Step 3: Develop an Action Plan

The action plan consolidates decisions regarding the type and level of action into a working document. With increasing frequency, an action plan, or at least a “blueprint” for action, is initiated at the in-country dissemination workshop, where the findings and recommendations of the assessment report are presented to local stakeholders for feedback and validation. This serves as a solid foundation upon which to base a plan for action, which articulates WHO will do WHAT by WHEN, with WHAT RESOURCES. In the event that a dissemination workshop was not possible, or the workshop concluded with building consensus around priority recommendations, there will be more work to do at this stage.

Putting Action Plans into Action

To be successful, action plans must lead to action! Activities following an assessment are often concentrated in the policy, service delivery, and health financing domains, as described below. However, interventions following an assessment have ranged considerably, and have included mhealth, NGO sustainability, behavior-change communication, pharmaceutical partnerships, and social marketing activities, as well as improving provider business practices and access to credit.

Policy

  • This includes facilitating public-private dialogue to serve as a foundation for policy reforms and partnerships going forward.
  • Establishing a public-private partnership unit—At the request of the Ministry of Health (MOH), the assessment team may be asked to help establish a PPP unit or office within a government entity to provide ongoing leadership and oversight of public-private health partnerships.

In Antigua and Barbuda, the MOH asked SHOPS to develop a forum to support multi-sectoral communication and cooperation, in response to a recommendation from a 2011 assessment. Since 2012, SHOPS has facilitated the design and roll-out of the Private and Public Health Sector Task Force, convening representatives from the public, private for-profit, and private not-for-profit sectors to develop health-related policies and implement initiatives to improve coordination across the sectors. Two technical working groups have been created, and the task force is seeking approval from the Cabinet of Ministers to formalize the group with a dedicated budget. View the agenda for the May 2013 meeting.

The public-private dialogue process in Ivory Coast began with a private health sector assessment in 2012, which identified the establishment of a public-private dialogue platform as a  key element in improving and sustaining public-private collaboration in health. In 2013, SHOPS convened over 50 public and private health stakeholders, who agreed to re-activate a nonfunctional Commission Paritaire (public-private commission) to serve this function. With SHOPS support, the commission is currently establishing committees to address problematic issues, such as dual practice. Both public and private stakeholders view SHOPS’s role as a neutral broker as crucial to advancing public-private collaboration.

Service Delivery

  • Develop or adapt training curriculum for private health providers.
  • Disseminate national protocols or standards for service delivery to private health providers (often specific to family planning or HIV and AIDS).

Service delivery interventions may also include establishing or improving provider networks, and activities to improve quality among private-sector providers.

Based on recommendations from a private sector assessment conducted in Bangladesh, SHOPS launched an initiative to increase private sector provision of family planning methods, with a focus on long-acting and permanent methods of contraception (LA/PMs), key to meeting national health and population goals. A joint venture—led by SHOPS, in partnership with USAID/Bangladesh, the government, and other implementers—has trained doctors and nurses at 27 private health care facilities in LA/PM skills, counseling, and infection prevention; developed materials for private health facilities to promote and market LA/PMs; and established a commercially available supply of IUDs and implants accessible to private providers.

Health Financing

  • Explore private sector role in a proposed National Health Insurance scheme.
  • Expand coverage of targeted health interventions or procedures in private health insurance plans.

To address an expected slowdown in mining revenues and reductions in donor funding, the government of Botswana is pursuing increased public-private cooperation to sustain the country’s HIV response. Based on a recommendation from the 2013 Private Health Sector Assessment, SHOPS is supporting the Ministry of Health as it seeks to expand enrollment of government employees in private Medical Aid Schemes.

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