S , T

P LE E N
C I E M
IN AG
R P N
S, A
T M
E P ND O F
N C A S
O E S ON N
C OL TI SA
R NC .T. E
F U R. O
D
 OUTLINE
• What are concepts?
• Key concepts in management?
• Principles of Management
• Levels of management
• Functions of the various levels of management
• What managers do?
• Skills and Competencies of effective managers?
• Qualities of effective managers
INTRODUCTION

• Today’s managers face complex situations that call for critical

thinking
• Examination of management processes, structures and behavior,
focusing on the changing nature of management in response to
turbulent internal and external environments are necessary
 T?
E N
E M
G
A
N
A
M
IS
A T
H
W
 DEFINITION
• A process or series of activities that gives necessary direction
to an organization’s resources so that its objectives can be
achieved as productively as possible in an environment in
which it functions.
• Taking responsibility for getting things done through
people by
 having concern for achievement of results
 having concern for people
DEFINITION …

• The efficient use of resources to achieve objectives effectively

• Management is a process of working with and through others to
achieve organizational objectives in a changing environment
• Management is a process of planning and controlling the
performance or execution of any type of activity
FROM THE DEFINITION
• Management is a
• Process or series of continuing and related activities
• It is aimed at achieving set organizational goals
• It reaches these goals by working with and through people and
other organizational resources
• It tries to balance effectiveness and efficiency
• It is about making the most of limited resources
• It is about coping with changing environments
 FROM THE DEFINITION…
A health manager must know how to manage:

Resources
(5 “M”s- Manpower, Money, Material, Machinery, Minutes , to..)
Effectively
(Achieving set objectives..)
and Efficiently
(at minimum cost not wasting resources)
By getting things done through people
(using the most important resource)
 WHAT IS HEALTH SERVICE MANAGEMENT?

The process of mobilizing and deploying

human, material & financial resources
for the efficient provision of effective
health services. It involves the
planning, implementation & evaluation
of health programs.
 WHAT IS A CONCEPT
• Synonyms to Concepts:
• Ideas, Thoughts, Notions, Themes, Conceive, Impression,
Understanding, a conclusion

• Therefore, management concepts are those identified issues,

impressions that relates to how to manage effectively,
CONCEPTS IN MANAGEMENT- MANAGEMENT: A
SCIENCE OR AN ART
• Management is thought to be a Art because:
•Art is bringing about a desired result through the application of skill
•With management as an art, you will need to have a practical knowledge
and skills of the responsibility, have a defined concrete result you look
out for and get better with practice.

•But, is this all management is about?

•A trial and error?
CONCEPTS CONT.- MANAGEMENT AS A SCIENCE
• Management is thought to be a science because:
• Science is a collection of universal principles and bodies of
systematically acquired knowledge or skill through proven methods
and theories such as observation and theories.
• And so, how is management a science?
• Management concepts and theories have been arrived at through
various levels of research.
• Several scientific tools have been developed with the aid of science
to aid managers, such as the use of the GANTT’s Chart, Flow charts,
Checklists, simulations,, Fish Bone Analysis, Use of Decision Trees,
to mention a few
CONCEPTS- WHICH OF THESE IS MANAGEMENT
• Management is BOTH an ART and a SCIENCE
• Why
• I will say that Management is an Artistic display of Science.
• If a manager decides to restrict himself to the science of
what things should be done as a manager without applying
an art of how such should be done, he will not be an effective
manager.
• Students can give practical examples.
DIFFERENCES BETWEEN MANAGEMENT AND
ADMINISTRATION
ADMINISTARTION VERSUS MANAGEMENT
A D M I N I S T R AT I O N
• The act of administering
• Said to be responsible for
staffing issues and accounts
• Involved in policy
formulations
MANAGEMENT
• Deals with daily operations
• Manage the business aspects of
the organization
• Involved in policy
formulations
• Also responsible for executing
actions on the policies
formulated
PRINCIPLES OF MANAGEMENT
Principles are frameworks or guidelines denoting how things should be done to get
or achieve the expected results.
They are fundamental truths that spells out cause effects relationships.
If you have a laid out principle of how a result was achieved, you may be able to
guarantee a repeatability of threat result given that the status quo remains
PRINCIPLES OF ORGANIZATION/ MANAGEMENT- HENRY FAYOL
1. Division of Work
2. Authority and
responsibility
3. Discipline
4. Unity of command
5. Unity of Direction
6. Subordination of individual
interests to general interests
7. Fair Remuneration
8. More of Centralization?
9. Follow the SCALAR Chain
10. Order and Orderliness
11. Equity (Justice and
Kindness)
12. Stability of Tenure (Job
security)
13. Encourage Initiative
14. Espirit De Corps
PRINCIPLES OF ORGANIZATION BY-
1. Principles of Definition 9. Principles of Unity of
2. Principles of Objectives Direction
3. Division of work 10. The scalar principle
4. Principles of continuity 11. Principle of Efficiency
5. Principles of span of control 12. Delegation of Authority
6. Principles of exception 13. Principles of responsibility
7. Principles of flexibility 14. Principles of uniformity
8. Principles of Balance 15. Simplicity and
Accountability
LEVELS / ECHELONS OF MANAGEMENT
Top/
Strat
egic
Leve
Middle/ltactical/
Administrative Level

Lower/ Operational / Supervisory

Level
 MAJOR FUNCTIONS AT THE STRATEGIC LEVEL OF MANAGEMENT
• Formulation of organization’s
• Vision, Mission, Goals & Objectives
• Formulation of organizations Policy- such as
• The financial policy, market policy, Human resource policy, production or
service policy, etc.
• Determines the organization’s framework- like the organizations’ structure
• Strategic planning- Determine how the organization will achieve its set
objectives
• Resource mobilization
• Evaluating the organization at the central level
MAJOR FUNCTIONS AT THE TACTICAL
LEVEL OF MANAGEMENT
• Organizational policy translation,
• Regional/ Departmental policy formulation
• Regional / Departmental planning
• Definition of tactics to achieving organizational objectives
• Coordination of activities
• Regional / Departmental evaluation
• Accountable to the top managers
• Provide guidance to the lower level managers
 MAJOR FUNCTIONS AT THE OPERATIONAL
LEVEL OF MANAGEMENT
• Policy implementation
• Operational planning
• Implementation of service operations & delivery of service
outputs
• Utilization of resources
• Activity scheduling
• Inventory control
• Monitoring of performance
• Supervision of how work is being done
ELEMENTS/ FUNCTIONS OF THE MANAGERIAL PROCESS

• Continuous decision-making
• Continuous problem-solving (after problem identification & analysis)
• Continuous Communication
• Planning
• Implementation
 Organizing
 Staffing Basic Management Process
 Leading (directing)
 Controlling
• Evaluation
 PLANNING
The process by which goals and objectives are selected and determine how best to
achieve them.
It is the most basic of all management functions, precedes others
Necessary because of scarcity of resources and the need to make choices.
It is a method of ensuring that the resources available now and in the future are used
in the most efficient way to obtain explicit objectives.
Planning helps to answer these sets of questions
Where are we going? (Objectives)
With what? (Resources)
How? (Efficient implementation)
By When (In future)
 PLANNING…..
Levels of health planning
This can occur at different levels which includes:
The Individual, family, community, facility level, District/ LGA, State,
National, Regional, Global
Types of Health Plans
 Flexibility of the plan
 Fixed Plans (rigid) or Rolling Plans (continuously revised)
 Duration of the Plan
 The Nature and scope of the Plan
 TYPES OF PLANS…
 Flexibility of the plan
 Fixed Plans or rigid
 rigid period of time; fixed objectives; fixed resources, less sensitive to
environmental changes.
 Rolling Plans
 Flexible targets and resource inputs; continuously revised/updated;
more sensitive to their environment; enhances continuity and relevance
 Duration of the Plan
 Long term (≥10yrs); Medium term (≥3yrs to <10yrs) Short term (<3 years)
 The Nature and scope of the Plan
 Strategic plan; operational plans; Work plans
 NATURE AND SCOPE OF THE PLANS
 The Nature and scope of the Plan
 Strategic plan; operational plans; work plans

Strategic Plans

Operational Plans

Work plans
THE PLANNING CYCLE
1.
Organizing
to plan
10. 2. Situation
Evaluation analysis

9. 3.
Implementati Selecting
on priorities

8. Detailed
programming and
resource 4. Setting
specification objectives

7. Selection 5.
of strategies 6. Constraints Specification
analysis and of Technical
specification Intervention
of strategies
 STEP I: ORGANIZING TO PLAN
Entails setting up a team to plan
Team should consisting of the following:
Relevant stakeholders to the plan
Executors of the plan
Beneficiaries of the plan
Technical advisers like epidemiologists, sociologists, statistician..
The vision of the intended plan should be shared
Terms of references defined and shared
 STEP II: SITUATION ANALYSIS
This is the process of determining the capacity to handle problems of any given place
or thing. It involves:
Conducting a community diagnosis of the health needs
Assess their socio-economic and demographic situation; health status, Religious and
cultural characteristics, the geographic or topographic information
Assess the available health service facilities
Determine the expected service utilization, the actual service utilization, the current gap,
Needs Assessment
Analyze the services provided by the Non-health sector
Assess the available resources in the health facilities and community
Done by observation, surveys, client record reviews, et,c
THE DELIVERABLES FROM STEP II
• A statement of the health problems, their current magnitude
and future trends

• The socio-demographic, economic conditions and other

possible conditions that are closely linked to the identified
health problems

• A description of the population that will be covered by the

planned program or project, like the age group, geographical
spread
STEP III: SELECTING PRIORITIES
• All the identified health problems are ranked in order of their priorities
• This is done using a set of criteria with a scoring system, Scores are summed up
after
• There are several national and international criteria
• A criteria could be:
• Who sees the health problem? (Health worker (1), Community (2), Both (3)
• Who is affected? Elderly (1), Adolescents (2), Work force (3), pregnant women
(4)
• Feasibility of intervention? Long term (1), Short term (2)
• Cost of intervention? Expensive (1), Cheap (2), Very cheap (3)
• Relative problem magnitude (Mortality)? Low (1), Medium (2), High (3)
• Social impact of problem? Lose working hours (1), Disability (2), Fatal (3)
STEP III: SELECTING PRIORITIES…
Another criteria could be simply
Technical feasibility? High (1), Medium (2) Low (3)
Financial feasibility? High (1), Medium (2), Low (3)
Resources? Imported (1), Not locally available (2), Locally available (3)
Community acceptability? Low (1), Medium (2), High (3)
Sustainability? Difficult (1), Fairly difficult (2), Easy (3)
The priorities could be
Health Needs/ Health Problems-
Service Inputs- Scaling up a health program,
Support priorities- Improving the Health Information systems,
Other Priorities
STEP IV: SETTING OBJECTIVES
Goals:-
Broad statements giving a specific idea of what is to be done.
They are large direction setting, gives enough focus to provide overall direction
for planning
Example: Health for by year 2020, Nutrition for All, Zero tolerance for HIV
Aim:
A goal for the particular health problem.
For example, To raise the nutritional level of under-fives
STEP IV: SETTING OBJECTIVES…
Targets:
These are specifically defined points on the way to attainment of an objective.
For example: To ensure that 95% of children under 6 months are exclusively
breast-fed by the end of this year

Operational Targets:
These are short term objectives achieved at a specific date as a step towards a
long term objective.
They are highly specific, quantifiable to a target population
STEP IV: SETTING OBJECTIVES…
Qualities of a good objective:
S- Specific: simple sentences, not too long, not ambiguous, easy to understand
M- Measurable: It can be quantified and compared with already set standards or
norms using action verbs
A- Achievable/ Attainable: Speaks to what is feasible
R- Relevant / Realistic: It must be responsive to the local situation and needs,
T- Time-bound: Results must be achieved within a specific time

For example; Example: To reduce the mortality from diarrhea among under-fives
using ORT by 80% in X district by December, 2017
STEP V: SPECIFICATION OF TECHNICAL INTERVENTION
This entails identifying the various technical interventions needed to achieve set objectives.
An intervention is an action directed towards solving a particular health problem
For example, Needed technical interventions to reduce the burden of malaria may include: Mass
Health education, community mobilization towards reducing the burden of malaria
Awareness creation and monitoring of Clearing of mosquito breeding sites or the actual
Provision of Window and door netting or provision and distribution of ITNs;
Provision of Chemoprophylaxis for the population being planned for
Providing equipment and commodities for Early diagnosis and treatment of cases;
Creating awareness for prompt presentation at the health facilities.
 STEP VI: IDENTIFICATION OF OBSTACLES /
CONSTRAINTS TO INTERVENTIONS AND SELECTION OF
STRATEGIES TO OVERCOME THEM
Health Health Obstacles / constraints Strategy to overcome
Problems Intervention obstacles

Diarrhea Health education 1. Inadequate transportation 1. Purchase of vehicles

2. Inadequate funds to
procure health education 2. Increased budgetary
equipment and tools allocation
3. Insufficient manpower

3. Recruitment of trained
personnel
STEP VII: SELECTION OF STRATEGIES
The particular strategies that will be used to overcome the constraints
from all the strategies specified is then selected.
This may be increased budgetary allocation to ease transportation.
You will need to set targets for the selected strategies
For example: Increased yearly budgetary allocation towards malaria
control program by 10%.
STEP VIII: DETAILED PROGRAMMING AND RESOURCE
ALLOCATION
Here, for each Goal, its Objective, its strategy, you identify:
activities,
who will be responsible- focal person, or who?
when will it be achieved- quarterly, monthly, yearly, biannually
at what cost- do a costing per activity
who will be responsible for the cost- is it government, implementing
partner.
This planning is done by the team or by a consultant and ratified by the team
This stage is called the Micro-planning stage.
STEP IX: IMPLEMENTATION
This is included in the planning stage.
This means, the various components of the implementation function of the manager
must be thought of even at the planning stage. For example,
to plan how many staff will be recruited,
who will take lead,
how the work will be organized and
what forms of supervision will be employed.
This is important to be thought of at the planning stage to allow for adequate budgeting for it.
The actual implementation will then be done after it had been planned for.
STEP X: EVALUATION
This is also another function of the manager that must be thought of from the
planning stage.
It is important to determine how many times evaluation will be done and what
forms it will take.
Will it be out-sourced or not or you will engage the services of a consultant?
You also determine the indicators to be tracked, the source of tracking the
indicators and the frequency of tracking them.
This will allow for proper budgeting for the evaluation process
This will then make evaluation feasible when it is time for such to be done.
 IMPLEMENTATION
Organizing
 It relates human resources and other resources together in a formal structure to
achieve organizational effectiveness

 It brings about order which is reflected in a well defined network of relationships

among personnel called ORGANISATIONAL STRUCTURE / ORGANOGRAM

 Good organization reduces friction, promotes harmony, avoids duplication and

conflict, optimizes the utilization of talents &facilitates the cost efficient
realization of the goals
AN ORGANOGRAM

NODAL OFFICER

CUSTOMER CARE/ SERVICE

CHARTER DESK
COMPLAINTS IMPROVEMENT
OFFICER
OFFICER DESK OFFICER
 IMPLEMENTATION- STAFFING
PROCUREMENT PREPARATION
 Recruitment: Application  Appraisal
forms  Training
 Selection: Testing &  Mentoring
Interviews  On the job
 Placement  Job rotations
 Orientation
 Transfers and Promotion Maintenance / Retention
 Leadership
 Control
 IMPLEMENTATION- CONTROL
Ensures that work proceeds Tools for effective control
as expected and that the  Plan of work
expected amount and  Written clear instructions
quality of work is done.  Work schedules
 Job descriptions
 Staff lists
Work is done according to  Check lists
set plans & objectives ,  Records of activities
time allotted and  Reports of progress and activity
resources provided.  Supportive Supervisory visits
IMPLEMENTATION- LEADING

• A leader is an individual who is able to influence group or

organizational members to help the group or organization
achieve its goals.
• He is an individual who is able to obtain voluntary co-
operation in a goal oriented manner from others
• He knows that each member of the team is important, has
something to contribute, and must be treated with respect
LEADING MANAGERS

Leadership is lifting a person's vision to higher

sights, the raising of a person's performance to a
higher standard, the building of a personality
beyond its normal limitations. - Peter Drucker

Managers who lead enable others to face

challenges and achieve results
 LEADERSHIP STYLES BY
TYPES OF LEADERS R E N S I S L I K E RT

Natural leader: Autocratic

 Exploitative authoritative
He/ She evolves  Benevolent authoritative
Democratic
 Participative
Vested leader:  Consultative
He/She is elected Anarchic
 Laissez- faire

Technical leader: (Depends on type of leader & the led,

He/she emerges and work to be done.)
LEADING PRACTICES
Scanning – Identifying internal and external conditions
that influence desired results
Focusing – Directing attention and efforts to priority
challenges and actions
Aligning and mobilizing – Uniting and motivating
internal and external stakeholders to commit
resources to support desired results
Inspiring – Creating a climate of commitment and
continuous improvements
 TO BE AN EFFECTIVE LEADER, ONE MUST

Empathetic: Place oneself in the position of one’s followers/

subordinates
Objective: Unemotional analysis of the facts
Engage in Team building: Realize that teams typically outperform
individuals.
Effective communication: A very important skill that can make or
mar the organization. Information well communicated is POWER
Motivator: Must know what motivates the followers and employ
such to get out their best
MANAGER VERSUS LEADER
SUBJECT MANAGER LEADER
ESSENCE STABILITY CHANGE
FOCUS MANAGING WORK LEADING PEOPLE
HAVE SUBORDINATES FOLLOWERS
SEEKS OBJECTIVES VISSION
APPROACH PLANS DETAILS SETS DIRECTION
DECISION MAKES FACILITATES
POWER FORMAL PESONAL
AUTHORITY CHARISMA
APPEAL HEAD HEART
ENERGY CONTROL PASSION
MANAGER VERSUS LEADER CONT..
Subject Manager Leader
STYLE TRANSACTIONAL TRANSFORMATIONA
L
EXCHANGE MONEY FOR WORK EXCITEMENT FOR
WORK
WANTS RESULTS ACHIEVEMENTS
RISKS AVOIDS TAKES
CONFLICT AVOIDS USES
DIRECTION EXISTING ROADS NEW ROADS
CONCERN BEING RIGHT WHAT IS RIGHT
CREDIT TAKES GIVES
BLAME BLAMES TAKES
 Manager administers; Leader innovates.
 Manager accepts reality; Leader investigates it.
 Manager focuses on systems and structures; Leader focuses on
people.
 Manager relies on control; Leader inspires trust.
 Manager has a short-range view; Leader has a long-range
perspective.
 Manager asks how and when; Leader asks what and why.
 Manager imitates; Leader originates.
 Manager accepts the status quo; Leader challenges it.
 Manager is the classic good soldier; Leader is his or her own
person
 EVALUATION
Least understood and least practiced function
Defined as the process of collecting information through various
methods so as to determine the relevance, adequacy, progress,
efficiency, effectiveness and impact of planned activities.
Conceptual framework for Evaluation entails:
 Inputs
 Process
 Output
 Outcome
 Impact
 TYPES OF EVALUATION
Pre-program evaluation (Input evaluation)
Monitoring (Process evaluation)
Mid-term evaluation
End of program evaluation
Impact analysis
Management Audit
Clinical audit
Medical audit
 STEPS IN THE EVALUATION PROCESS
Decide what is to be evaluated
Establish the desired norms and standards
Select the indicators
Observe performance
Compare performance versus standards
Conclude/ Judge
Decide what action is necessary
Quick feedback of decision
Take corrective action
AN EFFECTIVE
MANAGER R
?
E
G ?
A S
N S
A E
M S
S
E O
V P
I
T Y
C E
E H
F T
F
E O
D
N
A S
E
F I
O C
N
? S E
O E T
D I E
T P
S I
L M
R
E A O
G U C
A Q D
N N
A E
H A
M T S
O E L
D R L
I
T A K
A T S
H A T
W H A
W H
W
MANAGERS: WHAT DO THEY DO?
Managers’ prescribed roles:
 Planning
 Leading
 Organizing
 Controlling
 Coordinating
 commanding
 Monitoring
 Delegating
MANAGERS: WHAT DO THEY DO?
Managers described roles:
 Talking
 Listening
 Observing
 Consulting
 Roaming around
 Holding or attending meetings
 Sense making
 Influencing
 …………
THE EFFECTIVE MANAGER
What qualities do they possess?
 Excellent Personality characteristics
 Essential skills
 Good relevant knowledge and learning
 Positive beliefs and values
QUALITIES OF AN EFFECTIVE MANAGER
 Excellent Personality characteristics
 Energetic
 Charisma/self confident
 Practical
 Open minded
 Supportive
 …..
QUALITIES OF AN EFFECTIVE MANAGER

 Essential skills
 Technical skills
 Human relation skills
 Analytical and conceptual skills
 Ability to
i. diagnose & solve problems
ii. Identify and use opportunities
iii.See the organization as a whole
QUALITIES OF AN EFFECTIVE MANAGER

 Good relevant knowledge and learning

 Technical know how
 Environmental factors impacting on the
organisation
 Management theories and techniques
 Human behaviour theories
QUALITIES OF AN EFFECTIVE MANAGER

 Positive beliefs and values - About

 The work
 Workers
 Inputs, throughputs and outputs
 Human relations
 Management
 Organisational culture and environment …
THE EFFECTIVE MANAGER

Skills and competencies of Effective Managers

 Skill is the ability to perform a specified duty well
 Competency- the specification and application of
knowledge and skills to the standard of
performance required for a task given favorable
environment and psychological circumstances
THE EFFECTIVE MANAGER
What skills and competencies do they possess?
 Leadership skills
 Decision-making and planning
 Public relations/communication
 Financial acumen
 Developing others
 Personal attributes
 Negotiation
THE EFFECTIVE MANAGER

Additional competencies
 Computing
 Marketing
 Data gathering and analysis
 Time management
 Legal knowledge
SKILLS AND COMPETENCIES OF THE EFFECTIVE
MANAGER
Leadership – Ability to …
 Communicate desired organisational direction to facilitate
action and implement change
 Delegate, get others to act and accept responsibility
 Select and appoint appropriate people
 Foster & maintain appropriate organisational culture
SKILLS AND COMPETENCIES OF THE EFFECTIVE
MANAGER
Leadership – Ability to …
 Be versatile in leadership style
 Consult with staff and relevant people external to
the organization
 Recognize when it is appropriate to bend the
rules
SKILLS AND COMPETENCIES OF THE EFFECTIVE MANAGER

Decision-making and planning - Ability to

 Re-think and re-state the organization’s priorities
 Respond rapidly and appropriately to unexpected events
 Anticipate and forward plan –strategizing
 Guide & direct organizational decisions through
knowledge of relevant policies
SKILLS AND COMPETENCIES OF THE EFFECTIVE MANAGER

Decision-making and planning - Ability to

 Interpret industrial changes & implications of
same for the organization
 Interpret to staff the economic changes external
to the organization
 Favorably position the organization with current
and potential stakeholders
SKILLS AND COMPETENCIES OF THE EFFECTIVE
MANAGER
Public Relations – Ability to
 Empathise, listen and respond to someone else
 Create a conducive atmosphere for effective
communication
 Communicate effectively
 Understand the politics of a given situation and act
 Develop effective PR
 Use media to advantage
SKILLS AND COMPETENCIES OF THE EFFECTIVE
MANAGER
Financial Acumen – Ability to
 To question and look behind the figures
 Control budget
 Interpret financial matters
 Forward plan –fiscal planning
 Utilise performance measurements and industry averages
 Consult on financial matters
Preparedness to take calculated risks
SKILLS AND COMPETENCIES OF THE EFFECTIVE
MANAGER
Developing others – Ability to
 Develop an effective team
 Develop & maintain professional relationship among staff
 Provide sponaneous positive feedback
 Use quality assurance as a basis for constructive staff
development
 Assume a mentor role
 Use an effective appraisal system
 Develop, promote & review performance indicators for the
org.
SKILLS AND COMPETENCIES OF THE EFFECTIVE
MANAGER
Personal attributes – Ability to
 Focus on more than one issue at any one time
 Convey a personal management philosophy –managerial
discourse
 Make tough decisions
 Manage personal stress
 Perceive the positive aspects of negative events
 Cope with feelings of loneliness
 Establish & maintain personal support networks
 Celebrate victories & successes
SKILLS AND COMPETENCIES OF THE EFFECTIVE
MANAGER
Negotiation - Ability to
 Identify and manage conflicts
 Facilitate change
 Understanding of different points of view
 Negotiate in a trusting & positive manner
 Clarify issues of concern to all
 Negotiate with a variety of staff, groups and unions
 To mediate between conflicting groups
Thank you for listening.
Questions?