Guidelines for District Health Planning and Reporting

April 2003

Published by the South African Department of Health

Chief Directorate for Strategic Planning
Civitas Building
242 Struben Street
Pretoria 
0001
Tel: 012 312 0614
Fax: 012 312 0837
www.doh.gov.za

These guidelines were produced with assistance from the EQUITY Project. The EQUITY Project is a project of the Department of Health funded by the United States Agency for International Development (USAID)/South Africa through Management Sciences for Health (MSH), under contract 674-0320-C-00-7010-00. The opinions expressed herein are those of the author and do not necessarily reflect the views of USAID or MSH.

Principal Authors:

David Collins
Bupendra Makan
Yogan Pillay
Andy Burn

Acknowledgements

These guidelines were prepared by a task team appointed by the District and Development Cluster of the National Department of Health (DOH).

Members of that task team were: Bennett Asia, Yogan Pillay, David Collins, Bupendra Makan, Peter Barron and Emma Mabidilala. A separate task team including Andy Burn, Emmanuelle Daviaud and Sandy Schneider worked on the definitions of terms and indicators.

Thanks are due to Mpumalanga and North West DOH managers and staff for reviewing and testing earlier versions of the guidelines and providing feedback. Particular thanks are due to Richard Mnisi and Prudence Gwala of the Mpumalanga DOH, and Khetisa Taole of the North West DOH, who were instrumental in driving the district health planning process in those two provinces.

We would also like to thank Ukhahlamba District Municipality for sharing their Integrated Development Plan, and Pam van der Westhuizen, Information and Planning Officer for Rustenburg Sub-district, North West Province, for sharing copies of their business and operational plans.

Special thanks are due to Tim Wilson, Chief Director: National DOH District and Development Cluster, for his guidance and comments on earlier drafts.

We would like to thank the EQUITY Project partners for providing the financing and technical resources for writing and formatting these guidelines. This includes making available the time of David Collins, Bupendra Makan and Yogan Pillay, the principal authors; Carmen Urdaneta, editor; and Cathleen Fourie, who did the design and formatting. The EQUITY Project is a project of the DOH supported by the United States Agency for International Development (USAID) through Management Sciences for Health (MSH).

Any comments and questions should be sent to Yogan Pillay, Chief Director, Strategic Planning, National Department of Health (Pillay@health.gov.za).

Foreword by the Director General

Since 1994, we have developed and adopted a range of far-reaching health policies which we have implemented with provinces and municipalities. One of these key policies is the delivery of a comprehensive package of primary health care services through the District Health System.

To strengthen the delivery of services, we are also sharpening the planning processes that we have implemented since 1994. In terms of the 1999 Public Finance Management Act 29, national and provincial departments are expected to develop three year strategic plans, which will inform the medium-term expenditure framework (MTEF). In early 2003, the national and provincial departments of health tabled strategic plans for the MTEF period 2003/04 to 2005/06. These provincial plans must build on plans developed by health districts and municipalities that relate to health services, as reflected in the integrated development plans.

These Guidelines for District Health Planning and Reporting are intended for district teams to use in collaboration with provincial planning teams, ensuring synergy between district and provincial planning processes. I sincerely hope that district management teams will find these guidelines user-friendly and will use and revise them over time.

Plans are important but only if they are implemented. I am certain that if done properly and if the capacity to implement these plans is developed, we will be able to provide affordable and good quality health care to all South Africans.

Dr A Ntsaluba
Director-General: Health

Introduction

Purpose of these guidelines

These guidelines are intended to help district health managers – both from provincial and local government to prepare and implement medium-term sub-district and district health plans, and to assess and report progress in achieving the stated goals and objectives. Plans and reports prepared according to these guidelines should meet the requirements of the Public Finance Management Act (PFMA). They should also be compatible with plans required under Public Service Regulations and should serve as a basis for the health component of IDP.

The guidelines are divided into the following parts:

• Part A: Planning and Reporting Framework
• Part B: Developing Plans
• Part C: Preparing Annual Reports
• Part D: Planning Tools
• Part E: Key Ingredients for Successful Implementation
• Part F: Definitions and Norms

The guidelines should help managers to develop three-year district health plans, implement those plans, and prepare annual reports. Specifically, each part of the guidelines will help managers as follows:

Part A: Planning and Reporting Framework will help managers to understand:

• The role of planning and reporting in the district health system.
• How district health plans fit with other planning and reporting requirements.
• Treasury requirements for health plans.
• How district health plans should link with IDPs.
• How different elements of district health services (DHS) should be included in district health planning and reporting.
• The spiral relationship between plans and reports.
• How the process should be managed.

Part B: Developing Plans will help managers to:

• Prepare a three-year district service platform plan and budget based on the ten-year provincial service platform plan.
• Determine health priorities based on the challenges identified in an annual report.
• Develop a service delivery plan based on health priorities and available resources.
• Identify and describe service gaps.
• Develop an operational plan from the three-year plan.

Part C: Preparing Annual Reports will help managers to analyse and present:

• Background information, such as geographic, demographic and socio-economic information.
• The current health situation, including basic health indicators, incidence and prevalence rates, and main causes of death.
• The distribution and condition of health facilities.
• Health expenditure, by budget sub-programme and standard item.
• Service delivery performance for each budget sub-programme, including the use of resources and key performance indicators.
• Key challenges, based on the situation analysis and performance review.
• Short-term actions.

Part D: Planning Tools will help managers to:

• Understand service platform planning.
• Analyse problems.
• Set priorities.
• Choose service delivery mechanisms.
• Analyse the primary health care (PHC) package gap.
• Access other tools and documents.

Part E: Key Ingredients for Successful Implementation will help managers to:

• Understand the relationship between planning and implementation.
• Identify the key ingredients for implementation of plans.
• Know some project management tools.
• Understand how to link plans to performance management systems.
• Assess the key ingredients for successful implementation of plans.

Part F: Definitions and Norms will help managers to:

• Understand terms used in planning and reporting.
• Understand and use indicators.
• Access selected norms.

These guidelines build on and complement a series of guidelines and tools developed by, or for, the Department of Health. A list of guidelines, tools and other useful documents is shown in Part D: Planning Tools. These include the following:

• Handbook for District Managers;
• Health Planning for District Management Teams: Some Simple Frameworks and Tools; and
• District Health Expenditure Review Guidelines.

Acronyms

Relevant documents

• Community Health Workers Lekgotla