Towards problem solution : options analysis and implementation

To assist developing country health managers in this regard, this report, one of the Association of University Programs in Health Administration"s problem-solving (MAPS) modules, traces in workbook fashion the processes of problem analysis, development and selection of solutions, and solution implementation. After identifying health problems, various options for resolving the most important ones must be developed. This process involves reviewing the program"s inputs (i.e., personnel, facilities, drugs, materials, and information flows) and weighing each input"s quantitative and qualitative deficiencies (e.g., whether acquiring additional doctors is better than simply implementing new training courses for the present staff). The health manager must then choose which solution would best solve the identified problem and arrange hierarchically all the activities necessary to reach that solution. To select the most appropriate of available solutions, each solution should be assessed in terms of how well it resolves the particular problem and its perceived costs in time, personnel, and money. Among the tools used for such an assessment are contingency analysis, scenarios, the delphi technique, benefit cost ratios, internal rate of return, and cost benefit analysis. Successful implementation of the chosen solution depends on how much control the manager and the manager"s organization have over the process and the resources necessary to implement the solution. For actual implementation, the health manager must identify and overcome implementation constraints and be willing to take personal and organizational risks. To determine the appropriate implementation strategy, the manager must assess the extent to which participants agree on the proposed change, select the proper method for creating consensus, and determine what is necessary to overcome the constraints. Included is a method for collecting and analyzing the information needed to manage the implementation of a decision. Appended is a 9-item (1974-81) list of references.