principled leadership adapting different health strategies, supported by strong inter/intra-sectoral partnership focusing on the under privileged residents leading to a healthy and empowered citizens.

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Figure 9. Example of Internal Environment.

[CMD] 2.03 PROGRAM PLANNING – Dr. Juangco o set objectives that are feasible for the agency RELEVANT o align objectives with the mission and vision of the agency  TIME ORIENTED o establish a timeframe for achieving the objective  Example of Objectives o Measure of change, in what, by whom, by when  Ex. 20% increase in health department nursing staff by January 2014 o Degree of Change % Type of Change %Area of Change% Target Population %Time Frame  Ex. 15% decrease in obesity rates among 10 to 12 years old is XYZ community by June 2016 Strategies 

Figure 10. Prioritization Criteria. Each problem we try to score using the criteria. The problems with the highest scores are your first priority.

XII. STRATEGY DEVELOPMENT

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Goal Setting

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Key to good management Based on your Situational Analysis Mediocre managers concentrate on administration and problem solving Productive managers focus on finding goals that don’t exist yet Examples of goals: o To reduce the burden of non-communicable disease o To reduce the incidence of emerging health problems o To reduce the population growth by X%

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 Figure 11. Difference between Goals and Objectives. Goals – long term, broader in aspect while Objectives – short term, more specific. The general objective is your goal and your specific objectives are your objective when it comes to program planning. The objectives should answer your goal.

 Objectives     

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Should answer your goal and more specific than goals Numerous objectives for one goal SMART SPECIFIC o specify what is to be achieved, by how much, and by when MEASURABLE o make sure that the objective can be measured (I.e., data is or will be available to measure progress) ACHIEVABLE Page 4 of 6

How you are going to achieve and do your objectives Strategy is the overall approach the organization chooses to take to address strategic issues For example, an agency may determine that a strategy for addressing a particular health issue and impacting health disparities is community engagement With every action that is taken to address the health problem and reduce the health disparity, community engagement is part of the process. Fundamental choices o What courses to pursue and what to avoid in order to achieve the goals and objectives and reach the vision of the organization Answer the question “How can we best get to where we are going, how can we meet our goals and objectives to achieve our vision The TOWS MATRIX o Used for strategies o Combine your SWOT to do your strategies Strength + Opportunity o best strategy because both our POSITIVE Weakness + Opportunity o Making use of your opportunity to solve your weakness  Ex. Weakness > lack of personnel  Opportunity> lots of nursing school near the area that you can ask students to help administer vaccination Strength + Threats o Using your strengths to combat threats  Ex. Threat> Migration  Strength> a lot of BHWs, ask them to visit houses to give vaccines to the community Weakness + Threats o Two negatives, most difficult to achieve a positive when you have to negatives o Don’t use

[CMD] 2.03 PROGRAM PLANNING – Dr. Juangco Operational Planning Activities  What you need to do to achieve your strategies  Process began and completed at specified times in specified sequence and by specified people that will produce the required outputs.  Identify the key activities for each strategy, including corresponding targets, timetable. Focus of responsibility. Resource requirements and source of funds.  Key activities are activities, which are independent meaning they can stand alone.  Page 127 of manual for template o U1 goal, 3 objective in that goal, 3 strategies for each objective then you need 9 templates to submit (minimum)

Figure 12. TOWS Matrix

Figure 13. An example of Goals and objectives with strategies and activities for pneumonia (this is from DOH).

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This example Is not time bound Conduct training needs analysis o Try to find out what the personnel doesn’t know so you can focus your training This is just a sample, Our situation is community manage health program, hindi dapat health personnel ang target, dapat community ang ittrain ng health personnel na target)

Summary  

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Different models of program planning Strategic planning o Analysis o Mission, Vision, goals, objectives, strategies , activities and monitoring

[CMD] 2.03 PROGRAM PLANNING – Dr. Juangco 3.

MINI QUIZ 1. 2. 3.

Specific, Measurable, Achievable, Relevant, Time-bound

Name the 5 phases of “PRECEDE” What does “PROCEED” stand for? In goal setting, what does SMART stand for?

ANSWERS 1. Phase 1: Social diagnosis Phase 2: Epidemiological diagnosis Phase 3:Behavioral and environmental diagnosis Phase 4: Educational and organizational diagnosis Phase 5: Administrative and policy diagnosis 2. Policy, Regulatory, and Organizational Constructs in Educational & Environmental Development APPENDIX

Appendix A. Zopp-Zielorientierte Goal Oriented Program Planning

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