Module 1: Setting the scene for planning the health sector ... · Results based planning •Results...
Transcript of Module 1: Setting the scene for planning the health sector ... · Results based planning •Results...
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Module 1: Setting the scene for planning the healthsector response to HIV/AIDS
Unit 4: Planning for results
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Planning for results
• Why focus on results?
• What are results?
• What is results based planning?
• Methods and approaches
• The planning matrix
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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.
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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
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A result is a measurable ordescribable change resulting from
a cause and effect relationship.
What is a result?
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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.
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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.
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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
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Interventions must not only be necessary, but alsosufficient to achieve the expected result
If a problem is caused
by conditionsthree
‘necessary and sufficient’
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All three conditions
must addressedbe
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‘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
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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
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• 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
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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
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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)
!"#$"%&'()*+$,,',&
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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Methods and approaches
• ‘Change language’ – describes the change expected,NOT the things to be done
• Make results SMART
• Every results needs and indicator
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‘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
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‘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
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S SpecificM
AR
T
Measurable
Achievable
Relevant
Timebound
Results targets must be SMART
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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
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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
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Objec&ve
OutputOutput
OutputOutputOutput
Ac&vi&es Ac&vi&es Ac&vi&es Ac&vi&es
Theresultschainbecomestheplanningmatrix
Goal
Intervention Intervention
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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
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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….