Far Eastern University – Nicanor Reyes Medical Foundation - Extent

EHSM: PROGRAM PLANNING - Attitude of the health authority

Dr. Polly Chua-Chan and Dr. Opina-Tan
INDICATION OF AREAS OF CHANGE
PROBLEM IDENTIFICATION AND EXPLANATION - Technological
IMPORTANCE OF PROBLEM IDENTIFICATION - Procedural
- Accurate statement of problems lead to clear objective - Staffing
setting - Facilities
- Organizational
CATEGORIES OF PROBLEMS - Policies
- Disease/ Condition
- Problems of the health care delivery system PROGRAM PLANNING
- Enumerate the importance of program planning
SITUATIONAL ANALYSIS - Describe the steps involved in program planning
- Identification of the problem/s - Formulate an action plan to address their identified
- Explanation of the causes problem
- Indication of areas of change

IDENTIFICATION OF THE PROBLEM

- Population
- Health Status
- Health Resources
- Area of intersectoral relationship
- Issues of intrasectoral relationship
- Health Facilities
- Health Human Resources
- Health Expenditures
- Socio-economic Factors

EXPLANATION OF THE CAUSES

- Problem Tree
- Core Problem
- Causes
- Effects PLAN
- A map
- Preparation
- An arrangement
- Where do you want to go?
- How do you get there?
- How long is your journey?

WHY PLAN?
- To create an actionable link between needs and
resources
- Establishes a means of deciding which problems are most
pressing and which have the best chances of being
resolved, and the order in which that resolution is likely
to occur
CONSTRAINTS ANALYSIS
- Removability--- - Planning does not guarantee success, but lack of planning
- Nature – consumer, provider can lead to failure
- Magnitude

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 ELEMENTS OF PLANNING - At the end of 1 ½ years, all residents of the barangay would
- Identifying a vision and goals have access to some form of protection from mosquitoes
- Undertaking strategic planning
- Evaluation Component objective: At the end of the first year, at least 20% of
the adult population of the barangay would be able to (1) explain
STEPS IN PROGRAM PLANNING how DF is acquired, (2) explain how DF is prevented; and (3)
1. WHAT IS THE PROBLEM enumerate the most important signs and symptoms of DF
o Who is affected most? - Outputs:
o Where the problem occurs most frequently? - At the end of 1st month, a baseline survey on the knowledge
2. SELECT INTENDED PARTICIPANT GROUPS and practices of the population on Dengue fever should
o The group of people your intervention have been done.
is designed to influence - At the end of the 2nd month, a training manual / module
o Guide your decision about whom to target on Dengue Fever would have been produced
o General population - At the end of the 3rd month, all BHWs would have been
§ Require a lot of resources therefore expensive trained to
§ Reach a large number of people - give purok lectures on Dengue Fever
§ May not affect high-risk population as much as - At the end of the 6th month, brochures / information sheets
targeted interventions on Dengue Fever would have been disseminated to at least
o High Risk or At-risk 50% of the families in the barangay.
§ Culturally sensitive - At the end of the 6th month, posters on Dengue Fever would
§ May need help from a representative of the have
group - been posted in 10 identified strategic locations in the
3. SELECT A SETTING barangay.
o Where activities will occur - At the end of the first year, at least 30% of the adult
o Convenient, comfortable for the participants population of the barangay would have attended a purok
o Consider the type of intervention you are planning lecture on Dengue Fever
4. SET GOALS AND OBJECTIVES
o Goal 5. SELECT THE APPROPRIATE INTERVENTION
§ broad statement of what you want to achieve o Consider the following:
o Objectives § Characteristics of participants
§ specific things that you will need to do to § Settings
achieve your goal § Goals and objectives
§ SMART o Build on the experience of others
§ evidence-based
OBJECTIVES o Modify to make it appropriate
- Hierarchy of objectives o Consider using multiple interventions
o Goals 6. LOCATE RESOURCES
o Component objectives to achieve the goal o Sources of funding and materials
o Outputs o Commitment of time, effort and support
- SMART 7. INVOLVE THE COMMUNITY
o The best way to involve the community is from the
MAKING OBJECTIVES very beginning!
- Goal: At the end of 2 years, there will be no more cases of o When the community members are asked to help
Dengue Fever in the barangay plan and implement the intervention, they develop a
- Component objectives: sense of ownership.
o At the end of the first year, at least 20% of the adult 8. DEVELOP ACTIVITES AND MATERIALS
population of the barangay would be able to o Involve representatives of your intended participant
§ relate how DF is acquired group
§ Relate how DF is prevented o Consider culture
§ Enumerate the most important signs and o Pre-testing of materials and activities
symptoms of DF 9. STAFF INTERVENTION
- At the end of 1 ½ years, all possible breeding places of o Consider:
Aedes aegypti in the barangay would have been removed § Type of intervention

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 § Needs and preferences of the intended - Staff
participants - Participants
§ Resources available - If you find an activity is not achieving the outcome, you
§ Time of your intervention may need to alter it.
10. TRAIN THE STAFF
o Everyone involved in implementing the intervention 13. EVALUATE THE INTERVENTION
must receive training o Process of collecting and examining information to
o Training includes: determine the accomplishments, strengths and
§ Problem weaknesses of a program.
§ How to carry out the intervention o Assessing and measuring the value of something
11. IMPLEMENT THE INTERVENTION
o Execution of the program plan WHY EVALUATE
o Financing - Determines whether and how well program objectives are
o Marketing met.
o Building coalitions - Determines strengths and weaknesses of program for
o etc decision-making and program planning.
- Establishes a level of quality assurance and control.
IMPLEMENTATION - Meetings the demand for public or fiscal accountability.
- undertaking of specific actions designed to affect the goals - Improves staff skill in program planning,
identified implementation and evaluation.
- Taking necessary steps to put those forces in motion - Promotes positive public relations and community
- Assure that the effectuation of those forces is consistent awareness.
with the plans/strategy devised - Fulfills grant or contract requirements.

IMPLEMENTING REQUIRES COMPONENTS OF THE PLAN

- The role of all persons involved be defined as well as - Objectives
what is expected of that person - Activities that need to be done to attain the outcome
- The persons involved be engaged in meaningful activity - Resources needed
which provides maintenance for the program - Budget (if relevant)
- The design and implementation of ways to assess the - Persons in charge
program’s performance and effectiveness - Dates when the activities will be done
- Evaluation
IMPLEMENT THE INTERVENTION o Indicator/s for success or attainment of the objective
- Supervise and support the staff o Source
- Maintain a consistent level of participation o Method of evaluating the indicator
- Keep the community interested in the intervention
THE PLANNING MATRIX
12. MONITOR THE INTERVENTION
Output: At the end of the 2nd month, a training manual / module
o To see if activities are occurring according to the plan
on Dengue Fever would have been produced
o Identify unanticipated problems or bar
Activity Resources Budget Person Time Evaluation
Needed Responsible

DESIGNING PROGRAM STRATEGIES

STRATEGY
- An approach to facilitating change
- Chosen according to the results that they are intended to
WHAT TO MONITOR
create, or the typical activities they might include
- Measure key variables

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 FRAMEWORK OF STRATEGIES SAMPLE ACTIVITIES AND OUTCOMES
- Ottawa Charter for Health Promotion Strategies Sample Activities Sample Outcomes
o Build healthy public policy
1. Healthy • Awareness New policies,
o Create supportive environments
public policy campaign procedures, by-laws,
o Strengthen community action
• Community letter- regulations, legislation
o Develop personal skills
writing
o Reorient health services
• Deputation to
- **a program can include one or more strategies
council orboard
1. BUILD HEALTHY PUBLIC POLICY 2. Create • Support groups • Increase in
o Efforts to influence policies, operating procedures, by- supportive • Flex time perceived support
laws, regulations and legislation can have a direct environments arrangements • Changes in
impact on health. • Provide free organizational
o Examples childcare services procedure
§ Municipal alcohol or smoking policies • Structural changes
§ School board cafeteria in the
§ Seat belt and bicycle helmet laws environment
2. CREATE SUPPORTIVE ENVIRONMENTS 3. Community • Create local action Increase in ability,
o The places where people live, work and play can mobilization group capacity or confidence
impact behavior. • Training of local of individuals and
o “healthy environments” leaders groups to affect
o Examples: • Community forum community change,
§ Gym in a workplace can make it easier for policies, etc
employees to get daily activity 4. Develop • Parenting skill • Increase
§ Location of recreational facility can make it personal skills workshops confidence in
easier or more difficult for children to • Cooking ability to perform
participate in activities demonstrations a behavior
3. STREGTHEN COMMUNITY ACTION • Fitness program • Increase in
o Communities can be mobilized and work together to development and number of
improve health through projects. training attempts to
o Examples • Telephone change a behavior
§ Community gardens smoking cessation
§ Healthy lifestyle community projects counseling
§ Community projects
5. Strengthen • Lifestyle screening Increase in patient
§ Neighborhood anti-drug initiatives
of community during annual accessibility to broad
§ Community economic development projects
health services physical exams spectrum of services
4. DEVELOP PERSONAL SKILLS
o Development of knowledge and skills needed to • Develop Improve linkages
improve their health, and provide ongoing support interprofessional between physical
they may need to have more control over their lives health team for health care and social
o Examples provision of services
§ Capacity-building on the technical aspect of the services
program 6. Provide • Distribution of • Increase
§ Training on program management information health education understanding
5. REORIENT COMMUNITY HEALTH SERVICES and education materials health information
o The health sector can move toward health promotion, • Workshops and • Increase
beyond clinical and curative services. classes motivation
o Examples • Increase
§ Health lifestyle programs for the prevention of knowledge about
non-communicable diseases where to get more
§ Screening for community members with information
high cardiovascular disease risk

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 7. Health • Text message Increase in knowledge
communication campaigns and
• Contest to develop awareness
your own web Change in attitudes and
video behaviors
Increased discussion
about a
topic
8. Self-care • Online community • Increase sense of
for sharing one’s own power
concerns to affect health or
• Training of life circumstances
community peer • Increase in
support workers perceived social
support

PRIORITIZING THE OPTIONS

- Has significant bearing or potential to have
an impact on the situation
- Is amenable/likely to occur given your
available resources, expertise, etc
- Is aligned with your mandate and stakeholder interests
(what your organization is expected to do)

Notes from Lecture PPT and Handouts given

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