Step 2: System Diagnosis

1. Step 2: System Diagnosis

2. Learning Objectives • Define “system” and SWOT analysis • Participate in strategic planning teams

3. Systems Components Environment Inputs Process Output Information

4. Public RH Sector/System Environment Political climate Private sector Epidemiological profile Inputs OB/GYN RH budget FP centers Process Director, RH/FP Current strategy Management Output CPR MMR Unmet need Information Internal (MIS) External (private sector)

5. Socioeconomic factors Political climate Public Private Culture & religion Epidemiological profile RH Sector & Its Environment

6. System Diagnosis • Assessing environmental and internal components • Identifying factors responsible for the current situation • Identifying critical factors System Diagnosis Model/SWOT Analysis Root-cause Analysis

7. Diagnosing the Current Situation System Diagnosis Model SWOT Analysis • Goal • Environment • Input • Information • Process • External Environment • Opportunities • Threats • Internal Environment • Strengths • Weaknesses

8. Environment • Defined • Not under the direct control of the system • Hostile or friendly toward the system • Example • Political climate • Economy

9. RH Sector: Environment Sociocultural Political Climate Legal & Regulatory Commercial Sector Environment Economy Technology Health Policy Epidemiological & Demographic Profile International Donors

10. Environmental Analysis • Integrates quantitative and qualitative information for decision making • Encourages participation of external and internal stakeholders • Identifies characteristics that are outside the control of the sector

11. Favorable Growing interest of donors in RH Increasing level of literacy and awareness Growing share of the private sector Stable government Unfavorable 40% of the people below poverty line Dependence on national health policy Disparity between rural and urban health and fertility indicators Environmental Factors: Country Example

12. Internal Analysis: Definition • Defined • Internal factors include resources, management, and information over which the manager has direct control • Example • Inadequate FP clinics in rural areas • Decrease in budget for RH • Information is not used in decision making

13. Internal Analysis Involves…

14. Internal Analysis • Describes the human resources, communications, facilities, and information capabilities • Identifies characteristics that the organization can control • Encourages participation of internal stakeholders

15. Defined Inputs include all those resources that are used to produce output. Assessment Adequacy and quality Examples RH budget FP clinics Ob/Gyns Drugs and contraceptives Medical supplies Equipment Ambulances Trained health manpower Inputs/Resources

16. Input Analysis: Rajasthan Example

17. Defined Consists of all those elements responsible for the production and transmission of information about the system as well as to the system. Assessment Adequacy and reliability Example Collection, analysis, and use of information Flow of information Internal and external information Information System

18. Information System: Rajasthan Example

19. Defined Process/management involves all activities that are designed to convert the system’s resources into output Assessment Quality of system process Process/Management

20. Process/Management • Policymakers and managers • Current strategy • Organizational structure • Planning and programming • Implementation • Evaluation and feedback

21. Describe What is it? When adopted? Who/how developed? What other options considered? Assessment How precise and clear? How sound for achieving the goal? How cost effective? How widely accepted? How morally correct? Current Strategy/Strategic Approach

22. Current Strategy: Rajasthan Example “Widen the health infrastructure – network to facilitate delivery of comprehensive health care, especially in rural areas”

23. Process: Rajasthan Example

24. Analysis of Process Component • What is working and needs to be continued? • What is working and can be expanded? • What is not working and needs a new, more strategic approach? • What is not relevant to current needs and should be dropped? • What has not been addressed at all?

25. SWOT Analysis • Assesses the feasibility of achieving identified goals, based on internal and financial capabilities or challenges • Helps to identify critical factors • Internal analyses: strengths & weaknesses • External analyses: opportunities & threats Challenge: To Turn Constraints into Opportunities

26. Opportunities Growing interest of donors in RH Increasing level of literacy and awareness Growing share of the private sector Stable government Threats 40% of the people below poverty line and growing inequality Dependence on national health policy Disparity between rural and urban health and fertility indicators Analysis of External Environment: Country Example

27. Strengths Committed top leadership open to new ideas and experiments Reasonable level of health infrastructure High degree of public expenditure Weaknesses Lack of transparency and objective accountability Centralized planning Falsification and underutilization of information Irregular supply of contraceptives in rural areas Analysis of Internal System – Country Example

28. Situation Analysis and Strategic Plan Formulation • Main findings of the situation analysis provide the basic building blocks for strategic plan formulation • Strategic plan formulation involves: • Synthesis of the conclusion of situation analysis • Determination of priorities • Formulation of strategy using obstacles and opportunities identified in the situation analysis