National health policies, strategies and plans

Bringing it all together

In many countries, more could be done to ensure comprehensive, coherent, and balanced national health policies, strategies and plans. A key concern is ensuring adequate linkages with disease-specific or programme-specific plans.

The disconnect between programme planning efforts and national planning processes leads to imbalance, lack of coherence, and subsequent problems with implementation.

The causes are complex and include:

  • programme planning conducted by different actors with different planning cycles often delinked from the national planning cycle;
  • lack of adequate and comprehensive participatory situation analysis and priority setting;
  • donor practice to earmark funds, leading to fragmentation, competition for available scarce resources, and imbalances in national priority setting.

A comprehensive national health policy, strategy and plan addresses the full range of health problems and challenges. Each programme’s concerns should be reflected in the comprehensive national health policy, strategy and plan, while programme plans are informed by realistic assessments of how they can draw on shared resources and capacities and of how they will impact on these shared resources and capacities.

Global agencies have a major responsibility to assist in aligning programme planning efforts to national health policies, strategies and plans. The work around joint assessment of national strategies (JANS), the International Health Partnership (IHP+) and the Paris Declaration agenda provides a good basis for facilitating more complementary interaction between national health policies, strategies and plans and disease-specific or programme-specific operational plans.

When talking about strengthening health systems, some people use the essential building blocks or the primary health care policy directions, others refer to the Millennium Development Goals and aid effectiveness. All are relevant and interconnected.
This diagram presents the interrelationships between these different concepts and frameworks, how they link to programmatic aspects, and the desired flow from political commitments to service delivery outcomes that benefit the entire population.