Differences between national and district planning
This article is adapted from: The National Eye Health Coordinator Manual. International Agency for Prevention of Blindness, 2011.
National vs district level in VISION 2020
It is important to make the distinction between a VISION 2020 national plan and a VISION 2020 district plan.
National planning has several purposes. It:
- Helps to solidify the commitment made by the Ministry of Health towards the prevention of blindness
- Provides an opportunity to gather the stakeholders and develop a consensus on the priorities for the prevention of blindness in the country
- Supports the development of collaborative relationships amongst stakeholders.
In contrast, a VISION 2020 district plan addresses the implementation of an eye care programme in an administrative area of between about 0.5 and 2 million population. Such units may have a variety of names in different countries, for example regions, provinces, subdistricts or districts.
Table 1. National plans vs district plans
| National plans include: | District plans include: |
|---|---|
| National policies | Current assessment of service delivery, staffing levels, equipment and instruments |
| National training initiatives and plans to improve capacity | Targets for service delivery (e.g., cataract surgeries, spectacles dispensed) |
| Recommended staffing at different levels of service delivery | Activities needed to achieve each of the targets |
| National reporting guidelines | Plans for improving partnership and identifying new partners |
| National advocacy | Routine monitoring & reporting |
| Desired equipment and instrument norms | Coordination at the district level |
| Disease priorities (and basic strategies) | Time frame for each activity |
| National procurement of consumables | Budget |
| National supervisory structures | |
| Overall national targets for service delivery | |
| National coordination |
National planning
National planning must be open and transparent. Excluding certain people or organisations may cause resentment and the loss of valuable input. Nonetheless, national planning is often best organised by getting a small group of very experienced people together to make the first draft which can be sent around to a wider group of people for comment.
By the time of the national planning meeting, the draft should be virtually finished and most people coming to the meeting should already have provided their input. It is very helpful to have an external facilitator at the meeting who is an expert on VISION 2020 and planning.
District planning
District planning is organised differently to national planning. Much of the writing of the district plan is done during the planning session, using information collected ahead of time. The planning session should follow these basic steps:
- Review the current situation
- Discuss practical and desirable targets that will, with time, enable the team to reach their VISION 2020 goal
- Set 3-4 targets for service delivery. For each target decide on the specific activities needed to achieve the target
- Determine who will be responsible for each activity and when it will be done.
Pre-planning activities are essential
All planning, whether at national or district level, starts by considering the current situation. It is essential to devote sufficient time to pre-planning. Meeting to plan without having baseline evidence and information to hand is a waste of everyone’s time.
Information to generate before planning session
| National planning | District planning |
|---|---|
| Current human resources policies | Current service delivery for priority conditions |
| Current training capacity | Cataract surgeries |
| Current status of procurement of medicines and consumables | Presbyopic spectacles |
| Scientific evidence that could assist with planning of services | Childhood cataracts operated |
| Current service delivery by district using key indicators | Glaucoma surgeries |
| Diabetic retinopathy patients screened | |
| Human resources | |
| Equipment (working or not) | |
| Partners e.g. NGOs, companies |
Discussion
How would you respond to the following questions?
- Why is it important to make a distinction between a VISION 2020 national plan and a VISION 2020 district plan?
- How can the relevance of a national plan be maintained when planning for change at a smaller, or district, level?
- Why is it essential to devote sufficient time to pre-planning before a planning meeting?
Global Blindness: Planning and Managing Eye Care Services
Global Blindness: Planning and Managing Eye Care Services
