PLANNING THEORIES IN PRIMARY HEALTH CARE PLANNING

Abstract

ABSTRACT

Background:  Primary care planning is part of national health plan. Literatures indicate that rationalism, incrementalism and mixed scanning planning theories were widely used in health planning. This paper aims to compare the three type of planning theories and its’ applications in Primary Health Care planning. 

Materials and Method: A scoping review was used in this study. Articles were identified using four databases namely Scopus, Google Scholar, PubMed and Science Direct. Three commonly used planning theories which include rational planning theory, incrementalism planning theory and mixed scanning theory and relevant countries Primary Health Care planning with the application of the theories were selected. Five countries from five articles were reviewed that were relevant and related to the above theories and its application in primary care. Only articles written in English within the last 15 years were included.

Results: Rational planning is the most commonly practiced and the basis of all public planning. It enables list of alternatives or options and the best option is chosen based on the options that maximizes the optimum output. The example of rational planning can be seen in budgeting process. However, the challenges in rational planning are time consuming, only suitable in small organizations, and often it is difficult to evaluate all the alternatives or options. Incrementalism refers to a theory which improvise (based on past policies or programmes) in which, changes are applied over time to create a better programme or policy implementation. It is an alternative theory that accepts and improves the shortcomings of rational approach. The number of options are usually less than the other theories and it works best with limited resources and time thus sometimes is chosen in a crisis where rapid decision are needed. Mixed scanning is a hierarchical mode of decision making which combines higher order fundamental decision making with lower order incremental decisions; in which it aims to achieve for the higher order ones. The term scanning is used to refer to search, collection, processing and evaluation of information as well as the drawing of conclusions which are the elements in decisions making. This approach is described as the most effective decision-making tool with optimal financial involvement, moderate time consumption and large amount of flexibility allowing various levels of scanning which permits it to adapt to specific situation.

Conclusions: Different planning theories might suit Primary Health Care planning in different settings, based on the resources availability, social acceptance and political influence.

Keywords: Planning theories, Primary health care planning.