Sound policy and plan formulation

Sound policy and plan formulation

2Policy and planning

Key messagesKey messages

Policy process is messy, but there are elements of good practice you can use.

1. Sound processes

2. Realism

3. Comprehensive and balanced content

4. Linkage with health programs

5. Linkage with medium-term and subnational plans

Policy dialogue needs a range of skills

3Policy and planning

Policy dialoguePolicy dialogue

Policy dialogue includes analysis and advice that is:

accurate, timely and well informed

politically astute, and

based on broad consultation

4Policy and planning

Good policy adviceGood policy advice

is grounded in the big picture

focuses on the ‘customer’

comes from a strong analytical foundation

rests on a substantial evidence-base

appreciates the value of engagement, and

builds-in systematic evaluation

5Policy and planning

Policy dialogue skillsPolicy dialogue skills

More than technical expertise. Specific skills needed in:

rigorous problem identification identifying options applying analytical frameworks, and preparing clear advice.

Broad skills needed in: relationship building, negotiating, influencing, and aligning governance, strategy, policy, management

and service delivery.

6Policy and planning

Policy process and planning are messyPolicy process and planning are messy

Bottom-up participatory planning cycle

CSO

CSO

CSONGO

NGO

GHIpartners

5 year plan

Annual Review

Annual Review

Annual Review

Annual Review

Political priorities

partners

Lobbies

Elections

Programmes

Private sector 5 year plan

Government plan

Operational plan disease x

Civil service reform

Idealised planning processes

Real-life planning processes

Idealized

Real-life

7Policy and planning

Good policy and planning practice Good policy and planning practice

1. Sound processes

2. Realism

3. Comprehensive and balanced content

4. Linkage with health programs

5. Linkage with medium-term and subnational plans

Ref - A framework for national health policies, strategies and plans June 2010

8Policy and planning

1. Sound processes in all steps1. Sound processes in all steps

Situation analysis

Implementation & monitoring

Evaluation & feedback

Plan formulation

Priority setting

Costing & budgeting

9Policy and planning

2. Realism:2. Realism:

… the people who will implement the plans are involved in the planning decisions

… plans are within the sector’s resources, capacities, and constraints

… plans address the concerns of the implementing and middle management of the health sector

… plans have political commitment and buy-in of stakeholders with competing interests

Plans are more likely to be implemented if: … Plans are more likely to be implemented if: …

10Policy and planning

3. Comprehensive and balanced content3. Comprehensive and balanced content

A national health plan should address

i. Vision, values, goals, inter-sectoral approaches

ii. A robust situation analysis

iii. Possible policy directions for: improving health equity making services people-centered protecting and promoting the health of communities

iv. A comprehensive strategy, with associated costs, to respond to challenges and implement the plan

v. Financing and management arrangements, audit, procurement and monitoring arrangements

11Policy and planning

4. Linkage with programs - coherence4. Linkage with programs - coherence

Coherent health planning is more than the sum of programme plans such as MCH, TB, HIV …

Coherence requires:

Inclusive policy dialogue

each programme’s concerns are reflected in the national health plan

programme plans are based on realistic assessments of their use of shared system resources

12Policy and planning

4. Linkage with programs - coherence4. Linkage with programs - coherence

Coherence means:The relative priorities of the different programmes are set

in line with the BoD and overall sector priorities

The objectives of the different programmes are consolidated to assist implementation of service delivery

The use of shared system resources by different programmes is within the capacity of relevant levels

Programme monitoring requirements: • are included in the routine health information system,

and/or • monitoring labour & costs are feasible

13Policy and planning

How does a clinic nurse cope without coherence?

DEVELOPMENT PARTNERS

NATIONAL

AIMAG

SOUM

HEALTH CENTRECLINIC or NURSE STATION

COMMUNITY

WHO UNICEFGIZ

EPICancer

TB

ORAL HEALTH

RH

OTHERS

HAC

World Bank

DFIDADB

GFATMUNFPA

Under funded

Too much information

Too many trainings

HIV/AIDSDiabetes

Inadequate logistics

Too many requirements

Understaffed

Conflicting priorities

Too many meetings

orld Vision

14Policy and planning

5. Linkage with medium term & subnational plans 5. Linkage with medium term & subnational plans

Medium Term Expenditure Framework consists of:– top-down multi-year projection of resource envelope

(funds available)– bottom-up multi-year cost estimates for programmes

(funds needed)– Trade-offs: the political / administrative process to

reconcile the two

Linkage with operational plans depends on the level of detail in the national strategic plan, and autonomy or decentralization at different operational levels.

15Policy and planning

More than the sum of programme plans such as MCH, TB, NCDs …

Blueprints won't work

It is not only the "plan”. The process is as important!

… but the process is usually messy…

This is why inclusive policy dialogue is key

Idealized

Bottom-up participatory planning cycle

CSO

CSO

CSONGO

NGO

GHIpartners

5 year plan

Annual Review

Annual Review

Annual Review

Annual Review

Political priorities

partners

Lobbies

Elections

Programmes

Private sector 5 year plan

Government plan

Operational plan disease x

Civil service reform

Idealised planning processes

Real-life planning processesReal-life

Planning is messyPlanning is messy

16Policy and planning

1.Sound processes

2.Realism

3.Comprehensive and balanced content

4.Linkage with health programs

5.Linkage with medium-term and sub-national plans

Good policy and planning practice Good policy and planning practice

Thank youThank you