Step 2: System Diagnosis

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Step 2 System Diagnosis
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Learning Objectives

• Define system and SWOT analysis
• Participate in strategic planning teams

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Systems Components
Environment
Inputs
Process
Output
Information
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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)
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RH Sector Its Environment
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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
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Diagnosing the Current Situation
SWOT Analysis
System Diagnosis Model

• Goal
• Environment
• Input
• Information
• Process

• External Environment
• Opportunities
• Threats
• Internal Environment
• Strengths
• Weaknesses

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Environment

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

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

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Environmental Factors Country Example

• Unfavorable
• 40 of the people below poverty line
• Dependence on national health policy
• Disparity between rural and urban health and
  fertility indicators

• Favorable
• Growing interest of donors in RH
• Increasing level of literacy and awareness
• Growing share of the private sector
• Stable government

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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

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Internal Analysis Involves
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Internal Analysis

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

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Inputs/Resources

• 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

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Input Analysis Rajasthan Example
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Information System

• 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

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Information System Rajasthan Example
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Process/Management

• Defined
• Process/management involves all activities that
  are designed to convert the systems resources
  into output
• Assessment
• Quality of system process

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Process/Management

• Policymakers and managers
• Current strategy
• Organizational structure
• Planning and programming
• Implementation
• Evaluation and feedback

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Current Strategy/Strategic Approach

• 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?

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Current Strategy Rajasthan Example

• Widen the health infrastructure network to
  facilitate delivery of comprehensive health care,
  especially in rural areas

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Process Rajasthan Example
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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?

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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
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Analysis of External Environment Country Example

• 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

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Analysis of Internal System Country Example

• Weaknesses
• Lack of transparency and objective accountability
• Centralized planning
• Falsification and underutilization of information
• Irregular supply of contraceptives in rural areas

• Strengths
• Committed top leadership open to new ideas and
  experiments
• Reasonable level of health infrastructure
• High degree of public expenditure

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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