HEALTH ♦ Public Health Service -Any organized community program designed to conserve and promote community health. COMMUNITY (Definition) ♦“A body of people having common organization or interests or living in the same place under the same laws.” PREVENTION (definition) ♦“Anticipatory action taken to reduce the possibility of an event or condition occurring or developing or to minimize the damage that may result from the event or condition if it does occur.” (Torjman) MANAGEMENT ♦ Has been applied since the beginning of civilization and community living ( and not an invention of the 20th century). ♦ WHENEVER PEOPLE WORK TOGETHER IN GROUPS: to grow crops, to buy and sell, to wage war, to build a temple, etc, THERE HAS BEEN MANAGEMENT. MANAGEMENT (Definition) ♦There are many ways of defining management depending on the criteria used in looking at it. ♦Management could be a process, an art , a science , a class of people or a resource. ♦ It creates and controls and is a universal activity. ♦ is “GETTING THINGS DONE” - the underlying principle to this definition is “Commitment to achievement.” - Commitment to purposeful action, not to action for its own sake. ♦ “Getting things done through the efforts of other people and that functions bring closer into planning and control.” ♦ How people work together to attain a common goal. ♦ Management -Is “SAYING WHAT ONE WANTS TO BE DONE AND THEN GETTING IT DONE” - in other words management ensures that objectives are specified / stated specifically what is to be achieved , and then that they are achieved . Management (Definition) ♦ An art. - Is the art and science of working and through the people to attain a common organizational objective. - Management problems could also be solved thru individual styles based on creativity, judgment intuition, and experience rather than the systematic methods of service . ♦Art of securing maximum results with a minimum of effort so as to secure minimum prosperity and happiness for both employer and employee and give the public the best possible service.

Definition: • PUBLIC HEALTH ♦ The science and art of preventing disease, prolonging life, promoting health and efficiency through organized community effort for: - sanitation of environment - control of communicable diseases - the education of the individuals in personal hygiene ♦ the organization of medical and nursing services for the early diagnosis and preventive treatment of diseases and the development of social machinery to ensure everyone a standard of living adequate for the maintenance of health so organizing these benefits as to enable every citizen to realize his birthright of health and longevity. ♦The organization and application of public resources to prevent dependency, which would otherwise result from disease or injury. (Hanlon/Pickett) ♦ The art and science of maintaining, protecting, and improving the health of the people through organized community efforts. (American Medical Association) ADMINISTRATION (Definition) ♦“The guidance, leadership and control of the efforts of a group of individuals toward some common goal.” (Wm Newman) ♦“A process by which the potentials of men and materials are synthesized and activated for the achievement of defined goals.” (Freeman & Homes) ♦“The organizational activities that involve goal formation and accomplishment, performance, appraisal, and the development of an operating philosophy that ensures the organization’s survival within the social system.”(Duncan, W. J ) Differentiate between organization, management and administration: ♦ Organization-social units formed together to obtain a specific goal ♦ Management-how people worked together to attain a common goal ♦Administration - overall - includes policy making ♦Public Health Practice: - The application of multiprofessional skills of community diagnosis and community organization for health and of medical education or environmental therapy to maintain and improve the state of well-being of the community.

MANAGEMENT ( Definition cont’d) ♦It is a process, it is the series of systematic, sequential or overlapping steps in designing and maintaining an environment in which the individual working together in groups efficiently accomplishes selected aims. ♦ As a process it has 3 important features: - dimension of time thus it is dynamic - integrates efforts of a group and - requires skill for conflict resistance ♦ The process of allocating an organization’s inputs (human and economic resources) by planning, organizing , directing and controlling for the purpose of producing outputs (Goods and Services) desired by its customers so that organization objectives are accomplished in the process, work is performed with and through organization personnel in or ever-changing business environment. ♦Process by which the execution of a given purpose is put into operation and supervised. (Terry) ♦ Process involving the coordination of human and material resources towards accomplishment of objective. Simultaneously, it involves the judicious use of the resources. motivation of people , provision of leaderships, planning and controlling. MANAGEMENT (Definition cont’d) ♦ Practice of consciously and continually shaping organization. ♦Consists of all organizational activities (human resource) that involve goal formation and accomplishment , performance , appraisal and the development of an operating philosophy that ensures the organization’s survival within the social system. ♦ This basic definition can be expanded to mean : 1. Managers carry out the managerial functions of planning, organizing, staffing, leading, and controlling 2. Management applies to any kind of organization 3. It applies the managers at all levels of the organization 4. The aim of all managers is to create a surplus 5. Managing is concerned with productivity, which implies effectiveness and efficiency. ♦All systems require management for effective and efficient performance. MANAGEMENT (Definition cont’d) ♦A profession: Skills in designing, instituting and controlling the process can be taught and learned thus management evolved as a profession. Universities today now offer degrees in management and some programs like health administration require management courses. Its formal study includes discussions of the theories and practice of management ♦A science: A substantial portion of management can be accomplished thru the scientific method : empirical measurement of data, causal links among phenomena, logical organizational structure and conclusions that can be validated experimentally,etc.

It is interdisciplinary drawing its strength from the various disciplines as the focus of management is both physical and human. ♦A resource: Management is in itself a resource together with capital, materials and labor. The knowledge and practice of good management is in itself a wise investment in an organization. Upon it depends the success or failure of an enterprise. ♦An elite or class of people: -in this sense management is that group within a organization that has the legal authority to direct and control the organization. ♦The M’s of Management: -Man -Money -Materials -Methods -Mission ♦ Managerial Process: (Definition) -is defined as planning, directing and controlling the organization and weaving together its various parts see that all factors will function properly and all persons cooperate for a common purpose. -is the art of getting things done through people by proper allocation and choice of human resources, materials funds and methods. ♦ Manager (Definition) - the person who allocates human and material sources and directs the operation of an organization. - plans for the future and tries to determine the most efficient way to achieve the objectives -motivates employees and to increase overall efficiency, effectiveness and productivity Differentiate between organization, management and administration: ♦ Organization - social units formed together to obtain a specific goal ♦ Management - how people worked together to attain a common goal ♦Administration - overall governing power of an organization/enterprise responsible for the policy and major decisions concerned with the political, economic/financial matters as well as the well-being of the organization and its people (more popularly known as “management”, see above definition) - refers to the activities of group(s) or individuals who makes decisions, plan, organize, direct and control resources in order to achieve the objectives of the agency accdg to the specified quality, time, method, and expenditures. The Role of Doctors in Public Health Administration • The medical profession is one of the most important contributors as well as one of the most important problems in Public Health. • Many programs in Public Health requires the work of physicians– the management of TB and

STDs, prenatal and early childhood care, and clinical work in ambulatory care programs. Physician involvement is desirable although not mandatory in planning, organizing, and in managing Public Health Programs.

The difference between Public Health and Private Health Administration • Public Health Programs are by definition public although some of the activities may be purchased from the private organization, profit making and not for profit, impinge on the health of the public both in a positive and a negative way, but the administration of the public health programs involves the use of public funds on behalf of public health. PUBLIC SECTOR CHARATERISTICS: 1. The profit measure is absent. 2. They tend to be service organizations rather than product oriented 3. They tend to have legislative constraints on their goals and strategies 4. They are less dependent on their clients for their revenue. 5. They tend to be dominated by professionals 6. They have different governance structure, often elected 7. They are often lead by people not specifically trained for administrative leadership. Private sector has one overriding objective: to maximize profits. • There are two factors: 1. managerial accounting and 2. financial accounting • The one dominant goal is the famous bottom line: the excess of revenues over costs. • In the public sector, the bottom line is the public welfare. • Theories of Organization I. Classical Theory -rigid -emphasizes on the formal structure of the institution. There are 3 schools of thought which could explain the structure of an organization and its relation to its subordinates: I.A. Bureaucratic model (Max Weber) I.B.Scientific management (Tayl;or) I.C.Principlres of Administration School (Fayol,Guick and Urwick) II. The Neoclassical Theory -the organization is seen as a social structure: an intricate web of human relations band together by a system of sentiments -advocated group-oriented behavior and cooperation over competition and individualism as the basis for human social action

II.A. Cooperation system (Chester Barnard) II.B.New concept of authority (Barnard) III System Theory IV Contingency Model -flexible -states that no one way of managing that will apply best to all situations ♦Functions of Management: In 1926, Henry Fayol wrote that the functions of a manager are to plan organize, command, coordinate, and control. • These functions are often modified however the original list of Fayol remains as the basic outline for management functions. Some authors want to be more detailed, while others combine the functions in one entity. Planning} Planning} Planning} PM Implementing}P I E Organizing} POLCE Management} Evaluation} Leading} Controlling} Planning} Evaluating} Organizing} POEA Actuating} Planning} Evaluating} Organizing} Staffing} POSDCORBE Planning} Directing} Organizing}POMA Coordinating} Managing} Reporting} Appraisal and Control} Budgetting} Evaluation } FUNCTIONS OF MANAGEMENT ♦Planning - is a set of objectives associated with objective setting, policy-making, decIsion-making , looking for alternatives and strategies, procedures for attaining objectives within the organizational framework. - is the formulation of the steps to be taken by an agency at some future period to achieve a desired state/solve the problem, which the process itself specifies as its objective. - attempts to answer questions before they actually arise, anticipating as many implementing decisions as possible by foreseeing possible problems, ad deriving principles and setting rules for solving them. - Involves an analysis of the current and future state of the internal and external environment of the organization which in turn should lead to the choices of objectives.


Always result in an output- --a written plan Control device: Plan -Continually identifies expectations for people, programs, or projects and measure the process and the rate of progress towards the goal. -Lack of plan is viewed as an attempt of the manager to control and great flexibility best reigns over a situation - Budget – an expression in monetary terms of the plans of the agency.

- Before planning one must have a goal. 3 Components of planning ♦Analysis of current and future state of the environment ♦Formulation of policies. strategies, programs, procedures and rules ♦ Resource requirements Principal Areas of Planning ♦Objective-process that requires global vision, diplomatic skill and considerable good fortune. ♦ Tips for planning about objectives: a. Determine what problems there are and which of them merit priority attention b. Decide who is at risk from the problem or is exposed to are affected by it where they live and work c. Most importantly- extent to which it is intended to reduce the problem, the target time for achieving the reduction ♦ Activities ♦Tips for planning about activities: a. Decide activities that are needed , whom the activities are directed b. Determine the timing. sequence, frequency, location of activities and assignment of task and responsibility. ♦ Resources ♦Tips for planning about resources a. Determine the nature of resources (staff, equipment, supplies) b. Determine the amounts of each resource c. Know where the resources should come from and be sent (logistic consideration) Planning Steps ♦ Step 1. Look at the situation (fact finding community diagnosis) ♦ Step 2. Recognize important problems ♦ Step 3. Set objectives (establishing priorities) ♦ Step 4. Review obstacles and limitations ♦ Step 5. Schedule activities (establish activities, personnel, equipments, estimating financial support needed (budget) phasing activities) ♦WHAT TO DO? ♦ HOW TO DO IT? ♦ WHEN TO DO IT? ♦ WHO WILL DO IT? -means the identification of the problems -involves selecting of objectives and strategies, policies, and procedures for achieving them. - policies relating to authority process, programs of production, management, succession, etc. ♦ Confusion have arisen about who should plan and when all managers plan, whether they are at the top, middle or bottom of the organizational structure ♦ Organizing - is concerned with the division of labor and corresponding assignment of duties and the

establishments of lines of authority and of communication. - Activities are analyzed and the appropriate groupings of said activities are determined - Responsibility for each group of activity and corresponding authority is then assigned. - Relationships of the different activity groups are then identified and lines of communications are established. ♦Directing - this function initiates and maintains actions towards the objectives of the organization. -effective directing requires delegation, communication, training and motivation. -for better acceptance the term has just been changed to leading and directing -leading is influencing people so that they will contribute to group goals ♦ Coordinating - closely related with the directing process is the orchestration of all activities into the whole scheme of operation. -coordination begins by seeing to it that all the parts of the organization are bound together by common goals and objectives. ♦ Monitoring and Control - Monitoring means keeping tract of the work being done and seeing to it that it is done in accordance with the quality and other specifications set in the plan; the latter refers to controlling. - it is greatly dependent on the feedback mechanism thru an established information system. - a plan of work with the appropriate indicators , indicating progress in time is a useful is a useful tool in monitoring. - Control activities relate to measurement of achievement . - Means of control are budget for expense inspection records, records of labor hours cost. ♦Evaluating - this function is a systematic way of learning from experience and using these learned to improve current and future activities. -its basic concept is to improve health programs and structures in the delivery of health. -after everything has been planned and implemented there remains the task of evaluation. -this serves to check whether one’s project went according to plan if the objectives have been met and if one’s project lacked resources or not. -after reviewing all that has been done, one must particularly take note of the errors committed and the time and other resources not put to maximal use so that the next time a project is set up, these pitfalls may be prevented

General Principles of Management

♦ Principles of management are fundamental truths explaining relationships between 2 or more sets of variables. -They are descriptive or predictive but not prescriptive. 1.Principle of Unity of Command - Employees should receive orders from one superior only. - the more often the individual reports to a single superior , the more likely that the individual will feel sense of loyalty and obligation and the less likely that there will be confusion about instruction. 2. Division of Work - this is the specialization that economists consider necessary for efficiency in the use of labor e.g. the assembly lines 3. Authority and responsibility - Fayol finds the two related with responsibility arising from authority. - authority is derived from the position, and personal factors like intelligence, experience, moral factors, past service, etc . Principle of Line of Authority - in any organizational hierarchy , there is a chain of command from the highest to the lowest levels which has operational authority. - This is the authoritative side of the hierarchy with hiring ,firing, promotion, transfer, etc. - This principle is best illustrated in military organizations with chain of command from general to private

-the clearer the line authority from the ultimate management position the more effective will be responsible decision-making and organizational communication 10. Order - Fayol follows the simple adage” – a place for everything (everyone) ,and everything (everyone) in its (his) place. 11. Equity - Loyalty and devotion should be elicited from personnel by a combination of kindness and justice on the part of the managers. 12. Stability of Tenure - Fayol finds unnecessary turnovers to be both the cause and effect of management 13. Initiative - it is the thinking out and execution of a plan. -Fayol exhorts managers to sacrifice vanity to allow subordinates to exercise it 14. Esprit de corps - in union there is strength . - it is also extension of the principles of unity of command and emphasizing teamwork and communication 15. Span of control -there is a limit in each supervisor to the number of persons who can be effectively supervised The Goals of Administration and Managers: - Very often said that the aim of business managers is simply to make profit. But profit is really a measure of surplus. -For many firms, an imp’t goal is the long-term increase in common stocks -In all kinds of organizations, business or nonbusiness, the logical and publicly desirable aim is to create surplus. - Thus managers must establish an environment where everyone knows who is responsible for what results, and obstacles to performance caused by confusion and uncertainty of assignments are removed and therefore people can accomplish group goals with the least amount of time, money, materials, and personnel dissatisfaction or to accomplish as much as possible with available resources. Management Functions at Different Organizational Levels ♦ Managerial Levels - There are various managerial levels in an organization. - At any level of the hierarchy in the organization, someone is given the responsibility for the work at that level. He is also given authority to accomplish the given responsibility. 1. First Line Management /Operational Management - deals directly with the unit functions. - the people in charge at this level are sometimes called Unit Head/Supervisor/Foreman. First Line Management (cont’d)

• Principle of absoluteness of Responsibility: - An administrator cannot escape responsibility for the actions of his subordinates . It cannot be delegated.
4. Discipline - it is the respect for agreements which are directed in achieving obedience, applications, energy and onward marks of respect . -Fayol says that discipline requires good supervisors at all levels 5. Unity of Direction - this principle says that each group of activitis with the same objectives m8st have one head and one plan 6. Subordination of Individual to general interest - when the two are different, management must reconcile them 7. Renumeration - pay and methods of payment should be fair and afford the maximum satisfaction to employees and employer. 8. Centralization - Fayol refers to the extent to which authority is concentrated or dispersed 9. Scalar chain - there is a “chain of superiors” from the highest to the lowest. -it should not be needlessly broken but can be circuited if to follow it scrupulously would be detrimental.

- concern of management at this level are technical leadership to workers in the unit, thus manager has to be technically competent in guidance, training, quality control, and communication between rank and file and middle and top management; -translates administrative plans into schedules, assignments, clinics, visits -operational planning ♦Middle Management (Intermediate Level) -is between the first line management and top management. -management at this level interprets policies, strategies, and broad directives. (overall implementation of policies) -much of the time of middle managers is spent on communicating between the first and top levels of management -administrative planning ♦ Top Management (Central or National) - responsible for charting the direction of the agency (broad general direction of programs) and formulating approaches to be adopted.(directional planning or policy making of health policies) -National Health Programs and Projects ♦ All managers at the different organizational levels carry managerial functions. ♦ However time spent for each function may vary. ♦ Top- level managers spend more time on planning and organizing than do lower-level managers. ♦ Leading takes a great deal of time for the first time supervisors although in modern corporations of today, it has been found that leadership functions at top level management has greatly increased ♦ Time spent on controlling does not vary much among managers at various levels

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