Plan2Plan: A Project to support the

Development of the District Health Plan

Name: Kobie Snyman FPD Technical Advisor M.Cur. Nursing Research Date: 28 August 2014

Contents

1. Introduction

2. Overview Nelson Mandela Bay Health District

3. Framework for District Health Planning

4. Problem

5. Planning2Plan Project

6. Conclusion

Foundation for Professional Development

Vision Mission Focus Areas

• To build a better

society through

education and

development

• To catalyse social

change through

developing people,

strengthening

systems and

providing

innovative

solutions.

1. Teaching and

Learning

2. Community

engagement

3. Research

www.foundation.co.za

a systematic, evidence-based and consultative approach to

health systems strengthening

“Getting to Zero FASTER, SMARTER, BETTER”

FPD TA geographic scope

Where TA works:

Limpopo

•Vhembe

•Capricorn

•Gr. Sekhukune*

Gauteng

•Tshwane

Eastern Cape

•Amatole*

•Buffalo City*

•Cacadu*

•NMBM*

Mpumalanga

•Nkangala

Contents

1. Introduction

2. Overview Nelson Mandela Bay Health District

3. Framework for District Health Planning

4. Problem

5. Planning2Plan Project

6. Conclusion

Overview of Nelson Mandela Bay Health District

NMBHD Health Authority Map of NMBHD Health Facilities

• Geographically smallest in EC with second highest population

• 3 sub districts (not officially demarcated)

• 1 health authority (Provincialised)

• Provincial Department of Health

– 3 Secondary/Tertiary care hospitals

– 4 Specialised hospitals

– 1 District hospital

– 9 CHCs ( 5 with 24hr maternity services; 2 with 24hr trauma services)

– 41 PHC clinics

– 3 Mobile clinics (Poor condition)

• Total health budget (120.4% spend)

• Total Conditional grant (83.9% spend)

Overview of Demographics: NMBHD

NMBHD Demographics NMBHD Population Pyramid

• Total pop: 1,174,204 (2.2% SA pop)

• 48.3 % male (48.6% SA avg )

• 36% <20 years

• 28.2% households living under poverty line (IDP); 36.6% (Census)

• 97.7% Urban and 2.3% farm

• 90.3% Access to piped water

• 89.4% Access to sanitation

• 90.5% access to electricity

• 87.7% Adult literacy rate

• 36.6% unemployed (census 2011)

• Main employment contributing industries

– 26% community service

– 21% trade

– 19% manufacturing

Contents

1. Introduction

2. Overview Nelson Mandela Bay Health District

3. Framework for District Health Planning

4. Problem

5. Planning2Plan Project

6. Conclusion

Framework for District Health Planning

National

• Constitution

• National Health Act

• Public Service Act

• PFMAct

• National

Development Plan

• Medium Term

Strategic Framework

• 5yr Strat Plan

• Nat Service Delivery

Agreement

International

• WHO:

Millennium

Development

Goals

Community •Demography

•Geography

•Social determinants

•Governance

•Integrated

Development Plan

Provincial

• 5yr Strat Plan

• Annual

Performance Plan

• Service Delivery

Improvement Plan

• Policies& special

programmes

District Health Plan

Legislative directive (National Health Act, no 61 of 2003)

National Department of Health Provincial Department of

Health

District Management

Chapt 3, Section 21 (5) of NHA

of 2003:

The DG must integrate the

health plans of the national

department and Provincial

Departments annually and

submit the integrated health

plans to the National Health

Council.

Chapt 3, Section 25 (3) (a) of

NHA of 2003:

Head of Provincial Department

must prepare strategic,

medium term health and

human resources plans

annually for the exercise of the

powers of, the performance of

the duties of and the provision

of health services in the

province by the provincial

department; and submit such

plans to the DG…

Chapt 5, Section 33 (1)

Each district and metropolitan

manager must within the

national budget cycle develop

and present to the District

Health Council and the relevant

MEC a District Health Plan

drawn up in accordance with

the national guidelines issued

by the DG with due regard to

National & Provincial Policies,

and the requirements of the IDP

in terms of the MSA (Act No. 32

of 2000)

Legislative directive of each tier of Government is compared In the table below:

NDoH: District Health Planning Guidelines

Planning guidelines

Part A: Strategic Overview

Part B: Detailed plans

Part C: Linkages with other plans

Part D: Indicator description

Part E: Quarterly targets

District Health Planning Cycle

National DoH District Health Plan Guidelines

District Health Planning Cycle Spans Fiscal Year

Implement Current year

Develop Future Year

Contents

1. Introduction

2. Overview Nelson Mandela Bay Health District

3. Framework for District Health Planning

4. Problem

5. Planning2Plan Project

6. Conclusion

Problem Description

• District planning is often a compliance process rather than a meaningful contribution to tackle the problems faced within available resources

• District planning processes are irregular with processes lagging behind the deadline dates as required by the planning cycle

• Documents submitted late: – Prevents meaningful contribution to provincial planning inputs

– Prevents meaningful motivation for budget requirements

– Hampers consultation with governance structures at district level

• No sustainability of planning process knowledge at district level

Proposed Solution: Project Plan2Plan

A project plan was developed with the following objectives:

• To develop a tool to support planning at district level

• To set out the step by step activities to formulate the DHP

• To design a web based tool to support the tracking of the planning processes

• To develop an A-Z Manual on District Health Planning

• To secure the knowledge of the planning processes to ensure sustainability

Contents

1. Introduction

2. Overview Nelson Mandela Bay Health District

3. Framework for District Health Planning

4. Problem

5. Planning2Plan Project

6. Conclusion

Planning2Plan Project

Project Development

Completion of project mapping

Develop project plan

Training

Create tools

Test concept against district planners & TA’s

Project Gantt Chart and tick sheet

Chart DHP Cycle

Web based system to track &support DHP processes

FPD 9xTA’s

District Health Planners 9x supported districts

PROJECT

DESIGN

PROJECT

DEVELOPMENT

CAPACITY

DEVELOPMENT

Manual A_Z of District Health Planning

Four documents from project

Document

1. Tick List/ Document Health

2. Gantt Chart

3. Visual poster

4. A-Z Manual of District Planning

Web-based system is completed

High Level Dashboard

Tshwane District

Nkangala District

NMMH District

Cacadu District

BCM District

Vhembe District

Capricorn District

Amatole District

DHP DHER Ops Plan A Report 5 YSP

DHP

Progress

Ops Plan A Report 5 YSP

DHP DHER Ops Plan A Report 5 YSP

DHP DHER Ops Plan A Report 5 YSP

DHP DHER Ops Plan A Report 5 YSP

DHP DHER Ops Plan A Report 5 YSP

DHP DHER Ops Plan A Report 5 YSP

DHP DHER Ops Plan A Report 5 YSP

Problem Complete

DHER

High Level Dashboard

District Level Dashboard: NMBHD

General Government Activities

District Planning Activities

Task Information

Reminder e-mail for document submissions

Collaboration Rooms

HI Everyone, I am having trouble with the new DHER template...

Calendar of activities

Contents

1. Introduction

2. Overview Nelson Mandela Bay Health District

3. Framework for District Health Planning

4. Problem

5. Planning2Plan Project

6. Conclusion

Steps to follow

Completion of project mapping

Develop project plan

Training

Create tools

Test concept against district planners & TA’s

Project Gantt Chart and tick sheet

Chart DHP Cycle

Web based system to track &support DHP processes

FPD 9xTA’s

District Health Planners 9x supported districts

PROJECT DESIGN

PROJECT

DEVELOPMENT

CAPACITY

DEVELOPMENT

Manual A_Z of District Health Planning

Effect of Web Based Tool on Health System Strengthening

District Level:

• To guide the District Health planning processes through all the detailed activities necessary in the design of the DHP

• To stipulate clear timelines required for adherence

• To improve on the adherence to the timelines (reminders)

• To enable peer discussions and support among district health planners

• To track the progress against activities/submission (District)

• To preserve knowledge of District Health Planning Processes at District management level

Effect of Web Based Tool on Health System

Strengthening

Provincial and National Level:

• To track the processes and progress of development of the district health plan across districts at a higher level

• To have updated documents immediately available at provincial and national level (stored in cloud)

• To have all DHPs conveniently available at one single site of storage

• To standardise the processes followed in the development of the DHP

• To improve the quality of the DHP and planning for imporved health outcomes