|Guide to Strategic Planning Process for a National Response to HIV/AIDS: Introduction (UNAIDS, 1998, 12 p.)|
When one puts aside any pre-formulated ideas of things-to-do, strategic planning deals with real situations uncovered through objectively assessing a given country or region, considering the socio-cultural, economic, religious, and other specificities of the concerned populations.
Getting to the root of the problem
More than any other disease, AIDS has to do with complex behavioural and other determinants. A strategic approach to planning analyses the main personal, societal, and environmental factors that underlie behaviours that eventually expose people to HIV infection. By identifying these factors, planners will be able to focus on those strategies that have the potential to alter the situation.
Anticipating the impact of the epidemic
Young adults are the population category most affected by the HIV/AIDS epidemic. Because HIV/AIDS has much-delayed effects, the current situations impact will not be visible until several years hence. On the other hand, given the high morbidity and mortality rate among the most active portion of the population, the impact on families and societies will be profound in most countries, and severely affect their overall development. Strategic planners do not ignore these long-term effects, and try to design measures to mitigate them.
Dealing with obstacles
Interventions have often failed, not because they were ill designed or lacked resources, but because some obstacles, ignored or neglected by planners, prevented the action from achieving its objectives or even from starting at all. Identifying obstacles is an integral part of any situation analysis, and is the basis of planning for effective strategies and interventions.
Effective and sustainable action depends heavily on the quality, motivation, and commitment of human resources, and situations that provide a positive environment for its implementation. The strategic approach to planning identifies people and opportunities to form the backbone of a future response, and uses their catalytic effect to influence other interventions.
The complexities of HIV sometimes have led governments to attempt planning for all eventualities. Moreover, donors and other external agencies have frequently added their own agendas to already unwieldy plans that cover many areas, resulting in generally low implementation rates, poor performance, and overburdening of scarce national staff. A more strategic approach concentrates on planning in priority areas, through identifying the epidemics most important determinants.
Governments taking the lead
However expert they are, persons from outside the country should not impose priorities upon national planners. Effective prioritization implies the concerned communities active participation and good coordination among the key stakeholders. It also means that governments, responsible for establishing the agenda for social and economic development, must take the lead in the entire process. Moreover, only governments can integrate the response to HIV into the framework of their own development plan.
Learning from experience
For over a decade, the world tried to respond to the HIV/AIDS epidemic. Since everything was new in this difficult period, as much was learned from failures as from successes. Strategic planners want to draw from the vast pool of experience that was built up during this time, so as not to reinvent the wheel at every turn. Taking examples from neighbouring countries experiences or from a comprehensive set of best known practices and adapting them to the countrys particular situation will save time and increase the chances of achieving success.
An elaborate plan that cannot be put into action is useless. To implement strategies planned in priority areas requires will, people, skills, materials, and money. Strategists look for realistic and viable initiatives that exploit the inherent resources of communities affected by the epidemic and that receive the support of important political, religious, and community leaders. Many communities, institutions, organizations, and individuals can make valuable contributions to the response to HIV. If the most critical of these sectors are involved in the planning process, their needs can be considered, and their capacity for action harnessed.
Even though national communities, institutions, organizations, and individuals are effectively mobilized, local resources may not be available for all priority actions planned. Planning would not be strategic without appropriate measures, including advocacy to secure resources - human as well as financial and material - to implement all essential actions.
Foreseeing practical management structures
Effectively implementing the actions planned and achieving priority objectives are the primary goals of the planning activity. Strategic planners will therefore pay particular attention to designing practical management structures, indicating responsibilities to guarantee that activities materialize, and establishing partnerships to monitor them.
HIV/AIDS evolves in an environment that can change dramatically over a very short period of time: a drastic change in legislation or a shift in affected population groups can make entire sections of plans obsolete. The ability to adapt quickly to changing situations and to re-plan and support newly emerging successful initiatives is a pre-condition for effectiveness. Building flexibility into a plan and subsequently monitoring situations and responses are essential aspects of strategic planning.
Getting started on strategic planning for HIV
Much thinking, discussion, past experience with HIV planning, and expertise gathered from strategic planning in other areas have gone into developing draft guidelines on strategic planning for HIV. Currently, the best means for further learning is implementing the process in the field. However, since strategic planning reflects a change in habit and attitude for many people and institutions that have been used to the more normative approach of traditional health planning, an important question is how to initiate the process.
Initiation of the process
There are essentially two main entry points for a strategic approach to a planning cycle:
® The government may wish to make an overall assessment of the countrys HIV/AIDS situation to deal with it more effectively. This is a timely opportunity for implementing the strategic planning process in all its dimensions - from a thorough situation analysis, to analysing the response, to formulating a strategic plan.
® The country may be in the middle of an ongoing planning cycle. In that case, the government should be advised to take advantage of the steps already taken and to use a more strategic approach to complete the process.
As a first step, the National AIDS Programme Manager will review the countrys situation to determine where they are with their response to the HIV/AIDS epidemic:
® In which planning or implementation stages are they?
® What has been evaluated and when?
® What are the important upcoming HIV/AIDS-related events?
A well-documented request should then be put forward to the government through the National AIDS Commission or equivalent policy-making body, to plan for an adapted strategic planning process. This should include timing (when this process or the next step of the process should be initiated) and the adaptation to the specific country situation (which dimensions of the process will be needed). Adopting strategic planning does not mean that ongoing activities should be disrupted, or that everything has to begin from scratch. On the contrary, a strategic approach to planning implies taking advantage of ongoing action and building on it to adjust, re-orient or expand the response.
The United Nations agencies gathered in the Joint United Nations Programme on HIV/AIDS are keen to contribute to meeting the needs of countries wishing to adopt a more strategic approach to planning for HIV through a coherent set of means, which include the following:
Guidelines for the strategic planning process
UNAIDS has drafted a four-module guide that can be used by countries that want to get started. The first rule of a successful strategy is that it must be relevant to the particular situation. The same is true of the strategic planning process itself. Therefore, it is not possible to write guidelines that can be followed step by step in every situation or in every country. The UNAIDS draft guidelines aim to introduce the main concepts of strategic planning, remaining flexible enough so that they can be adaptable for planning at a national level in the different regions and can serve as a practical assistant for planners at a district or community level.
To this end, the guidelines contain the following parts:
® the core Strategic Planning Guide consisting of four modules, each handling one dimension of the strategic planning process, i.e. the situation analysis, the response analysis, the strategic plan formulation, and the resource mobilization, and including a detailed bibliography and a glossary;
® a set of background documents including real-life examples, adapted regionally, and developed by regional networks; and
® a comprehensive set of technical tools and Best Practices documents providing more detailed information on technical issues and on successful responses in a wide range of areas.