Strategy development and planning: Overview

Dr Bernadette DaelmansDepartment of Maternal, Newborn, Child and Adolescent Health

World Health Organization

National health plan

Maternal, newborn and child health

MDG 4 & 5

Regional maternal, newborn and child health strategies

The Global Strategy for Women's and Children's Health

MNCH: not in isolation

Planning and management cycles

Develop implementation plan

(1-2 yearly)

Prepare for review of implementation

status)1–2 yearly(

Evaluate programme

coverage and health impact )5-

10 yearly(

E.g. DHS, MICS

Develop strategic plan

)5-10 yearly(Manage

implementation )Ongoing(

National Health Plan

Financing

Policy Directions universal coverage ,

primary care ,

health in all policies

Strategies -Plans -Regulation Medicines

Technology & Infrastructure

Workforce

Policy dialoguewithin and beyond

health sector

Comprehensive , integrated , continuous

and people -centred care along the life -

cycle

Cost

-

effective and safe

interventions

:

clinical &

public health

Universal access to close -to-client

networks , responsible for a defined population

Trust in health authorities :

FairnessProtection

CompetenceAccountability

Health Equity

Health & health security

Health System building blocks

Service Delivery

Outcomes

Social inclusion and

participation

Strategic Information

Research

Governance Critical subsystems

MNCAH within the health system

Programmatic pathway for child health

IMPLEMENTATION OF ACTIVITIES

Advocacy for maternal and child health

Human, material and financial resource

mobilization

Human resource capacity development

Communication with families &

communities

Health system supports strengthened

Progress tracked

IMPROVED

Availability and access to health care

Quality of care

Demand for care

Knowledge of families and communities

INCREASED POPULATION-

BASED COVERAGE

of key effective interventions

IMPROVED SURVIVAL

AND HEALTH

Other determinants

Steps in strategy development

• Situation analysis• Setting goals, objectives and targets• Select priority interventions• Decide how to deliver and scale-up interventions• Review policy and resource implications• Costing of the strategic plan• Plan for monitoring and evaluation• Writing-up the strategic plan• Ensure inclusion in national health plan and

maximize synergies with other programs

Making critical linkages

1. Antenatal Care e.g.

2. Childbirth Care e.g.

3. Postpartum Care for mother and newborn e.g.

• Prevention of Mother to Child Transmission of HIV• Intermittent preventive treatment of malaria• Use of insecticide treated bednet• TB Care, including extra-pulmonary genital TB• Prevention of congenital TB

• Essential care during childbirth • Essential care for the mother and newborn after birth• Care of HIV positive women and affected newborn• Prevention of Mother to Child Transmission of HIV• TB care

• Support for breast feeding• ARV prophylaxis and feeding counseling for mother

and baby affected by HIV• Use of insecticide treated bednet• Integrated management of childhood illness

OneHealth supports several steps

• A tool to support processes for medium term (3-10 years) health systems to planning at country level

• Covers the national health sector, with focus on public sector health interventions.

• Allows for incorporating activities in private sector and costing of selected non-health sector activities that may have health impacts.

• Unified in three ways:– planning, costing, budgeting, impact analysis, financial space

analysis – all together– brings together disease programme planning and health systems

planning – one UN

OneHealth for strategic planning and costing

National

Hospital

Health Centre

Outreach

Community

HS4. Health Information

HS5. Governance and Leadership

HS6. FinancingPolicies

HS3. LogisticsHS1. Infrastructure and Equipment

HS2. Human Resources

Malaria

Disease Programmes

TB

HIV

Reproductive H

ealth

WA

SH

Imm

unization

Child H

ealth

Nutrition

…N

CD

s…

Health System

Envelope

Fiscal Space envelope

Service delivery planning

Flexible in use

Planning by programmes

• Nutrition • Child Health• Immunization• Maternal and

Reproductive Health

• Malaria• TB• HIV/AIDS• WASH• + )user defined(• + NCDs

)forthcoming(

Planning by levels• National• District• Hospital• Facility• Outreach • Community

Planning for systems Human Resources for

Health Infrastructure,

Equipment and Vehicles

Logistics Health Information

Systems Governance Health Financing Policy

Gender, Equity and the Private Sector as cross-cutting considerations

In conclusion

• A good (MNCAH) program strategic plan is a pre-requisite for sound inputs to a National plan…and a good national plan should reflect key (MNCAH) program issues

• The (MNCAH) program strategic planning cycle should be synchronized with the national health planning cycle

• The OneHealth supports both National health planning and (MNCAH) program strategic planning