Section 5

Intr oduction to
Str ategic
Management
Susan Scr ibner
Section 5
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Tabl e o f Co nte nts
Figu r e 5.1. Fa cets of Str a tegic Ma n a gem en t . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5- 2
Figu r e 5.2. Str a tegic Ma n a gem en t of On e St a ge of t h e Policy Process . . . . . . . . . . . . . . . . . 5- 4
Ta ble 5.1. Five Fa cets of Str a tegic Ma n a gem en t . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5- 3
Bibli ogr a ph y . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5- 5
An n ex 5- A. Str a tegic Pla n n in g a n d Str a tegi c Ma n a gem en t . . . . . . . . . . . . . . . . . . . . . . . . . . 5- 6
Section 5
Intro ducti o n to Strate gi c
Manage me nt
Hea lth policy r efor m s, even on es th a t h a ve been a ppr oved, decreed, or sign ed in to la w, wil l n ot
n ecessa r il y be im plem en t ed a s i n ten ded wit h ou t th e im petu s a n d gu ida n ce of policy ch a m pi-
on s. Th e policy pr ocess, a s expla in ed a n d dia gra m m ed in th e in tr odu ction to th is toolkit ( Sec-
tion 1, especia ll y Figu re 1.1) , i n clu des th e followin g st a ges: policy form u l a t ion a n d legitim a -
tion , con st itu en cy-bu ildin g, r esou r ce m obil iza tion , im plem en ta tion design a n d orga n iza tion a l
str u ctu r in g, a n d pr ogr ess a n d im pa ct m on itor in g. However, pr oposed r efor m s a re n ot likely to
progr ess th r ou gh th ese sta ges wit h ou t som eon e m a n a gin g or sh eph er din g th em .
For th ose wh o wa n t to pa r ticipa te in a n d fu r th er th e process of h ea lth sector r efor m , str a t egic
m a n a gem en t pr ovides a n effective a ppr oa ch . Str a tegic m a n a gem en t is a pr ocess for developin g
a n d en a cti n g pla n s to r ea ch a lon g- ter m goa l th a t ta kes in to a ccou n t in t er n a l va r ia bl es a n d
exter n a l fa ct ors. Str a tegic m a n a gem en t en com pa sses a n in t egr a ted, fu tu r e- ori en ted m a n a ge-
r ia l per spect ive th a t is
ou twa r dly focu sed
for wa r d- th in kin g
per for m a n ce- ba sed ( see Ki ggu n du 1996) .
Str a tegic m a n a ger s iden tify lon g- r a n ge ta rgets, sca n th eir opera ti n g en vir on m en ts, eva lu a t e
th eir or ga n iza ti on s str u ctu r es a n d resou r ces, m a tch th ese to t h e ch a l len ges th ey fa ce, iden tify
sta keh older s a n d bu il d a llia n ces, pr iori tize a n d pl a n a ction s, a n d m a ke a dju stm en ts to fu lfill
per for m a n ce objectives over tim e.
Br in kerh off ( 1991 a n d 1994) ch a r a cteri zes str a tegi c m a n a gem en t a s l ookin g ou t , l ookin g
in , a n d lookin g a h ea d. Lookin g ou t m ea n s explor in g beyon d th e bou n da ri es of you r or ga n i-
za tion to set fea si bl e objectives, i den ti fy key sta keh older s, a n d bu il d con st itu en cies for ch a n ge.
Lookin g in im plies cr itica l ly a ssessin g a n d str en gth en in g you r syst em s a n d str u ctu r es for
m a n a gi n g person n el, fin a n ces, a n d oth er essen t ia l r esou r ces. Fin a lly, looki n g a h ea den ta ils
m eldin g you r str a tegy wit h str u ctu r es a n d r esou r ces to r ea ch you r policy goa ls, wh il e m on it or-
in g you r pr ogr ess a n d a dj u stin g you r a ppr oa ch a s n eeded.
5-2 Po licy Too lkit fo r Str en gth ening Health Secto r Refor m
Ba la n cin g str a tegic m a n a gem en ts ou twa rd- , i n wa r d-, a n d forwa r d- lookin g fu n cti on s h elps
you develop a vision a n d a str a tegy for wh er e a n d h ow to m ove h ea l th sector r efor m for wa r d.
Ba la n cin g th ese differ en t per spectives is th e essen ce of m a n a gin g st ra tegica lly ( Br in ker h off
1991) .
Str a tegic m a n a gem en t com pr ises five key fa cets: goa l- sett in g, a n a lysis, str a tegy for m a ti on ,
str a t egy im plem en ta ti on , a n d str a tegy m on itor in g ( see Figu r e 5.1) . Th ese a r e th e in tegr a l ele-
m en ts th a t, wh en a pplied togeth er, di st in gu i sh str a t egic m a n a gem en t fr om l ess com pr eh en sive
a ppr oa ch es, su ch a s oper a tion a l m a n a gem en t or lon g- ter m pla n n in g. Str a tegi c m a n a gem en t
is a n itera ti ve, con tin u ou s pr ocess th a t i n volves im por ta n t in tera ction s a n d feedba ck a m on g th e
five key fa cets, wh ich a r e expla in ed in m or e deta il in Ta ble 5.1.
Fi gure 5 . 1 . Face ts o f Strate gi c Manage me nt
Goal-setting
Analysis
Strategy
Formation
Strategic
Management
Strategy
lmplementation
Strategy
Monitoring
Intr o duction to Str ategic Man agement 5-3
As m en ti on ed, you ca n u se str a t egic m a n a gem en t to h elp m ove h ea l th sector r efor m s
th r ou gh th e va r i ou s sta ges in th e pol icy pr ocess. Th e fr a m ewor k of th e policy sta ges ca n h el p
you deter m in e you r loca ti on in th e pol icy process a n d i den ti fy t a sks t o be don e. By a pplyin g a
str a t egic m a n a gem en t a ppr oa ch to ea ch su bsequ en t sta ge of th e policy process, you ca n fu r th er
im plem en ta t ion of h ea lth sector r eform s. Con sider ea ch sta ge of th e policy cycle fr om a str a te-
gic per spective, ba la n cin g th e lookin g-ou t, looki n g- in , a n d looki n g- a h ea d i ssu es. I n so doin g,
you ca n effectively in t egr a t e a st r a t egic m a n a gem en t a ppr oa ch in t o th e policy cycle. As a n
exa m pl e, Figu r e 5.2 il lu str a tes h ow you m igh t str a t egica ll y m a n a ge you r r eform s t h r ou gh th e
policy for m u la tion a n d legitim a tion sta ge.
Tabl e 5 . 1 . Fi ve Face ts o f Strate gi c Manage me nt
GoaI-Setting Goal-setting enables you to articulate your vision: identify what needs to be accomplished, define
short- and long-term objectives, and relate them to what your organization needs to do. A "mission
statement summarizes your purpose and goals in terms easily understood by both staff and external
stakeholders.
AnaIysis Analysis guides you to collect and consider information so that you fully understand your situation.
Assess external environments and internal situations to identify the strengths and weaknesses of your
organization and the opportunities and threats you face as you seek to reach your goals.
Strategy Formation To determine a strategy, you reflect, prioritize, develop options, and make decisions. Review the results
of the analyses, identify the issues that you and your implementing partners need to address, and
prioritize them in terms of their urgency and magnitude. Use these results to design alternative
strategies and plans that address the key strategic issues.
Strategy ImpIementation To implement your strategy, assemble the necessary resources and apply them. Put the chosen plans
into practice, marshal the resources and commitments necessary for moving ahead, tap existing
capacity and/or build new capacity, and seek to achieve results.
Strategy Monitoring Monitoring allows you to check your progress toward achieving your goals and assess whether any
changes in the environment necessitate alterations to your strategy. Modify plans and actions to adjust
to the impact of changes in the operating environment. Effective monitoring allows you to react and
anticipate. Monitoring also feeds back into analysis, strategy design, and implementation in the
immediate term and into goal-setting over the longer term.
5-4 Po licy Too lkit fo r Str en gth ening Health Secto r Refor m
Fi gure 5 .2 . Strate gi c Manage me nt o f One Stage o f the Po l i cy Pro ce s s
Constituency
Building
Constituency
Building
PoIicy
FormuIation and
Legitimation
PoIicy
FormuIation and
Legitimation
Resource
Mobilization
Resource
Mobilization
lmplementation
Design and
Organizational
Structuring
lmplementation
Design and
Organizational
Structuring
Progress/lmpact
Monitoring
Progress/lmpact
Monitoring
Goal-setting
Analysis
Strategy
Formation
Strategic
Management of
Policy Formulation
and Legitimization
Strategy
lmplementation
Strategy
Monitoring
= primary linkage
= secondary linkage
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Goal-Setting: Your goals might be to 1) have a community leader speak publicly on behalf of the
policy to create legitimacy, and 2) have someone from the health sector reform team list the
resources and actions that will be necessary to implement the policy.
Analysis: You might evaluate your stakeholders to see who is likely to favor the policy and, of
those supporters, who has the respect of the community.
Strategy Formation: You could identify 1) a supportive community leader and ask him or her to
speak for the policy and 2) additional information and resources needed to develop the policy
details.
Strategy Implementation: You could 1) arrange for a presentation or media interview with the
community leader and 2) attempt to collect information and other resources.
Strategy Monitoring: You should assess whether your efforts at legitimation and policy
definition were successful enough to allow you to focus most of your time and energy on
constituency-building tasks, or whether you need to continue with policy formulation and
legitimation.
Intr o duction to Str ategic Man agement 5-5
Bi bl i o graphy
Br in kerh off, Derick W. 1994. Looki n g Ou t, Lookin g I n , Lookin g Ah ea d. PA Tim es. vol. 17, n o.
12, 11.
_ _ _ _ _ . October 1991. Lookin g Ou t, Looki n g I n , Lookin g Ah ea d: Gu idel in es for Ma n a gin g
Developm en t Pr ogr a m s. Wor kin g Pa per No. 1. Wa sh in gt on , DC: I m plem en tin g Poli cy
Ch a n ge Pr oj ect, for US Agen cy for I n t er n a tion a l Developm en t.
Kiggu n du , Moses N. 1996. I n tegr a tin g St ra tegic Ma n a gem en t Ta sks in to I m pl em en ti n g Agen -
cies: Fr om Fir efigh t in g to Pr even t ion . Wor ld Dev elopm en t vol. 24, n o. 9: 14171430.
5-6 Po licy Too lkit fo r Str en gth ening Health Secto r Refor m
Anne x 5 - A
Strate gi c Pl anni ng and Strate gi c
Manage me nt
By Ben ja m in L. Cr osby
1
The follow in g is a n ex cer pt fr om Cr osb y, Ben ja m in L. 1 9 9 1 . Str a tegic Pla n n in g a n d Str a -
tegic Ma n a gem en t: Wha t Ar e They a n d How Ar e They Differ en t?Techn ica l N ote N o. 1 .
Pu b lished b y the Im plem en tin g Policy Cha n ge Pr oject, Ma n a gem en t Sy stem s In ter n a -
tion a l, In c. , for the US Agen cy for In ter n a tion a l Dev elopm en t.
Why Strate gi c Manage me nt?
Str a tegic pla n n in g a n d m a n a gem en t a r e m or e th a n a set of m a n a ger ia l tools. Th ey con stitu te a
m i n d- set, a n a ppr oa ch t o lookin g a t th e ch a n ges in th e in t er n a l a n d extern a l en vir on m en t th a t
con fron t th e m a n a ger. Usi n g pla n n in g a n d m a n a gem en t tool s str a tegica ll y, t h en , i n volves
essen t ia lly a wa y of t h in ki n g, a m en t a l fr a m ewor k or a ppr oa ch , a s well a s a set of a n a l ytic tools.
For st ra tegic m a n a gem en t to be effectively u sed th e m a n a ger m u st devel op a stra t egic m en ta lity
or ou tl ook. Th e pr oblem for th e con su lta n t is h ow to h el p th e m a n a ger a cqu ir e th a t m en ta lit y.
The Strate gi c Appro ach
Th e str a tegic a ppr oa ch or m en ta lit y con sists of fou r m a in elem en ts:
Fir st , th e str a tegi c a ppr oa ch is or ien ted towa rd t h e fu tu r e. I t recogn izes th a t th e en vir on m en t
will ch a n ge. I t is a lon g ra n ge ori en ta ti on , on e t h a t tr ies to a n ticipa te even ts r a t h er th a n sim -
ply rea ct a s th ey occu r. Th e a ppr oa ch lea ds th e m a n a ger to a sk wh er e h is/ h er orga n iza tion
wa n ts to be a fter a cer ta in per iod, wh a t i t will n eed to get to wh er e it wa n ts, a n d h ow t o devel-
op str a tegies a n d t h e m ea n s to get t h er e, a n d fin a l ly, h ow to m a n a ge th ose str a tegies to
a ch i eve th e or ga n iza ti on s goa ls a n d objectives. It is r ecogn ized th a t th e fu tu re ca n n ot be
1. Ben ja m i n L. Cr osby i s a Di r ector of MSI ; h e h olds a Ph .D. fr om Wa sh i n gt on Un iver si ty i n St . Lou is, Missou r i,
a n d m a n a ges th e I m pl em en tin g Pol icy Ch a n ge pr oject.
Ann ex 5-A 5-7
con t roll ed, bu t th e a r gu m en t ca n be m a de th a t by a n tici pa t in g th e fu tu re, or ga n iza t ion s ca n
h el p to sh a pe a n d m odify th e im pa ct of en vir on m en ta l ch a n ge.
Secon d, th e str a tegi c a ppr oa ch h a s a n extern a l em ph a sis. I t t a kes in t o a ccou n t sever a l com -
pon en ts of th e exter n a l en vir on m en t, in clu din g tech n ology, politics, econ om ics a n d th e so-
cia l dim en sion . Str a tegic t h in ki n g recogn izes t h a t ea ch of t h ese ca n eith er con str a in or fa cil-
ita te a n or ga n i za tion a s it seeks to im plem en t pol icy. Polit ics wil l det er m in e th e policies th a t
a re to be im plem en ted, econ om i cs will deter m in e t h e orga n iza tion s level of resou r ces, a n d
socia l fa ctor s m igh t well deter m in e wh o th e or ga n iza ti on s ben eficia r ies will be. I n pa r ticu -
la r, str a tegic th in kin g r ecogn i zes a n d em ph a tica lly ta kes in to a ccou n t politi cs a n d th e exer -
cise of polit ica l a u th or ity. Ma n a gers a r e n ot fr ee to do a n yth in g th ey decide. Ma n a ger s m u st
be sen sitive to th e n eeds a n d respon d to dem a n ds of con stitu en ts over wh om th ey h a ve l ittle
or n o con tr ol. Am on g th ose con st itu en ts, politica l a ct or s a r e per h a ps th e m ost i m por ta n t.
Th ir d, th e st ra tegic a ppr oa ch con cen tr a tes on a ssu r in g a good fit bet ween th e en vir on m en t
a n d t h e orga n i za tion ( in clu di n g i ts m issi on a n d object ives, str a tegies, str u ctu r es, a n d r e-
sou r ces) a n d a tt em pt s to a n ticipa te wh a t will be r equ ir ed t o a ssu re con tin u ed fit. Un der con -
dition s of r a pid polit ica l, econ om i c a n d socia l ch a n ge, str a tegi es ca n qu i ckly becom e ou t-
m oded or n o lon ger serve u sefu l pu r poses; or th e r esou r ces tr a di tion a lly r equ ired by th e
orga n iza tion to pr odu ce i ts goods a n d ser vi ces m a y su dden l y becom e u n a va ila ble. Th e st ra -
tegic a pproa ch r ecogn izes th a t to m a in ta in a close fit with th e en vir on m en t, th e differ en t el-
em en t s of t h e orga n i za tion will n eed to be con tin u ou sly r e- a ssessed a n d m odified a s th e en -
vir on m en t evolves.
Fin a lly, th e str a tegic a ppr oa ch is a pr ocess. I t i s con t in u ou s a n d recogn izes th e n eed to be
open to ch a n gin g goa ls a n d a ctivi ties i n l igh t of sh i ftin g cir cu m sta n ces wi th in th e en vi ron -
m en t. It is a pr ocess th a t r equ ir es m on it orin g a n d r eview m ech a n ism s ca pa ble of feedin g in -
for m a ti on to m a n a ger s con t in u ou sl y. Str a tegi c m a n a gem en t or pl a n n in g a r e n ot on e- sh ot
a ppr oa ch es, th ey a r e on goin g.
Wh en a ll ta ken toget h er, t h ese a ttitu des a n d beh a vi ors a r e r ea lly a wa y of a ppr oa ch i n g or
th i n kin g a bou t h ow t o m a n a ge or h ow to im pl em en t poli cy ch a n ge. Str a tegic m a n a gem en t ( or
pla n n i n g) is n ot som eth in g th a t ca n be a ppli ed on ly on ce a n d t h en for got ten a bou t or ign ored.
I n t h a t sen se i t is m or e th a n a t ool ; i t is a m en ta l fr a m ework.
The Strate gi c Manage me nt Pro ce s s
Wh a t does a str a tegi c m a n a gem en t pr ocess l ook like? Th e a pproa ch descr ibed below is su g-
gested a s a gu ide:
1. Agreem en t on a n d in itia ti on of th e str a tegic m a n a gem en t pr ocess.
2. I den tifica tion a n d cla r ifica tion of th e or ga n iza tion s m ission , object ives, a n d cu r r en t
str a t egies.
3. I den tifica tion of th e or ga n iza tion s in tern a l str en gth s a n d wea kn esses.
5-8 Po licy Too lkit fo r Str en gth ening Health Secto r Refor m
4. Assessm en t of th e th r ea t s a n d oppor tu n ities fr om th e extern a l en vi ron m en t.
5. I den ti fica tion of key con stitu en t s/ st a keh older s a n d th eir expecta tion s.
6. I den ti fica tion of th e key str a tegic issu es con fr on ti n g th e or ga n i za tion .
7. Design / a n a lysi s/ sel ection of str a tegy a ltern a tives a n d option s to m a n a ge i ssu es iden tified
in step 6.
8. I m plem en ta tion of st ra tegy.
9. Mon it or in g a n d review of t h e str a t egys per for m a n ce.
Th er e i s m u ch sim ila r ity in th e a pproa ch descri bed h er e a n d th a t of ot h er s ( see Appen di x
On e for a descr iption of th r ee) . I f on e wer e t o stop a fter Step n u m ber 7, th e pr ocess wou ld be
sim pl y a str a tegic pla n n in g exer cise. Fr equ en tl y, th is is exa ctly wh er e th e pr ocess does stop, espe-
cia ll y wh en m a n a gem en t a n d th e st ra tegic pl a n n in g fu n cti on s h a ve been de- lin ked. Th is
occu rs wh en th er e i s n o a ttem pt t o develop a str a tegi c m en ta lity a m on g lin e m a n a gem en t;
in stea d, th e or ga n iza tion a ttem pts to set u p a specia l depa r tm en t , di vision , or gu r u for str a te-
gic pl a n n i n g r a th er th a n in tegr a te th e fu n cti on s in to n or m a l l in e m a n a gem en t. Wi th ou t th e
expr essed lin ka ge it is often difficu lt for th e lin e m a n a ger to see th e va lu e of th e str a tegic pla n ,
a n d t h er e will th erefor e be less i n ter est a n d i n cen tive i n str a tegi ca lly m a n a gin g. I n con tr a st, if
th e str a tegic a pproa ch i s em ployed, or th e or ga n iza tion is im bu ed with a str a tegic m en ta lity,
th en str a tegi c pla n n in g will be don e a s pa r t of th e cou r se of n or m a l ( str a tegi c) m a n a gem en t
fu n ction s.
Ste p One : Agre e me nt o n the pro ce s s .
Th e fi rst step i n t h e str a t egic m a n a gem en t process is to get a gr eem en t n ot on ly to ca r ry ou t
th e pr ocess bu t a lso t o get a gr eem en t on h ow a n d wh en a n d by wh om it will be ca r r ied ou t.
Sin ce th e st ra tegic m a n a gem en t pr ocess is n ot a on e- sh ot exercise, com m i tm en t to th e l on g-
h a u l is vita l; with ou t com m it m en t, th e exercise wi ll be ster ile a n d likel y r ega r ded a s a wa st e of
tim e.
Wh o sh ou ld be in clu ded in th e st ra tegic m a n a gem en t pr ocess? At lea st th r ee differ en t t ypes of
in dividu a ls sh ou ld be con si der ed for i n clu sion : th e or ga n iza t ion s top decision - m a kers a n d
th ose offici a l s wh o wil l h a ve dir ect r espon sibilit y in im plem en ta tion of policy; t h ose wh o h a ve a
m a j or st a ke in th e ou tcom e of th e policy, wh eth er fr om with in or ou tside th e or ga n iza t ion ,
wh et h er su ppor ti ve or oppositi on a l, clien ts or resou rce su ppl ier s; a n d th ose with speci a l ized
kn owledge th a t ca n a dd to t h e a n a lysis of t h e policy to be decided or im plem en ted. Alth ou gh r el-
a tively br oa d i n volvem en t in th e pr ocess sh ou ld be en cou r a ged, ca re m u st be ta ken t h a t su ch
grou ps n ot be expa n ded to th e poin t of i n ca pa cit y t o m a ke a gile deci si on s.
How sh ou ld th e pr ocess be in itia ted? Fir st , a gr eem en t t o ca r r y ou t a n d com m i tm en t to th e
process of str a tegi c m a n a gem en t m u st be obta in ed from on e or m or e of th e or ga n iza tion s key
decision m a ker s. On ce su ch a gr eem en t a n d com m itm en t is a ccom plish ed, th en deci si on s a bou t
wh a t sh ou ld be con sider ed a n d wh o sh ou ld be in volved ca n be a ddr essed. I f issu es a r e com plex
a n d t h er e is a n eed to i n volve a rela tively wide spectr u m of a ctor s a n d sta keh older s, t h en wor k-
Ann ex 5-A 5-9
sh ops m igh t be con sider ed. I f th e i ssu es a r e less com plex or fewer a ctor s n eed to be in volved,
th en di rect con su lt a t ion s or sm a ll grou p a r ra n gem en ts m igh t pr ove m or e efficien t.
Ste p Two : Ide nti fi cati o n and cl ari fi cati o n o f the o rgani z ati o ns
mi s s i o n, o bje cti ve s and curre nt s trate gi e s .
On ce a n or ga n iza tion h a s a gr eed to en ga ge in a str a tegic pr ocess, t h e fir st ta sk i s to deter m i n e
wh a t a n d wh er e t h e orga n i za tion is. Wh a t a re th e n eeds t h a t th e or ga n iza tion a ttem pts to sa t-
isfy, wh ose n eeds a r e th ey, a n d wh a t i s th e va lu e of sa tisfyin g th ose n eeds? All t oo often or ga n iza -
tion s devel op a ser vice or a pr odu ct a n d th en fa il to per iodica lly exa m i n e wh et h er or n ot t h a t
produ ct a ctu a lly sa tisfies a dem a n d or wh et h er sa ti sfa ction of t h a t dem a n d a ctu a l ly m a tter s.
Wh o a r e th e people th a t com pose th e or ga n i za tion , wh a t a r e t h ei r va lu es, a n d wh a t n eeds does
th e or ga n iza ti on sa tisfy for t h em ? ( I n r esou r ce- poor en vir on m en ts, a gen cies th a t sa tisfy on ly
m a r gin a l or per iph er a l dem a n ds a r e vu l n er a ble to bu dget cu ts, a bol ish m en t, or a bsor pt ion by
oth er orga n iza tion s.) Wh a t a r e th e objectives of t h e orga n i za tion a n d h ow wel l do t h ey m esh
with th e n eeds a n d dem a n ds of clien ts, sta keh older s a n d con st itu en ts? Wh a t str a tegies does th e
orga n iza tion em ploy to a ch ieve th e objectives it h a s set for itself? Is th e or ga n iza tion bei n g
a sked to m a ke fu n da m en ta l ch a n ges in wh a t it does, or in th e ki n ds of clien ts i t ben efit s? If so,
wh a t a re th ose ch a n ges?
At th is poin t, Lou ise Wh it e, wh ose fr a m ewor k is in cor por a ted in t h e IPC [ Im plem en tin g Pol-
icy Ch a n ge] pr oject pa per, a r gu es t h a t th e policy in qu estion sh ou ld be exa m in ed wi th r espect to
its com pa tibi lity with t h e orga n iza tion s m ission , objectives a n d str a tegy. To a ccom plish th is i t i s
n ecessa r y to sta t e th e obj ectives of th e policy, th e n a tu r e of t h e ser vice or a ct ivity in ten ded, t h e
ben efits t o be pr odu ced a n d th e ben eficia ri es, a n d descr ibe th e com plexi ty of th e policy. ( Wh it e
1989)
Cla r ifi ca tion of t h e m ission , objectives, a n d str a tegies is fu n da m en ta l to i n iti a t ion of th e
str a t egic pr ocess. I t a m ou n ts t o a sta tem en t of wh er e th e or ga n iza tion i s, wh a t it does a n d h ow it
goes a bou t its bu si n ess. It sh ou l d a lso h elp cla r ify wh ich policies or dem a n ds ca n be fa cilita ted
by t h e orga n i za tion a n d wh ich wil l be im peded.
Ste p Thre e : Ide nti fi cati o n o f the o rgani z ati o ns i nte rnal s tre ngths
and we akne s s e s .
On e wa y t o exa m in e th ese i s to look a t th e or ga n iza tion s r esou r ce ba se ( skil l ba se, ca pita l or
fin a n cia l r esou r ces, et c.) Does t h e or ga n iza t ion h a ve th e wh erewith a l t o a ch ieve it s sta ted obj ec-
tives or to pu t i n to m otion it s str a t egies? Wh a t a r e th e levels of in ter n a l resou r ces possessed by
th e or ga n iza ti on ? How a va i la ble a r e th ey?
An a lysis of r esou r ces by itself i s n ot su fficien t, th e or ga n iza tion m u st a lso l ook a t it s t a sk per -
for m a n ce. Wh a t ta sks does it do wel l, wh ich does it n ot? Th is wil l give a better idea of h ow th e
orga n iza tion s r esou rces a r e or ga n i zed a n d h ow effectively th ose r esou r ces a r e pu t to u se. An
orga n iza tion m a y well h a ve excellen t r esea r ch skill s, bu t if its pri m a r y ta sks a re in ser vice del iv-
er y, th en su ch skil ls m a y be m or e a wea kn ess th a n a st ren gth . However, on e sh ou ld n ot a u to-
5-10 Po licy Too lkit fo r Str en gth ening Health Secto r Refor m
m a t ica lly m a ke th e a ssu m ption th a t sin ce idle ca pa city exists, it sh ou ld be dispen sed wi th . Su ch
ski lls m a y well be qu ite u sefu l if th e or ga n iza tion sh ou ld n eed to m a ke ch a n ges in or der to be
m or e com pa t ible with its en vi ron m en t.
I n a dditi on t o skills a n d r esou r ces, oth er elem en ts of th e in ter n a l or ga n iza ti on n eed to be
exa m in ed: wh a t is t h e n a tu r e of th e or ga n iza tion a l cl im a t e ( a r e th er e clea va ges, a r e t h ey con -
flictive?) , h ow a da pta ble a r e th e pa r tici pa n ts ( wou ld th ey r ea dily ta ke on n ew ta sks, h ow l on g
h a ve th ey been doin g th e sa m e th in g?) , wh a t is th e n a tu r e a n d flexibili ty of th e or ga n iza t ion a l
str u ctu r e ( is it r igid, h a ve sign ifica n t ch a n ges been m a de in th e pa st , a n d wh a t h a s been th e
r ea ction ?) , is th er e a n in for m a l st ru ctu re ( h ow does i t wor k a n d is it m ore cogen t th a n th e for -
m a l str u ct u r e?) , wh a t is th e n a tu r e of t h e in cen ti ve st r u ctu re ( i s it design ed to en cou r a ge in n o-
va tive beh a vior, ca n i t r ecru it a n d m a in ta in a su fficien tly h igh level of per son n el?) ? Wh ich ele-
m en ts fa cilit a te a n d wh i ch im pede perfor m a n ce of th e or ga n iza tion s ta sks a n d wh ich m igh t
fa cil ita te or im pede or ga n iza tion a l ch a n ge?
Ste p Fo ur: As s e s s me nt o f thre ats and o ppo rtuni ti e s i n the e xte rnal
e nvi ro nme nt.
Wh il e t h er e is fr equ en t ly a ten den cy on th e pa r t of m a n a ger s to focu s on th e i n ter n a l dim en -
sion s of th e or ga n iza ti on , pol icy ch a n ge a n d th e oft en vola tile n a t u r e of politi cs in cou n tr ies
u n der goin g m a jor policy ch a n ges r equ ir es con sciou s explor a t ion of th e en vir on m en t ou tside
th e or ga n iza ti on .
Polit ica l, econ om i c, socia l, a n d t ech n ologica l ch a n ges will in flu en ce th e dir ection a n d
sh a pe of a n orga n iza tion s poli cies a n d objectives. Wh a t a r e th e m a j or tr en ds t h a t ca n be
detected in ea ch of th ese a r ea s th a t will h a ve som e bea r in g on th e a ct iviti es of th e or ga n iza t ion ?
How m igh t m a cro- econ om i c m ea su r es bein g in sti tu ted a ffect t h e fin a n cia l resou r ces of th e
orga n iza tion ? Wh a t is th e n a tu r e of poli tica l su pport for th e poli cy u n der con sidera ti on ? How
politica l ly st a bl e is th e cu rr en t regi m e? I s policy lea dersh i p a bou t to ch a n ge? Will key officia ls
with in th e ca bin et be ch a n ged a n d wh a t will th a t m ea n to th e developm en t a n d im pl em en ta -
tion of th e pr oposed policy ch a n ge? To wh a t exten t h a ve th e govern m en ts pr im a r y pol itica l coa -
liti on s begu n t o ch a n ge? Does th is si gn ify im pen din g ch a n ges i n poli cy pr ior it ies? How effective
is th e poli tica l opposit ion ? Wh a t r ole do in ter n a tion a l for ces or a ctor s pla y in th e det er m i n a tion
of policy? To wh a t exten t h a s th e socia l com position of th e or ga n iza tion s pri m a r y clien tel e
grou p ch a n ged? Ha s it ou tgr own th e r esou r ces of th e or ga n iza tion ? Ha ve its n eeds ch a n ged over
th e yea rs?
An im port a n t fa ctor in t h e or ga n iza ti on s ext er n a l en vir on m en t i s i ts bu rea u cr a tic a n d i n sti-
tu t ion a l settin g. Is th e or ga n iza ti on a u ton om ou s? Or i s it lin ked t o a m in istr y, or m u st it coor di-
n a te its a ction s with oth er en t ities a n d wh a t is th e n a tu r e of th ose m ech a n ism s? Ar e oth er orga -
n iza tion s i n volved in th e sa m e a ctivi ty, wh a t a r e th eir r oles? Ar e th er e in cen tives for
cooper a tion ?
Ann ex 5-A 5 -1 1
Ste p Fi ve : Ide nti fi cati o n o f ke y co ns ti tue nts and s take ho l de rs ,
the i r e xpe ctati o ns and re s o urce s .
Th e expecta tion s a n d dem a n ds of con st itu en ts a r e key in gr edien ts for decision s a bou t wh a t a n
orga n iza tion will do a n d h ow i t goes a bou t ca r r yin g ou t its ta sks. Sta keh ol der s or con sti tu en ts
a re th ose wh o h a ve a dir ect i n terest in a n d a re ca pa ble of in flu en cin g i n som e m ea su re th e ou t-
com es or a cti on s of th e or ga n iza tion . Sta keh ol ders pr ovide th e pri m a r y ba se of pol itica l su ppor t
for th e or ga n iza t ion , a n d i n a si gn ifi ca n t wa y a r e its r a ison dtr e. A r a th er wide ra n ge of a ctor s
m i gh t be in clu ded: com pet itor s, ben eficia r ies, dir ector s, em pl oyees, politi ca l pa r ties, con su m -
er s, in ter n a ti on a l don or s, etc. Wh a t do t h ese pa r ticu la r grou ps wa n t fr om t h e or ga n iza t ion ? Ar e
th ey sa ti sfied with th e cu r r en t a r r a y of ser vices a n d level of per for m a n ce? Ar e th eir in t er ests sh ift-
in g? I n wh i ch dir ecti on ? An d if so, will th e or ga n iza t ion be a ble to r ea ct fa vor a bly?
I n exa m in in g th e in t er ests of st a keh older s, a ca u tion a r y n ote is in or der. Th er e ca n be a
tem pta tion to tr y t o con sider ever y a ct or wh o m igh t h a ve som e in ter est or in flu en ce in th e orga -
n iza tion . Th a t tem pta t ion ou gh t to be a voided a n d th e a n a l yst sh ou ld ta ke ca r e to a ssu r e th a t
on ly th ose th a t ca n h a ve a rea listic a n d r ea son a bly sign i fica n t im pa ct a r e con si dered in th e
sta keh older a n a lysis.
Ste p Si x: Ide nti fi cati o n o f ke y s trate gi c i s s ue s .
Th e in for m a ti on gen er a ted by th e pr ecedin g steps sh ou ld iden tify a set of fu n da m en ta l qu es-
tion s or key problem s r ega r din g th e fi t of th e or ga n iza ti on wit h i ts en vir on m en t. Th ese pr ob-
lem s m igh t con cer n th e or ga n iza tion s m ission , i ts pr odu cts or services, its clien ts, fin a n cin g
m ech a n ism s, m a n a gem en t, or r el a t ion sh ip to cer ta in sta keh older s. Str a tegic issu es a r e th e
pri n cipa l pr oblem s th a t m u st be dea lt with effecti vely or th e or ga n iza tion ca n expect u n desir -
a ble r esu lts. Th e effect ive tr ea tm en t of st r a tegic issu es ca n sign i fy fu n da m en ta l ch a n ge in h ow
th e or ga n iza ti on goes a bou t it s bu sin ess. Su ch issu es m a y gen er a te con flict with in th e or ga n i-
za tion sin ce th eir r esolu t ion will pr odu ce win n er s a n d loser s both in ter n a ll y a n d ext er n a lly. Th e
orga n iza tion m u st be pr epa r ed to dea l wi th th a t con fl ict.
I n iden t ifyin g str a tegic i ssu es or pr oblem s, ca r e m u st be ta ken in specifyin g exa ctly wh a t t h e
problem or issu e is, wh y it is a pr oblem for th e or ga n iza tion , a n d th e or ga n iza tion a l con se-
qu en ces of i n a ction . All too often in su fficien t a tt en ti on is given to pr oblem iden tifi ca tion r esu lt-
in g in m i sa ll oca ted r esou rces a n d lost oppor tu n i ties. I t i s a lso im port a n t t o determ in e wh eth er
or n ot th e or ga n iza ti on ca n do a n yth in g a bou t th e pr oblem if n ot, it is n ot a n issu e. Ma n a g-
er s m u st a lso r ecogn i ze th a t it wi ll be im possible t o ta ckle a l l issu es a t on ce; th erefor e, pr oblem s
sh ou ld be i den tified a ccor di n g t o sh or t- , m ediu m - or lon g- r u n im port a n ce a n d t h e u r gen cy of
a ction n eeded. Ma n a gers will fi n d t h a t en ergy expen ded in pr obl em a n d issu e iden tifi ca tion a n d
cla r ifica tion will h a ve pa yoffs in th e developm en t of str a tegies for th eir tr ea t m en t.
5-12 Po licy Too lkit fo r Str en gth ening Health Secto r Refor m
Ste p Se ve n: De s i gn, anal ys i s , and s e l e cti o n o f s trate gy al te rnati ve s
and o pti o ns to manage i s s ue s i de nti fi e d i n Ste p 6 .
On ce issu es a n d pr oblem s h a ve been iden tified, str a tegies to solve t h ose pr oblem s n eed t o be
iden tified. Gen er a l ly, m or e th a n on e option for dea lin g wi th th e pr oblem will be iden ti fied; th en
option s m u st be exa m in ed for th eir com pa ra ti ve via bilit y, fea sibility, a n d desir a bi lity. Ca n th e
str a t egy wor k fr om a pr a ctica l a s well a s th eor etica l st a n ce? I s th e orga n iza tion ca pa bl e of ca r r y-
in g ou t th e str a tegy? I s th e str a t egy a ccept a bl e to t h ose ca r ryin g it ou t a n d t o th ose t o wh om it is
dir ected? Does th e or ga n iza tion h a ve th e h u m a n a n d m a ter ia l resou rces, does it h a ve th e
kn ow- h ow n ecessa r y, a n d is th e a ppropr ia te or ga n iza tion a l str u ctu r e a va ila ble for im plem en t-
in g th e str a tegy? Will th e str a tegy a ccom plish wh a t t h e m a n a ger wa n ts a n d ben efit th ose
in t en ded? Ca n th e str a tegy be su sta in ed, a n d ca n i t a da pt t o th e pr ojected ch a n ges in th e en vi-
r on m en t? I s flexibili ty bu il t in to th e st ra t egy? Ca n th e n ecessa r y r esou r ce ba se be su sta in ed over
th e life of th e str a tegy?
Desir a bility h a s to do wit h t h e fit of or ga n iza t ion a l a n d en vir on m en ta l va lu es a n d objectives
with th e str a tegy. I s th e str a tegy com pa tible with th e i m plem en tin g in sti tu ti on s m i ssion or it s
fu n da m en ta l obj ecti ves, a n d/ or wit h th e m issi on a n d objectives of colla bor a tin g or ga n iza tion s?
I s th e str a tegy ta r geted to th e m ost a ppr opri a te ben eficia r ies? I s i t com pa tible with th e l ega l a n d
bu r ea u cra t ic settin g? How well will th e str a tegy a dju st to for eca st tr en ds in th e m ediu m a n d in
th e lon g ter m ? How wil l key sta keh ol der s be a ffected, h ow com pa tible is t h e st ra t egy wi th th ei r
va lu es a n d expecta t ion s?
Ste p Ei ght: Impl e me ntati o n o f the s trate gy.
I m plem en ta tion of a str a tegy is n ot a n a u tom a tic process; th er e a r e two m a jor pa r ts to th e pr o-
cess. Th e fi rst step i s th e developm en t of a n a cti on pla n , wh ich is a sta tem en t of wh a t, wh o,
wh en , a n d h ow th e a ct ion s n ecessa r y t o ca r r y ou t t h e st ra tegy wi ll be don e. Per for m a n ce goa ls
a n d obj ecti ves wi ll a lso be specified. Mu ch of t h e in for m a tion n eeded to devel op th e a ction pla n
will h a ve been gen er a ted in Step Seven .
Th e secon d pa rt of im plem en ta tion con sists of a ction s a im ed a t m a rsh a lin g a n d a pplyin g
r esou rces. I n th e con text of policy ch a n ge th ese a ction s m a y con sist of ( bu t a re n ot lim ited to) ,
ch a n ges in orga n iza tion a l stru ctu res, sh ifts a n d recla ssifica tion of person n el, th e esta blish m en t of
n ew rou tin es, ta sks, a n d procedu res; in sta lla tion of n ew in cen tive system s; retoolin g produ ction
for n ew pr odu cts or services; m a rketin g of n ew ser vices or crea tion of dem a n d a m on g n ew ben efi-
cia ries or con su m ers; developm en t of n ew fin a n cin g m ech a n ism s; orga n izin g coa lition s to m a in -
ta in politica l, bu dgeta ry, a n d ben eficia ry su pport; a n d developin g colla bora tive m ech a n ism s with
coopera tin g orga n iza tion s. It sh ou ld be n oted th a t th e m a n a ger s ta sk is m ore th a n ju st th e in ter-
n a l opera tion of h is orga n iza tion , th ey m u st a lso m a n a ge its fit with th e en viron m en t.
Ste p Ni ne : Mo ni to ri ng and re vi e w o f pe rfo rmance .
Str a tegic m a n a gem en t a ssu m es con t in u a l ch a n ge. Th er efor e m ech a n i sm s m u st be developed
for m on itor in g a n d a n a lyzin g t h e per for m a n ce of th e or ga n iza tion with r espect to a ch ievin g th e
Ann ex 5-A 5 -1 3
goa l s a n d objectives set in th e a ct ion pl a n . As th e en vir on m en t u n der goes ch a n ges, a s m in i st er s
ch a n ge, election s occu r, or bu dgets go u p or down , pr ior iti es will a lso ch a n ge. Resou rce fl ows
m a y be u n even . Al l of th ese el em en ts ca n a l ter perfor m a n ce, pr ior iti es, a n d th e desi ra bili ty of
cer ta in policies. I f th e or ga n iza tion wa n ts t o m a i n ta in a good fi twit h t h e en vir on m en t, it
m u st fi rst be a ble to tr a ck th ese ch a n ges in order to a dju st.
Th e m on it or in g pr ocess sh ou ld be con ti n u ou s, r egu la r, a n d ca pa ble of feedin g in to th e deci-
sion - m a kin g pr ocess. Th e m a n a ger sh ou ld develop con trol m ech a n ism s to ga u ge th e efficien cy
of r esou r ces u sed a n d i m pa ct m ech a n ism s to ga u ge th e effect iven ess of its a ct ion s. Fin a lly, it is
vita l th a t th e m on it orin g pr ocess be tim ely a n d u sa ble.
Appe ndi x One : Di ffe re nt Appro ache s to Strate gi c Pl anni ng
and Manage me nt
Mu ch a tt en ti on i n t h e litera tu r e h a s been devot ed to st ra t egic m a n a gem en t a n d str a tegic pla n -
n in g bu t wi th m ost em ph a si s on th e pr iva te sector. Never th eless, in th e la st sever a l yea r s,
th ere h a s been a gr owin g in terest a n d litera tu r e ( eg., Rin g a n d Per r y, 1985, a n d Sa m u el Pa u l,
1983) on a ppl ica tion s in th e pu bli c sector. Th r ee recen t a ppr oa ch es a r e br iefly descr ibed in th is
a ppen dix.
Two recen t books on str a t egic pla n n in g a n d str a t egic pu bl ic m a n a gem en t illu stra t e th e over -
la p bet ween th e two con cepts. Ea ch develops a str a tegic pr ocess con sisti n g of sever a l steps.
Dr a wi n g on Nu t t a n d Ba ckoff ( 1987) , Bozem a n a n d St ra u ssm a n ( 1990) ou t lin e six steps for
pu tti n g str a tegic m a n a gem en t to work. Th ese st eps a m ou n t to a ba sic fr a m ewor k for str a tegic
m a n a gem en t:
1. Dea lin g with h istory: a n a n a l ysis of th e h istor y of t h e orga n i za tion , it s m ission a n d its
m a n da t e.
2. Stock Ta kin g: a n eva l u a tion of t h e orga n iza tion s cu r r en t in ter n a l fin a n cia l, or ga n iza -
tion a l, a n d h u m a n r esou r ces.
3. Eva l u a tin g I ssu es: i den ti fica ti on of th e sign ifica n t issu es th a t will a ffect th e perform a n ce
or ca pa city of th e or ga n iza ti on .
4. Developin g St r a tegies: devel opm en t of str a t egic a lter n a ti ves t o r espon d t o a n d m a n a ge
th e issu es iden t ified.
5. Assessin g Fea sibility: eva lu a ti on of th e ca pa city of th e orga n iza tion to ca r r y ou t th e str a te-
gic a l ter n a ti ve with in th e con text.
6. I m plem en ta tion : t h e a ctu a l ca r r yin g ou t of t h e st ra tegy sel ected.
I t is ea sy to r ecogn ize sever a l pa r a l lels between Bozem a n a n d Str a u ssm a n a n d th e eigh t- step
process for str a tegic pla n n in g la id ou t by Joh n Br yson ( 1988) :
1. I n iti a t in g a n d a gr eein g on a str a tegic pla n n in g process.
2. I den tifyin g or ga n iza tion a l m a n da tes.
5-14 Po licy Too lkit fo r Str en gth ening Health Secto r Refor m
3. Cla r ifyin g or ga n i za tion m ission a n d va lu es.
4. Assessin g th e ext er n a l en vir on m en t oppor tu n iti es a n d th r ea ts.
5. Assessin g th e i n ter n a l en vir on m en t: st ren gth s a n d wea kn esses.
6. I den ti fyin g th e str a tegic issu es fa cin g a n orga n iza tion .
7. Form u l a t in g st ra tegies to m a n a ge th e issu es.
8. Esta blish i n g a n effecti ve orga n iza tion a l vision for t h e fu t u r e.
Lou ise Wh ite ( 1989) esta blish es a sligh tly sh or ter bu t sim ila r str a tegic pr ocess:
Step 1. Agr ee on a pr ocess for developin g a n im plem en ta tion st ra tegy.
Step 2. Ma p or a ssess th e situ a tion ( th is in clu des a n a lysis of th e ext er n a l a n d in ter n a l en vi-
r on m en ts, th e con ten t of th e policy, a n d sta keh older expecta tion s a n d r esou r ces) .
Step 3. I den t ify th e str a tegic issu es.
Step 4. Design a n im pl em en ta ti on str a tegy.
Step 5. Design a pr ocess for m on i tor in g r esu lts a n d m a kin g on goin g a dju stm en t s.
Wh ere do th ese pr ocesses di ffer ? I s i t r ea ll y on ly a t th e en ds of ea ch pr ocess? Br yson con -
clu des with th e form u l a tion of str a tegies a n d t h e esta blish m en t of a n effective or ga n iza ti on a l
vision for th e fu tu re; Bozem a n a n d Str a u ssm a n con clu de t h e process with im plem en ta tion of
th e st ra tegies for m u la ted. Pla n n er s in Bryson s m odel, a r e n ot dir ectl y r espon sible for th e im ple-
m en ta ti on of wh a t th ey h a ve pl a n n ed, except in sofa r a s th ose sa m e per son s a lso will be ta sked
with im plem en ta tion ( n ot a ll or ga n i za tion s ca n rea di ly sepa r a te th e pla n n in g a n d m a n a ge-
m en t fu n ction s) . Bu t in a ll fa ir n ess, Br yson is a da m a n t i n i n sistin g th a t th e a lter n a tives devel-
oped to cope wi th st ra tegic issu es be both wor ka ble a n d a ccepta ble. Assu r in g th a t cou l d well be
con sider ed ta n t a m ou n t t o im plem en t a t ion .
Wh it e, on t h e oth er h a n d, goes fu r th er th a n ei th er of th e ot h er t wo. Wh er ea s Bozem a n a n d
Str a u ssm a n en d wit h im plem en t a tion s,Wh ite con cl u des h er m odel of str a t egic m a n a gem en t
with su ggestion s for th e developm en t of m ech a n i sm s for m on itor in g to feed th e on goi n g pr o-
cess of a dju st m en t a n d cor rection s. Th is la st st ep i s a vita l on e, a n d deser ves em ph a si s. Th e LDCs
u n der goin g a dju stm en t ten d t o be ch a r a cteri zed by en vir on m en ta l vola ti lity t o a ssu m e t h a t a
sin gle str a tegy is n ot su bject t o eit h er r evision or m odifica tion ( a n d often r a th er extr em e r evi-
sion or m odifi ca tion ) wou l d be sh ort [ - si gh ted] . Th er efor e, m ech a n ism s to m on itor th e or ga n i-
za tion s con tin u in g fit with th e en vir on m en t a s well a s pr ogr ess towa rd obj ecti ves a r e cr itica l.
An oth er differ en ce li es in ea ch s tr ea tm en t of th e extern a l en vir on m en t. Wh it e a n d Br yson
pu t con sider a ble specifi c em ph a sis on t h e en vir on m en t in th e steps th ey descr ibe a s pa r t of th e
str a t egic process. Bozem a n a n d Str a u ssm a n cert a in ly r ecogn i ze th e im port a n ce of t h e exter n a l
en vir on m en t a s ca n be seen in th e foll owi n g excer pts fr om th eir wor k:
On e pu r pose of st ra tegic m a n a gem en t is to m edia te between th e orga n iza tion a n d t h e
en vir on m en t .
Ann ex 5-A 5 -1 5
Pu bl ic m a n a gem en t n ecessa r ily r equ ir es a t ten tion to th e or ga n iza t ion s en vir on m en t
beca u se th e in flu en ce of exter n a l politica l a u t h or ity em a n a tes from th e en vi ron m en t
[ for th is r ea son , effecti ve pu blic m a n a gem en t requ ir es a tt en ti on t o str a t egy.
...a n exter n a l per spective em ph a sizin g n ot a da ptin g to t h e en vir on m en t] bu t a n ticipa t-
in g a n d sh a pin g of en vir on m en ta l ch a n ge. Str a tegi c pu bl ic m a n a gem en t a dds a n a ddi -
tion a l in gr edien t: str a tegic th in kin g m u st be cogn iza n t of th e exercise of politica l
a u th or it y.
However, u n like eith er Wh ite or Bryson , Bozem a n a n d Str a u ssm a n do n ot descr ibe a specifi c
step for a n a l ysis of th e exter n a l en vir on m en t with in th ei r r ecom m en ded fr a m ewor k. An a lysi s of
th e en vir on m en t is left a s a n im plicit ta sk. Th e da n ger of th is a ppr oa ch i s th a t su ch a n a l ysis
m i gh t sim ply be over looked a s bein g t oo h a r d to do or a s bei n g too ten u ou s t o a dd a n yth in g.
Given t h e im pa ct of th e en vir on m en t on pu blic or ga n iza ti on s, explicit a n d direct a n a lysis is
im per a t ive.
Not su r pr isin gly, th e fa ct th a t bot h a ppr oa ch es em ploy t h e ter m str a tegic gives th e two a
grea t dea l in com m on . St ra tegy, or t h e str a t egic ou tlook sign ifies a for wa r d lookin g m en ta lit y.
Str a tegy does n ot con cer n t h e pa st except for th e lesson s a n d in pu t t h a t ca n be extr a ct ed fr om
pa st exper ien ce. Str a tegy con cer n s th e fu tu r e, a n d to th e exten t th a t th e fu tu re is u n kn own , th e
grea ter it s u n cer ta in ty. Ta sks th a t con cer n th e ver y sh or t r u n a r e gen er a lly n ot gri st for t h e st ra -
tegic m ill. Th e fu r th er th e h ori zon of tim e in volved in th e ta sk, th e gr ea ter t h e level of u n cer -
ta in t y. I n a sm u ch a s str a tegy in volves th e fu tu r e, a n d pa rt icu l a r ly th e m id- t o lon g- r u n fu tu r e,
u n cer ta in ty t h en becom es a pa r t of th e str a tegic pr oblem . Th e str a t egy m ou n ts to a bet th a t th e
fu t u r e wi ll evolve in a pa r ticu la r wa y a n d t h a t th e m a n a ger s pa r ticu la r vision of th e fu tu re
im plied i n th e selection of a st ra tegy wil l be th e cor r ect on e.
5-16 Po licy Too lkit fo r Str en gth ening Health Secto r Refor m
Re fe re nce s
Ba r r y Bozem a n a n d Jeffr ey D. Str a u ssm a n , Pu b lic Ma n a gem en t Str a tegies: Gu id elin es for
Ma n a ger ia l Effectiv en ess. Oxfor d: Jossey- Ba ss Pu blish ers, 1990.
Joh n M. Br yson , Str a tegic Pla n n in g for Pu b lic a n d N on pr ofit Or ga n iz a tion s. Oxfor d:
Jossey- Ba ss Pu blish er s, 1988.
Ha yes, Rober t H., Wh y Str a tegi c Pla n n i n g Goes Awr y., The New Yor k Tim es, Apri l 20, 1986.
Nu tt , P.C., a n d Ba ckoff, R.W. A Str a t egic Ma n a gem en t Pr ocess for Pu bl ic a n d Th ir d-Sector
Or ga n iza tion s. Jou r n a l of the Am er ica n Pla n n in g Associa tion , 1987, 53, pp.4457.
Pa u l , Sa m u el, Str a tegic Ma n a gem en t of Dev elopm en t Pr ogr a m m es: Gu id elin es for Action .
Gen eva : In ter n a t ion a l La bor Office, Ma n a gem en t Developm en t Ser ies, No. 19, 1983.
Rin g, P.S., a n d Per r y, J.L., Str a tegic Ma n a gem en t in Pu blic a n d Pri va te Orga n iza tion s: I m pl i-
ca tion s of Disti n cti ve Con texts a n d Con str a in ts. Aca d em y of Ma n a gem en t Rev iew,
1985, 10, pp.27686.
Lou ise G. Wh ite, Ma n a gin g Policy Refor m in the LDCs. Bou lder, Color a do: Lyn n e Rein n er
Pu bl ish er s, 1990.
_ _ _ _ _ _ _ _ , I m plem en t in g Policy Ch a n ges ( u n pu bl ish ed pa per a t ta ch ed to USAI D Proj ect
Pa per for Im plem en tin g Policy Ch a n ge Pr oject.) Septem ber, 1989.
Ann ex 5-A 5 -1 7
I PC Techn ica l N otes is a pu b lica tion of the U. S. Agen cy for In ter n a tion a l Dev elopm en t
( USAID) Im plem en tin g Policy Cha n ge Pr oject ( # 9 3 6 - 5 4 7 0 , Con tr a ct # AEP- 5 4 7 0 - I- 0 0 -
5 0 3 4 - 0 0 ) , w hich is m a n a ged b y the Agen cy s Glob a l Bu r ea u , Cen ter for Dem ocr a cy a n d
Gov er n a n ce. The Cen ter for Dem ocr a cy a n d Gov er n a n ce is USAIDs foca l poin t for d em oc-
r a cy a n d gov er n a n ce pr ogr a m m in g. The Cen ter s r ole is to pr ov id e USAID a n d other d ev el-
opm en t pr a ctition er s with the techn ica l a n d in tellectu a l ex per tise n eed ed to su ppor t d em o-
cr a tic d ev elopm en t. It pr ov id es this ex per tise in the follow in g a r ea s:
Ru le of La w
Election s a n d Politica l Pr ocesses
Civil Soci ety
Gover n a n ce
Th e Cen ter pu bli sh es a n u m ber of tech n i ca l docu m en ts design ed to in dica te best pr a cti ces, les-
son s l ea r n ed, a n d gu idelin es for pr a cti tion er con sider a tion . Th ey a r e a lso in ten ded t o stim u l a te
deba te a n d discu ssion . For fu r th er in form a tion r ega r din g t h ese Cen ter- specific pu bli ca tion s,
plea se con ta ct th e Cen t er s In for m a ti on Un it a t ( 202) 661- 5847.
Th e IPC pr oject s con t ra ct tea m con sists of Ma n a gem en t Syst em s I n t er n a tion a l ( pri m e con tr a c-
tor ) ; Abt Associa tes I n c.; a n d Developm en t Alter n a t ives. Th e I PC Pr oject Office i s loca t ed a t MSI ,
600 Wa ter Str eet, S.W., Wa sh in gton , D.C., 20024. Teleph on e: ( 202) 484- 7170; Fa x: ( 202)
488- 0754.
US Agency for International Development
1300 Pennsylvania Avenue, NW, Washington, DC 20523-5900
Tel.:202.712.5859 Fax: 202.216.3262
Pan American Health Organization
525 23rd Street, NW, Washington, DC 20037-2895
Tel.:202.974.3832 Fax: 202.974.3613
Partnerships for Health Reform
Abt Associates Inc.
4800 Montgomery Lane, Suite 600, Bethesda, MD 20814-5341
Tel.:301.913.0500 Fax: 301.652.3916
Family Planning Management Development
Management Sciences for Health, Inc.
165 Allandale Road, Boston, MA 02130-3400
Tel.:617.524.7799 Fax: 617.524.2825
Data for Decision Making
Harvard School of Public Health
665 Huntington Avenue, Boston, MA 02115
Tel.:617.432.4610 Fax: 617.432.2181
The Latin America and Caribbean Regional Health Sector Reform Initiative is a joint effort of the following organizations:
Latin America and Caribbean Regional Health Sector Reform Initiative website:
http://www.americas.health-sector-reform.org