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NAPT – Needs Assessment and Planning Tools: Disease Control at District Level

Programme Introduction

With the decentralization of health services in most developing countries at the end of the last and beginning of this century, district health teams have become the cornerstone of analysing local health conditions and population health and developing annual plans for improving the situation. This course on Needs Assessment and Planning Tools (NAPT) helps to understand the tools used for the situational analysis of health and health conditions in tropical districts and how to prepare a consistent and meaningful local health plan which can be implemented in resource poor settings.  Real life examples and information will illustrate the challenges faced by public health physicians and their teams and possible solutions will be discussed.

The course is part of the 3 month course for the Diploma in Tropical Medicine & Hygiene so the orientation is towards practice in developing countries.

Who Should Attend

This course is particularly suitable for health professionals and associated disciplines who are working or will work in health projects, research or development programmes in tropical countries or those who are interested in understanding the mechanisms of implementing macro-or micro plans in the reality of a resource poor district.

Learning Outcomes

Upon successful completion of the course, you will be able to:

• Explain the main elements of district health management in a tropical district
• Use a simple framework for analysing health and health services in a district
• Identify control measures which are feasible at district and community level
• Understand the main elements of health planning

Teaching & Learning Strategy

This is taught through highly interactive sessions to bring the public health concepts alive.

Student Feedback:

“Dr Kroeger was excellent and such a nice man. He conducted the NAPT sessions is such an enjoyable and interactive way! He has definitely kindled an interest in public health for me” (DTMH Student 2011)

“Enjoyed NAPT, was good to go through the activities as it makes the concepts easier to understand” (DTMH Student 2011)

“I found the NAPT sessions very useful for grasping the principles of public health medicine” (DTMH Student 2011)

“Really enjoyed NAPT - thought that Dr Kroeger turned a dry subject area (for me!) into an interesting and enjoyable 1.5 days” (DTMH Student 2011)

“The NAPT sessions were excellent. The teaching style was great, very refreshing not to have a powerpoint presentation. Also by actually making us use statistical equations, working in groups ensured we actually understood what he was talking about” (DTMH Student 2011)

“NAPT was really well run and enjoyable, thanks” (DTMH Student 2011)

Pre-requisites – include:

Open to all health related disciplines, including medicine.

Non-graduates who are suitably qualified by experience.

Proof of English to IELTS 6.5 or TOEFL iBT 88 / paper based 570

Conceptual framework

• District Health Management and Disease Control  - history
• From Primary health care to global health
• Increased importance of district health management
• The essential tasks of a District Health Officer (DHO) or District Medical Office (DMO)
• Diagnostic tools for the District Health Team:  The planning, implementation and monitoring of health programmes.
• The Planning Cycle
• The nine epidemiological questions

What are the main health problems and health services problems in my district?

• How many of these problems exist?
  • Quantifying health problems by means of prevalence and incidence rates, morbidity statistics, mortality (Infant Mortality, Crude death rate, etc..)
  • Quantifying health services problems by means of indicators
  • When do the problems occur? (seasonal variation of diseases)
  • Where in my district do the cases occur (risk mapping)
  • Who is the most affected (identification of risk groups)
  • Why does this happen? (causal analysis using the “problem tree”)
  • Planning: What has been done? With which results? What else can be done?

Systematic presentation of health / health services problems

• Case Study - The model district
• Systematic presentation of the situational analysis
• What are the priority problems?

Descriptive Epidemiology and Health Services Analysis

• How many health services problems?
• Rates and health services analysis with indicators
• Indicators for district health systems – Input, Process and Output Indicators

Analysis of the problems, objectives, alternatives for intervention as the basis for planning

• Why does it happen? The problem tree, making the causation tree

Planning Tools

• Planning matrix for district health planning

Professor Axel Kroeger, TDR Scientist at WHO and part of the Disease Control Strategy Group at LSTM

Axel is the Middlemass Hunt Professor of International Community Health at LSTM, seconded to the Special Programme for Research and Training in Tropical Diseases (TDR) at the WHO in Geneva.  Originally trained as physician he has worked in clinical and public health programmes mainly in Latin America and Asia.  His special interest is in Implementation Research/Operational Research in the area of disease control, in recent years particularly on vector borne disease such as dengue, visceral leishmaniasis (VL), malaria and Chagas Disease. At present he is coordinating various multi-centre studies on dengue vector management, outbreak detection and response and on implementation research in the context of the VL elimination initiative in the Indian sub-continent which includes an important element of capacity building.