Situation analysis
Dr Mai Abdulrahman.
MBBS, MPH , MD , MSc in HEs
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By the end of this session the candidate
should identify:
• What is a situation analysis of the health
• sector?
• Why should a situation analysis be done?
• When should a situation analysis take place?
• Who should be involved in a health sector
• situation analysis?
• How should it be conducted?
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What is a situation analysis of the health
sector?
A health sector situation analysis should aim:
(a) to realistically assess the current health
sector situation, with all its strengths,
weaknesses opportunities and threats,
including their root causes and effects;
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(b) to provide an evidence-informed basis for
responding to health sector needs and
expectations of the population;
(c) to provide an evidence-informed basis for
formulating future strategic directions for the
health sector.
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Several characteristics of a sound health sector
situation analysis.
These are:
Participatory and
inclusive—include all relevant stakeholders in
the health sector, including the population.
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• Several characteristics are recommended to
ensure a sound health sector situation
analysis:
1-Participatory and inclusive—include all
relevant stakeholders in the health sector,
including the population
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2-Analytical:
base it on a causal framework of how inputs,
processes, and outputs interact with each
other and with other important environmental
factors i.e. attempting to understand the
current situation based on past decisions,
choices, and plans, as well as underlying
causal factors.
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3-Relevant
focus on issues that ultimately affect the health
status of the population, and consider
solutions to ongoing challenges.
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4-Comprehensive
cover all aspects related to the health sector,
including health systems, programmes, the full
range of (personal and non-personal) health
services, intersectoral action for health, etc.
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5-Evidence-based
utilize a wide range of information and data,
both quantitative and qualitative, as well as,
where relevant, other countries’ experiences.
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The spectrum of a situation analysis
A situation analysis can happen:
(a) at any stage of the national planning process, from
priority-setting to monitoring and evaluation;
(b) at any level of the state (national, province/ region,
district);
(c) on varying themes and scopes (i.e. for the health
sector in general or for health financing in particular,
for example);
(d) with the lead taken by ministry of health (MoH).
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Why should a situation analysis be done?
A whole-of-sector situation analysis is important
because:
• it is a crucial step in the planning cycle;
• it gives a voice and a platform to all health
• sector stakeholders, including the population;
• it increases accountability and transparency;
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• it supports and strengthens monitoring and
evaluation;
• it contributes to concretizing roles and
responsibilities; and
• it helps to establish consensus on the status
of health in the country.
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When should a situation analysis take place?
• It should be done as a key initial step in the
development of a NHPSP.
• Ideally, it should be undertaken at least once
during the health policy and planning cycle,
and updated every few years.
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• because an updated, in-depth technical
analysis that includes stakeholder viewpoints
is an invaluable resource for the whole health
sector.
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Who should be involved in a health sector situation analysis?
A health sector situation analysis typically brings
together some or all of the following
stakeholders
Population/beneficiaries
• population and community representatives;
• civil society, including nongovernmental and
faith-based organizations;
• special interest groups.
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Government and government-affiliated entities
• various central-level MoH departments;
• other ministries whose work is pertinent to
health;
• regional MoH departments;
• other institutions and agencies linked to the
MoH (e.g. parastatals);
• development partners.
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Health providers
• public services providers and in particular local
health systems authorities;
• professional associations;
• private for- and not-for-profit health services
providers.
Other
• research institutions;
• think tanks.
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How should it be conducted?
• It is recommended to go for an approach
which is as participatory and inclusive as
possible, with a core team coordinating
working groups.
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• The working groups should be comprised of
relevant experts and health stakeholders who
are given adequate space and time for
dialogue.
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Methodology: how should a situation analysis
be organized and conducted?
A situation analysis can be conducted in different ways
but there are key elements which must be in place to
ensure that all the chief characteristics are fulfilled:
• participatory and inclusive;
• analytical;
• relevant;
• comprehensive;
• evidence-based.
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1 -Organization of the situation analysis:
Establishment of a “steering committee”
Nomination of a “core team”
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The core team’s tasks include (but are not
limited to):
• preparing the situation analysis, including
obtaining official approvals and a budget;
• constituting working groups;
• making available relevant documentation;
• informing and sensitizing relevant
stakeholders;
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• organizing workshops and meetings between
relevant actors and/or working groups on
cross-cutting topics;
• technically supporting working groups;
• ensuring that the three streams of work as
described below are done well and accurately,
and that they are adequately linked.
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2-Establishment of “working groups”
• Meetings, workshops and communication
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Working groups: proposed sequencing of work
• Review the taxonomy: subheadings and possible key words.
([Link] products , Clinical biology , Blood , Vaccines,
Priorities and ways forward ,Others )
• Identify main issues and aspects for the working group
report.
• Formulate the identified issues in strength-weakness-
opportunity-threat (SWOT; see Box 3.11) bullet points and
discuss root causes and effects.
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• Identify key sources of information and assure their availability.
• Verify if each of the identified aspects is evidence-based, and can be
referenced.
• Identify information and analysis gaps and search for complementary
documentation.
• Based on feedback, especially from other working groups and the
Streams 1 and 2 focal points, revise the first SWOT version.
• Start writing a concise working group report, with quotes and
references
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Three streams of analysis
To ensure solid results, three distinct streams should be
examined by the situation analysis working groups :
• analysis of health data and measuring the
performance of the health sector as per its indicators;
• analysis of the implementation of health sector
activities, budgets and finances;
• analysis of the effectiveness of NHPSP activity areas:
policy dialogue with a wider stakeholder group on the
strengths and
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What can a good data analysis report include?
It includes:
• assessment of progress against targets for key
indicators (core NHPSP indicators, as well as
additional programme specific indicators);
• equity analysis by key stratifiers;
• comparative analyses with peer countries;
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• customer satisfaction surveys/health facility
exit surveys;
• performance and efficiency analysis
comparing inputs and outputs at the sub-
national level;
• computation of lives saved through
interventions;
• data quality assessment
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• Often, due to time and resource constraints,
health sector situation analyses draw heavily
from internal, or government, documentation.
• These are usually data sets and documents
which the MoH is familiar with and can easily
access
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• It takes a concerted extra effort to go and find
out about the existence of, and obtain, other
non-sectoral, non-government material.
• A solid situation analysis, however, depends
on this, since changes in health status are
sometimes better explained by other
“external” health determinants and activities
in which the government may not be directly
involved.
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• A SWOT analysis can provide a strong and
broad base for NHPSP situation analysis and
sets the stage for strategic planning, especially
because of its unique ability to illuminate new
strategic options via evaluating the balance
between internal and external factors.
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• A truly participatory and inclusive situation
analysis will take at least 3-5 months, ensuring
adequate time for real policy dialogue.
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• Priority-setting processes the
recommendations and insights coming from
the situation analysis and accords them a
specific priority level
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References
• Schmets ... [et al],Strategizing national health
in the 21st century: a handbook /
Gerard,WHO, 2016, Geneva.
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Thanks
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