Unit One:

Overview Health Policy and

Management

By: Nigusu Worku (BSc, MPH)

Email: nigusuworku29@gmail.com

April, 2020
Gondar, Ethiopia
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Session Objectives:
 Key definition's of health and management

 Define relationships between management and organization

 Identify and discuss management processes

 Discuss on the managerial roles, Levels, types of managers and

skills required

 Discuss the management principles

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Brain storming (10 minutes)
What is:
 Health?
 Health care?
 Health services?
 Health service organization?
 Health system?
 Organization?
 Goals?
 Management?
 Manager?
 Efficiency?
 Effectiveness?
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 CONCEPTS OF HEALTH

HEALTH
 Is widely used in public communication and yet its
meaning looks simple.
 Definitions:
 Lay point of view

Persons are healthy when they are doing their activities with
no apparent symptoms of disease in them.

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 CONCEPTS OF HEALTH…
 Professional
- Is defined as a measure of the state of the

physical bodily organs and the ability of

the body as a whole to function.

- Refer to freedom from medically defined

diseases.
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 CONCEPTS OF HEALTH…
Holistic Definitions:
WHO
 In 1948, in the Constitution.
 “A State of complete physical, mental, and social well-being
and not merely the absence of disease or infirmity”.
 Having these health definitions, values, conceptualization by
different people/professionals, is it easy to manage the
health sector/service?

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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.

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 CONCEPTS OF HEALTH…
H/Service Organizations:
 are entities that provide the organizational structure within
which the delivery of H/services is made directly to
consumers, whether the purposes of the services is preventive,
acute, chronic, 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).

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 Organizations and The Need for Management
Organization
•Collections of people who work together and coordinate their
actions to achieve a wide variety of goals
– Two or more people who work together in a
structured way to achieve a specific goal or set of
goals.
What does goal mean ?

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Goal : The purpose that organization strives to achieve.

•Goals are the fundamental elements of an organization.

Why?

•Goal is the reason to exist and an organization can not

exist without a goal

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 What do all organizations need to achieve goals?

To achieve goals all organizations should

Have a method and
Have to acquire and allocate resources
Thus the need for management.

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 What is Management?
• It is impossible to provide a single, comprehensive ,
universally accepted definition of management.
• Has been defined in ways that appear different but with a
strong underlying similarity

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 Some common definitions
 It is the process of reaching organizational goals by working with
and through people and other organizational resources.

 Is a process of efficient utilization of available resource to

achieve organizational goals.

 Is the process of planning, organizing, staffing, leading, and

controlling efforts of organizational members, and using all
available organizational resources to reach predetermined
goals.

 The practice of consciously and continually shaping

organizations.

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 Common points in Management
This definition incorporates several important ideas.
•A process – a set of interactive and interrelated ongoing functions
and activities
•It involves accomplishing of organizational objectives
•It involves achieving these objectives through people and the use
of other resources
•It occurs in formal organizational settings, where a single,
independent organization or a system of organizations; or
organizations invariably exist in the context of larger external
environment.

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 Rational for Learning Management

• Management is universal and essential function in all

organizations.

• Proper health planning and health services management skill is

an important tool to bring about change in the health care
system.

• Resources are scarce urging the need for proper skills in planning
and management for efficient utilization.

• Difficulty to address all health problems at a time demands

prioritize problems.
 Characteristics of Management

• Universal : It applies every where

• Continuous process: Carried out through out the budget year.

• Dynamic: Changes from one form to another

• Pervasive: practiced in every organization

 What is manager?
• A manager is a person who plans, organizes, leads and controls
human, financial, and other resources to meet organizational goals.

• who coordinates and oversees the work of other people so that

organizational goals can be accomplished.

• A manager’s job is not about personal achievement-it’s about

helping others to do their work.

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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.
• 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 level in the hierarchy
• Generally managers are categorized into three levels.

Top
Managers
Middle Managers
First-Line Managers
Nonmanagerial Employees

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 1. First-line (first/ low level),Supervisory managers
 Responsible for the work of operating staff 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.

 Lowest level of managers in the organizational hierarchy.

 They report to middle managers

 E.g. team leaders and team facilitators who oversees the work of non-
management people

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 2. Middle level managers
 Managers in the midrange of the organizational hierarchy.

 They are responsible for other managers and sometimes for some operating employees.

 They report to more senior managers.

 Responsible for managing the performance of a particular org’nal unit and for
implementing top managers’ strategic plans.

 example, director of human resources

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 3.Top / Senior managers
 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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Different names of manager :
 Executive Administrator

 Leader, Boss, Principal

 Chief, Supervisor, Senior Manager

 Superintendent, Commissioner

 Overseer, Officer, Coach

 President, Executive, Prime Minister etc.

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• The primary differentiation between levels of managers
is :
The degree of authority
 Scope of responsibility and
 Organizational activity.

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 Common Attributes to all managers regardless of their
title and level

• Formally appointed to positions of authority by the

organization.
• Directing work efforts of other subordinates.

• Responsible for utilization of organizational resources.

• Accountable to superiors for work results.

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 Classification based on scope of activities

 Functional Manager: Responsible for one

organizational functional area/activity e.g. finance

 General Manager: Responsible for all functional

activities e.g. a company

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 Managerial Skills

• Are competencies a manager holds to undertake the roles effectively.

• A manager should posses Three major 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.

• Such skills can be acquired through training, education and work

experience

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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.
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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 Managerial Skills…
Which skill is equally needed by all managers?
Answer: Human skill
•Because the common denominator are people at all levels,
•an inability to work with people, not a lack of technical skills, is
the main reason some managers fail to reach their full potential.
A manager with human skill:
•Knows weaknesses and strengths,
•Knows how feelings harm others.

NB- Do not make wrong judgments about people without studying

contents of information.
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Management Level and skills

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Managerial Roles
•Managerial roles refers to specific actions or
behaviors expected and exhibited by a manager.
•Henry Mintzberg defines 10 roles that managers are
expected to play and group them in to 3 categories.
1. Interpersonal role
2. Informational role
3. Decisional role

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Mintzberg’s Managerial Roles

Interpersonal roles
Decisional role 1.Figurehead
1.Entrepreneur 2.Leader
2.Disturbance /influence
handler 3.Liaison
3.Resource
allocator
4.Negotiation
Informational role
1.Monitor
2.Disseminator
3.Spokesperson

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 1. Interpersonal Roles:
A. Figureheads: engage in activities that are ceremonial and
symbolic in nature; as a symbol of legal authority, attending
ceremonies, signing documents, receiving visitors etc

B. Leaders/influencer: providing guidance and motivating

subordinates to get the job done properly.

C. Liaison: involves formal and informal contacts beyond the

vertical chain of command (inside and outside).

•Links in horizontal as well as vertical chain of communications.

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 2. Informational Roles
A. Monitors/ Nerve Center: receiving all types of information.
filter, evaluate and choose to act or react to that information.

B. Disseminators: involves communicating selected information to

subordinates.

C. Spokesperson: represent and speak on behalf of the

organization; Transmitting selected information to outsiders.

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 3. Decisional Roles
A. Entrepreneurs: designing and initiating changes within the
organization

B. Resource allocators: managers decide who gets what based on

priority setting.

C. Negotiators: managers choose how to interact with their

superiors, peers, and subordinates.

•Negotiating with other parties representing organizational

interests.

D. Disturbance handlers: They handle both internal and external

disturbances. They anticipate disturbances and resolve conflicts.

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 Principles of management (WHO)

1. 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.

When it is be completed.

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 Principles of management…

2. Learning from Experience

• Analysis of the results between the objectives and achievement

made.

• For better performance there should be feedback to learn from

experience.

3. Division of Labour

• Management attempts to bring about balance of work among

the different work and the different people concerned.
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 Principles of management…
4. 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.

5. Convergence of Work

• Working relations should contribute to the success of each

activity and so to general effectiveness.

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 Principles of management…
• These working relations of activities are:

 The logical relations with each other

 Time relations or sequence

 Spatial relations between activities

 Functional and structural working relations between people.

6. 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…

7. Delegation

• Delegation is the downward transfer of formal authority from

superior to subordinate.

Factors to consider in delegation

• Experience, ability, urgency, availability, past performance,

motivation, risks/rewards

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 Principles of management…
8. Management by Exception

Do not be overloaded with the routine and unnecessary

information, be selective and make BIG decision first.

In short management by exception means:

 Selectivity in information and priority in decision

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 Principles of management…
9. 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 to those affected by it.
10. Management by walking Around

 The practice of managers interacting with the workforce by

visiting the work area where the general staff work.

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Management functions

 Managers just don’t go out and haphazardly perform

their responsibilities.
 Good managers discover how to master five basic
functions:
1. Planning --------------- Planning
2. Organizing
3. Staffing -------- Implementation
4. Leading(directing,
motivating)
5. Controlling --------------- Evaluation

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 Planning
 It is the process of establishing goals and charting out suitable
course of action to achieve these goals.
 Helps to deal with the present and anticipate the future.
 It involves what to do, how to do, when to do, who is to do it,…
• Planning is a primary management function. Why?

Because:
 Through planning managers clearly put and outline exactly
what organizations must do to be successful.

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 Organizing
 Creates a mechanism to put plans into action. How?
 Through Assigning the tasks developed during planning
to individuals/groups within the organization.
 Is the process of arranging and allocating work, authority and
resources among organization members to achieve goals.

 involves establishing authority - responsibility relationships among

people working in groups and creating a structural framework.

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 Staffing
• Staffing is filling and keeping filled with qualified people
all positions in the HSO.

• Recruiting, hiring, training, evaluating and

compensating are the specific activities included in
the function.

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 Leading
 Primarily concerned with people in the organization.
 It is the process of directing and influencing the task-
related activities of group members or an entire
organization.
 The process of guiding the activities of organization
members in appropriate direction.
 Influencing, directing , motivate
Controlling
 The process of ensuring the actual activities in
relation to planned activities.
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 Thank
you !!

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