CHAPTER-3

03/28/2024
FUNCTIONS OF MANAGEMENT

Esrom kebebew/MPH/
By Esrom. k/Bsc, MPH /
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Management functions
Developed by Henri Fayol

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1. Planning

2. Organizing

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3. Staffing

4. Leading/directing

5. Controlling 2
1. Planning

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Esrom kebebew/MPH/
 Session objectives
At the end of this session the students will able to :

Define planning

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Describe types of planning

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Discuss conditions for successful Plan

Explain steps to be followed during planning

Understand Limitations of planning

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Planning…
—Planning is deciding in advance:

what to do

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how to do

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who will do it and

with what to do it.

—Planning bridges the gap between where we are and where we want
to go in the future.

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Planning…
 Compiling & analyzing information in order to arrive at a decision
about what should be done.
Is the process of establishing an organizational objectives & charting

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out suitable course of actions for achieving these objectives.

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Continuous process which involves choice among alternative ways of
using available resources to achieve goals in the future

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Planning…
Planning is a means to:

─ Make a choice

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─ Allocate resources

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─ Achieve goals

─ Planning for the future (schedule activities)

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Health planning
Health planning is the process of:
 Defining community health problem
 Identifying needs and resources

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 Establishing priority problems and goals

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 Setting administrative action to reach at those goals

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Components of definitions of planning
• Important components include:
where are we going (objectives)
with what (resources)

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how (efficient & appropriate implementation)
when (future)

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A degree of formalization (explicitness & method ) about the process

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Purpose of planning

 Provides direction
 To reach the objectives of the organization
 Minimize risk by reducing uncertainties

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 Increase the degree of organizational success

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 Minimizes waste and redundancy
 Reduces the Impact of change
 Sets standards to facilitate control

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Conditions for successful Plan
Practical (attainable)
Required resources are obtainable
Organization for its implementation is available

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Socially acceptable
Involvement of stakeholders
Acceptable to all stakeholders

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Economically sustainable

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Types of plans

Plans can be classified on different bases.

The most important ones are:

— Repetitiveness

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— Time dimension, and

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— Scope dimension

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Types of plans . . . .

Classification of Plans Based on Repetitiveness

• Standing Plans:

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That can be used for again and again

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Include policy, procedure, and rule.

• Single-use Plans:

─ Used only once 13

─ Include programs, projects and budgets

Classification of Plans Based on Time
• Long-range planning

–Ranges from 5 - 10 years

• Intermediate-range planning

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‾ Ranges for 2-3years

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• Short-range planning

– Ranges from 1 to 2 years

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Classification of Plans Based on Scope

1. Strategic Planning: is a long-term planning that involves

all the organization’s areas and includes goals,

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strategic objectives, strategies, and measurable
results.

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It asks and answers four questions:
• Where are we now?
• Where do we want to go?
• How will we get there? 15

• How will we know whether we are getting there?

Strategic Planning:
Designed by high-ranking managers
Define the broad goals for the organization

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Allocative planning
It is a long term plan

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Example: GTP, MDG, HSDP

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2. Operational ( tactical) plans:
 Contain details for implementing those strategic plans in day to day life.
 Short term plan that emphasize on current operation of parts of the
organization.
 Setting of monitorable timetables & schedules for the implementation

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of pre - set activities
 It is an activity planning
Example: course plan, weekly action plan

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3. Contingency plans
Alternative plan that can be implemented when the original plan is
inadequate because of changing circumstances.

Events beyond a manager’s control may cause even the most

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carefully prepared plan to go awry.

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Differences b/n strategic and tactical plan

Areas of Operational Strategic plans

difference (Tactical ) plans

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Experts involved Developed by low Developed by upper
and Middle level level management
management.

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Time horizon Covers short period Covers relatively
(1 week to 1 year) longer period (five
years or more)

Scope Narrow range of Wide range of goals

operations
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Degree of detail Detail & specific Simplistic and
activities general
Steps in Health Planning

1. Situational analysis
2. Priority setting

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3. Setting objectives & Targets
4. Identifying obstacles and limitations

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5. Designing the strategies
6. Writing Plan of action
PROJECT WORK

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1) Situational analysis
Gathering and analyzing of data to provide information about a
particular situation

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Examine the current and projected health situation, and
demographic pattern

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Analysis of present and future health needs of the population

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SWOT analysis
• Is a strategic planning tool that matches internal organizational
strength and weakness with external opportunity and threat
Example of strength:
Availability of resource

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Trained man power
Example of weakness:

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Lack of managerial talent
Obsolete facilities

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Example of threat:
• Adverse believe toward modern medicine
• Growing cost of essential drugs

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Example of opportunity:
• Presence of health policy

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• Presence of health committee in the community

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SWOT analysis framework
Internal external

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Positive Strength Opportunities

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Negative Weakness Threats

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Factors to be analyzed
• Analysis of Population characteristics

• Analysis of Infrastructure

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• Analysis of Policy and political environment

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• Analysis of Community health need

• Analysis of Health service coverage

• Analysis of available Resource

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• Analysis of Past implementation experience

2) Priority setting
 All problems identified during situational analysis should be
prioritized.
 Because all problems cannot be solved with limited resources we
have in hand

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Criteria's used to set priority problems:
▬Magnitude
▬Severity

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▬Feasible
▬Sustainability
▬Community concern
▬Political concern

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• Problems should be ranked on five point scale
• 5 points –very high
• 4 points –high
• 3 points –moderate

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• 2 points –low
• 1 point –very low

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Example
S.N Problems

Comm. Con.
sustainabilit
magnitude

Feasibility
severity

Political
Total
con.
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y
1 Absence of latrine 1 3 2 2 3 4 15

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2 Low immunization 4 2 3 4 2 5 22
3 High home delivery 4 4 4 4 3 5 24
4 Low FP usage 5 3 3 3 1 4 19
5 High malaria 2 3 3 2 4 4 18
prevalence
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3) Setting objectives and targets
Vision, mission, Goals, aims, objectives and targets should be
clearly defined.
Vision:

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• A vision is a picture of a desired future which describes where the
organization wants to be.
• It includes an image that you can see in your mind.

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Example: To see healthy and productive population of district X.

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objectives and targets….
Mission: A mission states why the organization exists.
Example: To reduce mortality, morbidity and disability of people of
district X through providing a comprehensive package of promotive,
preventive, curative and rehabilitative health service.

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Goal:
 Are broad statement

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 There is generally one goal for a service
 Example: Health for all by 2000 and beyond

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Aims
 There are a number of aims for a goal
 Are specific for a particular health problem
 Example: to raise the nutritional status of women and children
Objectives

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 For each a program aim there may be a number of objectives
which are specified by measurable terms

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 Example: to ensure that 95% of children are adequately nourished
by 2014.

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Target
 For each objective, there may be various
targets which specifies various points on
the way to the attainment of objectives.

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 They are defined in relation to a point in

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time
 Example: to ensure that 95% of infants
are adequately nourished by 2014.

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• Objective should be ‘’SMART’’
S –specific
M –measurable
A –achievable
R –realistic

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T –time specific
Example: By the end of 2013, 90% of eligible children in Harar town
will be vaccinated against all vaccine preventable disease.

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4)Identifying obstacles & root causes
• Obstacles usually determines how the objectives will be met

• So resource, legislative & organizational policies should be

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systematically assessed

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• Obstacles and root causes are determined through root cause
analysis

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▬Root cause analysis involves problem-solving methods that is
aimed at identifying the root causes of problems or events.

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▬RCA is practiced on the belief that the problems are best solved
by eliminating root causes, rather than addressing the symptom.

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 Techniques of RCA
/Route Cause Analysis/
1) THE FISHBONE TECHNIQUE

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▬Purpose: To identify the root causes of the current, undesirable
situation keeping you from achieving your intended result.

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 The Fish bone Diagram

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 Esrom kebebew/MPH/ 03/28/2024
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Steps to develop fishbone diagram
Step 1: Write your obstacle or current situation on the right end of
the diagram.

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Step 2: Brainstorm the possible reasons why the current situation is

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the way it is.

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Fishbone diagram….
In the Fishbone diagram, the causes can be
grouped under four categories:
• People: Knowledge, skills, motivation, support

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• Policies: Rules and regulations

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• Processes and procedures: Standards,
equipment
• Environment: WHOf, RHB, community, other
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stakeholders…
 Steps…..

Step3: Connect the categories to the central

spine of the diagram

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Step4: Identify the causes that are most

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responsible for the current situation
• This could be done by using five why technique

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2. The Five Whys Technique

Purpose
• The Five Why is used for identifying the primary or root causes of a
problem.

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• Asking “why” five times prevents mistaking symptoms from causes,

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 Process

• When you have identified a probable cause, ask, “Why is that true?” or
“Why is that happening?”

• To each answer, ask “why” again and continue asking “why” until the

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answer is “That is just the way it is,” or “That is just what happened.”

• Be sure that you are asking about things that are in your sphere of

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influence to affect.

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Example:
• Cold chain frequently breaks down, interrupting vaccination
campaigns.
• Why is the current situation like this?
Response: Because there is no back-up during power outages.

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• Why is this so?
Response: Because there was no money in the budget for a back-up

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arrangement.
• Why is this so?
Response: Because no one thought about it when the budget was
made.

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• Why is this so?
Response: Because the budget was made by an accountant who does not
know the importance of an uninterrupted cold chain.
• Why is this so?
Response: Because technical experts do not get involved in budgeting.

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• At this point you might see that what is missing is more involvement of
technical experts in setting budgets.

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5) Designing the strategies
• Strategy is courses of action to achieve organizations, vision/mission
and goals

• It is the method through which the plan is implemented.

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 The Challenge Model
The Challenge Model is a tool that you can use to
improve the performance of any group.”

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6) Plan of action

At a minimum, an action plan should identify:

• The actions or activities that will be implemented;
• Who will be responsible for carrying out each action;
• The human, financial, and material resources needed to

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implement the actions;
• A timeline showing when the actions will be carried out.

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 Action plan format

Challenge: Indicators:

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Desired measurable result:

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Priority actions:

Activities Person responsible Start date End date Resources

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Limitations of Planning
• Lack of accurate information
• Problems of change
• Failure of people

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• Internal inflexibilities
• External inflexibilities

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• Rigidity in planning
• Time and cost factors

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 2. Organizing

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 Session objectives:
At the end of this session the students will able to :
• Define organization
• Understand organizational structure

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• Discuss types of authority

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• Explain types of organization

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 Organizational Structure
Organizing is the process by which managers establish working
relationships among resources.
Organization is collection of two or more people working together

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in a coordinated fashion to achieve goals.
Organizational structure:
The process of arranging jobs within an organization to achieve the

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mission.
Formal system of task and reporting relationship.

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Principles of Organization
• A process involving decisions about six
key elements:

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1. Work specialization

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2. Departmentalization
3. Chain of command
4. Span of control
5. Centralization and decentralization
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6. Formalization
Organizational Structure
1. Work Specialization(division of lobour)

• Dividing tasks into manageable units with

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each job completed by different person.

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• However, Overspecialization can result in
human diseconomies, increased
absenteeism, and higher turnover.
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Steps during division of lobour
• Divide the whole work in to manageable jobs
• Group similar jobs in to sections
• Combine related sections together
• Assemble related sections into department

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• Assign head to each department
• Grant responsibility to the person in charge

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• Give authority equal to responsibility
• Create clear span of control
• Allocates organizational resources.

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Departmentalization by types
2. Departmentalization – Grouping of related activities
into similar units.
1. Functional

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 Grouping jobs by functions performed

2. Customer

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 Grouping jobs by type of customer and needs

3. Product

 Grouping jobs by product line

4. Geographical
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 Grouping jobs on the basis of territory
Organization Structure…
3. Chain of Command
Continuous line of authority from top to
bottom of an organization, clarifies who

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reports to whom.

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Tells you who your boss is, where to go for
help.
• Authority
• The right of a manager to do something or
to tell people what to do. 58

• The right of taking decision due to position

Types of Authority
Line Authority

• Someone in the direct line or chain of

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command who has formal authority over

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people and resources
• Officially sanctioned power to issue order for
the subordinate and over resources
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Types of authority
Staff Authority

• Managers who are functional-area

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specialists that give advice and assist to line

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managers.
• They provide advisory and counseling role

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4. Span of control
• When a manager manages a small number of subordinate it is called
narrow span of control.

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• When a manager manages large number of subordinate it is called
wide span of control.

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• There is no specific limit to decide the span of management as it
varies from organization and situation to situation.

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Organization Structure…
5. Centralization: Centralization of authority refers to
systematic retention or concentration of managerial authority in a

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relatively few managerial position at the top level
• That is, managers at middle and operating level are vested with very

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little authority.

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• Decentralization: Decentralization refers to
systematic and purposeful dispersal of
managerial authority among all levels of

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management

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• That is, managers at all levels are vested with
authority up to their task and responsibility.
• Decision-making is pushed down to the
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managers who are closest to the action.

Delegation
• Sharing some or whole parts of works or management to others,
normally to immediate subordinates.
• Delegation of Authority is a process by which managers assign some

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of their tasks to their subordinate and permit them to exercise

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authority on their behalf.

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Actions during delegation

1. Assign duty to subordinate

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2. Grant sufficient authority
3. Make him feel that he has obligation

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4. Explain to others that he/she had delegated
5. Give support and follow up

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Organization Structure…

6. Formalization

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• The degree to which jobs within the

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organization are standardized and the
extent to which employee behavior is
guided by rules and procedures.
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 Esrom kebebew/MPH/ 03/28/2024
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Tall vs. Flat Organization
• Tall structures have many levels of authority and narrow spans

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of control.

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• As hierarchy levels increase, communication gets difficult

delaying decision making.

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 Tall Organizations

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Tall Vs Flat Organizations
• Flat structures have fewer levels and wide spans of control.
• Structure results in quick communications but can lead to overworked
managers.

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Mechanistic Organization

• A rigid and tightly controlled structure

• High specialization
• Rigid departmentalization
• Narrow spans of control

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• High formalization/Bureaucratic

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• Unidirectional communication(downward)
• Low decision participation

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Organic Organization

• Highly flexible and adaptable structure

• Non-standardized jobs
• Fluid team-based structure

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• Little direct supervision

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• Minimal formal rules
• Multidirectional communication
• Empowered employees

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 3. STAFFING

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INTRODUCTION
• The management function that deals with recruitment, selection,
placement, training and development of organization members.

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• It involves filling the organization structure through proper and
effective personnel.

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• Staffing means filling and keeping filled positions in the organisation
structure.

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Basic Activities of staffing
Staffing includes seven basic activities.
1. Human resource planning

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2. Recruitment
3. Selection

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4. Socialization (Orientation)
5. Training and Development
6. Performance Appraisal
7. Promotions, Transfers, Demotions, discipline 76
and Separations.
1. Human resource planning
 Human resource planning is a process by which an organization
identifies its human resource need and decide to bring the right
number and kinds of people.

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 Planning for future needs

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 Planning for future balance (number needed versus present)

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2. Recruitment
 The development of a pool of job candidates in accordance with a
human resource plan

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 Once an organization identifies its human resource needs through
employment planning, it can begin the process of recruiting
potential candidates.

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Recruitment includes...

• Job description: a written description of a non-management job

• Position description: a written description of a management

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position

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• Hiring specification: a written description of the education,
experience, and skills needed

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Principles of recruitment
• Prohibiting discrimination

• Equal employment opportunity

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• Affirmative action

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• Equal Pay: like pay for like jobs

• Comparable worth

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3. Selection

 Selection is the process by which an

organization chooses a person who best

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meet the selection criteria from

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applicants.
 The organization decides whether or not to make job offer and the
candidate decides whether or not to accept it.

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Steps in the Selection Process
1. Preliminary Screening
2. Employment Test

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3. Employment Interview
4. Background and Reference Checks

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5. Job offer
6. Physical Examination

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Difference between Recruitment and
Selection

Recruitment Selection

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It is an activity of establishing contact It is a process of picking up more
between employers and applicants. competent and suitable employees.

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It encourages large number of It attempts at rejecting unsuitable
Candidates for a job. candidates.

The candidates have not to cross over

Many hurdles have to be crossed.
many hurdles.

It is a positive approach. It is a negative approach.

It proceeds selection. It follows recruitment. 83

Socialization/Orientation
 After the best applicant is selected and
offered a job, it is necessary to introduce
the new employee to the philosophy, rules

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and polices, etc. of the organization.

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 It is a program designed to help employees
to fit into the organization smoothly

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Types of information provided

• General information
• About the organization

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• Services /products expected

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• Detailed presentation  policies, rules...

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Training and Development
 Training begins the very first day, which is designed to improve the
person’s skills and knowledge to do the current job at high level.

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 Development refers to the organizations efforts to help employee’s
acquire knowledge, skills and behavior that improve their ability to

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meet changes in job requirements and customer needs.

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Approaches of training
On-the-job training
 Job rotation
 Internship: Combined classroom teaching

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 Apprenticeship: training under guidance of
skilled co-worker

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Off- the-job training
 Vestibule training: training on realistic job
setting or equipment
 Behaviorally experienced training:
simulation exercises, cases, games, role-
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playing (done outside the organization)
Performance appraisal
 It is the process through which a manager measures
employees’ activities and output against organizations

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objectives.

 It involves measuring actual performance of an employee and

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providing information about his/her strengths and weakness

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Purpose of Performance Appraisal
 To give feedback,

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 To recognize outstanding performance,

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 To locate the need for additional training

 To identify candidates for promotion

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Promotion, Transfer, Demotion and
Separation
A. Promotion
 Moving to a higher position and

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responsibility
based on outstanding performance

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B. Transfers: Shift to other positions

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Discipline, Demotion and Separation

C. Discipline: when the organization’s policy is

violated
• Steps:
 Warning

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 Reprimand
 Probation

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 Suspension
 Disciplinary transfer
 Demotion
 Discharge
• For poor performance, separation is better than letting the 91
employee stay on the job.
 4. LEADING

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Objectives of the unit:
At the end of this unit, you will be able to:

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▬Define leadership

▬Explain the differences between leadership and

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management
▬Describe leadership and management practices

▬Describe the different leadership theories 93

▬Differentiate leadership styles

 Leadership
Definition: - Leadership is the process through which a manger influences
employees in order to accomplish a common goal.

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• Leadership is the manager’s role to determine what is to be
accomplished by a group & influence others to contribute to achieving
that goal.

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Theories of leadership
1.The trait Theory:
• Identifies the personal characteristics of leaders such as skill to
lead, self confidence and intelligence.
• “leaders are born but not made”

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2. The behavioral Theory

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• studied behavioral characteristics of leaders
• “ leaders are made but not just born”

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 Theories of leadership
3. The contingency approach:

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• Convinced that no one best style of leadership

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exists, vary with the situation or circumstances

• Successful leadership occurs when the leader’s

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style matches with the situation
4. Transformational Leadership
• Transformational leaders are visionaries who challenge people to
achieve high level of performance.

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• Because they are masters of change:-
• They can envision a better future

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• Effectively communicate that vision

• Inspire others to willingly make it a reality

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Differences b/n leadership &Mgt
• Leadership and management have different functions, both are
necessary for success of an organization.
• Good leader moves toward a better future

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• Good manager makes that current operations run smoothly
and efficiently.
• That is why the notion of "managers who lead," is advocate to

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make sure that both areas are covered.

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Practices of managers & leaders
Practices of Effective managers:
• Plan
• Organize
• Implement
• Monitor and evaluate.

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Practices of good leaders:
SCAN their environment

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FOCUS attention for the critical challenges
ALIGN and MOBILIZE their organizations
INSPIRE those around them to learn and create effective
solutions

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Differences (Managers versus leaders)
Manager Leader

A copy An original

Maintains Develops
Seek Objectives Set Vision
Reactive Proactive
Appeal to head Appeal to heart
Prevent risk/ make rule Accept risk/break rule
Avoid conflict Uses conflict
Blames others Takes blame
Do thing right/efficient Do the right thing

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Who is a leader?
Leaders are:
 Agents of change

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 Influence others to achieve objectives.
 Has a vision

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 Inspire and challenge people to take action.
 Examples of great leaders: N. Mandela, M. Gandhi, M. Luther
King, A. Lincoln.

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Dimensions of leadership
• Leadership involves not just doing but being.
• Leadership is exercised with others.

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• Leadership is about responsibility, not about position.
• Leadership happens at all levels.

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• Leadership and management are two distinctive complementary
action

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Power and authority
• To effectively lead an organization a leader should have both Power
and Authority.

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• Power: is ability to do something

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• Authority: is the right or legal power of a manager to do
something or to tell people what to do.

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Leadership styles
1. Autocratic/dictatorship
• Keep authority and control in their own hand

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• Expect employees to follow their orders
• No Participation of employees

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• Traditional, unilateral
• They says “Do just what I say”

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Leadership style…
2.consultative: Subordinates are consulted and their feedback taken
into consideration in the decision making process
• They says “This is my decision , improve it before you take it”
• 3. Democratic/participatory:

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• Encourages full employees participation, even though the leaders make
the final decision

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• Members encouraged to demonstrate initiative & creativity and
interest
• They says “Let’s do together”

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Leadership style…
4. Laissez- faire or anarchic or free- reign
• The leader is just a figure head and does not give any direction
• Lets the subordinates plan, organize and develop their own
techniques for accomplishment of organizational policies

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• The leader becoming one of members
• They say “do as you like” and used as remote control

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Leadership style, grids model
• Developed by Blake and Mouton.
• Uses two variables of leadership orientation
• “Concern for people” and “concern for production”
Identified five distinct leadership styles:

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• 9,9……Team management
• 9,1……Authority compliance

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• 1,9……Country club management
• 1,1……Impoverished management
• 5,5……Middle of the road management

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Leadership style, grids model
(1,9)- Country club mgt (9,9) –team mgt
High

Concern

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for People
(5,5)- Middle of the road mgt

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Low (1,1) – Impoverished mgt (9,1)- Authority Cop
Low Concern for Job High mgt
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 5. Controlling

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 Controlling
• Control refers to the task of ensuring that activities are producing the
desired results.

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• Controlling is determining what is being accomplished and if necessary,

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applying corrective measures so that performance takes place according to
plan.

• It ensures that the overall directions of individuals are consistent with

short and long range plan.

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Steps of controlling
• There are essentially four steps in controlling process

Establish objectives and

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standards.

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Measure actual performance.
Compare results with standards.
Take corrective action.

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 Step 1: Establishing Standards
Standards: are units of measurement established by management to serve
as benchmarking for comparing performance level

• The control process begins with establishment of performance

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objectives/standards.

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• Establish a base for future measurement

• Predicts specific expectations for individuals

• Occurs mainly in top management

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Step 2: Measure Actual Performance
• Measurements must be accurate to spot deviations between what
really occurs and what is most desired.
• Without measurement, effective control is not possible.

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During performance measurement
management should pay attention for:
• Timeliness of information
• Appropriate units of measurement

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• Reliability of information

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• Validity of information
• Channeling information to proper Authority
• Simple: minimal and flexible

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Step 3: Compare Performance to Standard
• Comparing results with standards determines variation
• If performance matches the preset standards managers may
assume everything is under control

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• A slight departure from standard is normal and expected
• But gross departure needs immediate corrective action

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Step 4: Take Corrective Action
• This step is necessary if performance fall short of standard
• It should be taken at appropriate time
• Corrective action may be done by:

• Adjustment of resource allocation

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• Modification in selection and training

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• Improvement in supervision and
motivation
• Reassignment or clarification of duties
• Changing objectives
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Forms of management control
• There are three forms of management control.

1. Monitoring:

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 Monitoring is the routine collection and analysis of information to
track progress against set plans and check compliance to

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established standards.

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2. Evaluation
• Evaluations involve identifying and reflecting upon the effects of what
has been done.
• Their findings allow managers to learn from experience and
improve future interventions.

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Types of evaluation
Formative evaluations: occur during programme implementation to

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improve performance and assess compliance.
Summative evaluations: occur at the end of programme
implementation to assess effectiveness and impact.

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Types of evaluation…
• Internal or self-evaluations: are conducted by those responsible for
implementing a programme.
• External or independent evaluations: are conducted by evaluators
from outside of the implementing team, often by technical

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expertise.

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 Monitoring and Evaluation
Indicator
• An indicator is like a road sign.

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• Shows whether you are on the right road, how far you
have gone to reach at your destination

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• Indicator—a marker of change over time
• Are markers of progress toward your desired result.
• It allow you to measure whether any change occurs as a
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result of your leading and managing practices
3. Supervision
• Supervision is defined as a process of guiding, helping, training, and

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encouraging staff to improve their performance in order to provide
high-quality health services

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• Supervision is a helping process it is not an inspection

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Steps during supervision:
• Prepare for conducting supervision
• Conduct supervision
• Introduction
• Interview Appropriate Staff

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• Performance Review
• Administrative Review
• Community Involvement Review

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• On-site Update/Training
• Discussion and Problem Solving
• Conduct Visits to Selected Health Facilities
• Provide Constructive Feed Back
• Record and report supervisory findings

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Any Question

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