Downloaded 162 times
More Related Content
Similar to Situation analysis
Situation analysis
- 1.
- 2. Functions of Management 2 PlanningImplementatio n Evaluation
- 3. PLANNING A systematicmethod of trying to attain explicit objectives for the future through the efficient and appropriate use of resources, available now and in the future. (Green, 2007) 3
- 4. Planning Cycle /Spiral 4 Situation Analysis Implementation and Monitoring Evaluation Option appraisal Priority, goal, and objective setting Programming
- 5. SITUATION ANALYSIS Firststage – to improve the understanding of the current situation Purpose provide a common reference point for rest of planning process provide the background for the selection of priority areas of concern for planning 5
- 6.
- 7. SITUATION ANALYSIS isconducted to Describe the current status (What is?) Describe trends (past, present, future) Project (base future) Identify problem and reasons for their existence Prioritize problems 7
- 8.
- 9.
- 10. Key content ofa situation analysis Population characteristics Area characteristics & Infrastructure Policy and political environment Health needs Health services Services provided by non-health sector Resources Efficiency, Effectiveness, Equity and Quality of current services 10
- 11. Population characteristics Demographic information Size & distribution of population age & sex structure vital rates - birth, death and fertility rates immigration & emigration rates over all population rates ethnicity, class & geographical distribution 11
- 12. Current situationon baseline information morbidity, mortality, service utilization for service provision for young or elderly health 12
- 13. Population characteristics (cont.) Religious, educationaland cultural characteristics Important impact on health Education level and literacy rate eg. High literacy rate vs Low IMR Cultural or religious characteristics 13
- 14. Area characteristics and infrastructure Geographical situation Infrastructure Transport modes & routes Communications Water supply & sanitation facilities Utilities - distribution of main electricity 14
- 15. Area characteristics and infrastructure(cont.) Socio-economic situation Linkage between economy & other sectors pattern of economy & activities Public and private sector structure Information & relationship 15
- 16. Policy and politicalenvironment Overall national policies Existing health policies National Health Policy Political environment In order to recognize potential opponents or supporters 16
- 17. Health needs Medicallyperceived health needs Come from community health survey Records of health services Morbidity rates - Incidence and Prevalence Mortality rates - IMR, MMR, CFR Disability rates 17
- 18. Health needs (cont.) Non-illnessrelated needs Antenatal care & Family Planning Burden of disease – DALY Community perceived health needs express in terms of service deficiencies from community surveys of attitudes & views existing community structure 18
- 19. Health services Servicefacilities Type & number of services, facility capacity, location, ownership of facilities Service utilization Hospital occupancy rate, attendance rates, immunization, family planning, DOTS, water supply, Latrine Service gap Health service organizational arrangement degree of centralization of decision making community participation on decision making Linkage between sectors 19
- 20. Services provided byand plans of non-health sector health services Brief description of the main services and future plan of sectors related to health Education Water & sanitation Agriculture & forestry Community development Public works Industrial and mining sectors 20
- 21. Resources Financial resources capital& recurrent budget, constraints, source, projected inflation rate Personnel staff employed, training, losses Buildings, land, equipment and vehicles Times Information 21
- 22. Efficiency, Effectiveness, Equity, Qualityof current services Evaluate the current services as situation analysis look closely to option appraisal & economic techniques Planning future allocation Assess effectiveness and quality of service Compare among different facilities/ services Examine distribution of resources between different population groups in compare with their needs (Equity) 22
- 23. Techniques Participatory RapidAppraisal (PRA) to obtain information from community Health needs assessment to collect information about health needs using a variety of epidemiological methods SWOT analysis to get common understanding of issues facing a particular organization Stakeholder analysis to assess attitudes of particular issues 23
- 24. SWOT Analysis InternalAnalysis Strengths Weaknesses External Analysis Opportunities Threats 24
- 25.
- 26. Example of SWOTanalysis of NGO hospital Strengths (Internal) Weakness (Internal) Committed staff Access to external donations Poor management Lack of lab. Staff Old building Opportunities (External) Threats (External) Decentralization Contracting of services by government Rise of private sector likely to poach “private bed” patients essential for funding 26
- 27. Typical issues inSituation Analysis High population growth rates High infant and child mortality Changing burden of disease Poor prospects for future growth in resources for the health sector Inappropriate organizational structures 27
- 28. Lack of coordinationbetween Public sector and other health services Inefficient allocation of resources between levels of facilities Shortage of health professionals and low morale among health workers Inequitable distribution of resources 28
- 29. Who should carriedout? Health professionals & service manager Representatives of other sectors related to health sector Community representatives 29
- 30.
- 31. Setting Priorities Fundamentalrationale for planning - inevitable between available resources and competing uses Limited resources best allocation approach Demand based market mechanism Need based planning approach Priorities are expressed in a hierarchy of objectives – goals, aims, objective, targets 31
- 32. Goals, aims, objective,targets Goal - broad statement, one goal for service eg. Health for All, MDG Aim - a number of aims relating to the goal - specific to particular health problem eg.To raise the nutritional status of women and children Objective - a number of objectives relating to the aim - specified in measurable terms eg.To ensure that 95% of children under 5 are adequately nourished by the year 2010. Target - a number of targets which specify various points on the way to the attainment of the objective eg.To ensure that 75% of children under five are adequately nourish as pre-defined by the year 2008.32
- 33. Health needs Generallack of something, relate directly to the measurement of health Gradation of need - depending on observer Viewed predominantly from epidemiological perspective - emphasis on mortality and morbidity Perceived need – needs that is neither a scientific judgment nor the province of medical profession alone 33
- 34. Underlying perceptions ofhealth Groups in different positions within health system - different perceptions Different health problems have varying combinations of effects of ill health Injury - pain and discomfort polio - disability cholera - death alcoholism - social effects Setting priority – depend on attitudes towards the particular effects of different health problems 34
- 35. Who should setpriorities Provision of information – health & other professionals Decision on needs National level - d/p on political structure Local level - community involvement Central - to ensure equity of resource availability, maintenance of standards, provision of framework for determination of local needs Relationship between political structures at the national level and those at community level 35
- 36. Criteria for priorities maximum feasible health gain within available resources ( efficiency ) effects on equity level of public demand 36
- 37. Priority setting Determinationof ‘what it wants to achieve’ (hierarchy of objectives) To ensure feasible within the social and political climate, available resources Clear criteria for selection are needed Allow broad view of health Balance decision making at national and local Transparent process Needs to end up with objectives that are feasible 37
- 38. Prioritize the problem effect on the majority of population effect mothers and children has high mortality has a solution & can be solved with available resources the community accept as a problem the community participate in solving it 38
- 39. Priority assessment of Healthproblems and needs Prevalence / Incidence Severity of problem Effective Intervention Acceptability / Feasibility Community involvement Cost and Resources 39
- 40. Prioritization of healthproblems was based on Objective criteria : morbidity, mortality, trend Subjective criteria: Political concern, community concern, availability of preventive technology, availability of curative technology, socio economic impact 40
- 41. Prioritization technique Prioritization =MIV/C M = magnitude of the health status effected by the problem i.e., morbidity, mortality and disability I = importance/ extent of problems, area, risk group, impact of disease V = Vulnerability C = Cost 41
- 42. Techniques for prioritysetting Economic appraisal Combine consideration of health gain & resources Use cost per DALY Applicability ?? Lack appropriate data in developing countries Multivariable decision matrices Delphi technique42
- 43. Hypothetical example ofa multi-variable decision matrix Weighting of criteria Criteria Cost per DALY Public demand Mortality rates Disability rates Allocated score 4 Measles AIDS AIDS Polio 3 TB Alcoholism TB Alcoholism 2 Malaria Malaria 1 Gastro-enteritis Scoring AIDS 8 TB 6 Measles 4 Alcoholism 6 Malaria 4 43
- 44.