Health Policy and management

Credit Hours: 3

Chalie Tadie (BSC, MPH)

Department of Health system and Health policy

Institute of Public Health
College of Medicine and Health Sciences
University of Gondar

April, 2021
Gondar , Ethiopia

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 Course Outline

1. Introduction to management
 Types
 Roles
 Skills
 Principles
 Efficiency & effectiveness
2. Management Functions
 Planning
 Organizing

 Leading
 Controlling
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 Course Outline…

3. Health system and policy in Ethiopia.

 The concept of health system

 Building blocks of health system
 Ethiopian health system major objectives
 Health Policy and Reforms in Ethiopia

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 Out line con…
4. Resource management
 HRM
 Time management
 Financial management
5.Health service coverage and quality of health services
• Health service coverage and measurements
• The concept of health care quality
6. Economic evaluation and health care financing

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 Teaching Methods

 Interactive lecturing
 Group discussion
 Assignments

 Independent reading/study

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 Evaluation methods
• Written exam- 70%
• Group Assignment(Seminar) -30%

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 Assignments

 Monitoring and evaluation of health programs: challenges

and recommendations in Ethiopia
 Decision making and conflict resolution
 Motivating and retaining health professionals: Importance,
challenges and the way forward in Ethiopia
 Logistics management: Challenges and the way forward
 Health team management and challenge model
 SDG
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 References

 Stoner J.A.F, Freeman R.E., Gilbert Jr. D.R. Management. 6th edition, 1996.
 Kerzner H. Project Management: A Systems Approach to Planning, Scheduling and
Controlling, 2nd edition. 1984.
 Rakich, J.S. Managing Health Services Organizations, 2nd edition, 1985.
 Rao V.S.P and Narayana P.S. Principles and Practices of management, 1st edition
(1987), Konark Publishers.
 Hersey P., Blanchard K.H. and Johnson D.E. Management of organizational behavior:
Utilizing human resources, 7th edition (1996), Prentice Hall.
 Kreitner R. Management. 7th edition (1998), Arizona State University, Houghton
Mifflin Company, New York.
 Shortell S. M. and Kaluzny A.D. (1997). Essentials of Health Care Management,
Delmar Publishers

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 Introduction
Objectives:
• Identify and discuss advantages of management

• Identify different types of managers

• Discuss on efficiency and effectiveness in

organizational activities

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 Introd….
• Discus about the roles and skills of
manager
• Discus about the principle and concepts
of management

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 Brain storming (10 minutes)
What is:
 Health care?
 Health services?
 Health system?
 Organization?
 Goals?
 Management?
 Efficiency?
 Effectiveness?

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 CONCEPTS OF HEALTH…
Health Care:
 It is the total societal effort, undertaken in the private and
public sectors, focuses on pursuing health.
Health Services:
 are specific activities undertaken to maintain or improve
health or to prevent decrements of health. These services
can be: preventive, acute/chronic, restorative, palliative,
etc.
Health System:
 is defined as the sum total of all organizations, people, resources
and all activities whose primary purpose is to promote health, to
restore or maintain health (WHO). 12
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 What is Management?
 It is the process of reaching organizational goals by working
with and through people and other organizational resources.
 It is a process of accomplishing predetermined objectives via
effective use of different resources

 Getting people to work harmoniously

together and to make efficient use of

resources in order to achieve objectives

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 What is Management…
 The practice of consciously and continually shaping
organizations.
 The process of planning, organizing, staffing, leading,
and controlling the work of organization members and of
using all available organizational resources to reach

stated organizational goals.

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 Efficiency vs. Effectiveness
• Efficiency (“Doing things right”)
• The ability to minimize the use of resources in
achieving organizational objectives.
• Is about reaching ends by only the necessary
means or by the least wasteful use of resources
 Effectiveness (“ Doing the right thing”).
• The degree to which a stated objective is being
or has been achieved.
• It is something that management tries to
improve
• Doing the right things in the right way at the
right times
 Efficiency and Effectiveness in Management

Efficiency (Means) Effectiveness (Ends)

Resource Goal
Usage Attainment

Low Waste High Attainment

Management Strives for:

Low Resource Waste (high efficiency)
High Goal Attainment (high effectiveness)
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 Types of Managers
Classification by management level
• First-line ( low level) ,Supervisory mangers:
• Middle managers: Middle level
• Top/ senior managers : high level Top
Top
Managers
Managers
MiddleManagers
Middle Managers
First-LineManagers
First-Line Managers
NonmanagerialEmployees
Nonmanagerial Employees 18

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 Types of Managers
1. First-line ( low level) ,Supervisory

mangers
• Responsible for the work of operating and do not supervise
other managers
• Direct non management employees and have authority and
responsibility for overseeing a specific type of work and a
particular group of workers.
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Lowest level of managers in the organizational hierarchy.
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 Types of Managers…

2. Middle managers
• Managers in the mid-range of the organizational
hierarchy
• They are responsible for other managers and
sometimes for some operating employees
• They report to more senior managers
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 Types of Managers…

3.Top managers / senior

• Mangers responsible for the overall
management of the organization
• They establish operating policies and guide the
organization’s interaction with its environment.
• Small in number
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 Types of Managers…
What are the Attributes common to all managers
regardless of title or level?
• Formally appointed to positions of authority by the
organization
• Directing work efforts of subordinates and non
subordinates
• Responsible for utilization of organizational resources
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Accountable to superiors for
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work results
 Types of managers…
The difference is in the scope of activities they oversee.
The primary differentiation between levels of
managers is the degree of authority and scope of
responsibility and organizational activity.
Discussion…
Are non-managers,
• responsible for utilization of organizational resources?
• accountable to superiors for work results?

If both are responsible,

• What is the difference between managers and non 23

managers?
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 Types of managers…
• The non managers are not formally appointed to positions of
authority by the organization for directing work efforts of others.
Classification based on scope of activities: Functional and general
manager

• Functions: Refers to a group of similar activities in an

organization, such as marketing, production, finance.
• Functional Manager: Responsible for one organizational
functional area/activity e.g. finance
• General Manager: Responsible for all functional activities e.g. 24a
company
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 Skills, Roles, Functions and Principles of mgt
Skills of manager
• Three basic types of skills for successful
management
1.Technical Skill
2. Human Relation Skill
3. Conceptual Skill

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 Managerial Skills…
1.Technical Skill
• the ability to use procedures, techniques and
knowledge of a specialized field
• using specialized knowledge and expertise in
executing work related techniques and procedures.
• Related to things :process or physical objects
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 Managerial Skills…
2.Human skill

 the ability to work with, understand and

 motivate other people as individuals.

 The ability to understand, alter, lead, and control the

behavior of other individuals and groups.

 builds cooperation among the team.

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 Cont…..
3. Conceptual skill

 Ability to see the organization as a whole.

 A manager with this skill has the ability or better understand how

various functions of the organization complement one another

• The relationship of the organization to its environment

• How changes in one part of the organization affects the rest of the

organization

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 Management level and skills

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 Roles of Managers(Henry-Mintzberg )

.
Interpersonal
Decisional role roles
Entrepreneur Figurehead
Disturbance Leader
handler Liaison
Resource allocator
Negotiation

Informational role
Monitor
Disseminator
Spokesperson 30

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 Principles of management
Management by Objective
Management sees that objectives are specified then that
they are achieved.
The objectives should state:
 What is to be accomplished?
 How much of it?

 Where it is to be done.
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 When it is be completed.
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 Principles of management…
Learning from Experience
• Analysis of the results between the objectives and
achievement made.
• For better performance there should be feedback to learn
from experience.
Division of Labour
• Management attempts to bring about balance of work among
the different work and among the different people concerned
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 Principles of management…

Substitution of Resources
• Often when the resources that are normally used to
provide service became scarce or too expensive,
different resources may be used to provide the
intended results.
Convergence of Work
• Working relations should contribute to the success of
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each activity and so to general effectiveness

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 Principles of management…
Functions Determine Structure
• When the work is defined i.e. the function and duties of the
individual members of the team are clearly defined and
known to all, the working relations (structure) follow.
• The exact nature of authority will be clearly delineated on
the structure.

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 Principles of management…
Delegation
• Delegation takes place when somebody’s authority is
lent so as to enable that person to take responsibility
when the occasion arises.
Management by Exception
• Do not be overloaded with the routine and unnecessary
information, be selective.
• Make BIG decision first.
In short management by exception means:
 Selectivity in information and priority in decision

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 Principles of management…

Shortest Decision-path

This principle deals with issues like:

Who should make which decision?

When and where?

Decision must be made as closely as possible

in time and place to the object of decision and
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to those affected by it.

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 I thank you!

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