Introduction to health sector

management
Abiot Kassahun(BSC in PH, MPH)
Department of public health
Injibara University
December, 2024
 Learning objectives
 At the end of this session, students are expected to:
 Define management
 Describe rationale of learning management
 Discuss basic concepts of management
 Compare and contrast effectiveness and efficiency
 Differentiate management and administration
 Describe types, skills and roles of managers
 Apply principles, skills and roles of management in
the work
 List functions of management
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 Entry questions
Do you think that learning management is
important?
How do you understand the term
management?
What do you think is the function/job of
managers?

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 Rationale of the course
 Management is universal and essential function in
all kinds of organizations
 Planning and management skills are needed as most
health professionals may be put in a managerial
position
 Proper health planning and health services
management skill is an important tool to bring about
change in the health care delivery system
 Knowledge and skill of controlling is important to
achieve organizational objectives
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 Rationale…
• Resources are scarce in most countries urging the
need for proper skills in planning and management
for efficient utilization
• It is also difficult to address all health problems at
a time
• Therefore, it is necessary to prioritize problems and
make an informed decision which requires experts
with such skills

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 Introduction to management
 We are born in an organization (a family)
 Live in organizations (society) and work in
organizations (Business, Government, Army, School,
College etc.)
 Each one of these organizations is a group of persons
working together to achieve some common
objectives

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 Introduction to management…
 The organizations can be successful only when the
efforts of various individuals in the groups are
integrated into team work
 The central agency which performs this task is known
as management
 It plays the same role in an organization which
BRAIN does in human body

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 Introduction to management…
• The essence of management is getting work done through
others.
The underling principle of this definition is 'commitment to
achievement',
• i.e. commitment to purposeful action, not to action for its
own sake
To stress is notion of purpose the definition might be rewritten
as
• “management is saying what one wants to be done, and then
getting it done “
So management ensures that objectives are specified (i.e. states
specifically what is to be achieved) and then that they are
 Management
 It is impossible to provide a single, comprehensive ,
universally accepted definition of management
 Different scholars from many disciplines view it
differently from their own angles:
– The economist view management terms of
resource like land, capital, labor etc
 Has been defined in ways that appear different but
with a strong underlying similarity.
 Management is the art of knowing what you want to
do and then seeing that it is done in the best and
cheapest way (F.W.Taylor)
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 Management…
 Management as a process consisting of planning,
organizing, actuating and controlling, performed to
determine and accomplish the objective by the use of
people and resources (George R. Terry)
 Planning, Organizing, Commanding, Coordinating
and Controlling (Henri Fayol)
 Decision Making, Organizing, Staffing, Planning,
Controlling, Communicating and Directing (Warren
Haynes and Joseph Massie)
 Planning, Organizing, staffing, directing and
Controlling (Koontz Donnell)
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 Management…
All in all, the definitions focused what the manager does:
– Getting things done through people & other resources
– Providing direction and leadership

 Therefore, management is the process of planning, organizing,

leading and controlling the work of organizational members
for the attainment of organizational goals in an effective and
efficient manner using organizational resources.
• Good management is to organization what health is to the
body
– the smooth functioning of all its parts.

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 Management…

The manager uses resources and carries out functions to

achieve goals
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 Administration Vs Management

 Administration is an overall determination of polices

& major objectives
 Management is essentially an executive function ,
the active direction of human effort
 Thus, as a function, administration is determinative
while management is executive
 Yet the same person may perform both functions
 As we go down the hierarchical ladder, the
administrative function became less and less and the
management function more and more
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 Efficiency Versus effectiveness

Efficiency
 Efficiency: A measure of how well resources are used
to achieve a goal
 It is 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 resource

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 Efficiency Vs effectiveness
Basic concept of efficiency:
– do not waste resources;
– produce each output at least cost;
– produce the types & amounts of output which people
value most.
 Division of labor and convergence of work

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 Efficiency Vs effectiveness
• Effectiveness: (“ Doing the right thing”)
 A measure of the appropriateness of the goals
chosen (are these the right goals?), and the degree
to which they are achieved
Doing the right things in the right way at the right
times
It is the comparison of objectives with their
achievement

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 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)

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• High Goal Attainment (high effectiveness) 17
 Principles of management
1. Management by objectives
A process in which specific performance
objectives are jointly set by subordinates and
their superiors.
Progress towards objectives is periodically
reviewed and rewards are allocated on the basis
of progress.
Each person’s major area of responsibilities is
clearly defined in terms of measurable outcome

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 Principles of management…

Application of management by objective

Cascading of organizational goals and objectives
Specific objectives for each member
Participative decision making
Explicit time period
Performance evaluation and feedback

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 Principles of management
2. Learning from experience
Gap assessment
Analysis to identify causes of the gap
Discover causes of the gap
3. Division of labor
Management attempts to bring about balance of work
among different people concerned.
Assign the right proportion of each kind of staff to
the task at hand

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 Principles of management…
4. Substitution of Resources
 When the resources normally used to provide service
become scarce or too expensive, different resources may
be used to deliver the same service.
5. Convergence of work
 Working relations should contribute to the success of each
activity and so to the general goal of the organization
6. Functions determine structure
 Determining the function & duties of individual member is
followed by working relations (structure).

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 Principles of management
7. Delegation
Assigning job activities and corresponding authority
to specific individuals within the organization.
8. Management by exception
 Selectivity in handling information & prioritized
decision making
9. Short Decision path
Decision must be made as closely as possible in time
and place to the objective of decision and to those
affected by it.
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 Types, Skills and Roles of managers
Managers
Are people formally appointed/selected to positions of
authority in organizations or systems who:
 Enable others to do their direct or support work
effectively
 Have responsibility for resource utilization
 Are accountable for work results
Are the people who plan, organize, direct, and control so as
to manage organizations and organizational units.

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 Types of managers
A) Classification by management level
 Front - line (or first/ low level) / Supervisory mangers:
 Middle managers: Middle level
 Top/ senior managers :Top/ high level
B) Classification based on scope of activities
 Functional
 General
C) Other way of classification
 Policy level
 Administrative
 Operations level
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 Types of managers by level
Three levels
A. Top level managers
B. Middle level managers
C. First line managers

 The primary difference between levels of

managers is the degree of authority and the
scope of responsibility .

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 1. Top level (senior) managers
 Have authority over and are responsible for the entire
organization
i.e. all staff, resources and organizational results
 Are accountable to the governing body
 Establish operating policies and guide the organization
with its environment
 Include individuals with the title of chairperson,
president, chief executive officer, executive vice
president, vice president, or chief operating officer.

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 2. Middle-level managers
 Report to senior/top managers
 There are numerous middle level managers than top
managers
 Have authority over & responsibility for a specific
segments of the organization
 Terms such as director or manager usually used for
middle manager
E.G director of human resources or western regional
manager.

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 3.First-level (front line) managers
 Oversee the nonsupervisory employees.
 Spend the greatest amount of time actually directing
employees.
 Except for making small, on-the-job adjustments, they
seldom perform planning and organizing activities.
 Instead, supervisory managers initiate the upward flow of
information that middle and top managers use to control
organizational behavior.

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 Managerial Levels and Job Titles

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 Managerial Skills

 Skill is ability to do something expertly and well.

 It is an ability related to performance that is not
necessarily inborn but which can be developed/
acquired
 There are three distinct types of skills:
1. Conceptual skill
2. Human relation skill/interpersonal skill
3. Technical skills

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 1. Conceptual Skills
 The ability to perceive an organization or
organizational unit as a whole.
 Reflect the mental abilities of managers to visualize the
complex interrelationships in a work place .
 Permits managers to understand how the various factors
in particular situations fit together & interact one
another
 Cognitive ability to see the organization as a whole and
relationship among its parts
 These skills are used most frequently by top managers,
who take responsibility for organization-wide strategic
endeavors.

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2. Human relations &/ communication skills

 Are the abilities of managers to get along well with

other people, to understand them, & to motivate &
lead them in the work place
 The ability to motivate, facilitate, coordinate, lead,
communicate & resolve conflicts.
 The ability to work effectively as a group member
and build cooperation among the members of an
organization or unit
 This skill is equally needed for managers regardless
of level.
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 3. Technical skills
 Are abilities to use the methods, processes, and
techniques of managing
 It includes:
 Methods & techniques

 Specialized knowledge

 Competent use of tools

 Techniques to solve problems in that specific

discipline
 Frontline managers need most

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 Essential Managerial Skills Vs Types of managers

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 Managerial Roles
 A role is an organized set of behaviors.
 Managerial role is the behavioral pattern expected
of someone within a functional unit.
 Managerial roles categorize managers' actual
behavior
 All mangers have formal authority over their
organizational units & derive status out of that
position.
 The work of managers is viewed as a series of three
broad categories of roles, (Henry Mintzberg).

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 Mintzberg’s 10 managerial roles

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 Managerial Roles
1. Interpersonal roles
A. Figurehead
 Performs ceremonial & symbolic duties such
as greeting visitors, making speeches at
organizational events, signing legal
documents etc.
B. Leader (influencer)
 direct & motivate subordinates
 seek to motivate, inspire & set examples
through their own behavior
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 Managerial Roles…
C. Liaison
 Allows managers in formal & informal
contacts both inside & outside their
organization to establish relationships that
will help them achieve organizational
objectives.
 Interpersonal roles provide managers with
opportunities to gather information.

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 Managerial Roles…
2. Informational roles
a. Monitor role
 Managers gather information from their network
of contacts, including those established in their
liaison roles .
 Filter the information, evaluate it and decide
whether to act as a result of the information

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 Managerial Roles…
b. Disseminator
 This role grows out of the managers’ access to
information and his ability to choose what to do with
that information
 Distributes information to those who should receive it,
both outside and inside the organization
c. Spokesperson
 Communicating the position of their organizations to
internal and external stakeholders who affect their
areas of responsibilities
 transmit information to people outside the work unit,
keep supervisors informed or representing the
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organization in dealing with the external environment
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 Managerial Roles…
3 . Decisional roles
 The authority granted by their organization
supported by their interpersonal and informational
roles permits managers to play decisional role.
A. Entrepreneur
 Are initiators and designers of changes intended to
improve performances in their organizational domains
 Act as change agents → initiate improvement
projects, identify new ideas, delegate idea
responsibilities to others

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 Managerial Roles…
B. Disturbance handler
 Detect wide variety of problems & decides on and
implements solutions
 Takes corrective action during disputes or crises and
resolves conflicts among subordinates
 The ability to make good decisions about handling
disturbances is and important determinant of
managerial success.

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 Managerial Roles…
C. Resource allocator
 Prioritize tasks and make decisions regarding the use
of limited resources to meet conflicting needs to
achieve goals
D. Negotiator
 Interact and bargain employees, suppliers, regulators,
customers, clients and others.
 Represent departmental interests during negotiations
 Negotiating includes deciding what objectives to seek
through negotiations and how to conduct the
negotiations.
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 Functions of Management
• Henri Fayol’s 1916 list of managerial tasks:
– planning, organizing, commanding, coordinating, and
controlling the work of a group of employees (Wren,
1972).
• Lombardi (2001) points out that two-thirds of a manager’s
time is spent on people problems.
– The rest is taken up by budget work, going to meetings,
preparing reports, and other administrative tasks.

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 Management functions

 The set of social and technical functions inherent in

the management process includes:
o Planning
o Organizing
o Staffing
o Directing/leading
o Controlling/ M and E
o Decision making and communication
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