Planeamento estratégico no setor da saúde da Guiné-Bissau: evolução, influências e processos: Strategic planing in Guiné-Bissau´s health sector: evolution, influences and processes

Catia Sá Guerreiro, Augusto Silva, Tomé Cá, P Ferrinho

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Abstract

Although it is recognized that strategic planning (SP), when evaluated according to predefined goals and objectives, has a low execution rate, it has value as a complex, participatory and mobilizing procedure in all quarters of society. Strategic health planning has (SHP) has begun to emerge since the 1990s, strongly driven by the global strategy for health for all by the year 2000 (WHO, 1981) and more recently by the Health 21 - Health for All in the 21st Century (WHO, 1998).
The Republic of Guinea-Bissau (RGB), one of the poorest countries in the world, presents a context of fragility and deficiencies in health and functioning of it´s health system, which does not respond to the health needs of the country.
It is however, a State that over the years has made the exercise of SHP.
The strategic management of the RGB´s health system was, until March 2017, guided by a National Health Policy adopted and approved in 1993. It has, over time, framed various thematic policies and guided the preparation of two National Health Development Plans (NHDP). The extension of the first NHDP was framed by the first National Strategy Document on Poverty Reduction (DENARP I 2004-2007) and the second NHDP by the DENARP II (2011-2015). the third NHDP, in preparation, will be guided by the National Health Policy adopted in March 2017, by the Strategic and Operational Plan of the Government Terra Ranka (2015-2025) and by the recommendations that emerged in October 23014 from the 1st National Health Conference.
The SHP process in RGB also incorporates and feeds other planning processes by partners, services and civil society bodies, giving rise to a web of guiding documents - policies, plans, programs, projects.
The management of this complexity should have been taken over by the NHDP Management Office, which has not happened. This is partly due to the lack of staff in the Office, and also to the fact that the SP is seen not as an element of dynamic strategic management, but as a self-contained process that allows mobilizing funds from donors and guides other thematic planning cycles, not always articulated with the NHDP´s time horizon.
The present article makes a review trip to the SHP process in RGB in three moments, each associated with a NHDP: 1998-2002 (extension of 2003-2007); 2008-2017; 2018-2020. In a narrative that intends to keep a memory of these processes, the article reports either to the personal experiences of the authors, or follows a methodology of analysis of documents, mostly unpublished, obtained from key informants in the course of several works in which Authors were involved as directors or consultants of the Ministry of Public Health of RGB.
Original languagePortuguese
Pages (from-to)47-60
Number of pages14
JournalAnais Do Instituto De Higiene E Medicina Tropical
Volume16
Issue number1
Publication statusPublished - 2017

Keywords

  • health planning
  • Guiné-Bissau
  • health system

UN Sustainable Development Goals (SDGs)

  • SDG 3 - Good Health and Well-Being

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