25 Find a way or make one: A project to improve the health planning process in Sri Lanka

Background National Planning Department is the central organization granting project approvals in the government sector in Sri Lanka. As a prerequisite for implement a project, an approval is mandatory. This entire process was paper-based and possessed several limitations resulting in stagnations and rejections. Four major gaps identified in the current process: insufficient knowledge and experience of the personnel in project formulation and submission, unavailability of guiding materials in native languages, absence of project appraisal mechanism and lack of feedbacks. To address these issues, a set of interventions designed and implemented. Methods Project was carried out in three phases at the decentralized health management units in Northern Province of Sri Lanka. Phase I, a preintervention arm involved evaluation of current proposal statuses. Phase II consisted design and implementation of interventions. Upon identifying gaps, an online proposal feedback portal that used colour coding and provided real-time feedbacks was developed. Health planning unit staff were trained through workshops to develop project proposals and get feedbacks via an online portal. A project appraisal committee also formed and guiding documents translated into native languages. Phase II spanned across three months. Phase III comprised of post-intervention result assessment. Findings Post-interventional analysis indicates that all major gaps are bridged. Evaluation of submitted and approved project proposals revealed a post-intervention approval rate of 60-100% as compared to pre-intervention which was 40-50%. Post-intervention mechanisms were rated more favorably than pre-intervention, including convenience to obtain feedback (mean 2.0-4.29) and were statistically significant. Impact This research project is bringing an impact on Health Care System by ensuring the timely implementation of the projects without delay. It prevents cost, quality and time overruns.