Module 1: Setting the scene for planning the healthsector response to HIV/AIDS

Unit 4: Planning for results

Planning for results

• Why focus on results?

• What are results?

• What is results based planning?

• Methods and approaches

• The planning matrix

Why focus on results?

• Accelerates progress: ensuring that progress is being made towardsrealizing intended benefits for concerned populations.

• Improves efficiency: distinguishing between inputs, processes and outputsthat contribute to achieving the intended results and those that are notessential to achieving results - ensure more rational use of resources andgeneration of implementation arrangements that are better oriented towardsproducing results.

• Improves transparency and accountability: focus on achieving resultsmore transparent and accountable - clear about what is to be achieved, soeasier to keep track of how the programme is performing and whetherresults ARE being achieved.

• Generates support: often generate more support from stakeholders andwell wishers - people often want to be associated with success and areoften motivated to supporting when intended ends of a programme are veryclear.

What are results?

• Results are changes

• Changes happen at different levels and are of differentkinds

• A hierarchy of Results

• ‘Necessary and sufficient’

• The logical chain

A result is a measurable ordescribable change resulting from

a cause and effect relationship.

What is a result?

Two major elements in ‘Results’

Change Causality

Measurabletransformation

• In an individual• In a group• In an organization• In a society• In a country

Causeandeffectrelationshipbetweenanactionandtheresultsachieved.“If-then”logic.

The likely or achieved short-term andmedium-term effects of an intervention’soutputs.

Long-term effects produced by adevelopment intervention, directly or indirectly,intended or unintended.

Impact

Outcome

Output

Changes happen at different levels and areof different kinds

The products and services which result from thecompletion of activities within a developmentintervention.

Types of Change

Impact

Outcomes

Output

Changes in the lives of people: realisation of theirrights

Institutional Change (includes environmentalchange): values, laws – associated with institutionalperformance, new institutions

Behavioural change: new attitudes, practices

Operational Change: products and services –knowledge, skills

Interventions must not only be necessary, but alsosufficient to achieve the expected result

If a problem is caused

by conditionsthree

‘necessary and sufficient’

All three conditions

must addressedbe

‘necessary & sufficient’

• Necessary: Each activity should play a critical andunique role in producing the output– no duplication– no non-essential activities

• Sufficient: The set of activities together must beadequate to produce the output– all critical elements must be present– activities should complement and reinforce one

another

Result

ResultResult

ResultResultResult

Result Result Result Result

The results chain usually takes the form of a more complexlogical chain or results framework, linking necessary and

sufficient results to produce higher level results…

The logical chain

• Critical resources needed to implement theplanned activities (staff, equipment, etc)

• High level objective to which outcomescontribute

• Long-term improvement in society thatcontributes to changes in the lives of people

Outcomes

Outputs

Activities

Inputs

Goal (Long-term Impact)

The Results ChainThe Results Chain

• Products and services - knowledge,skills, etc

• Effects or behavior changes ( new attitudes,practices, new laws, etc)

• What actually was done with the availableresources to produce the intended outputs

Results based planning

• Results based planning is an approach to planning whichensures that all the elements of the plan are orientedtowards achieving the intended results.

• It is constructed around the hierarchy of results to beachieved and demonstrates strategic coherence acrossthe components of the plan.

• It is based upon a robust logic chain linking all levels ofresults together across the full period of the strategicplan

Results based planning…….

• Based on situation analysis

• Defines clear results to be achieved

• Identifies means to measure the results

• Ensures adequate resourcing

• Defines appropriate implementation arrangements

• Describe accountability mechanisms

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Linked in strategic coherence

(implementation

plans and

budgets)

(costs,

financing,

gaps, flows,

tracking)

(indicators,

methods,

information

systems)

Strategic

Framework

(Goal,

Objectives,

targets

Interventions

Situation

Analysis

M&E

Framework

Financial

Framework

Operational

Framework

(evidence,

context,

response)

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Linked in strategic coherence

(implementation

plans and

budgets)

(costs,

financing,

gaps, flows,

tracking)

(indicators,

methods,

information

systems)

Strategic

Framework

(Goal,

Objectives,

targets

Interventions

Situation

Analysis

M&E

Framework

Financial

Framework

Operational

Framework

(evidence,

context,

response)

Methods and approaches

• ‘Change language’ – describes the change expected,NOT the things to be done

• Make results SMART

• Every results needs and indicator

‘Doing’ Language expresses results

from the provider’sperspective

can be interpreted inmany ways

focuses oncompletion ofactivities

Change Language describes changes in

the conditions of people sets precise criteria for

success focuses on results,

leaving options on howto achieve them

Results Language = Change Language

‘Doing’ Language

Increase thepercentage of sexworkers who usecondoms

Change Language

By 2015 60% of sexworkers use a condomduring their last sex act -increased from 10% in2009

S SpecificM

AR

T

Measurable

Achievable

Relevant

Timebound

Results targets must be SMART

Measuring Results: Indicators

• Indicators = tools to measure your results

• Indicators for every level of results

• Indicators should be S.M.A.R.T

• Indicators should show proportion (%) rather thannumbers

The planning matrix

• Identify the goals, objectives and interventions – basedon the priority setting

• Analyse the cause and effect chain

• Set targets – make the results SMART and identifyindicators

• Identify the ‘common identifiers’ for strategic coherence

Objec&ve

OutputOutput

OutputOutputOutput

Ac&vi&es Ac&vi&es Ac&vi&es Ac&vi&es

Theresultschainbecomestheplanningmatrix

Goal

Intervention Intervention

Outcome

Impact

Output

Activity

HIV incidencereduced

Condom useincreased

Knowledgeincreased

Condomawarenesscampaign

<1 yr

<3 yrs

5 yrs

5-10 yrs

Institutions/Behaviours

Knowledge,skills, abilities,

services

Human!

Outcome HIVpreventionscaledup

Institutions/Behaviours

5 yrsthenif

if

if

if

then

then

then

Level of Change

ResultsChain

Focus ofchange

<1 yr

<3 yrs

5 yrs

Timeframe Account-ability

more

less

Objective 2.1: To improve the capacity of the health care system tomanage HIV and related diseases

Strategies and broad action areas 2.1.1. Train, treat and retain health workers

2.1.1.1 MoH and partners to increase the number of health workersavailable

2.1.1.2 MoH and partners to undertake in- and pre-service training on HIVmanagement

2.1.1.3 MoH and partners to continue piloting and scaling up task shiftingstrategies

2.1.2 Strengthen infrastructure, systems and quality assurance2.1.2.1 MoH and partners to increase the number and capacity of sites for

pre-ART and ART services, i.e. adequate counselling space andstorage capacity

Common identifier….