Balancing Structure and Flexibility for Effective Public Health Planning

November 04, 2024 | Sara Bell, Marta McMillion, Megan Drake-Pereyra

Many governmental public health agencies in the U.S.-Affiliated Pacific Islands are developing or revising plans to guide work throughout the agency. Staff assisting with these plans can build their internal capacity to do so by reflecting on key lessons learned from a recent learning community series. This series offered a platform for sharing key strategies and insights on effective planning, and underscored planning as a foundational activity for resilient and adaptable health departments. Effective planning remains a structured yet flexible process that, when embraced with humility, can lead to lasting success.

Leaning into the Core Elements of Planning

Though the responsibility of developing these plans can seem overwhelming, planning doesn’t need to be overcomplicated, as the learning community participants learned. The core elements of a planning cycle remain consistent, and learning to embrace the idea of revisiting and revising a plan is key to keeping it alive.

Preparing to Plan

Effective planning begins with strong organization, which involves identifying a lead, forming a workgroup, securing leadership support, and understanding available resources. Developing a team charter is key to outlining expectations for how the team will operate. The mission and vision are critical, serving as guiding principles for the plan’s purpose and long-term goals. Importantly, these should remain flexible, evolving as the planning process unfolds to meet changing needs.

Defining roles and responsibilities early on ensures that everyone involved understands their part in the process. Clear communication, decision-making strategies, and engagement with partners are essential to maintaining alignment across initiatives. This groundwork lays the foundation for a dynamic, adaptable planning process that can evolve over time.

Planning

Planning starts from the current situation and relies on understanding both internal capabilities and external motivators—which is where an environmental scan or assessment plays a crucial role. By gathering data and information, organizations can uncover important insights about their strengths, challenges, and the opportunities or threats they face. This step is essential for identifying the key factors that shape strategic direction and for anticipating changes that may impact future plans.

With this understanding in place, the focus turns to prioritizing actions that will drive meaningful progress. By refining priorities, organizations can concentrate their efforts on the most significant areas for impact, ensuring teams direct resources effectively. Workplans then break these priorities into clear and actionable steps, assigning responsibilities, setting timelines, and outlining the resources needed to achieve long-term goals. This approach transforms strategic priorities into real-world action, ensuring the organization is prepared to adapt and succeed in an evolving environment.

Implementing: Do, Review, Revise

Bringing a plan to life is just the beginning. True success lies in the ongoing process of monitoring progress and evaluating impact. Monitoring ensures that teams complete activities on time, within budget, and in alignment with the plan's goals. Evaluation, on the other hand, digs deeper, assessing whether the actions taken are truly driving meaningful outcomes. Together, these processes create a feedback loop that keeps the organization accountable, allowing for adjustments as needed.

Once implementation is underway, regular review and revision are essential to keep the plan relevant. This is where flexibility comes in—organizations should treat plans as living documents, open to adjustments based on real-time feedback and evolving circumstances. By embedding monitoring and evaluation into the process, organizations can ensure they are not only on track but also adapting to new challenges and opportunities as they arise. This cycle of doing, reviewing, and revising is what keeps the planning process dynamic and effective​.

Fostering Community

In addition to abiding by the core planning elements, collaborating with and offering support to fellow public health agencies is powerful and important to effective planning. Doing so fosters community, which can enable individuals to learn from others’ experiences and develop relevant strategies.

For example, the participants of the learning community came from diverse planning backgrounds—whether working on data modernization, workforce development, or non-communicable disease prevention—yet they all faced common challenges. The learning community provided an invaluable space for them to exchange ideas, share templates, and offer support. During one session, a participant mentioned they were working on a project charter for their plan, to which another offered up a charter template they found helpful.

By fostering an environment of knowledge sharing and collaboration, agencies can exchange innovative ideas and best practices, and adapt them to their unique contexts.

Embracing Humility

At its core, planning is not a one-time task but an ongoing process that requires humility and resilience. Whether it’s reaffirming values or revising a team charter or work plan based on new insights, the willingness to adapt is what keeps planning effective.