Strengthening the Annual Action Planning Process in Ministry of Health, Sri Lanka: A Case Study of Process Evaluation and Improvement Strategies

Abstract

Annual Action Plans are central management instruments for translating national health policies and strategic priorities into operational activities. This study evaluated the Annual Action Planning process in selected units of Sri Lanka’s Ministry of Health, identified operational challenges, examined the highest-priority problem, and developed improvement strategies. A descriptive case study design was used. Data were obtained through document review, key informant interviews, and assessment of Annual Action Plans using a structured checklist informed by published literature, national planning guidance, and expert opinion. Five operational challenges were prioritised using the Nominal Group Technique, and the highest-ranked challenge was analysed with a Fishbone diagram. The absence of formal institutional review mechanisms received the highest score (27/27), followed by delayed submission of Annual Action Plans and progress reports, incomplete or inaccurate plans, inadequate monitoring of financial and physical progress, and ad hoc plan preparation. Among ten assessed units, compliance was universal for alignment with national health policies, incorporation of previous and current priorities, and assignment of responsibilities. Lower compliance was observed for alignment with sectoral strategic plans (40%), stakeholder participation (60%), defined timelines (30%), routine monitoring using milestones and key performance indicators (30%), periodic performance reviews (40%), timely progress reporting (60%), and review of previous-year performance (40%). Strengthening institutional review mechanisms, standardising procedures, building staff capacity, and integrating routine monitoring may improve the consistency, accountability, and operational effectiveness of Annual Action Planning within the Ministry.