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The planning process is essentially the same for both strategic and operational health plans. Planning requires a systematic approach i.e. the process involves a series of systematic stages. However, we must caution that planning does not consist of moving rigidly up a static stairway of steps. In practice, the continuity of the process may be constrained at any points by environmental factors, and may not therefore proceed in the cyclical form. In other words, planning is a dynamic movement back and forth between various stages of the process, culminating in a purposeful projection of actions to achieve pre-determined goals. It is however necessary to describe it in stages, in order to provide a general framework or outline of what needs to be done to ensure a systematic approach.
Fig. 1: Planning Cycle Source: (Olumide, 1997)
The first stage in the process consists of organizing for planning, also known as
―planning the planning‖ during this stage, the planning team is assembled and prepared
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for the task ahead. The detailed composition of the planning team will vary with the level at which the plan is being formulated.
The second stage is situation analysis, the main purpose of this stage of the process is to determine the most common health and health related problems and the population groups which they affect, the factors which contribute to the development of the problems and so to identify obstacles and constraints to the improvement of health care.
The situation analysis requires a definition of the common health problems in quantified terms, for example, incidence and prevalence rates. It also requires fore-casting of situations which are likely to have direct or indirect implications on health and health care in future.
The third stage is prioritization of health problems; this step is informed by the fact that the resources for the implementation of our plans are presumed to be insufficient to address all the health problems which are discovered.
Fourth is setting objectives-specification, for each priority problem, set objectives in terms of the specific results to be achieved e.g. proportional reduction in incidence of the disease. These will be guided by personal experience of disease control in the field, given the prevailing conditions. It will also be guided by reported experiences of other workers in similar situations. The objectives should be SMART- Specific, Measureable, Achievable, Realistic and Time-bound.
Fifth, specification of technical interventions, for each desired objective, alternative technical interventions which will be required to make the prescribed impact on the health status of the community should be specified in terms of desired proportional increase in coverage e.g. ―to increase coverage with potable water from 22% to 50%‖.
These technical interventions consisted of appropriate promotive, preventive, curative and rehabilitative services, which would result in the desired changes.
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Six stage, Constraints analysis and specification of strategies (identification of constraints to implementation and alternative strategies for circumventing the constraints), For each technical intervention specified, the major obstacles, problems, bottlenecks and constraining factors, which were likely to impede implementation, were identified. These generally are resource and operational deficiencies, which had been identified in the health system during the situation analysis.
Seven stage, selection of strategies -selection of priority strategies, The strategies should be evaluated and selected on the basis of perceived cost effectiveness, feasibility, cost-efficiency logistical requirements, etc. Economic evaluation techniques are invaluable tools for the effective selection and priority strategies.
Eight stage, detailed programming and resource specification, this stage involved the translation of the interventions and strategies through the techniques of activity analysis and task analysis into specific activities and tasks to be carried out by the health system, and other sectors and the community i.e. identify the activities required for the execution of each strategy and clearly specify what exactly was to be done, by whom, where it should be done, when and with what resources.
Nine stage, output of the planning process, the exercise produced a detailed plan of work which clearly specified the objectives to be attained, activities to be executed, standards and procedures, who was responsible for each task, the time of execution and completion and the resource and budgetary requirements for each direct task and support activity.‖
Planning does not really end at this stage. It is important, particularly at the local level that the planners should also participate in the implementation and evaluation of the programmes. The planning cycle thus continues through implementation and evaluation, during which valuable information is collected. These are fed-back for the improvement of the next planning cycle.