Health Program Tools and Their Applications

Programming Tools

Description of the Logic Model and the Reasons for Its Selection

According to Allmark, Baxter, Goyder, Guillaume, and Crofton-Martin (2013), the logic model is a visual depiction of the relationships between different resources needed to implement a successful health program. The model also outlines the planned activities and the expected changes that are needed to attain specific desired results. The basic logic model includes five steps as described below.

Logic model.
Figure 1. Logic model (Kellog Foundation, 2004).

As highlighted above, the first and second steps define the planned work. These steps include the resources used in the health program/inputs and associated activities. The third, fourth, and fifth steps outline the intended benefits. The steps include outputs, outcomes, and impacts.

How the Logic Model is useful in the Ebola Awareness Campaign

Our planned public health campaign is the Ebola awareness campaign, which strives to create awareness about the disease in Sierra Leone. The logic model would be useful to this campaign in the following three ways. The first one is through the prevention of mismatches between the program’s activities and effects. In other words, the use of the model would help to improve alignment between program tasks and their intended goals (Goeschel, Weiss, & Pronovost, 2012). The second way that the logic model would be useful in the Ebola awareness campaign is through its ability to help program implementers identify the most effective and useful tasks that require the most resources (Kellog Foundation, 2004). This way, program implementers would be better informed when making their resource allocation decisions because, while using the model, they would divert more resources to the most useful programs. Lastly, the logic model would be instrumental in the Ebola awareness campaign in Sierra Leone because it could help stakeholders improve the data analysis process (West, 2014). In detail, the model would help to reveal the data needs which are required to complete each phase of the analysis. Furthermore, it would help to provide a framework for analyzing this data.

The Challenges of Using the Logic Model in the Ebola Awareness Campaign

Two potential challenges may be associated with the use of the logic model in the Ebola awareness campaign. One of them is the pursuit of excellence that may impede its effective utility. The second challenge is the excessive time it takes to develop an effective model (Allmark et al., 2013).

Strategies for Addressing the Challenges of Using the Logic Model

As highlighted above, the use of the logic model in the Ebola public health campaign could be problematic because of the aforementioned reasons. However, to solve the problem of the pursuit of excellence, as an impediment to its effective utility, program designers need to introduce measurable results as a definition of excellence (Goeschel et al., 2012). This strategy is opposed to associating the logic model with excellence, without a criterion for measuring it. The lack of this criterion is the main reason for impeding effectiveness in utility because the concept of achieving excellence may instill fear or intimidate public health workers. However, if excellence were substituted for measurable and attainable goals, such fear and intimidation would disappear leaving adequate room for program improvements. Lastly, to solve the problem of excessive time consumption when developing the model, program planners need to start the model development process earlier than expected so that they do not affect other aspects of the policy implementation process.

Description of Budget and Its Use in Implementing Public Health Programs

Typically, budgets are used not only in the health care sector but in other fields as well. However, when budgets are used correctly in implementing public health programs, such as the Ebola awareness campaign, it is an effective programming tool for ensuring the program is completed using the appropriate financial resources and on time (Lenoir-Wijnkoop, Gerlier, Bresson, Le Pen, & Berdeaux, 2015). One benefit that could be derived from using budgeting, as a programming tool, is increased coordination that would suffice through the alignment of different program activities (Lenoir-Wijnkoop et al., 2015). This programming tool is also beneficial in the implementation of the health program because it would provide a platform for evaluating the performance of those involved in its implementation. For example, through its use, we could easily establish how well each stakeholder implemented his or her plan. Generally, this programming tool would improve the effectiveness of different activities in the Ebola awareness campaign.

Challenges and Solutions of Using the Budget Programming Tool in Public Health Programs

One challenge associated with using the budgeting tool in the context of implementing the Ebola awareness campaign is the excessive focus on finances, as a measure of performance (Lenoir-Wijnkoop et al., 2015). This is a problem because the health program is designed to improve subjective outcomes associated with human wellbeing – increased awareness about Ebola. In this regard, it would be difficult to fit such a subjective outcome to a programming tool that mostly focuses on quantifiable outcomes. One solution for this problem is limiting the programming tool to only the resource inputs associated with the program and not to the subjective outcomes involved with the same. In other words, it is important to limit the use of this programming tool for the improvement of how the implementers of the program using available resources to achieve the desired goals. Subjective outcomes should be measured using other tools like the linear programming model.

Applying Programming Tools

Logic Model

The goals for the proposed public health program are presented below:

  • Goal 1: To inform Sierra Leoneans about social behaviors that spread Ebola by 2020.
  • Goal 2: To inform Sierra Leoneans about how to care for Ebola patients by 2020
  • Goal 3: To inform Sierra Leoneans how to detect Ebola by 2020

Based on the above-mentioned goals, below there is the logic model for the proposed public health program:

Inputs Activities Outcomes Goals
Short-term
Outcomes
Intermediate Outcomes Long-term Outcomes
  • People:
    • Project Manager
    • Project

Coordinator

    • Evaluation Consultant
    • Community health leaders
  • $300,000 in financial resources
  • Media partners
  • Training facility
  • Capacity building facility
  • Training community health leaders about Ebola
  • Technical assistance from media organizations in designing Ebola campaigns
  • Financial assistance sub-awards
  • Community health leaders gain new knowledge about Ebola prevention and management
  • Public health practitioners gain new partners in the media and community mobilization
  • Mass media messages start to be broadcast to community members
  • Partners start to mobilize communities and teach them about Ebola prevention and management
  • Residents of Sierra Leone are more aware of how to care for Ebola patients
  • Communities are knowledgeable about how to prevent Ebola
Goal 1: To inform Sierra Leoneans about social behaviors that spread Ebola by 2020.

Goal 2: To inform Sierra Leoneans about how to care for Ebola patients by 2020.

Goal 3: To inform Sierra Leoneans how to detect Ebola by 2020.

The logic model has a lot of value to offer in the implementation of the Ebola awareness program. First, it is important to point out that the logic model introduces measurable metrics in the implementation of programming tools, which help users to track their performance (Breuer, Lee, De Silva, & Lund, 2016). In this regard, the first value of the logic model is hinged on the fact that what gets measured is easily accomplished. In other words, by introducing measurable progress in the program implementation process, the actors involved in the program can complete specific tasks easier because they are subject to measurement reviews. A converse argument to demonstrate this value lies in the fact that it would be difficult for the actors to understand what is successful and what is not, if they are unable to measure their progress (Fertman & Allensworth, 2017).

Since the logic model attaches specific values to different project outcomes, it is easy for the stakeholders to attach rewards to successful activities and improve the problematic areas. Indeed, as Knowlton and Phillips (2012) point out, without understanding how success looks like, it is easy to reward failure. Another value proposition offered through the implementation of the logic model is the ability to learn from the failures attributed to the Ebola awareness campaign. Similarly, the model offers a platform for people to learn from its successes because without recognizing success in the program plan, it is easy not to learn from it. Similarly, it would be difficult to correct aspects of the project that failed to meet their intended goals, if the project implementers are unable to recognize failure. Lastly, the implementation of the logic model would be useful to the actors involved because it would help them to gain public support. After all, if they can demonstrate results by increasing the awareness of residents of Sierra Leone about Ebola, then it would be possible to convince the people to support them some more (Madanat, Arredondo, & Ayala, 2015).

Budget

Budget Items Cost
Administrative services
Full-Time Employees
Part-time Employees
Community Health Leaders
Transportation
Licenses
$50,000
$5,000
$7,000
$2,000
$500
Technical Services
Development of Public health Campaign
Training
$40,000

$100,000

Advertisement
Radio
Television
Print
Social Media
$10,000
$30,000
$15,000
$12,500
Program Evaluation $28,500
Total $300,000

The value of using a budget for the Ebola public health campaign rests in the fact that it provides a spending plan for public health workers to follow. In this regard, the budget-programming tool is of value to project implementers because it allows them to secure financing for the most important activities attributed to the health plan (Krisberg, 2012). This provision is essential in realizing effective resource allocation because there are many instances where health programs have failed to meet their goals because of ineffective budgeting and poor resource allocation (Krisberg, 2012). Budgeting also helps to improve accountability in the program implementation process. This way, different actors are forced to be responsible for the funds allocated to them because the failure to do so could lead to serious repercussions (like criminal proceedings because of fraud) (Krisberg, 2012).

Increased accountability could also help in improving stakeholder relationships, especially where there are external partners involved in the program (Krisberg, 2012). For example, if the UN and the World Health Organization choose to participate in the program, they would demand a budget to assess their involvement and expectations (Krisberg, 2012). Without such a tool, it would be difficult for project implementers to get additional funding (if need be) or justify their current expenditures. At the same time, these budgets are of value to the stakeholders because they help them to minimize wastages by getting a “bigger picture” of how the money will be spent before the project commences. This way, they can amend the budget before it is used. It would be difficult to gain such insights without this programming tool because if the project implementers embark on the project without the general overview of how the funds would be spent, it would be difficult to track the areas of implementation that would be affected by erroneous allocations and similar issues.

Timeline

Assuming that the Ebola awareness campaign would take three years, the following timeline would be applicable

First-year

Tentative Deadline Task
Jan – March
April – June
July – September
October – December
  • Meet with partners and engage them in program planning
  • Brainstorm on ideas regarding how to design the public health awareness program
  • Choose which media partners to use
  • Review the messaging and evaluate whether key areas are addressed in the program

Second-year

Tentative Deadline Task
Jan – March
April – June
July – September
October – December
  • Undertake community health campaigns spearheaded by local health leaders
  • Start Radio awareness campaigns
  • Start television campaigns
  • Start print and social media campaigns

Third-year

Tentative Deadline Task
Jan – March
April – June
July – September
October – December
  • Address any concerns of the members of the public regarding the program and answer any questions associated with the same
  • Obtain feedback from community members regarding the campaigns
  • Assess the community’s awareness regarding the program
  • Review the effectiveness of the overall campaign

As explained by Perrin (2014), the program timeline is like the pulse of a health program. In this regard, it is valuable to the project implementers because it allows them to capture the essence of what the project is about – making Sierra Leoneans aware of Ebola. This programming tool is not only valuable because it allows the program implementers to complete their programs on time, but also critical to its successful implementation. After all, it allows them to complete it in high quality and in a financially responsible way (Perrin, 2014). Similar to the budgeting and the logic modeling tools, timelines are also valuable because they increase the efficiency of resource distribution in the overall program plan (Perrin, 2014). This tool draws our attention to the most time-consuming tasks and those that require less involvement of stakeholders, thereby giving program planners an indicator of the kinds of resources that would be required to complete them. Furthermore, the resource allocation process could be made more efficient by using this tool to give project planners an indicator of the best time to deploy their resources. Generally, this timeline programming tool would help the project implementers to complete their program successfully and on time.

References

Allmark, P., Baxter, S., Goyder, E., Guillaume, L., & Crofton-Martin, G. (2013).

Assessing the health benefits of advice services: Using research evidence and logic model methods to explore complex pathways. Health and Social Care in the Community, 21(1), 59–68. Web.

Goeschel, C., Weiss, W., & Pronovost, P. (2012). Using a logic model to design and evaluate quality and patient safety improvement programs. International Journal for Quality in Health Care, 24(4), 330-337. Web.

Kellog Foundation. (2004). Using logic models to bring together planning, evaluation, and action: Logic model development guide. Web.

Lenoir-Wijnkoop I., Gerlier, L., Bresson, J., Le Pen, C., & Berdeaux, G. (2015).

Public health and budget impact of probiotics on common respiratory tract infections: A modelling study. PLoS ONE 10(4): 1-12. Web.

West, J. (2014). Public health program planning logic model for community engaged Type 2 diabetes management and prevention. Evaluation and Program Planning, 42, 43–49. Web.

Breuer, E., Lee, L., De Silva, M., & Lund, C. (2016). Using theory of change to design and evaluate public health interventions: A systematic review. Implementation Science, 11, 63-65. Web.

Fertman, C. I., & Allensworth, D. D. (Eds.). (2017). Health promotion programs: From theory to practice (2nd ed.). San Francisco, CA: Jossey-Bass. Web.

Knowlton, L., & Phillips, C. (2012). The logic model guidebook: Better strategies for great results. London, UK: SAGE. Web.

Krisberg, K. (2012). Budget cuts straining capacity of public health departments: Services in demand. Web.

Madanat, H., Arredondo, E., & Ayala, G. (2015). Introduction to health promotion & behavioral science in public health. Boston, MA: Cengage Learning. Web.

Perrin, K. (2014). Essentials of planning and evaluation for public health. New York, NY: Jones & Bartlett Publishers. Web.