1. REQUIREMENTS TO START DISTRICT ACTION PLANNING
(AUGUST SEPTEMBER)
  1. DHO should identify and notify members of the DHPC to work on DAP (August 1st week)
  2. DHPC to establish a time frame for the DAP, and assign roles and responsibilities for each DHPC member (August 2nd week)
  3. Conduct DHPC pre-planning consultation on policy and strategic requirements (SHSS, EPHS, and Provincial Operational Plan) (August 3rd week)
  4. Ensure availability of relevant materials including Annual DHIS data, data from MIS reports, and manual on DAP planning, implementation and reporting (September 2nd week)
  5. Update District Analytical Profile data, related to resources (profile updating after every 3 years is mandatory as part of 3 year rolling plan) (September 3rd week)
2. SITUATION AND GAP ANALYSIS
(AUGUST SEPTEMBER)
  1. DHPC to analyze management, budget and service utilization data, using updated District Profile Information (August 3rd week)
  2. Review available resources both at district and facilities level: equipment, medicines, HR, infrastructure and finance (September 2nd week)
  3. Update HFA information (service availability and inventory)through HF in-charges for addressing EPHS standards (September 2nd week)
  4. Review Stakeholder Mapping and available resources from development partners (September 4th week)
3. PRIORITIZATION OF HEALTH AND MANAGEMENT ISSUES
(SEPTEMBER OCTOBER)
  1. List and categorize health conditions/diseases based on district DHIS and other MIS reports (September 4th week)
  2. List and categorize health management issues through consultation with DHPC (September 4th week)
  3. Prioritize identified issues based on scoring according to magnitude, severity, vulnerability to intervention, cost effectiveness and political expediency (October 1st week)
4. IDENTIFY KEY INPUT REQUIREMENTS
(OCTOBER)
  1. Cost centers in-charges to support DHPCs for identifying key input requirements for HR, capacity building, equipment, medicines, logistics, monitoring and supervision, infrastructure, costing and budget demand (October 4th week)
  2. DHPCs to identify support from development partners (October 4th week)
5. ROOT CAUSE ANALYSIS
(NOVEMBER)
  1. Identify causes of all prioritized health and systems issues for designing interventions and activities through consultative meetings (November 1st week)
  2. DHPC to categorize causes of prioritized issues and propose interventions for each category (November 2nd week)
6. INTERVENTIONS AND ACTIVITIES
(NOVEMBERDECEMBER)
  1. List activities to implement the proposed interventions.(November 3rd week)
  2. Develop Activity Plan Matrix: Medium term matrix for three year rolling plan, with yearly targets (November 4th week)
  3. Develop Activity Plan Matrix: Annual Operational Plan, with quarterly targets (November 4th week)
  4. Indicate potential stakeholders for support against planned activities (December 1st week)
7. COSTING OF ACTIVITIES
(NOVEMBERDECEMBER)
  1. Unit cost: Use government approved rates, last year expenditures and comparative lowest current market rates (November 4th week)
  2. Total cost: Use unit cost, activity components and physicaltargets (November 4th week)
  3. Segregate cost of activities among cost centers, where necessary (December 1st week)
8. KPI TARGET SETTING
(NOVEMBER)
  1. DGHSS to provide KPIs list by type of HF (November 1st week)
  2. Set KPI targets at the level of HF (November 2nd week)
  3. Aggregate KPI targets at cost center level, where multiple facilities are attached to one cost center (November 3rd week)
  4. Use current year’s data as baseline and set targets for subsequent years
9. DAP SUBMISSION AND APPROVAL
(DECEMBER -JANUARY)
  1. DHO to submit finalized DAP to DGHSS for review (December 1st week)
  2. DGHSS to submit DAPs to DOH for approval and onward submission (December 2nd week)
  3. DOH to submit approved DAPs to Finance Department for allocation of funds (January 1st week)
10. DAP IMPLEMENTATION & REPORTING
(JULY - JUNE)
  1. DHO to prepare implementation details of planned activities (July 1st week)
  2. DHO to ensure timely implementation of planned activities
  3. DHPC to facilitate DHO/cost centers in implementation of activities and preparation of progress reports
  4. Periodic progress review in DHPMT, and submission of progress to DGHSS and DOH (within two weeks of DHPMT meeting)
  5. DGHSS to review quarterly utilization of funds compared to KPI targets achieved (Within two weeks of the above step)
ACRONYMS
AOP
ANNUAL OPERATIONAL PLAN
DAP
DISTRICT ACTION PLAN
DHIS
DISTRICT HEALTH& INFORMATION SYSTEM
DHO
DISTRICT HEALTH OFFICER
DHPC
DISTRICT HEALTH PLANNING COMMITTEE
EPHS
ESSENTIAL PACKAGE OF HEALTH SERVICES
DGHSS
DIRECTORATE GENERAL OF HEALTH SERVICES SINDH
BCC
BUDGET CALL CIRCULAR
DHPMT
DISTRICT HEALTH AND POPULATION MANAGEMENT TEAM
FD
FINANCE DEPARTMENT
HF
HEALTH FACILITY
HFA
HEALTH FACILITY ASSESSMENT
HR
HUMAN RESOURCE
KPI
KEY PERFORMANCE INDICATOR
MIS
MANAGEMENT INFORMATION SYSTEM
PDHS
PAKISTAN DEMOGRAPHIC AND HEALTH SURVEY
PSLM
PAKISTAN SOCIAL AND LIVING STANDARDS MEASUREMENT SURVEY
CONTENTS: • Demographic information• Socio-economic indicators• Service provision data• Available resources• List of HFs• HR status• Financial utilization• Stakeholder mapping DATA SOURCES: • DHO office record• DHIS data• HFA• PSLM• PDHS KEY CONSIDERATIONSFOR TARGET SETTING: • Historical trend• Current and expected availability of resources• Natural increase in population• Improved staff performance and client satisfaction SITUATION ANALYSIS • HR• Equipment• Furniture• Vehicles KEY INPUTREQUIREMENTS RESOURCE GAPANALYSIS PROBLEMIDENTIFICATION SNE (BCC-IV) PROBLEMPRIORITIZATION INTERVENTIONSANDACTIVITIES HEALTHPROBLEMS MANAGEMENTISSUES LIST OFIDENTIFIEDPROBLEMS • Magnitude• Severity• Vulnerability to intervention• Cost effectiveness• Political LIST OFPRIORITIZEDPROBLEMS ROOT CAUSE ANALYSIS ACTIVITYMATRIX ACTIVITYCOSTS ACTIVITYTARGETS COSTINGOF PLANNEDACTIVITIES TOTAL COST UNIT COST ACTIVITY TARGETS LOWESTCURRENTMARKETRATES GOVTAPPROVEDRATES KEY PERFORMANCEINDICATORS FACILITYLEVELTARGETS SUBMITTODGHSS COSTCENTERLEVELTARGETS SUBMITTODOH BCC-IX SUBMITTO FD DAP/AOP