Public Health Planning and Health System Analysis LEC 2 Thursday, November 15, 2018

2. REVIEW OF POLICY GUIDE LINES Process of familiarization with directives and conditions that prevail and must be followed in the preparation of the District Plan. National or Regional policies. National or Regional policy and community decisions that are to be translated into action. Plan is limited to and implemented within available resources. Research: Central guidelines Resource (MMM) Thursday, November 15, 2018

III- SITUATIONAL ANALYSIS Process of analyzing and interpreting all information available from the Health System and resources as it prevails in a geographic area. To identify health problems and health service needs arising from these. Thursday, November 15, 2018

SITUATIONAL ANALYSIS Determine existing problems Ascertain layout of existing resources in a problem Identify weakness and strengths of existing system as well as prevailing constraints Thursday, November 15, 2018

SITUATION ANALYSIS (CONT) DETERMINING EXISTING PROBLEMS Background information Initial problem diagnosis Indicators of health status Primary indicators Secondary indicators Thursday, November 15, 2018

SITUATION ANALYSIS (CONT) PRIMARY INDICATORS Birth Death Morbidity Disability and invalidity Anthropometry Hematology Physical exam Thursday, November 15, 2018

SITUATIONAL ANALYSIS (CONT.) SOURCES OF DATA FOR PRIMARY INDICATORS Vital statistics Census HMIS Hospital information Health facility Special survey Thursday, November 15, 2018

SITUATION ANALYSIS (CONT) SECONDARY INDICATORS Factors which are associated with primary indicators, often more difficult to quantify. Thursday, November 15, 2018

SITUATION ANALYSIS (CONT) SUMMARISING THE HEALTH SITUATION Go for a few overall indicators. Determine health problems, both subjective and objective very precisely according to age groups. Mortality and morbidity should be clearly spelt out. Thursday, November 15, 2018

SITUATION ANALYSIS (CONT) PROBLEM PRIORITISATION Magnitude of problem Severity of problem Vulnerability to intervention Cost effectiveness Political expediency Thursday, November 15, 2018

PRIORITY MATRIX Thursday, November 15, 2018

PROBLEM TREE Economic Loss Social Problems Reduced Child Health High Maternal Mortality Poor Obstetric. Care Severe Anemia Insufficient Food Intake High Fertility No Family Planning Low Food Security Conservative Religious Beliefs Poorly Trained TBA's Noncompliance Poor Post Partum Care Ignorance Traditional Beliefs Thursday, November 15, 2018

NEEDS TREE Reduced Econ. Loss Less Social Problems Impr. Child Health Reduced Maternal Mortality Good Obstet. Care Reduced Anaemia Good Post Part. Care Adequate Food Intake Reduced Fertility FP Being Practiced Improved Food Sec. Liberal Religious Beliefs Increased Compliance Improved Knowledge Changing Trad. Beliefs Well Trained TBAs Thursday, November 15, 2018

SITUATION ANALYSIS (CONT) (a) ASSESSMENT OF HEALTH SERVICE PROGRAMS Assessment of resource inputs What programs need to be offered What programs are currently offered Are they appropriate for needs What are main strengths and weaknesses What major lacunae can be identified Thursday, November 15, 2018

SITUATION ANALYSIS (CONT) EXAMPLES OF SERVICE INPUTS Outpatient care service Inpatient care service Outreach service Thursday, November 15, 2018

SITUATION ANALYSIS (CONT) (b) ASSESSMENT OF HEALTH SERVICE INPUT DISTRIBUTION Availability (Geographic) Accessibility (Affordability) Physical accessibility 5-10kms. or 60-120min walk. Indoor facilities with 4-6 hrs displacement Financial accessibility. Social accessibility religious/ tribal. Thursday, November 15, 2018

SITUATIONAL ANALYSIS (CONT.) (c) Assessment of service outputs Quality Quantity (d) Assessment of outcome (e) Assessment of effect of Ecology (f) Assessment of community involvement Verbalization Contribution Utilization Thursday, November 15, 2018

SITUATIONAL ANALYSIS (CONT) (g) Assessment of M&O Systems (h) Assessment of adequacy of support services Thursday, November 15, 2018