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Progressive realization of Universal Health Coverage is inevitable given resource constraints. The incremental approach must be reflected in health sector strategic plans which serve as roadmaps. Using a matrix based on the health systems building blocks to extract data, we reviewed three successive sector strategies to assess priority issues addressed. We undertook a thematic synthesis to draw lessons and conclusion reported in this paper. Our review shows good practice as well as areas desiring attention if health sector strategic plans are to serve the intended purpose. Although all strategies were aligned to global and national development aspirations, were developed in a participatory manner they did not reflect the required incremental approach. The challenges to be addressed and the priorities remained largely the same over a 15-year period. The strategies and key results areas to be implemented in the different strategies were numerous with funding gaps. Improving the utility of strategic plans requires improving both the process and content. Implied in this approach is the need for prioritised and affordable strategic plans that reflect incremental efforts to attaining long term targets coupled with strong trend analysis and monitoring. Additionally, we advocate for strategic plan with a longer timeframe perhaps 10 years with adjustments at regular intervals., (© 2022 John Wiley & Sons Ltd.)

Background: Many countries are faced with a multitude of health workforce-related challenges partly attributed to defective health workforce planning. Earlier efforts to guide the process and harmonise approaches to national health workforce policies and planning in the Africa Region included, among others, the development of the WHO Africa Regional Office (WHO/AFRO) Policies and Plans for Human Resources for Health Guidelines for Countries in the WHO African Region in 2006. Although this guideline has led to uniformity and rigour in developing human resources for health (HRH) policies and strategies in Africa, it has become imperative to synthesise the emerging evidence and best practices in the development of health workforce strategies., Methods: A document analysis was conducted using the READ ( R eadying materials; E xtracting data; A nalysing data and D istilling) approach., Results: Fourteen HRH policy/strategic plans were included in the study. The scope of the HRH strategic plans was described in three dimensions: the term of the strategy, sectors covered by the strategy and the health workforce considered in the projections. We found that HRH strategic plan development can be conceptualised as a cyclical, sequential multimethod project, with one phase feeding the subsequent phase with data or instructions. The process is very complex, with different interest groups and sectors that need to be satisfied. The HRH strategic plan development process comprises five main phases linked with external forces and national politics., Conclusion: There is a need for accurate and comprehensive HRH data collection, astute HRH leadership, and broad base and multisectoral stakeholder consultation with technical support and guidance from experts and major external partners for effective HRH strategic plan development., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

As countries embrace the ambitious universal health coverage (UHC) agenda whose major tenents include reaching everyone with the needed good quality services, strengthening the planning process to work towards a common objective is paramount. Drawing from country experiences-Swaziland and Zanzibar, we reviewed strategic planning processes to assess the extent to which they impact on realising alignment towards a collective health sector objective. Employing qualitative approaches, we reviewed strategic plans under implementation in the health sector and using an interview guide consisting of open-ended questions, interviewed key informants at the national and district level. Results showed that strategic plans are too many with majority of program strategies not well aligned to the health sector strategic plan, are not costed, and there overlaps in objectives among the several strategies addressing the same program. Weaknesses in the development process, perceived poor quality of the strategies, limited capacity, high staff turnover, and inadequate funding were the identified challenges that abate the utility of the strategic plans. Moving towards UHC starts with a robust planning process that rallies all actors and all available resources around a common objective. The planning process should be strengthened through ensuring participatory processes, evidence informed prioritisation, MoH institutional capacity to lead the process, and consideration for implementation feasibility. Flexibility to take into consideration emerging evidence and new developments in global health needs consideration., (© 2018 John Wiley & Sons, Ltd.)

Background: Policy dialogue can be defined as an iterative process that involves a broad range of stakeholders discussing a particular issue with a concrete purpose in mind. Policy dialogue in health is increasingly being recognised by health stakeholders in developing countries, as an important process or mechanism for improving collaboration and harmonization in health and for developing comprehensive and evidence-based health sector strategies and plans. It is with this perspective in mind that Guinea, in 2013, started a policy dialogue process, engaging a plethora of actors to revise the country's national health policy and develop a new national health development plan (2015-2024). This study examines the coordination of the policy dialogue process in developing these key strategic governance documents of the Guinean health sector from the actors' perspective., Methods: A qualitative case study approach was undertaken, comprising of interviews with key stakeholders who participated in the policy dialogue process. A review of the literature informed the development of a conceptual framework and the data collection survey questionnaire. The results were analysed both inductively and deductively., Results: A total of 22 out of 32 individuals were interviewed. The results suggest both areas of strengths and weaknesses in the coordination of the policy dialogue process in Guinea. The aspects of good coordination observed were the iterative nature of the dialogue and the availability of neutral and well-experienced facilitators. Weak coordination was perceived through the unavailability of supporting documentation, time and financial constraints experienced during the dialogue process. The onset of the Ebola epidemic in Guinea impacted on coordination dynamics by causing a slowdown of its activities and then its virtual halt., Conclusions: The findings herein highlight the need for policy dialogue coordination structures to have the necessary administrative and institutional support to facilitate their effective functioning. The findings also point to the need for further research on the practical and operational aspects of national dialogue coordination structures to determine how to best strengthen their capacities.