Section 5

Introduction to Strategic Management

Health policy reforms, even ones that have been approved, decreed, or signed into law, will not necessarily be implemented as intended without the impetus and guidance of policy champions. The policy process, as explained and diagrammed in the introduction to this toolkit (Section 1, especially Figure 1.1), includes the following stages: policy formulation and legitimation, constituency-building, resource mobilization, implementation design and organizational structuring, and progress and impact monitoring. However, proposed reforms are not likely to progress through these stages without someone managing or shepherding them. For those who want to participate in and further the process of health sector reform, strategic management provides an effective approach. Strategic management is a process for developing and enacting plans to reach a long-term goal that takes into account internal variables and external factors. Strategic management encompasses an integrated, future-oriented managerial perspective that is outwardly focused forward-thinking performance-based (see Kiggundu 1996). Strategic managers identify long-range targets, scan their operating environments, evaluate their organizations structures and resources, match these to the challenges they face, identify stakeholders and build alliances, prioritize and plan actions, and make adjustments to fulfill performance objectives over time. Brinkerhoff (1991 and 1994) characterizes strategic management as looking out, looking in, and looking ahead. Looking out means exploring beyond the boundaries of your organization to set feasible objectives, identify key stakeholders, and build constituencies for change. Looking in implies critically assessing and strengthening your systems and structures for managing personnel, finances, and other essential resources. Finally, looking ahead entails melding your strategy with structures and resources to reach your policy goals, while monitoring your progress and adjusting your approach as needed.

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Policy Toolkit for Strengthening Health Sector Reform

Balancing strategic managements outward-, inward-, and forward-looking functions helps you develop a vision and a strategy for where and how to move health sector reform forward. Balancing these different perspectives is the essence of managing strategically (Brinkerhoff 1991). Strategic management comprises five key facets: goal-setting, analysis, strategy formation, strategy implementation, and strategy monitoring (see Figure 5.1). These are the integral elements that, when applied together, distinguish strategic management from less comprehensive approaches, such as operational management or long-term planning. Strategic management is an iterative, continuous process that involves important interactions and feedback among the five key facets, which are explained in more detail in Table 5.1.

Figure 5.1. Facets of Strategic Management

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Introduction to Strategic Management

5-3

Table 5.1. Five Facets of Strategic Management

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As mentioned, you can use strategic management to help move health sector reforms through the various stages in the policy process. The framework of the policy stages can help you determine your location in the policy process and identify tasks to be done. By applying a strategic management approach to each subsequent stage of the policy process, you can further implementation of health sector reforms. Consider each stage of the policy cycle from a strategic perspective, balancing the looking-out, looking-in, and looking-ahead issues. In so doing, you can effectively integrate a strategic management approach into the policy cycle. As an example, Figure 5.2 illustrates how you might strategically manage your reforms through the policy formulation and legitimation stage.

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Policy Toolkit for Strengthening Health Sector Reform

Figure 5.2. Strategic Management of One Stage of the Policy Process

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