by Tabian Ambang 2018 PNG Update 14 th of June 2018 Introduction National Health Plan NHP is a key policy document for the health sector in PNG NDoH 2011 NHP explains PNG governments policy directions for the health sector in PNG and priority areas for planning and servi ID: 726556
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Slide1
Implementation planning
of the National Health Plan in a decentralized health system in Madang province, PNGbyTabian Ambang2018 PNG Update 14th of June 2018Slide2
IntroductionNational Health Plan (NHP) is a key policy document for the health sector in PNG (
NDoH, 2011).NHP explains PNG government’s policy directions for the health sector in PNG and priority areas for planning and service delivery.The current publication (NHP2011) is the sixth edition – 1973 to 2011.Slide3
Background
NHP 2011 - NHP 2050Implementation of NHP1973 to 2010 (short/medium term plans – NDOH’s goals.2011 to 2050 (long term plan - PNG Vision 2050.
D
ecentralised
health system (
PNG):
- NHP planning & documentation –
NDoH
-
Implementation, Monitoring, Evaluation –
Provincial
& District Health Administrations.Slide4
PNG Development Strategic Plan (PNGDSP)
(2010 to 2030 & 2031 to 2050)PNG Vision 2050 (2010 – 2050)
Sector Plan
(Health, Education,
etc.)
NHP2011-2020
Medium Term Development Plan (MTDP)
District implementation plan
(89 districts in PNG)
P
rogram implementation plan - Facility
Provincial Dev. Plan
(e.g. Madang Prov. Health Plan)
Provincial Development
Plan (22 provinces in PNG)
District Development Plan
c
ont ….
Dept. of Planning, PNG Govt, 2011Slide5
Planning in the Health sector, PNG
Ministry of HealthHealth Vision 2050PNG Vision 20507 pillars of development1.Human Capital Development, 2.Wealth creation,
3. Institutional development and Service delivery,
4. Security & international relations, 5. Env. Sustainability 6. Spiritual, Cultural and Com. Development, 7. Strategic planning integration etc….
NHP2011
(2011
to 2020
)
NHP2021
(2021 to 2030
)
NHP2031
(2031 to 2040
)
NHP2031
(2041 to 2050
)
Provincial Administrations (Health)
District Administrations (Health
NDOH, PNG Govt, 2014
Provides direction for implementation
Implementing policies, national plans and program activities
Health facilities & Program Areas
c
ont ….Slide6
Study: Research topicThis
study investigated the implementation planning of the National Health Plan in Madang province, PNG. Aim to provide an understanding of the implementation planning of the NHP in a decentralised health system, 2011 to 2017. MethodologyResearch design: Qualitative.Data collection – in-depth interviews and written documents (operational plans & documents on NHP). Data analysis - content analysis (in each data set) to identify the codes. Thematic analysis - across data sets) to explain the relationship between the codes across the data sets and to develop themes. Slide7
Interview: Key InformantsManagers of the health facilities and health program units at the provincial health office and in the districts in
Madang provinces Health ProviderHealth ServiceNo. of ParticipantsGovernmentProvincial2
District
12
Church
Lutheran
Health Services
4
Catholic
Health Services
7
Total 25Slide8
Written documentsOperational plans – Rural hospitals & Health Centres
ProviderFacilityDocumentGovt.Health Ser.1.Provincial Health Office2.District Health Office
3.Health facility
Program operational plans X 5
District Health Plans x 6
Facility health plans x 6
Church
- Lutheran
1.Provincial Office
2.Facility
Operational plan x1
Operational plan x 2
Church
Catholic
1.Provincial Office
Operational plan x 1
Operational
plan x4
Total: 25Slide9
Findings
Limited understanding of NHP - Content & structure - District Health Program Managers & Program CoordinatorsCause factors: ineffective communication between the provincial health administration, district health administration and the health facilities particularly on planning and implementation of health policies & plans. Slide10
Cont. Findings
Implementation planning - Strategic alignment between provincial health plan, district health plan and facility health plan – Use of a standard planning template – Program Budget PlanningNo strategic alignment between district health plan and district development plans, district administration & district health service – Districts do not have strategic plan, No integrated planning template.Slide11
Continue ….
Decentralisation reform - More emphasis on structure and less effort on process and systems. Well documented plans/policies, are not implemented effectively in the districts .Management capacity issues in the province & districts– implementing the national development objectives at the local level. – Leadership, resources, good & governanceLack of continuous monitoring and evaluation -- implementation progress.Slide12
Opportunity for improvement
Establishment of PHA – to take ownership of implementation planning & implementation process of health policies/Plans.Establishment of DDA – Partnership with PHA & Provincial Administrations.Structure reforms must accompanied by process and procedural reforms to ensure NHP key results areas and their strategic goals are integrated in the district development plan.Slide13
Suggestion
The study suggested for an integrated program activity implementation planning framework at the district level.Slide14
integrated program activity implementation planning frameworkSlide15
Conclusion
The study highlighted challenges health care providers experienced on implementing the NHP in a decentralised health system. The study suggested that an integrated implementation planning framework is required at the district level to link and align health program activity plans with NHP, district and provincial development plans.Strategic alignment through the process of integrated planning will provide opportunity for improvement To review the current implementation process in the province and district to facilitate effective implementation of NHP. Slide16
References
National Health Plan 2011-2020, NDoH, Govt. of Papua New Guinea.Bolger, J; Mandie-Filer, A; & Hauck, V. (2005). Papua New Guinea’s health sector: A review of capacity, change and performance issue.
European Centre for Development Policy Management, Maastricht.
Thomason
, J; and
Kase
, P (2009). Studies from Papua New Guinea,
Studies
in
State and Society, No.5 pp. 117-130, Canberra: Australian National University Press.
World
Health Organisation, (2013) Bulletin of the World Health
OrganizationSlide17
Thank you