Management in Health

Module 01
Part 2: Introduction and Strategic Planning
and Strategic Management

World Bank
Institute

Presentation Script

Management in Health
Module 01: Introduction and Strategic Planning and Strategic Management - Part 2

Presentation Script

SWOTAnalysis

Thereareavarietyofperspectivesandapproachesusedinstrategicplanning.
Thewaythatastrategicplanisdevelopeddependsonthespecificneeds,
natureoftheorganization'sleadership,cultureoftheorganization,
complexityoftheorganization'senvironment,sizeoftheorganizationand
expertiseofplanners.Thereareseveralanalytictechniquesortoolsthatcan
beusedinstrategicplanning;letslookattwothatyoumightfinduseful,
SWOTAnalysisandPESTAnalysis.

SWOTanalysisisastrategicplanninganalyticaltoolusedtoevaluatethe
Strengths,Weaknesses,Opportunities,andThreatsinvolvedinaprojector
businessventure.Onceyouhavespecifiedanobjective,aSWOTanalysisisa
systematicwayofidentifyingtheinternalandexternalfactorsthatare
favorableandunfavorabletoachievingtheobjective.ASWOTanalysisis
oftenthenextstepinstrategicplanning,afteranobjectivehasbeendefined.
Takealookattheresourcesonthepagetogiveyouanclearerideaofhowto
conductaSWOTanalysis.Notethatalthoughtheexamplesyouseerelateto
business,SWOThasbeenusedinthehealthsectortohelpgovernments
determinewhethertheyshouldexpandservicedeliverytoothergeographic
areas,toimprovehealthstatusofatargetpopulation,andtostrengthenthe
healthsectorasawholeinacountry.

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Management in Health
Module 01: Introduction and Strategic Planning and Strategic Management - Part 2

Presentation Script

HowtoConductaSWOTAnalysis

TherearefoursetsoffactorstoconsiderinaSWOTanalysis.Thequestions
posedineachsquareofthistwobytwomatrixprovideausefulguidefor
conductingyouranalysis;theyarebynomeansexhaustive,andthe
usefulnessoftheSWOTanalysisdependsonaskingandansweringgood
questions.Afterbrainstorming,youwillwanttofocusonthemostimportant
factorsthatyouidentify.Remember,strengthsandweaknessesusually
pertaintofactorswithinyourorganizationandopportunitiesandthreats
usuallypertaintoexternalfactors.

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Management in Health
Presentation Script

Module 01: Introduction and Strategic Planning and Strategic Management - Part 2

PESTAnalysis

PESTanalysisisasystematicwayoflookingatthebroadexternal
environmentinwhichyourorganizationexists.ItworkswithaSWOTanalysis,
remindingyoutothinkaboutthepolitical,economic,socioculturaland
technologicalfactorswhichaffectyourwork,andwhichcaneitheroffer
opportunitiesorbethreats.

Politicalfactorscanincludegovernmentregulationssuchasemployment
laws,environmentalregulations,governmentprocurementproceduresand
healthpolicies.Otherpoliticalfactorsarepoliticalstability,citizendemands
andexpectationsandaccountabilitytocitizens.Economicfactorsaffectyour
budget,abilitytoincreaseyourfunding,andwhatpatientscanaffordtopay
forhealthservices.Economicfactorsalsoincludeinterestrates,inflationand
currencyexchangerates,anddonorcountrieseconomicgrowth,whichcan
alsoaffectyourresourceavailability.Socialfactorsincludepopulationgrowth,
agedemographicsandattitudestowardshealthandhealthcare.
Technologicalfactorsmaybethreatssuchasthedifficultyofmaintaining
yourambulancesandothervehicles,oropportunitiessuchastheincreased
useandlowercostofmobilephoneswhichoffernewwaystoreachoutto
andcommunicatewithpatients,ortocollectandcompiledataveryrapidly
andcheaplyfromallhealthfacilities.

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Management in Health
Module 01: Introduction and Strategic Planning and Strategic Management - Part 2

Presentation Script

WhatMattersMost?PlantoMeasureandMonitorit

Wevemadeseveralreferencestoclearobjectives,andyouhaveprobably
heardtheadvicethatobjectivesshouldbeSMARTSforspecific,Mfor
measureable,Aforachievable,Rforrelevantmeaningimportant,andTfor
timebound.

Letsfocusonmeasuringandmonitoring.Ifprogressisnotmeasuredand
monitored,thenyoucannotknowwhethereffortsarefailingorsucceeding.
Soyouneedtochooseindicatorsthatcanbemeasuredandmonitoredand
willletyouknowquicklywhethercorrectionsandimprovementsareneeded.
Foreachindicator,baselinedataforthecurrentsituationmustbeavailableor
possibletocollectquickly,beforeimplementationstarts.Sobeclearabout
thedatathatwillbeneededforeachindicator,howoftenitwillbecollected,
howitwillbecollectedandbywhom.Datacollectioncanbeexpensiveand
timeconsuming,althoughtheinternetandmobilephonesnowenablecheap
andquickdatacollection,processinganddisplay.

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Management in Health
Presentation Script

Module 01: Introduction and Strategic Planning and Strategic Management - Part 2

Duringstrategicplanning,decidewhodatawillbereportedtoitisbestif
everyonecanaccessit,andinaclear,easytounderstandformatlikesimple
graphsshowingtrends,orcomparingactualtodesiredprogress,andsothat
facilitiescancomparetheirperformancetoothers,tolearnfromandcatchup
withthehighestperformers.Ifyouplanaheadforhowthemonitoringdata
willbeused,youarelesslikelytowasteresourcescollectingdatathatisnever
used.TheAbiyeprograminOndostate,Nigeriatracksthenumberof
registeredpregnantwomen,thepercentdeliveringinafacility(whichrosein
thepilotfrom16percenttoalmost90percent),thecostperdeliveryand
otherefficiencyindicatorssuchasthenumberofdeliveriesbyeachdoctor,
andofcourseoutcomesforthemothersandbabies.Inthefirst2000
deliveries,therewasjustonematernaldeath,causedbyotherhealthissues
andnotbysystemfailure,adramaticturnaround.Carefulmonitoringand
managementofcostshasmadeitpossibletoscaleuptheprogram
statewide,andotherstatesandcountriesaretakingnotice.

ActionPlansforImplementation

AStrategicplanshouldnotgointotoomuchdetail.Itsetsbroaddirections
andtakeskeydecisions.Butonceimplementationstarts,itmightbeusefulto
developsimpleactionplans,thatsetoutthemainactivities,definewhen
theywilltakeplace,whowillberesponsible,andifrelevant,whereand
perhapshowtheactivitieswilltakeplace.Ascautionedbefore,planningis
notanendinitself,andplansareonlyusefuliftheyguideactionandare
used.Ifyourorganizationisdoingstrategicplanningbecauseafunder
requiresit,butthennotusingtheplans,thenanopportunityisbeingmissed,
andscarceresourcesarenotbeingusedeffectively.

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Management in Health
Module 01: Introduction and Strategic Planning and Strategic Management - Part 2

Presentation Script

WhereandWhatcanwedoBetter?

Similarly,thewholepurposeofmonitoringandmeasuringprogressistobe
abletousetheinformation,tofixorstopthingsthatarenotworkingor
notprogressingwell.Youwillnoticethatinthismodelofstrategic
managementthatyousawinanearlierslide,trackingstatusisanintegral
partofimplementation,andmeasurementandevaluationisakeypartof
strategicmanagement.Communicatingprogressandresultsareimportant
mostespeciallydiscussingprogressandresultswithyourteams,and
empowering,helpingandencouragingthemtodobetter.Therearealways
differenceinperformance,thatprovideopportunitiesforhealthfacilitiesand
healthproviderstolearnfromoneanother,andshareandteacheachother.A
greatmanagerisabletocreateaworkenvironmentinwhichsuccessis
recognized,celebrated,andthenspreadbybeingshared,adaptedand
adopted,andlackofsuccessisseenasanopportunitytodobetter,rather
thanhiddenorignored

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Management in Health
Presentation Script

Module 01: Introduction and Strategic Planning and Strategic Management - Part 2

MonitoringandEvaluationDifferandareComplementary

Thetermsmonitoringandevaluationarealmostalwaysusedtogether,and
youmightbewonderingwhethertheydifferandifso,how.Monitoringisa
routinemanagementactivity,inwhichdataarecollectivecontinuouslyor
regularlytobeabletotrackprogress.Thisdatacanalertmanagersandstaff
toemergingproblems,enablingquickactiontocorrectproblemsand
improveprogress.Thedatacanalsobeusedtocompareperformanceacross
theorganization,identifyingopportunitiestolearnandimprove,andspread
goodpractice.

MonitoringandEvaluationDifferandareComplementary

Whenroutinemonitoringshowsthatthereisasharpdifferencebetween
actualperformanceandplannedperformancewhetherifactual
performanceismuchbetterormuchworsethanexpected,orlarge
differencesinperformanceacrossvariouspartsofanorganization,then
evaluationandresearchmaybeusefultounderstandwhy.

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Management in Health
Module 01: Introduction and Strategic Planning and Strategic Management - Part 2

Presentation Script

MonitoringandEvaluationDifferandareComplementary

Evaluationinvestigateswhyperformanceisbetterorworsethanexpected,
whyexpectedresultsareorarenotbeingachieved.Itisoftenaoneoffor
specialassessmentofcausesandeffectsofactions.Itcanalsolookcloselyat
processesanddiagnoseproblemsorunderstandthefactorsimportantto
success.Evaluationsanswerwhyquestions,andcanprovideusefullessons
andrecommendationsforimprovingperformance.Evaluationsalsoofferthe
opportunitytolookcarefullyatcostsandcosteffectiveness,todecide
whetherthemoneymightachievemoreifspentonotherthings,orto
identifycostsavingssothatmorecanbedonewithscarceresources.

DesigningGoodEvaluations

Agoodevaluationisonethatiscredible,usefulandactuallyusedtoinfluence
importantdecisions.Inordertodesignagoodevaluation,youhavetoaskthe
rightevaluationquestions,andthencollectcredible,reliabledatathat
providetheanswers.Mostimportantofall,istousetheevaluationresultsfor
makingdecisions.Wecandefinethiskindofresultsbasedevaluationasan
assessmentofaplanned,ongoingorcompletedprogram,todetermineits
effectiveness,efficiency,impact,relevance,costand/orsustainability.
Evaluationthatinformsbetterdecisionsandamoreeffectivepublichealth
sectorispartofstrategicmanagement.

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Management in Health
Module 01: Introduction and Strategic Planning and Strategic Management - Part 2

Presentation Script

StrategicManagementis"ManagementforResults"

Weveusedthewordresultsmanytimesinthismodule,andyoumayhave
heardthetermmanagementforresults.Strategicmanagementis
managementforresults.Itisallaboutmobilizingtheorganizationtoachieve
thestrategicgoalsthatwillimprovehealthoutcomesandpatientsatisfaction.
Asmonitoringandevaluationprovidenewinformation,andascircumstances
changeandnewopportunitiesandthreatsemerge,strategicplansmayneed
toberevisitedandrevised.Aseffectivemanagersknow,organizationsachieve
resultsbydecisionsandactions,notbyplansalone.Ifplansarenot
implementedinapurposefulandsystematicway,thenthestrategieswillnot
takehold,nomatterhowcompellingorinspiringtheplanningprocess.

RecapWhatisStrategicManagement?

Beforeweendthemodule,letsdoaquickrecaponwhatwehavelearned
aboutstrategicmanagement.Strategicmanagementaimstoalignresources,
decisions,andprocessestowardachievingdesiredoutcomes.Itstartswith
clearlydefinedgoals.Itthenbringstogethereffortsandprocessesacrossthe
organizationtofocusonachievingthosegoals.Thislinksoperational,
daytodaydecisionstolongerrunstrategicobjectives.Inastrategically
managedorganization,budgeting,performancemeasurement,human
resourcedevelopment,programmanagement,andothermanagement
processesareguidedbyastrategicagendathathasbeendevelopedwith
buyinfromkeyactors,andcommunicatedwidelywithintheorganizationand
amongexternalstakeholders.Strategicmanagementisconcernedwith
implementingthestrategy,measuringperformanceandadjustingactionsas
neededtostayontracktowardsresults.Justasadriverglancesintherear
viewmirrorfromtimetotimeandwatchestheroadaheadtoanticipatewhat
mighthappen,astrategicmanagermonitorstrends,andwatchesfor
emergingissuesthatmightrequirestrategicresponses.

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Management in Health
Module 01: Introduction and Strategic Planning and Strategic Management - Part 2

Presentation Script

PuttingitallTogetherStrategicManagement,andtheCourseModules

Strategicmanagementmakessurethatallthepiecesandprocessesofthe
organizationcometogetherinacoherentwaytoachieveresults.Theother
fivemodulesinthiscourseeachlookatoneofthefunctionsofstrategic
managementthenextmoduleonorganizationalbehaviordealswith
managingpeople,module3withmanagingmoney,module4withmanaging
information,module5oncommunicationswithmanagingmessages,andthe
finalmoduleisaboutmanagingchange.

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