Planning and Implementation of District Health …

1 world Health OrganizationRegional Office for AfricaBrazzavilleDistrict Health Management TeamTraining ModulesMODULE 4 Planning and Implementation of District Health ServicesAFR/ Chatora, Prosper TumusiimeWorld Health OrganizationRegional Office for AfricaBrazzaville 2004 District Health Management Team Training ModulesMODULE 4 Rufaro Chatora, Prosper TumusiimePlanning and Implementation of District Health ServicesAFR/ WHO regional Office for Africa(2004)Publications of the world Health organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention.

2 All rights designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the world Health organization concerning the legal status of any country, territory, city or area or of its authorities or concerning the delimitation of its frontiers or mention of specific companies or of certain manufacturers products does not imply that they are endorsed or recommended by the world Health organization in preference to others of a similar nature that are not mentioned.

3 Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. MODULE 4 world Health organization regional Office for AfricaiiiContentsFOREWORD ..viiACKNOWLEDGEMENTS ..ixLIST OF ABBREVIATIONS ..xiOVERALL INTRODUCTION TO THE MODULES ..xiiiINTRODUCTION TO MODULE 4 ..xvUNIT 1: BASIC CONCEPTS OF District Health Planning ..1 Introduction .. Health Planning .. Reasons to Embark on District Health Planning .. The Planning Cycle .. Important Issues to Keep in Mind During the Planning Process.

4 5 UNIT 2: PREPARATION FOR Planning ..7 Introduction .. Preparatory Activities .. District Health Profile ..7 UNIT 3: Health SYSTEMS RESEARCH ..9 Introduction .. Why did HSR Develop? .. Examples of Possible Research Questions by Different Decision-makers .. Who Should be Involved in HSR? .. Guidelines for HSR .. Health Systems Research Process: Designing and Conducting HSR Projects .. Use of Research Findings for Decision-making .. HSR Training: HSR Proposal Development and Data Analysis Course.

5 18 UNIT 4: STEPS IN THE Planning PROCESS ..21 Introduction .. Situation Analysis and Problem Identification .. Problem Analysis and Prioritization .. Setting Objectives and Targets .. Formulating (developing) Interventions .. Determining Resource Requirements ..30 District Health MANAGEMENT TEAM TRAINING Preparing the Plan of Action .. Preparing the Budget .. Implementation .. Monitoring and Evaluation .. District Health Plan Write-up ..44 UNIT 5: ESSENTIAL Health PACKAGE ..45 Introduction.

6 Definition .. What Should be Included in the Package .. Determining the Content of the Package .. Steps to Follow in Selecting Cost-effective Interventions .. Determining Cost-effective Interventions ..51 UNIT 6: DISASTER PREPAREDNESS ..53 Introduction .. Some Facts about Disasters .. National and International Preparedness for Disasters .. What Should be Done at District and Health Facility in Case of Disasters .. Principles of Epidemic Control ..55 SUGGESTIONS FOR FURTHER READING ..57 ANNEX: DETERMINING THE ESSENTIAL PACKAGE USING DALYs.

7 61 LIST OF BOXES1. Possible research questions ..102. Main components of HSR proposal and HSR report ..133. Example of Kabwe District research team ..174. Example of use of research results ..185. HSR training series ..19 LIST OF FIGURES1. Three main determinants of District Health status ..12. The Planning cycle ..43. Steps in the development of a Health systems research proposal ..144. Steps in data analysis and report writing ..155. The Planning steps ..216. Example of a problem tree ..257. Example of an objectives tree.

8 27 MODULE 4ivPLANNING AND Implementation OF District Health SERVICES MODULE 4 world Health organization regional Office for AfricavLIST OF of an intervention matrix with objectives and targets .. of resource requirements for a programme for immunization of womenagainst neonatal tetanus .. of a plan of action matrix .. of a cost analysis table .. Example of a line budget ..35 Example of a programme budget for maternal and child Health (MCH) by line itemand programme component (recurrent costs).

9 Example of a programme budget for maternal and child Health (MCH) by line item and programme component (capital costs) .. of a performance budget .. of classification of costs by inputs .. of cost by input category .. shared costs ..4810. Example of determination of cost-effective intervention ..5211. Standard life expectancy and DALYs lost due to premature death at each age .. the severity of disability classes and weights set by GBD protocol for 22indicator conditions ..63 MODULE 4 world Health organization regional Office for AfricaviiviiForewordHealth systems in Africa are undergoing considerable change, often in a context of ongoing Health sec-tor reforms.

10 In most countries, decentralization of Health services is very central to these changes, andconsequently there is a need to prepare and empower those working at the District level for their newresponsibilities and tasks. Many countries have requested WHO/AFRO to support them in the imple-mentation of the change processes at the District level, and the regional Office is giving special attentionto these requests. Apart from the technical support that WHO can provide to the countries concerned,several support tools, modules and frameworks have been and are being developed to support thestrengthening of District Health systems.