Health management planning

PES covers the period 9/76-4/79 and is based on interviews, document review, and visits to the MHSW"s Bureau of Planning, Research, and Manpower Development (BPRMD). Despite some achievements (implementation of a health system in Lofa, Cape Mount, and Bong counties; work on devising management and supervision systems and the provision of inservice training to the personnel involved; preparation of a draft National Health Plan; and completion of ad hoc studies), little progress has been made in developing the planning/analytical capacity of the BPRMD. Major problems are: (1) an unrealistic project design - which was developed without input from Liberian medical personnel - in terms of available resources (data processing, trained personnel), insufficient management capability, commitment, and back-up from MHSW; and (2) an inappropriate concept of the project by the contract team, which has focused its attention almost exclusively on establishing systems and procedures within the MHSW while failing to analyze operational problems in the health system. External factors hindering the project include four personnel changes in the MHSW. Lessons learned are that: (1) Liberians must be involved in project design from the beginning; (2) the Government of Liberia must fully understand its obligations and responsibilities; (3) TA personnel should have relevant experience in the project environment; (4) MHSW decisionmakers should assume more control over the project; (5) the BPRMD should have greater authority within MHSW; and (6) field operatives should be regularly involved in health planning. It is recommended that the MHSW clearly define the BPRMD"s role and give it the authority needed to fulfill that role, and then define what kind of health planning can feasibly be accomplished in the next 10 years and what type of TA is required to achieve it. Disbursement of USAID/L funds should be halted until these conditions are fulfilled.