Plan Together

A guide to the planning process

This section describes 16 of the most common tasks involved in creating a community action plan. When you hold your planning session with the community, some or all of these tasks will form the essence of that session and be the means whereby participants will design their commuity mobilization effort.

Before you hold that session,however, you need to become familiar with these 16 tasks and carefully plan how you are going to execute them when the time comes. Your planning session(s) may not follow this sequence exactly, and you may add or omit certain items, but this list gives you a general idea of the most important tasks to be accomplished.

Your job during this step of the Plan Together phase is to do the following:

  1. Review the 16 tasks described below and decide which ones are appropriate for your situation and then delete or add tasks as necessary.
  2. Decide on the sequence of the tasks.
  3. Decide who will be responsible for facilitating each task.
  4. Decide how these tasks will be carried out.
  5. Decide what materials or tools will be needed to carry them out.
  6. Decide on any other matters that need to be arranged before the planning meeting.
In the list that follows, the descriptions explain what should happen vis-à- vis each task at the actual planning session, and the word “participants” refers to the attendees at that session. As you read this list, your focus should be on what you have to do now—in preparing for the session—so that the activity described under each task can be successfully carried out.

Task 1: Orient participants to the overall goals of the CM program.

Even though many of the participants may already have heard about the program, it is important to review the goals of the program, the timeframe, and who is involved in the program.

Task 2: Clarify the specific objectives of the planning process.

Participants should understand what they are trying to achieve in this planning session. As mentioned earlier, the program team/meeting facilitators may want to do an exercise to clarify participant expectations and address any of their concerns now.

Task 3: Consolidate and review relevant information.

This is the time for core group members to present what they have learned during the Explore the Health Issue and Set Priorities phase. Participants need to be able to have a chance to ask questions, discuss the relevance of the information to the community and contribute their knowledge and experience of the health issue (and you should, accordingly, plan for such a discussion).

(Note: During the actual planning session, you may want to organize the information generated by the following tasks, 4 through 10, using the Community Action Plan Matrix presented in the tools section under this phase.)

Task 4: Develop a consensus on program priorities, objectives, desired results or other indicators of success.

During the planning session, the participants will need to agree on priorities. These priorities should be stated in a positive way so that they can be seen as “desired results”, “dreams” or “objectives.” For example: “All people of reproductive age in this community will have access to family planning information and services.” Or: “We will have no reported cases of measles in this community by the end of this year.” Prior to the meeting, you may want to ask health service providers what kinds of relevant indicators the national health system recommends to measure progress in health status related to the community mobilization health issue.

As readers will have seen in the previous phase, this field guide actually recommends that the core group set priorities at the end of the exploration phase. The reason for suggesting this approach, i.e., that the core group set priorities before this general planning session, is to better ensure that individuals with less power (who are usually the ones most affected by health issues and who should, therefore, be part of the core group)—to ensure that such individuals are at least listened to, which is often not the case in a more open forum such as this planning session. (In the example from Malawi, we see how even when those with minimal power help design and facilitate the planning process, their voices can still go unheard.) If this particular problem is not an issue in your community, you may want to move priority setting into the planning session.

MALAWI: Whose Priorities?

In a concerted effort to develop greater youth ownership and control over a Malawi-based adolescent reproductive health program, youth were trained in focus group methods, developed their own questionnaires, and were supported during their fieldwork as they collected information from other youth, parents and healthcare providers in their community. They consolidated and analyzed the results from their focus groups together with program staff in preparation for the joint strategic planning meeting that would determine the program's priorities, approach, strategy, and activities.

An unprecedented group of concerned youth, healthcare providers, religious leaders, teachers, government officials, and local and international NGOs attended the planning meeting. Youth helped prepare and facilitate the meeting, participating even as daily chairpersons. Planning participants reviewed the data collected from the youth focus group discussions and secondary data from government statistics and health facilities. Young girls presented startling findings of beatings that resulted from having refused sex, encouragement from family members to engage in sex for money or goods due to conditions of poverty, and pressure from local 'sugar daddies' to exchange sex for shoes or food. During the planning workshop, however, the young girls repeatedly tried to bring up these important findings but were continuously dismissed for having exaggerated the situation or they were 'out-voiced' and accused of being 'silly' by either young boys and/or the adults-many times by the older men in the group.

Ultimately, the whole issue of "sugar daddies" was left out of the plan because they (the sugar daddies) were actually the ones making the decisions about priorities in the meeting.This may not have happened if a core group including the young girls affected by the problem had decided on the priorities before going into the planning session. They then could have presented them in the meeting as "These are our priorities and let's deal with them."

Save the Children Federation, Malawi Field Office

Task 5: Identify resources, opportunities, challenges and constraints.

When the participants have agreed upon their desired results, they should then reflect on their current situation and what it will take for them to get to where they want to go. As they do so, they will begin to identify challenges they will need to plan for, opportunities that may open up new possibilities, resources they may need to reach the objective, and barriers or constraints they may have to overcome. It helps for participants to be specific here and provide concrete examples rather than talk in general, abstract terms. Some techniques you may want to consider using to make this exercise more real include: role playing, socio-dramas or skits, story telling (real stories or composites of real stories), making an inventory of participant knowledge and skills, and identifying potentially available public and private resources.

Task 6: Develop a variety of strategies to achieve the desired results.

Developing strategies can be a fun and creative process for participants. Encourage participants to think of as many strategies as possible to achieve a desired result before they select one or two. The brainstorming process should allow for “crazy” ideas that may spark new thinking that may ultimately lead to effective new strategies. At the session, the facilitator can help the creative juices flow by giving some funny examples or, better yet, ask participants to vote for the funniest/most outlandish idea presented.

To help participants develop strategies, the facilitator may suggest the following:

  • Think of strategies that you have used in the past that have been successful. What made these strategies successful? How can you apply what you have learned to this exercise?
  • Imagine that you could enlist anyone to help you. Who would you enlist? Why? What would that person do to achieve the desired result?

  • Think of what your community does better than any other community you know of. What skills, systems and resources contribute to your community doing this so well? How can these be utilized to help you achieve your objective?

  • Organize participants in smaller groups that may be based on gender, age, occupation or another common characteristic that may influence their perspectives. Then ask the groups to develop strategies for the same desired result. When the groups are ready, they can present their ideas to the other groups.

  • Ask individual participants to think of their own strategies before they work with a group. This process may encourage more independent, creative thinking that can then be contributed to the larger group.

During this strategy forming stage of planning, many groups include an exercise on determining root causes, such as the “problem tree” activity. The assumption is that if participants are aware of the root causes of health or other problems they will develop more effective strategies. This exercise can be very enlightening to illustrate how the larger environment and other factors affect individuals’ health status. Through the exercise, participants come to realize that poverty, social injustice, and other macro-forces are ultimately responsible for many people’s poor health and other social problems (although one could argue that many community members are already aware of this). (A more detailed description of the problem tree exercise can be found in the Nonformal Education Manual listed in the resources section.)

The problem tree is visually appealing to many facilitators and the discussion that it generates is rich, making it popular to use. However, it can sometimes overwhelm participants involved in a planning process if they believe that they must work on these difficult macro-issues before they can hope to address their health concerns. Additionally, some cultures view causality very differently from a more linear western concept. While communities no doubt need to grapple with these issues—and they do every day—your team should carefully consider whether this exercise will help participants plan more effectively.

Task 7: Select strategies with the most potential to improve health.

Once participants have developed a number of strategies to choose from, they will need to select one or two to develop further. Establishing selection criteria, such as those listed below, will helps participants better assess a strategy’s potential.
  • Feasibility. Can we do it? Do we have the necessary resources, skills, time?
  • Reasonable costs
  • Probability of success in improving health
  • Political support
  • Available resources
  • Easy to understand, clear
  • Length of time needed
During this selection process, it is important to pay attention to whether there are any hidden agendas or unrealistic expectations. The facilitator needs to remind participants to be realistic while also allowing them to envision a better reality.

Task 8: Specify activities, resources needed and how resources can be obtained.

If participants have carefully thought through the earlier tasks, it will be relatively easy for them to specify activities. If the participants have very limited experience with group planning, the facilitator may want to take them through the exercise in the chart on this page.

Learning to Plan in Groups: Building on what we already know

This exercise demonstrates how participants in a community health planning process can apply what is familiar to them (see second column below using agricultural planning as an example) to planning something they may not be familiar with (a health intervention). It shows how their knowledge can be generalized and applied in other contexts.
Planning Questions Planting example Vaccination example

 
What do you want to achieve? (Goal) Food to feed my family and income to pay for school fees and other household expenses. All the children in our community will not be sick with diseases that can be prevented by vaccination.

 
What will you see when you achieve your goal? (Desired results; objectives.) X# bushels of wheat, X# bushels of peas, etc. All children one year and older will be completely immunized.

 
What things do you need to keep in mind as you decide how you want to do it? (opportunities, challenges, constraints, resources) How much land I have, predictions for rain this year, amount of money I have for seed, amount of time it will take, # helpers who know how to plant, etc. How much vaccine we have, # people who can help, time, whether parents will come, cold chain, etc.

 
How will you do it? (strategy) (Ideally, you would generate alternatives here first and then select the most promising one.) We will plant X# hectares with wheat, X# with peas and will leave X# fallow, etc. Work with community groups to increase awareness. Vaccinate at the market every week and at health post every day.

 
Describe step-by-step how it will be done. (activities) 1. Schedule people to help
2. Purchase seed
3. Prepare the soil.
4. Etc…….		 1. Ensure that cold chain is in place.
2. Meet with community leaders and organizations.
3. Train vaccinators, etc…..

 
What will you need to do it? (resources) Money, seed, 3 helpers X# hectares of land, etc. Vaccine,4 vaccinators 4 thermoses, etc.

 
When will you begin? How long will it take? (timeline) May 15, 2000 5 months June 1, 2000- December 31, 2000

 
How will you know when you have succeeded? (indicators) We will have produced X# bushels of __. My family will have 3 meals/day for 6 months. I will be able to pay school fees & will have $____ left for household expenses. By December 31, 2000, at least 80% of children one year and older will be completely immunized.

Task 9: Assign responsibilities. Participants need to determine who will be responsible for each activity and the desired results.

Rather than delegating everything to the formal community leader, which often happens, community members might want to consider who would be most effective implementing each activity and how best to share responsibility so that activities can be accomplished more efficiently while building a broader community skill base. Does the person have the time necessary to accomplish the task? Would it be better for one person or a group to do it?

Simply assigning responsibilities will not be enough if the assignees don’t have the knowledge or skills they need to complete the tasks. Part of your plan, therefore, may have to include knowledge and skill building elements. In the Act Together phase, we will go into more detail on how to strenghten the group’s capacity to carry out its activities.

Task 10: Determine timelines.

When community groups are excited about beginning to work on an issue, they often propose that everything be initiated immediately or very soon after the planning meeting. The facilitator’s role is to help them think through whether their proposed timelines are realistic. Participants should consider whether the dates they propose would conflict or opportunely coincide with other community activities. What happens if implementers encounter a delay? How will this delay affect the other planned activities? More literate groups may use tools such as Gantt charts (see example below) to help them visualize when activities will occur. If you think it will help a less literate group, you can adapt the Gantt chart concept using a more pictorial tool. For example, you could ask participants to draw pictures of special events that occur each month of the year that will serve as headings and then place pictures of planned activities in the corresponding month row or column. Whatever tool is used, it needs to be included in the final, formal plan so that it can be used as a planning and monitoring guide.

Months
Desired Results/ Activities 1
Jan		 2
Feb		 3
Mar		 4
Apr		 5
May		 6
June		 7
July		 8
Aug		 9
Sept		 10
Oct		 11
Nov		 12
Dec
80% of children > 1 year will be completely immunized  
1. Establish cold chain   X X  
2. Train vaccinators   X  
3. Meet with community members to plan market day vaccination activities   X  
4. Weekly market day vaccination sessions   X X X X X X
5. Etc.  

Task 11: Establish or reaffirm coordination mechanisms.

Some planning sessions result in wonderful plans, but the plans are ultimately never followed because the group failed to establish coordination mechanisms during the planning session. It is especially important to discuss how coordination will be done when there are a number of organizations or individuals who have not worked together before in any formal way. Here are some questions you can include in the planning session to begin this discussion.
  • How are we going to make sure that these plans are carried out?
  • Who will track our progress?
  • How often will we need to review our progress?
  • What happens if we need to change our plans?

If participants decide they would like to form a coordination committee, they will need to determine what committee members will do, what criteria will be used for selection, and how selection will occur. It is usually better to determine this during the planning session when all participants are present, unless there are very good reasons to postpone it.

Task 12: Determine how the community will monitor progress.

The group should also consider how it would like to monitor progress. Two of the most common types of monitoring, process and outcome, are briefly illustrated below.

Process monitoring asks:

  • Are we doing what we said we would do?
  • How well are we doing it?
  • What difficulties or challenges have we faced?
  • What have we learned?

Outcome monitoring asks: Are we achieving our desired results?

  • health status?
  • health indicators?
  • our capacity to address our health needs?
  • changes in health policies including resource allocation for health programs?

What other spin-off effects and outcomes do we see from our efforts?

You should consider the level of experience of the group and time considerations to help you structure this part of the planning process. For less experienced groups, it may be enough to introduce the concept of monitoring and then plan another session later on that goes into more depth on monitoring tools and techniques.

If you use a type of planning matrix such as the one in Useful Tool II, it can easily be converted into a monitoring tool by adding three more columns to the right side of the matrix, one entitled “status,” one entitled “observations/comments,” and one called “next steps” to monitor progress on process and outcome indicators. (See Useful Tool III)

Task 13: Determine next steps and congratulate the group.

The planning participants should be given the opportunity to determine immediate next steps. If they need to present their draft plan to others before they can commit to it, they should determine when they will do this and who will do it. They should establish a time and place for their next meeting and identify who needs to attend. They may have other next steps that they would like to work out before leaving the group. It helps to write these agreements down.

Planning together is hard work and participants should be congratulated when they have completed a draft or final plan. This is very important.

Task 14: Present draft plans to the broader community if appropriate.

As mentioned above, sometimes participants would like to seek broader community support for the plan before they commit to it, particularly if they represent others in the community who were not present during the planning sessions. A community meeting or assembly is an easy way to accomplish this. Task 15: Revise plans if necessary based on feedback. When participants share the plan with others, they may get helpful feedback that will need to be discussed with the other members of the planning group. The plan may need to be revised before it is finalized.

Task 16: Finalize plans in a formal document.

The final action plan should be a formal agreement. Communities often have traditional practices to recognize formal agreements, and these practices should be honored. For example, some communities ask all participants to sign and seal or stamp the agreement. They may celebrate the agreement with a meal or dance. Ask participants how they would like to celebrate.

Once a plan is in “final” form, communities can still modify it. Indeed, it should be a living document. However, recognizing that the plan has been agreed to publicly means that implementers are accountable to others in the community when they change directions.

These, then, are the key tasks and activities involved in creating a community action plan. Now that your planning team has reviewed these tasks, you are in a position to prepare for the planning session by answering the six questions posed at the beginning of step 1.

One final task you have is to create an agenda for the planning session. The sample shown here is from an HIV program in Malawi:

SAMPLE
PLANNING TOGETHER AGENDA FOR AN HIV/AIDS PROGRAM

  1. Welcome
  2. Introductions (with icebreaker/warm up)
  3. The AIDS Community Mobilization Program: Goals and objectives
  4. Goals and Objectives of this Planning Session
  5. AIDS in our community: Results from our community assessment and analysis
  6. Planning to take action on AIDS
  7. Planning how we will work together and monitor our progress
  8. Next steps