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Sound policy and plan formulation. Key messages. Policy process is messy, but there are elements of good practice you can use. Sound processes Realism Comprehensive and balanced content Linkage with health programs Linkage with medium-term and subnational plans
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Key messages Policy process is messy, but there are elements of good practice you can use. • Sound processes • Realism • Comprehensive and balanced content • Linkage with health programs • Linkage with medium-term and subnational plans Policy dialogue needs a range of skills
Policy dialogue Policy dialogue includes analysis and advice that is: • accurate, timely and well informed • politically astute, and • based on broad consultation
Good 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
Policy 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.
Policy process and planning are messy Idealized Real-life
Good policy and planning practice • Sound processes • Realism • Comprehensive and balanced content • Linkage with health programs • Linkage with medium-term and subnational plans Ref - A framework for national health policies, strategies and plans June 2010
1. Sound processes in all steps Situation analysis Evaluation & feedback Priority setting Plan formulation Implementation & monitoring Costing & budgeting
2. Realism: Plans are more likely to be implemented if: … • … 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 politicalcommitment and buy-in of stakeholders with competing interests
3. Comprehensive and balanced content A national health plan should address • Vision, values, goals, inter-sectoral approaches • A robust situation analysis • Possible policy directions for: • improving health equity • making services people-centered • protecting and promoting the health of communities • A comprehensive strategy,with associated costs, to respond to challenges and implement the plan • Financing and management arrangements, audit, procurement and monitoring arrangements
4. Linkage with programs - coherence • Coherenthealth planning is more than the sum of programme plans such as MCH, TB, HIV … • Coherencerequires: • 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
4. Linkage with programs - coherence Coherencemeans: • 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
How does a clinic nurse cope without coherence? GFATM ADB DFID World Bank DEVELOPMENT PARTNERS UNFPA UNICEF WHO GIZ orld Vision NATIONAL TB OTHERS ORAL HEALTH EPI HAC AIMAG Cancer RH HIV/AIDS Diabetes Conflicting priorities SOUM Under funded Understaffed Inadequate logistics Too much information HEALTH CENTRE CLINIC or NURSE STATION Too many requirements Too many trainings Too many meetings COMMUNITY
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.
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 inclusivepolicy dialogue is key Planning is messy Idealized Real-life
Good policy and planning practice Sound processes Realism Comprehensive and balanced content Linkage with health programs Linkage with medium-term and sub-national plans