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Participatory Health Planning: A Framework for Effective Improvement of the WellBeing of the Poor

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'Conclave' Analysis of determinants. Systematic review of intervention effectiveness ... Option 1- 'Conclaves': Social society representatives. Health priority ... – PowerPoint PPT presentation

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Title: Participatory Health Planning: A Framework for Effective Improvement of the WellBeing of the Poor


1
Participatory Health Planning A Framework for
Effective Improvement of the Well-Being of the
Poor
  • 33rd Annual International Conference on Global
    HealthWashington, DCJune 1, 2006

2
Contents
  • Background
  • Limitations of traditional health planning
  • Participatory Health Planning
  • A new approach
  • Key principles
  • Basic steps in Participatory Health Planning
  • Lessons learned
  • Next steps

3
Background
Peruvian State decentralization legislation
(2002-2003)
Election of Regional Governments (2003)
Health sector decentralization map (2004)
Health sector medium term transfer plan to
Regional Governments (2005)
Health sector 2005 annual transfer plan to
Regional Governments (2005)
Regional participatory health planning (2005)
Accreditation of 37 health functions by Regional
Governments (2005-6)
Transference of health functions to Regional
Governments (2006)
4
Limitations of traditional health planning
5
Participatory Health Planninga new approach
6
Participatory Health Planningkey principles
  • Envisioning the health plan as a tool for change
  • Strengthening of State-citizen relationships
    throughout the policy making cycle
  • Key decisions made with active participation of
    citizens
  • Multi-sector involvement (health, sanitation,
    education)
  • Multi-level articulation (national, regional and
    local governments)
  • Use of quantitative and qualitative evidence
  • Explicit focus on equity and social justice

7
4
1
Review of evidence based interventions
Organization of the planning process
Priorities
Visioning
Epidemiological information
Goal setting (indicators)
Technical menu of - Health problems - Health
system problems
Participatory process to set priorities -Referen
dum -Conclave
Perceived health needs
Analysis of determinants
Definition of interventions
Demand-supply analysis
Institutional arrangements
Systematic review of intervention effectiveness
Regional Health Accounts
Paso 5
Health policies
Step 2
Step 4
Step 3
Step 5
8
Participatory strategy
9
How to get started
Organization of the planning process
Step 1
  • Set up a steering committee, in charge of
    planning, assisting and promoting the process
  • Incorporate key actors from public and private
    health sectors (authorities and providers),
    experts and social society representatives

Regional Government
Regional Health Council
Technical Information Unit
Communication and Participation Unit
10
Gather and analyze data
Health Needs Assessment
Step 2
  • Map available information (quantitative and
    qualitative)
  • Identify gaps in information
  • Collect additional information
  • Analyze information and list main health and
    health related problems

Epidemiological information
Perceived health needs
Demand-supply analysis
Regional Health Accounts
Mortality data
Morbidity data
Household data
Financial data
Facilities data
11
Establish priorities
Health priority setting
Step 3
  • Validate technical list of main health and health
    related problems
  • Determine rules and organize participatory
    priority setting process
  • Carry out participatory priority setting
  • Option 1- Conclaves Social society
    representatives

Technical
Participatory
District Conclave
Regional Conclave
No. of health problems
33
22
5
12
3
Ucayali region
No. of health system problems
22
19
3
9
2
12
Establish priorities
Health priority setting
Step 3
  • Carry out participatory priority setting
  • Option 2- Referendum Population

Technical
Participatory
Participatory Workshop
Referendum
No. of health problems
63
26
6
3
Lambayeque region
No. of health system problems
14
10
4
2
13
Voters General population Urban and rural School
children over 14 years Members of the Armed and
Police forces Oversight National Office of
Electoral Processes Ombudsman Cooperation agencies
14
(No Transcript)
15
Identify what works
Review of evidence based interventions
Step 4
  • Analyze the situation of each prioritized problem
  • Target population
  • Define indicator (s) and base line
  • Analyze determinants
  • Socio-economic
  • Environmental
  • Service related
  • Behavioral
  • Identify interventions that act on the
    determinants
  • Review evidence of the effectiveness of the
    interventions
  • Prioritize interventions

16
Set goals, interventionsand policies
Strategic planning
Step 5
  • Define a strategic objective for each priority
  • Construct a vision that reflects the desired end
    state considering the strategic objectives
  • Set goals for the selected indicators of each
    priority
  • Map the prioritized interventions
  • Determine the new institutional arrangements
  • Formulate the policies needed to implement the
    interventions
  • Approve and disseminate the plan

17
Set goals, interventions and policies
Strategic planning
Step 5
Vision
Governance and citizen participation policies
Evidence based intervention
Financial policies
Evidence based intervention
Services provision policies
Service quality policies
Health promotion policies
18
Lessons learned key factors to keep in mind
  • Strong political support
  • Involvement of the highest political authorities
  • Defined and recognized leadership
  • Commitment to results
  • Ample social participation
  • Mix of diverse participation mechanisms
    (information, consultation and active
    participation)
  • Enhanced communication skills
  • Clear rules for decision making

19
Lessons learned key factors to keep in mind
  • Enhanced technical skills
  • New health data requirements perceived needs,
    not only mortality and morbidity
  • New financial data collection and analysis
  • Integration of socio economic data
  • Support from experts (particularly for
    systematic reviews)
  • Allow for more time and resources than
    traditional planning
  • Awareness that traditional planning inertia exists

20
Next steps Towards implementation
Organization of the planning process
Health needs assessment
Health priority setting
Implementation
Evaluation
Review of evidence based interventions
Strategic planning
Communication of the plan
Screening
Identification of the problem
Development of action plans
Scoping
Agenda setting
Strengthening of multi-sector management
Participatory appraisal / assessment
Policy formulation
Promotion of multi-level negotiation
Development of recommendations
Legitimization
Evaluation
Alignment of investments and budgets
State-Citizen negotiation
Implementation
21
Contact
  • Midori de Habich
  • mdehabich_at_praes.orgPRAES - Promoviendo Alianzas
    y EstrategiasAbt Associates Inc.Antequera 777
    Piso 8San Isidro  Lima  PeruTel. 51 1 422 5002
    / 51 1 422 5544
  • www.praes.org
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