Planning matters: a document analysis of 23 Portuguese national health programs

BACKGROUND: Health planning is crucial for effective public health interventions and optimal use of resources. Portugal has a long history of developing health plans and programs, with the General-Directorate of Health (GDH) publishing programs for communicable and noncommunicable diseases. Yet, these programs’ evaluation is rare, not only in terms of results but also in their design and content. This study aimed to analyze all available GDH programs to assess their structure and content. METHODS: We performed a document analysis of the 23 national health programs, analyzing the items well-established by the literature as fundamental to be present in these plans and programs. Each program was analyzed independently by two independent researchers, and discrepancies were resolved within the authors’ group. Besides assessing items as present or absent, comments were added. RESULTS: Programs largely varied: of the 23 programs, 17 were outdated, and four were dispersed among multiple documents. Sixteen complied with at least 75% of the predefined items, with priority programs having a higher compliance rate compared to non-priority ones (83% vs 33%). The definition of goals was the most commonly fulfilled criterion, present in 91.7% of the analyzed documents. Though, the time scope of the programs was updated only in 20.8% of the programs, accounting for the criterion least commonly met. DISCUSSION/CONCLUSIONS: Despite being published by the same institution, the programs analyzed were heterogeneous, and most were not updated. Establishing a standardized structure for the design of these health programs would ensure that fundamental items are present, accelerate the update of the programs, and facilitate communication and collaboration with partners and stakeholders in public health KEY MESSAGES: • This study analyzed 23 national health programs published by the Portuguese General-Directorate of Health (GDH) and found great heterogeneity in their structure and availability. • Establishing a common standardized structure for health planning is essential to ensure all fundamental aspects are taken into consideration and improve communication and stakeholders partnership.