DIP Preparation Implementation

Question 1

Name the components of the DIP cycle?

Answer 1

1. planning
2. implementation
3. monitoring and evaluation

Question 2

What are the components under planning?

Answer 2

1. Stakeholder Analysis
2. Situation Analysis
3. Priority & Objective Setting

Question 3

What are the components under implementation?

Answer 3

Work Breakdowns
Scheduling
Task Allocations
Budget and Accounts
Management
Procurement
Supervision
Co-ordination
Monitor Progress and Review Plans

Question 4

What are the components of monitoring and evaluation?

Answer 4

1. monitor progress
2. evaluate outcomes

Question 5

What are the steps in DIP?

Answer 5

1. stakeholder analysis
2. invite stakeholders to activities and meetings
3. conduct a situational analysis
4. create district specific objectives
5. analyze and prioritize strategies to achieve objectives
6. build concensus with stakeholders around objectives and prioritized strategies
7. develop implementation plan
8. develop budget for implementation plan
9. reprogram the implementation plan according to ministry of finance ceilings
10. conduct peer review of draft DIP within zone
11. review draft DIP with stakeholders
12. present final DIP to zonal health support office
13. obtain official approval from zonal health support office for DIP
14. submit approved DIP to district assembly
15. distribute copies of the draft DIP to stakeholders
16. revise DIP based on approved budget from parliament
17. distribute copies of final
18. quarterly reviews of the implementation of DIP

Question 6

What is the importance of stakeholder analysis?

Answer 6

1. Reminds the DHMT of significant players in health delivery
2. Promotes coordination to efficiently use resources (financial and other)

Question 7

How to conduct situational analysis?
What questions to ask?

Answer 7

1. Which stakeholders were involved last year?
2. How were they involved? How could they be involved?
3. Are there any new groups working in the District?
4. At what level/stage should they be involved?

Question 8

How do districts invite stakeholders?

Answer 8

1. Set up work plan for DIP development
2. Create a stakeholder contact database – phone numbers, emails, etc.
   - Identify key person (s) to involve
3. Let stakeholders know about important dates within work plan in advance.
4. Share information even if they can’t attend

Question 9

What is situational analysis?

Answer 9

The goal is to identify priority health problems for the district.

Question 10

How to conduct situational analysis?
What questions do you ask?

Answer 10

1. who gets sick
   – extent or magnitude
2. what conditions or diseases are prevalent in the area
3. when do people get sick
   – patterns and trends of diseases/conditions
4. Where do the clients/patients come from
   – location of where the various conditions
5. Why do they get sick
   – underlying social or economic factors that we can directly or indirectly influence to improve the situation such as water, sanitation, diet etc.
6. How do we overcome the problems – coming up with solutions to address priority problems

Question 11

What is SWOT analysis?

Answer 11

1. strengths
2. weaknesses
   - internal origin
3. opportunities
4. threats
   - external origin
   > for companies, organizations etc.

Question 12

What are the factors under PESTEL analysis?

Answer 12

Political
Economic
Social
Technological
Environmental
Legislative

Question 13

What is PEARL analysis?

Answer 13

PEARL is a tool which will help us to assess whether the problems that have been selected are feasible to address.

Question 14

What does PEARL stand for?

Answer 14

P – Propriety: Is it your responsibility?
E – Economics: Does it make economic sense?
A – Acceptability: Will the community accept it?
R – Resources: Is funding available?
L – Legality: Is the program legal?

Question 15

How do you come up with good district specific objectives?

Answer 15

objectives must be SMART
Specific
Measurable
Achievable
Realistic
Time bound

Question 16

Describe what SMART objectives are?

Answer 16

1. SPECIFIC - An objective describes the details of the tasks.
2. MEASURABLE - provides a baseline or standard for before-and-after comparison e.g. use numbers to specify the amount of change
3. ACHIEVABLE - describes the tasks to be accomplished with considerations of resource constrains (human resources, money and time).
4. REALISTIC - objectives make sense and are practical.
5. TIME BOUND - An objective with a deadline helps organize what should happen, when it should happen, and who is responsible for the task

Question 17

What is the essential health package?

Answer 17

A set of interventions that targets the leading causes of morbidity and mortality that mainly affect the poor and vulnerable sections of the society

Question 18

How are the interventions of the EHP selected on the basis of?

Answer 18

1. Country’s epidemiological and disease profile
2. Cost-effectiveness of the interventions

Question 19

What is decentralization?

Question 20

What is community participation?

Answer 20

Encourages communities to be active participants in their health and well-being

Question 21

What are the existing structures that are utilized under community participation?

Answer 21

1. Village Health Committees (VHCs)
2. Village Development Committees (VDC)
3. HSAs
4. Health Centres
5. Area Executive Committee

Question 22

What are examples of national policies?

Answer 22

1. Malawi Growth and Development Strategy (MGDS)
2. National Health Policy (NHP)
3. Malawi Vision 2020
4. Health Sector Strategic Plan (HSSP)
   - Outlines the Essential Health Package (EHP)
5. Decentralization of the Public Health Sector

Question 23

What is prioritization?

Answer 23

is key to dealing strategically with resource constraints such as:
1. Time
2. People
3. Money

Question 24

Prioritization ensures that the DIP facilitates what?

Answer 24

1. Quality - appropriate care at the right time and place
2. Equity - access for all, equal care for equal need
3. Efficiency - maximizing care for given funds

Question 25

Describe the process of prioritization?

Answer 25

1. Identify issues (or health problems) 2. Identify possible interventions to address the issues 3. Discuss criteria with which to evaluate the possible interventions 4. Discuss and determine weightings for each intervention

Question 26

How do you build a consensus with stakeholders?

Answer 26

- DHMT needs to call for a meeting with major stakeholders to discuss objectives, strategies and activities - Such a meeting will help ensure that stakeholder activities are aligned with district priorities

Question 27

How do you develop the implementation plan?

Answer 27

The Objectives and Activities developed in the previous stages of the planning process now need to be entered into the DIP Implementation Plan Work

Question 28

What is the DIP costing workbook?

Answer 28

The costing sheet provide a methodical way to cost aspects of the DIP budget. - The costing workbook should be filled out once the prioritized objectives and activities have been set e.g. Equipment Maintenance (CS3) easier to use. Training Needs Sheet (CS5 a) more detailed

Question 29

Describe the peer review of the DIP?

Answer 29

From last year, Districts are being asked to peer review each others’ DIP within the Zone: Zones will review all DIP. - This provides and learning opportunity for all Districts. - It is hoped that this step will improve the overall quality of the DIP.

Question 30

How do you review draft DIP with stakeholders?

Answer 30

Involving the Stakeholders, who were identified in the original Stakeholder Identification Matrix, is critical to ensuring the DIP reflects the needs and priorities of the District.

Question 31

What do you include in the final DIP submission?

Answer 31

Introduction · Table of Contents · Executive Summary · Mission, vision, values · Overview of District Services, Demographic, socio-economic situation · Summary of Annual Report of District (previous year review) Description of the DIP development process followed and sources of data · Summary of District Health Profile/Situation Analysis · Key Objectives, Strategies to address them and prioritized activities. · Highlights of Implementation Plan and Budget · DIP Submission Forms – Central Equipment Purchases, Training Plan, and Procurement Plan.

Question 32

What are the goals of the review process?

Answer 32

1. To have a thorough review of the DIP – assess activity implementation, its impact and its limitations 2. To link this review to evidence based decision-making 3. To ensure participation of NGO’s and other Development Partners 4. To adjust the DIP where appropriate

Question 33

What is the purpose of monitoring and evaluation?

Answer 33

Creating the DIP is only the START of the process. Implementation of the DIP is the most important step. To measure the progress of implementation, the DHMT must actively MONITOR & EVALUATE activities against the DIP. Joint quarterly HMIS and DIP review meetings are key!

Question 34

For Quarterly Reviews, the DHMT can facilitate by?

Answer 34

Ensuring that preparatory meetings take place i.e. that Health Programme level DIP review occurs; Ensuring that appropriate and responsible persons participate in meeting CHAM, NGO’s and others; and, Ensuring that funding is set aside in the DIP for the quarterly review meetings.

Question 35

Important EHP indicators for review

Answer 35

EHP Coverage OPD Service Utilization % fully immunized under one children TB cure rate % of pregnant women starting antenatal care during the first trimester Family Planning coverage Proportion of births attended by skilled health personnel; # of people ever started on HAART # of ITNs sold/distributed % Surveyed population satisfied with services % health centres with minimum staff norms % of functional utilities (water, electricity, and communication)

Question 36

At Quarterly Reviews, DHMT should

Answer 36

Review of HMIS indicators relevant to DIP as well as key coverage data. Review HMIS data on programme Review of DIP activities to monitor progress (each programme area) Financial review – to provide financial report on ORT for last quarter Feedback from supervisory activities at HC level and hospital level – in order to inform future DIP activity implementation