ALKAN Health Science , Business & Technology
College
Health Education
Credit Hrs-3
By: Desta Debalkie (MPH)
destad2a@[Link]/destad@[Link]
7. Planning, implementation, monitoring and
evaluation of health education programs
Dec, 2018
Learning objectives
At the end of this session, students will be able to:-
• Define what planning is.
• Explain the purposes of planning.
• List the principles of planning.
• Explain the steps of planning.
• Identify the models used in health education planning.
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What is planning…?
• Is deciding in advance what to do, how to do,
when to do, where and who will do activities.
• It is charting a course of action for the future.
• It bridges the gap b/n where we are now and
where we want to go/be
• Is deciding about what should be done in the
future
Is an anticipatory decision making about
what needs to be done, how it has to be done,
and with what resources.
Why we plan interventions…?
Purposes of planning:-
– Reduces uncertainty.
– It improves efficiency or Minimizes wastage.
– Sets the standards for controlling.
– Decision coordination (consider tomorrow).
– Emphasis on organizational objective.
– It gives direction to the organization.
– It eliminates duplication of efforts.
– It concentrates resources on important services.
– It reduces guess work.
– It improves communication and coordination of activities.
Principles of planning.
1. Based on the existing conditions
2. Based on careful analysis of the situations
3. Based on the needs and interests of the people
[Link] with the people who are involved in its
implementation
5. Should be a continuous process- new problems may
arise as old problems are solved
6. Flexible enough to meet long time situation.
[Link] be achievable considering such factors as
finance, personnel, time etc.
[Link] personnel should be utilized for preparing a
plan.
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Steps in planning HE intervention
nsi d er ation
Reco
Evaluation Situational
(VI)• . Analysis (I)
Identifying
Problems &
Implementations
Prioritize(II)
(V)
Setting
Develop plan
Objectives(III)
of work (IV)
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steps of planning health education intervention.
Planning process/ Steps….
[Link] ANALYSIS:- Env’tal scanning
• Gives improved understanding of the current
situation from various perspectives.
• Answers the question “where are we now…?”
• The current situation is described with
identification of health and health related needs
and available resources:-
– Population characteristics
– Area characteristics and infrastructures
– Policy and political environment
– Health need analysis
Community need assessment
• Assessment:- is the process of identifying and
understanding a problem or set of problems and later
planning a series of actions to deal with the problems.
• Need:- is a variety of felt urgencies related to the
existence, continuation, and maintenance of life and
the enhancement of living.
• Therefore, community need assessment is necessary to
determine:-
– The issues that are priority to the community,
– Determine the purpose of the intervention,
– It is a baseline for monitoring and evaluation.
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Sources of information for needs assessment .
• Primary data:- can be collected through direct
observation, semi-structured interview, focus group
discussion, key informant interview etc.
• Secondary data:- can be collected through a literature
review of the health services at the national and district
level.
• Secondary data should be collected first since it is
useful for the formulation of :-
– questions,
– identification of issues which require further investigation.
– For example, records, prior research studies, reports.
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Planning process/ Steps …
Step [Link] Problems & proritize:
• Is identifying priority health problems
• Setting priorities for health services organization in the
light of competing needs and limited resources
• A problem is a difficulty or an obstacle seen to exist
between the present situation and a desired future
situation.
• Grouping of problems:
– Environmental problems
– Diseases/health problems
– Socio-economic problems
– Health services problems
Criteria for problem Prioritization
1. Immediate necessity
2. Number of people benefiting
3. Magnitude of the problem
4. Severity of the problem
[Link]’s capacity for self help and interest/
community concern
6. Equity
7. Sustainability
8. Cost
9. Resource available
10. Local leadership available for the task
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E.g. Prioritization of health problems for FH
Hospital, Nov, 2018 Ran
N Problems Magnitu Severit Feasibili Communit Governme Sustainability Total
k
O de y ty y concern nt concern
2
1 EPI 4 3 5 5 4 4 55
50%
1
2 Deliver 5 5 5 5 5 4 59
y
3.4%
4
3 Latrine 2 2 3 4 4 4 49
84%
3
4 FP 3 3 5 5 4 4 54
76%
4
5 HCT 2 3 4 3 4 3 49
Planning process/ Steps …
Step 3: Setting Objectives and Targets
• Describing the desired direction of a service definition in
terms of measurable parameters.
• Answers the question “where do we want to go…?”
• Importance: Clear statement of objectives enables:
– to decide how to achieve them.
– to evaluate how effective one is in achieving and
reaching objectives.
• Objective should be measurable and attainable
state that can be achieved within a foreseeable
period with the resources available.
Steps…
A program objective is a series of statement that must
answer:-
• What do we want to achieve?
• Where?
• Who is the target group?
• When do we want to achieve?
• Extent of achievement?
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Steps.
For example:-
To increase immunization coverage from 60% to 90%
among under 5 children in “ 16” village within the
project period or by 2007.
• What:- Increase immunization coverage
• Where:- In village “16”
• Who:- Among under 5 year children
• When:- Within the project period/by 2007
• Extent:- From 60% to 90%
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Planning process/ Steps …
Objectives of a program must be ‘SMART’:-
• S-Specific: What needs to be achieved is
unambiguous. helps to solve the cause of the problem.
• M-Measurable: Is it possible to determine if the
desired conditions has been achieved. For M& E
e.g. Say “Reduce delays by 20% by the end of 2007”.
• A-Agreed: There is a consensus and commitment to the
objectives among the major stakeholders. Appropriate
to the problems, goals & strategies
• R-Realistic/Relevant: Objectives need to be achievable.
Is it feasible; meaningful
• T-Time bound: A clear understanding of the time scales
associated with each objectives is defined. Remember
there is no commitment without time frame.
e.g. “Reduce delays by 10% per year over the next 5
years”.
Step 4. Develop plan of work
A plan of work is a detailed schedule of activities to
be done in a given period of time.
It should specify the role of different persons involved,
the time in which the particular activities have to be
carried out, and the different methods to be used.
Principles of a good work plan:-
• Clear objectives
• List of activities
• Specific priority tasks
• Time frame
• Clear indicators
• Specific resources to be utilized
• Responsible body
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Work plan…
In short, an action plan should answer the following
questions:-
When should it start and when should it be completed?
Who does it?
Who is responsible for seeing it is actually carried out?
What materials and resources are needed?
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Implementation of HE programs
• Implementation:- is carrying out the plan or
putting the plan/ program into action.
• It is translating the goals, objectives and methods
into a community based health education programs.
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Implementations….
• Monitoring:- is the process of assessing the progress
of the activities (health education activities) in order
to track that the activities are being performed
according to the plan.
• It is a very helpful tool which enables the planners to
detect any kind of problems related to the performance
of the activities as early as possible and to give relevant
solutions to the problems detected.
• Evaluation:- is the process of assessing whether the
health education interventions are attaining their
goals and objectives which are predetermined while
planning the interventions.
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Planning Model
• There are many planning model in health education and
promotion.
• Among these models, the Precede-Proceed model is the
well known and most frequently used model to plan,
implement and evaluate health education and
promotion programs.
• PRECEDE-PROCEED:-model provides a
comprehensive structure for assessing health and
quality-of-life needs and for designing, implementing,
and evaluating health promotion and other public health
programs to meet those needs.
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PRECEDE-PROCEED….
PRECEDE:- is an acronym standing for: Predisposing,
Regulatory & Enabling Constructs in Educational
Diagnosis & Evaluation.
• Outlines a diagnostic planning process to assist in the
development of targeted and focused public health
programs.
PROCEED:- stands for: Policy, Regulatory &
Organizational Constructs in Educational &
Environmental Development.
Guides the implementation and evaluation of the programs
designed using PRECEDE.
PRECEDE-PROCEED model is a combination of all other models.
• It is a frequently utilized model in health promotion programs.
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The 9 phases within the PRECEDE-
PROCEED model
D E
• PHASE 1 SOCIAL DIAGNOSIS
E
EC
• PHASE 2 EPIDEMIOLOGICAL DIAGNOSIS
5 )
(1-
PR
• PHASE 3 BEHAVIORAL & ENV’TAL Dx
• PHASE 4 EDUCATIONAL & ORGANIZATIONAL Dx
• PHASE 5 ADMINISTRATIVE & POLICY DIAGNOSIS
• PHASE 6 IMPLEMENTATION
ED
• PHASE 7 EVALUATION (PROCESS)
E
OC
• PHASE 8 EVALUATION (IMPACT)
-9 )
(6
• PHASE 9 EVALUATION( OUTCOME)
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PR
Phase 1:- Social diagnosis:-
Involves determining the quality-of-life or social
problems and needs of a given population.
Involves assessment of people perception about of
their own quality-of-life.
Phase 2:- Epidemiological diagnosis:-
Identifying the health determinants of these problems
and needs.
Epidemiological diagnosis data may be needed to
identify the major causes of morbidity and mortality in
the population.
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.
Phase 3: Behavioral and Environmental diagnosis;
Involves analyzing the behavioral and environmental
determinants of the health problems.
The behavioral and environmental factors that are related
to the identified health problems should identified in this
phase.
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Phase 4. Educational & Organizational
assessment
• This phase assesses the causes of health
behaviors which were identified in Phase 3 such
as:-
Predisposing factors (intrapersonal)
Enabling factors (community)
Reinforcing factors (interpersonal)
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Phase 5: Administrative & Policy Assessment
• This includes the assessment of:-
– Resources,
– Budget development and allocation,
– Development of an implementation timetable,
– Organization or personnel within programs, and
– Coordination of the program with all other departments, and
institutional organizations and the community.
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.
Administrative Diagnosis:-
- The analysis of policies, resources and circumstances
prevailing organizational situations that could hinder or
facilitate the development of the health program.
Policy Diagnosis:-
– To assess the compatibility of your program goals
and objectives with those of the organization and its
administration;
– Does it fit into the mission statements, rules and
regulations…?
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.
PROCEED is composed of four additional phases.
Phase 6: Implementation:-
The interventions identified in phase five are
implemented.
Phase 7: Process evaluation:-
Entails evaluation of the program activities.
Whether or not the services are delivered as planned.
It can undertake through monitoring and supervision
while the program is on implementation.
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.
Phase 8: Impact evaluation:-
Involves evaluating the impact (short term
changes) of the interventions on the factors
supporting behavior, and on behavior itself.
For example, person coming for treatment:-
changes in community knowledge,
changes in practice,
use of oral rehydration,
latrine construction, and
contraceptive use etc.
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Phase 9: Outcome evaluation:-
The ninth and last phase comprises outcome evaluation
(long term changes)—that is,
Determining the ultimate effects of the interventions on the
health and quality of life of the population.
For example:- gains in health, reduction in mortality,
morbidity, disability, quality of life etc
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.
In actual practice, PRECEDE and PROCEED function
in a continuous cycle:-
Information gathered in PRECEDE guides the development
of program goals and objectives in the implementation phase
of PROCEED.
This same information also provides the criteria against
which the success of the program is measured in the
evaluation phase of PROCEED. In turn,
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The data gathered in the implementation and evaluation
phases of PROCEED clarify the relationships examined
in PRECEDE between the health or quality-of-life
outcomes, the behaviors and environments that influence
them, and the factors that lead to the desired behavioral
and environmental changes.
These data also suggest how programs may be modified
to more closely reach their goals and targets.
This model is based on the principle of community
participation.
It begins by engaging the population of interest
themselves in a process of identifying their most
important health or quality-of-life issue.
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Thank You!!!
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