Human resources section3a-textbook_on_public_health_and_community_medicine

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Human resources section3a-textbook_on_public_health_and_community_medicine

  1. 1. 10095752550
  2. 2. Section 3 : Health Policy & Health Care Systems 3a) Management Process in Health Care59 Medical Informatics and Public Health LS Vaz 30960 General Concepts in Management Sciences Anuj Bhatnagar 31461 Personnel Management & Human Resource Development Anuj Bhatnagar 32262 Financial Management Anuj Bhatnagar 32663 Logistics Management Anuj Bhatnagar 33364 Modern Management Techniques Anuj Bhatnagar 338 3b) Health Systems and Policies65 Planning and Evaluation of Health Services / Programmes RajVir Bhalwar 34366 An Introduction to Health Systems Kunal Chatterjee 34767 Assessing “Health Status” and “Health Needs” Amitava Datta 35368 Assessing the “Health Impact” Amitava Datta 35869 Community Diagnosis Amitava Datta 36170 Ethics in Public Health, ; Health and Human Rights Amitava Datta 364 General Principles for Developing Management71 Amitava Datta 369 Information Systems in Public Health Practice72 Making Public Health Policies Amitava Datta 37273 Strategic Planning in Health Care Amitava Datta 37574 Bringing about Equality in Health Care Amitava Datta 37975 Health Care Quality Amitava Datta 38276 Social Marketing Anuj Bhatnagar 38677 Public Health Aspects of Disaster Management Ashok K. Jindal, Puja Dudeja 38978 Principles & Practice of Hospital Management Anuj Bhatnagar 39979 Advanced Diagnostic Technologies in Public Health Rohit Tewari 41180 Accreditation of Health Care Facilities Udai Bhaskar Misra 420 Sunil Nandraj, N Devadasan,81 Health Care Financing 427 Alaka Singh82 Trade and Public Health Sunil Nandraj 434 3c) Public Health Administration & Community Health Care in India83 International Health Rajesh Kunwar 44184 Organization of Health Care in India Leo S. Vaz 45785 Reports of Health Committees Sunil Agrawal 46786 Health Planning Process in India Sunil Agrawal 47187 Public Health & Community Medicine Related Policies in India Sunil Agrawal 47888 National Rural Health Mission (NRHM) Sunil Agrawal 49089 Reproductive and Child Health (RCH) Programme Puja Dudeja, Ashok K. Jindal 49690 Revised National Tuberculosis Control Programme (RNTCP) Puja Dudeja, Ashok K. Jindal 50491 National Vector Borne Disease Control Programme (NVBDCP) Puja Dudeja, Ashok K. Jindal 51392 National Leprosy Eradication Programme Puja Dudeja, Ashok K. Jindal 524 Pilot Project On Prevention and Control Of Human93 Puja Dudeja, Ashok K. Jindal 528 Rabies Under 11th Five Year Plan94 Guinea Worm Eradication Programme Puja Dudeja, Ashok K. Jindal 52995 Leptospirosis Control Programme Puja Dudeja, Ashok K. Jindal 52996 National Aids Control Programme Puja Dudeja, Ashok K. Jindal 53097 Polio Immunization Programme Puja Dudeja, Ashok K. Jindal 536
  3. 3. 98 Integrated Disease Surveillance Project (IDSP) Puja Dudeja, Ashok K. Jindal 53899 National Mental Health Programme (NMHP) Puja Dudeja, Ashok K. Jindal 541100 National Cancer Control Programme Puja Dudeja, Ashok K. Jindal 542 National Programme for Prevention & Control of101 Puja Dudeja, Ashok K. Jindal 544 Diabetes, Cardiovascular Diseases & Stroke102 National Iodine Deficiency Diseases Control Programme Puja Dudeja, Ashok K. Jindal 545103 National Programme for Prevention & Control of Deafness Puja Dudeja, Ashok K. Jindal 547104 National Programme for Control of Blindness Puja Dudeja, Ashok K. Jindal 548105 Other Important National Health Programmes Puja Dudeja, Ashok K. Jindal 550106 Health Legislations in India Sunil Agrawal 555107 Rehabilitation : Policies & Procedures in India Sunil Agrawal 565108 Human Manpower Resources in India (Including AYUSH) Anagha Khot 574109 Medicines in India : Access & Availability Dr. Amit Sengupta 591110 Medical Education in India111 Health Care of Disadvantaged Groups Kunal Chatterjee 601112 AYUSH RajVir Bhalwar 604
  4. 4. 2. Well-defined responsibility leads to accountability and General Concepts in Management 60 Sciences thus enhances performance of individuals. However responsibility can only be effective when it is combined with delegation of authority. Anuj Bhatnagar 3. Discipline in any organisation is essential and a hallmark of compliance and mutual cooperation between variousThe key issue which forms the basis of any organisation or functionaries. Discipline within any organisation directlygroup of people is a common objective or a goal, which may be depends on good supervision, fair codes of conduct andwinning the match, prevent thefts in the neighborhood, deliver judiciously implemented rewards & punishments.good quality health care to community or earn maximum 4. An employee should ideally receive his/her orders onlyprofits. It is thus natural that without a common goal or from one superior since multiple commanding authoritiesobjective, there would be no need for people to form groups would lead to confusion and chaos. This principle isor organisations. Since achievement of a common goal forms well entrenched in the armed forces, where the unity ofthe basis for forming groups, each organisation must then command is practiced.also have some plans to achieve the common goals and every 5. Organisational goals should receive preference and areorganisation must also procure and dedicate certain resources more important then individual goals.(in the form of money, material and men) for achieving the 6. Remuneration in form of pay and allowances should becommon goals. pre-determined for all personnel, to avoid uncertainty. 7. Centralization of important policy decisions and keyDefinition of Management matters is essential in any organisation to provide a wellThe shortest definition of ‘Management’ is “Management is defined direction to efforts of individuals.getting things done through and with people”. However, two of 8. Employees should function in well defined functionalthe most widely quoted definitions are : chain of senior-subordinate relationships, called scalar“Management is the art of getting things done through and with chains, ideally depicted by a line organisation (explainedpeople in formally organized groups. It is the art of creating subsequently).the environment in which people can perform and individuals 9. Unity of direction, which means that directions for thecan cooperate towards attainment of organisational goals. It is entire organisation should flow downwards from the headthe art of removing blocks to such performance and a way of of the organisation to all other functionaries.optimizing efficiency in reaching goals.” (Harold Koontz) 10. An order in an organisation ensures stability & efficiency. 11. Equity in an organisation removes conflicts and ensures“Management is a distinct process consisting of planning, compliance & cooperation.organizing, actuating and controlling, performed to determine 12. Stability of working period (tenure) ensures certainty inand accomplish stated objectives, by the use of human beings minds of workers and enhances performance by inculcatingand other resources.” (George R Terry). Box - 1 represents this a sense of belonging & responsibility among individuals.often quoted definition of management : 13. Initiative among employees gives them a chance to utilize their skills and hence results in better employee Box - 1 satisfaction, besides enhancing performance. Basic Resources Fundamental Functions Objectives 14. Team spirit (spirit-de-corps) is essential for any (inputs) (managerial transformation (outputs) organisational work. process) Why must you study management as a medical doctor?: Men Staffing & Products It is sometimes said that doctors are poor managers. The Planning unwillingness to study management sciences has led to a large Material Directing Services Machines Profits number of brilliant doctors being failures when it comes to Methods Satisfaction leading. Like any other team, any medical team also consists Money Goal achievement Markets Organising Controlling of various individuals who perform their respective tasks in Others order to meet the common goal - of providing best health care with optimum utilization of scarce medical resources. AllBasic Principles of Management aspects of management are equally, in fact more, applicableHenry Fayol (1881-1925), generally considered as the founder to a health team, be it at a PHC or a highly specialized teamof classical management theory, laid down certain basic of a multi-speciality tertiary care centre in a metropolis. As aprinciples of management. Prior to Fayol, it was believed that medical doctor, you are expected to lead a highly professionalgood managers were born, not made. Fayol proposed that team of trained health care workers. All your activities, be it amanagement, like any other skill, could be taught and mastered vaccination drive in a village or a highly complicated surgeryonce its basic underlying principles, as under, were understood. has to be planned well in advance. You will have to carefullyThese principles are : select your team members & motivate them to perform. In short, any health team with you as its leader is just like any1. Division of work according to the ability, capacity and other organisation with its unique organisational objectives, aptitude of the workers is essential in any organisation which have to be attained through sustained efforts of all the for optimal utilization of scarce human resource and to members. maximize productivity in any form. • 314 •
  5. 5. In addition, we must also remember that all medical personnel Fig. - 2are highly trained and intellectual, posing a challenge to anyleader of such capability. Medical logistics and resources, like Planning Organising Staffing & directingin any other field are always in short supply and hence have tobe optimally deployed and utilized to ensure maximum benefit.For example, a MRI scan machine worth a few crores must Feedback Controlling Decision makinggive adequate returns in the form of adequate patient load.Investing heavily in such equipment at a location where only Planningone or two MRI scans are done in a month would be waste Planning is the fundamental and initial process in any activityof vital resources which could be better utilized elsewhere. and success of any project or activity depends on how well itThus, medical profession today is no more isolated and has has been planned. If any team effort has to be successful, allto extensively draw upon all managerial sciences of human team members must know in advance what they are expectedresource development, financial and material management to accomplish (objectives). Thus setting the objectives is afor smooth functioning of the health team. Hospitals today major function of planning. Planning consists of deciding inare complex organisations and hospital management, as a advance what to do, how to do, when to do and who is to do it,sub-specialty of management, has gained grounds rapidly. It and thus it bridges the gap between where we are presently andis now being increasingly felt that basic management skills where we have to reach. Planning consists of taking consciousare essential for every medical doctor for him/her to function and well thought out decisions about which course of actioneffectively as a team leader. to take out of the many available and most suitable method toManagement Vs Administration achieve these objectives. Planning ensures that pre-determinedSome ambiguity exists regarding ‘management’ and objectives and goals are identified so that all resources can be‘administration’, with some writers thinking them to be allocated and dedicated in achieving these goals in the mostdistinct activities whereas others feel they are different optimal manner. In short, it can be said that the process ofaspects of management itself. Having defined management, planning answers the following questions for the manager :administration can be defined as ‘those functions in an a) What will be done – identifying short and long termorganisation, which are concerned with policy formulation, objectives and goals.finance, production, distribution and ultimately control all key b) What resources will be used – identifying the available &activities for meeting the organisational objectives’ (Sheldon). potential resources required for achieving the objectivesIt can thus be assumed that policy-making, planning and and filling the gaps in resources, if any.decision making are the basic components of administration c) How will it be done - determining the specific activitieswhereas supervision, implementation and operational aspects required for attaining the goals and formulating strategies,are considered components of management. Thus the top policies, procedures, methods, standards & budgets.management such as Director or Dean of a teaching hospital is d) Who will do what – delegating responsibilities to variousmore concerned with policy and decision making and lesser of individuals for attaining the organisational goals.day-to-day supervision & control, whereas lower management e) When will it be done – assigning the time frame andlevels (Heads of Departments and Registrar) are concerned sequence for completing each activity.more with effective supervision & control of daily activities The Planning Process in Health Sectorbeing carried out. Fig - 1 depicts the difference betweenAdministration (administrative management) and Management As a leader of medical professionals, a doctor is often faced(operative management). with a situation where he has to plan various health activities. The basics of planning process in the health sector can be remembered by answering the following key questions : Fig - 1 (i) Where are we at present (situational analysis) Administration (ii) Where do we finally want to reach (objectives & goals) Top level (iii) ow do we get there (resources & constraints) H (iv) How effectively we have performed the required activities Middle level (evaluation, monitoring & feedback) (v) What new problems do we face and how do we overcome Lower level them (re-planning) Management Steps Involved in Planning a Health Program This aspect has been deliberated in detail in an exclusiveThe Management Processes chapter in the section on epidemiology. You are advised to goA medical officer, in many ways is like any other leader and through the same.manager and has to daily meet some objectives, which may General Terms used in Relation to Plans : As a leader of therange from implementing a health program in a district to health team, it is important for a medical officer to know aboutundertaking a complicated surgery with his surgical team. the various types of plans and the distinction between them.To successfully attain the objectives with optimum resources, As discussed earlier, all organizational plans are formulatedrequires a series of managerial processes, which are as shown with the instinct to achieve the pre-determined objectives in thein Fig. 2 : • 315 •
  6. 6. most efficient manner. Various types of plans can be classified organizational objectives.as under : (iii) Goals often represent a target to be achieved or a hurdle to(a) Mission : The mission of an organization is described as the be overcome.very reason why that organization exists. It is always described (iv) Achievement of goals has to be within a specific timein terms of the benefit (direct or indirect) provided to users by frame.the organization and not in terms of the product or services Thus we have seen that goals are action-oriented, provide arendered. It is of utmost importance for any organization to means for converting plans into smaller achievable tasks andclearly define its mission, since that will determine all efforts are time bound. Goals also play a major role in motivatingof that organization. The organization must ask the question people towards working in a coordinated fashion towards the“what is our business” and answer it from the users’ viewpoint. larger organizational objectives.The mission of an organization is described in its ‘mission (d) Strategies : Strategy is any decision, plan or action whichstatement’. For example the ‘mission statement’ of Department takes into consideration the actions of competitors and otherof Community Medicine of a medical college would be “To provide factors in external environment, with the aim of achievingcomprehensive training in community medicine to medical the objectives. For example, when as a doctor, you wouldgraduates and post graduates, with the aim to make them better plan your IEC campaign for promoting condom usage amongpublic health specialists.” The mission of an organization is community, keeping in mind the reaction and resistance of adynamic and must adapt to the environmental changes and particular section of community, it would be called a strategy.requirements. The organization has to decide how it would like The strategist would thus consider the reaction of externalto define what its business would be. Formulating the mission is environment and plans of his ‘rivals’ (anyone who could delayof utmost importance and never easy; it must balance between or derail the achievement of his goals & objectives), whilethe present & the future. A narrow definition of ‘mission’ will planning his course of action. As a health strategist, one wouldlimit the activities of the organization to the immediate present select strategies (plans) that would help in achieving the& prevent its growth and utilization of newer opportunities & objectives and which would create an advantageous positiontechnologies, whereas too broad a definition of mission will for the entire health team in dealing with the external (socio-not enable the organization to concentrate on any workable economic & socio demographic) environment in which theactivity and opportunities at present. For example, a doctor health team has to operate.at PHC would most likely describe his mission as “providing (e) Policies : It is important to understand the differencetimely and expert primary care to villagers in his jurisdiction” between strategies and policies, since both are often confusedwhereas a cardiothoracic surgeon at a large multispeciality and used interchangeably. Whereas strategies focus of the bestmetropolitan hospital would describe his mission as “providing course of action (among alternatives) after considering externalhighly specialized cardio-thoracic surgery to all those who are environment and possible actions of competitors / rivals, policiesbrought to the cardiothoracic department of the hospital”. on the other hand, provide guidelines for decisions and actions.(b) Objectives : Having first formulated the ‘Mission’ of For example, it is the policy of a state government to immunizethe organization, which answers the question ‘what is our all children against Hepatitis B, which is thus the guidelinebusiness’, the next step would be to translate this relatively for the health directorate of that state to procure vaccines andabstract mission into smaller, tangible, measurable & implement Hepatitis B vaccination at all its health centers &achievable ‘objectives’ for managers at lower levels. Thus hospitals. Policies do not tell a manager what he should orobjectives are the ‘action orientation of the mission’ and form should not do in a given situation. Policies tell a manager whatthe basis for taking action in appropriate direction and for he can do by setting a limit within which a manager mustmeasuring the performance. For example, let us assume that operate. Well formulated policies in any organization help inthe mission statement of a measles immunization program achieving the pre-determined objectives by channelising allis ‘to immunize children below 2 yrs with measles vaccine managerial decisions in the right direction, providing tangibleto protect them against measles’. The objective in this case and measurable criteria for evaluation of decisions taken andwould be ‘immunization of 90% of all children in any given by ensuring uniformity in decisions throughout the entirevillage’, which would form the basis of action to be taken by organization.the health workers and would also act as a measurement of (f) Rules : As compared to policies (which are guide toperformance. However, it must be remembered that objectives decisions), rules are guides to action and prescribe a type ofremain statements of expected outcomes and not the actual behavior / actions which are permissible. Rules define whatperformance or outcome. should or should not be done. For example, the attendance rule(c) Goals : Goals can be described as intermediate time-bound of PHC staff states that if any health worker is late for threeand specific targets which are necessary for achievement of days in a month, he shall loose one day’s casual leave. Rulesobjectives in the organization. Being derived from objectives, are effective only when they carry a penalty / punishment forgoals are very specific (quantitatively or qualitatively). ‘Goals’ non-compliance and thus regulate employee behavior, thoughwould broadly have four characteristics as under: at the same time restricting their initiative and innovativeness.(i) Goals are derived from the objective which they seek to Policies by and large, define a broad sphere within which a fulfill. leader has to act using his discretion. Rules on the other(ii) Goals form the benchmark and standards for measuring hand, leave no scope for any discretion by clearly defining the performances & progress towards achieving the larger acceptable behaviour/actions. • 316 •
  7. 7. which aim at achieving certain health related objectives within General principles to be followed for formulating a stipulated time-frame through a series of actions. organizational policies 1. Policies should always assist in achieving the Organising organizational objectives. As a function of management, organizing deals with identifying and grouping various activities, delegating authority and 2. Policies should be well defined and should be in command to managers and coordination of various activities writing. and hierarchies in the organization. The process of organizing 3. Policies at each level should be derived from and should can be described as a series of steps as under : support the policies of the next higher level. (i) Detailed description of various activities to be performed 4. Policies of a department in the organization should be for achieving organizational goals : For achieving the pre- well coordinated with policies of other departments, determined organizational goals, we must know in detail what and should not pose a hindrance / obstacle to policies of activities are to be performed. For example, before a hospital other departments. team can actually start treating the sick (organizational goal), 5. Policies should be just, unbiased and equitable towards they must know what equipment to buy, how many doctors, all sections of employees. nurses and paramedical workers to hire, where to locate the hospital, how to construct and how many departments to 6. To incorporate the changing needs and changing create in the hospital. organizational environment, policies should be periodically reviewed and revised. (ii) Grouping of various activities in some meaningful manner : An organization invariably functions better when(g) Procedures : We have seen that policies are guides to activities of a similar nature are grouped together, based ondecisions and rules are guides to action. Procedures are their essential similarity & difference from other activities. Thischronological steps involved in performing any action or taking would be best exemplified in creation of various departmentsany decision. For example, the procedure of administering an in a large hospital. For example, all patients requiring surgicalintra muscular injection to a patient can be broken down into intervention (which may be for hernia, burst abdomen, gundistinct sequence of actions as under : shot wound or a simple abscess requiring incision & drainage) are referred to & attended in the surgery department (which(i) Disinfection of site with spirit. itself may be further divided into cardio-thoracic surgery,(ii) Assemble the syringe & needle. gastrointestinal surgery, neurosurgery or vascular surgery(iii) Break the injection vial. depending on the detailed type of surgeries performed).(iv) Fill the syringe with injectable drug (say Inj Voveran).(v) Insert the needle into the muscle (deltoid or gluteal (iii) Delegation (comprising of authority, responsibility region) and accountability) : Consists of assigning each group(vi) Partly withdraw the plunger to ensure that needle is not in of activities (departments) to a manager with authority to a blood vessel. supervise its functioning (head of the department). Delegation,(vii) Depress the plunger to inject the drug. thus, is the most important part of organizing since any(viii) Withdraw the needle out of the skin without shaking/ manager due to limited individual capabilities, can not carry bending . out all organizational activities alone and has to delegate(ix) Swab the injection site with cotton. work to his subordinates. Successful delegation of work isThus, procedures are sequence of activities that have to be accompanied by delegation of authority to take decisions &performed in order to achieve a certain objective (e.g. giving actions of accountability.an intramuscular injection). All medical officers are well (iv) Coordination (horizontal and vertical) : Makes theconversant with many surgical or nursing procedures which organizing process complete. In any organization, everyhave to be performed sequentially to complete a task, such as individual or group of individuals very often start concentrating‘Hand washing procedure’ in operation theatre, procedure for on performing only their specific assigned task, often relegatingstarting an intravenous lifeline in intensive care unit etc. the overall organizational goals to the background and(h) Programs : As a doctor, one is often required to manage and generating conflicts. For example, in a large multispecialityimplement various health programs in our respective areas, hospital, the medicine department may be unwilling to partwhich makes it important for every doctor to understand the with their assigned vacant bed in ICU in anticipation of a caseconcept of a program as a plan at the national level. A program even when the surgery department needs it urgently for ais a set of those activities which have a specific time schedule patient of burst abdomen. The medical stores may be refusingand a distinct mission. Thus programs are a series of actions to issue costly medicines prescribed by a junior doctor withperformed for achieving the organizational objectives ‘within the aim to curb wasteful expenditure, not realizing that thethe scheduled time’. In our example, when a medical officer of a medicine is urgently required by the patient. Such occurrencesPHC undertakes specific actions with the objective of attaining are quite common in medical practice and this is where thethe 90% vaccination mark for measles among children below role of the medical superintendent as a manager is of utmost2 years by the end of the year 2010, it is a health program. importance. Coordination between departments and betweenAll medical students are also well aware of several National various hierarchies in organization is thus an essentialHealth Programs (described in detail elsewhere in this book), requirement to channelise energies towards achieving the • 317 •
  8. 8. overall organizational goals and look beyond individual or responsible is ideal for research and development such as indepartmental goals. groups developing new drugs, vaccines or conceptualizingPrinciples of organizing : Some important principles of newer & better methods of health care delivery in remoteorganizing are enumerated below : villages.(i) Unity of direction : One leader & one plan for a group of Factors determining an effective span of control : Though thereactivities having the same objectives. is no laid down limit of the optimum number of subordinates a manager can supervise effectively, the most important factor(ii) Unity of command : A subordinate reports only one boss is the managers ability to reduce the time he spends with eachto avoid conflict of orders. subordinate in order to gain the maximum output from him.(iii) Authority : Every individual in an organization has some Seven important factors which determine the frequency andresponsibility commensurate with his authority. duration of superior-subordinate interaction (time spent by a(iv) Span of control : Number of subordinates supervised by a superior with each subordinate, hence the span of control ofleader should not be too many for better control. each manager) are as under :(v) Flexibility : Organisational staffing pattern & structure (a) Training levels of subordinates : Well trained subordinatesshould be able to accommodate changes in internal & external require less frequency and duration of contact with superiors &environments. result in wider span of control for the superiors.(vi) Management by exception : All routine decisions should (b) Clear delegation of authority : If a subordinate’s task isbe taken by subordinates & only policy decisions and unusual not clearly defined or if he is not given enough authority, hematters should be referred to the leader. would be spending disproportionate time seeking clarifications,(vii) Scalar principle : Clear lines of authority in hierarchical thereby reducing his span of control.structure ensures more effective performance. (c) Clarity of plans : A superior would need to spendFormal and Informal Organisations : The organizing process considerable time supervising & guiding the decisions ofresults in a deliberately designed and thought out organizational subordinates wherever subordinates have to do much of theirstructure where it is specified who will do what, with whom own planning. This usually occurs whenever organizationaland under whose supervision. Such an organization is said plans are not clearly laid down.to have a formal organization where hierarchies and levels of (d) Objectivity in standards : Use of tangible and measurableauthority are formally laid down and observed. For example, a standards against which actual performance of subordinates islarge corporate hospital, with its clearly and formally defined to be measured enables the manager to avoid time-consumingdepartments and its rigid hierarchy with the CEO at the top is procedures to ascertain if his subordinates are actuallya formal organization. On the other hand, a volunteer group following the plans.of specialists who undertake charity work every weekend at (e) Rate of organizational change : Narrow span of controla nearby charitable hospital for the poor would have emerged becomes necessary wherever the rate of change in thespontaneously due to their common likes and dislikes. Such an organization is fast; which determines the stability of policies.organization, which was not ‘planned’ to come into existence Organizations with slow rate of changes (or relatively stableand which has no formal departments or hierarchies, is an organizations in stable environment) would do better to have ainformal organization. As a doctor, one is faced everyday with broader span of control.informal groups, like the village elders, a village self help (f) Communication techniques : If instructions have to begroup, a youth club etc and we must remember that informal personally delivered by a superior to his subordinates andorganizations, with expressed shared values and sentiments of repeated clarifications have to be sought, naturally there willa large majority, can be very effectively utilized for achieving be an added burden on the managers time, reducing his spanthe organizational goals. The effort to include religious leaders of control.& volunteer groups such as Rotary Club in the Pulse PolioImmunization in India is an example where such informal (g) Amount of personal contact required : Under manygroups are often more successful in achieving organizational circumstances, face to face meetings or conferences withgoals than the highly formal organization of the government. subordinates are essential, which draw upon the time of a manager resulting in narrower span of control.Staffing The concept of line and staff relationships : Traditionally,The concept of ‘span of control’ : Depending on the type of it has been held that line functions & personnel are those thatorganization and objectives to be achieved, every manager are directly responsible for achieving an organization’s primarymust decide how many subordinates he/she can effectively objectives, while staff functions and personnel are those thatsupervise. Consequently, a wider span of control (generally assist line managers to function more effectively. Conceptually,found in highly technical organization with highly motivated it is important to note that in line relationship, there is a directsubordinates) will result in lesser ‘levels of management’ than relationship of command between superior and subordinate,a narrow span of control (where one subordinate is controlled whereas staff functions are advisory nature to line managersonly by one superior). A ‘flat organisation’ (with lesser levels whom they support. It is essential for any medical manager toof management) has faster flow of information and greater know in what capacity (for example, an orthopedic consultant tosatisfaction levels for individual subordinates. Such type of a tertiary care hospital) their job is to advise and not command,organization, where subordinates are highly motivated and • 318 •
  9. 9. but when in line capacity (such as a medical superintendent of Box - 3 : Line and staff organizationa large government hospital), they must make decisions andissue instructions for others to follow. AdvantagesLine organization : A line organization consists of line ●● Managers at various levels get the benefit of specializedpersonnel, where each position has direct authority over technical advise of specialists.all lower positions. No subordinate is under more than one ●● Staff specialists (like financial experts) are able tosuperior, and the scalar principle and principle of unity of concentrate fully on their technical jobs and performcommand are strictly adhered to. The flow of authority in line them more effectively.organisation is depicted in Box - 2. ●● Staff specialists assist line managers in taking better decisions, by providing them the right information at Box - 2 the right time. ●● Since experts can be appointed to advise line managers Advantages on technical issues, the structure is more flexible than  Simple, economical & effective A the line pattern.  Permits rapid decisions & effective coordination Disadvantages  Follows unity of command B ●● Conflict between line and staff personnel is very common  Directly fixes responsibility for in such kind of organizational structure. performance of subordinates. ●● Performance of staff personnel may not be optimum Disadvantages since, they in their capacity as technical advisors, are  Cannot be adopted for large organizations. C not directly accountable for achieving the objectives.  Lack of specialization, each level has to perform all functions & does not have ●● Inadequate job satisfaction among staff personnel due access to specialized advice from experts. to slower promotional avenues.  Too much responsibility on single manager. D Functional organization : In the large and complex organizations of the present day, the traditional principle of oneLine and staff organization : When in addition to the line boss and one subordinate (unity of command) is not possible.authority of managers, there are specialists and experts to In such organizations, different superiors performing differentadvise various levels on specialized issues, it is called the line functions (finance, human resource, inventory control etc)and staff organization . In the figure below, A, C and D managers exercise control over a subordinate in respect of their respectiveare in direct line relationship as discussed earlier; but B is in functions. Thus a functional organization is one wherein astaff relationship and advises A and C on important issues. B worker is accountable to two or more different executivesmay have lower status than A and higher status than C in the for a given specific and specialized function. For example aorganization, but is not in direct line of command. Generally radiographer in a large corporate hospital may be providingin any organization, those personnel who develop new ideas, specialized services (radiotherapy) in three different wards andundertake research and advise on technical matters and fall thus would be accountable or advising their respective Medicaloutside the direct chain of command are staff personnel. It is Officers in-charge in addition to being accountable to the Headimportant to remember however that even in a staff department of Department of Radiology Services. The advantages and(for example, finance department of a large corporate hospital), disadvantages are as in Box - 4.the departmental head would still have line control over allsubordinate financial experts. The flow of authority in line and Box - 4 : Functional Organizationstaff organization is depicted in Fig. - 3. Advantages Fig. - 3 ●● Benefits of specialization at work are available to all levels of managers. ●● Supervision is easier since each specialized manager is A C D an expert in his / her own field. Disadvantages ●● From the view point of control, the system appears confusing since exact nature of functional authority is B often not well defined. ●● The lines of authority and responsibility, as seen in line organization are totally merged.The advantages and disadvantages of Line and Staff ●● Since same worker has to work under different superiors,Organization are as in Box - 3. control is not easy. ●● It is difficult for the management to fix responsibility for non performance. • 319 •
  10. 10. The Matrix Organisation : A combination of the product and called a ‘task-management leader’.functional structures, the matrix structures are the choice for ●● The (1, 9) leader, called the ‘Country Club’ managementlarge and complicated projects where the skills of a functional leader, is only concerned with people, to establish goodman (manager) and specialized (technical) knowledge (e.g. relationship with and among his subordinates such leadersfinance consultant) are both required. Under the matrix has least concern for tasks.structure, an employee is accountable & takes orders from two ●● The (1, 1) leader (impoverished leader) is neither concerneddifferent superiors at the same time. For example, a ward nurse with welfare of his subordinates nor with the task. Suchis accountable to the Head Nurse of the Hospital as well as to a leader does not take any decision and stays out of thethe ward MO in which she is working. An example of the matrix way.organization in a large hospital is as represented in Box - 5. ●● The (9, 9) leader (Team Management leader) has maximum concern both for people and for task. Though an ideal Box - 5 situation, such a leader wants to achieve the goals through committed people. Ward MO ICU i/c Anesthesio- ●● The (5, 5) leader (middle-of-the-road leader) attempts to logist compromise between high production and satisfaction of Head Nurse Ward Nurse ICU Nurse OT Nurse the subordinates. Chief Sanitary Ward sweeper ICU OT Sweeper Supervisor Sweeper Box - 6 : Managerial Grid Chief Ward ICU Nurse OT Storekeeper Pharmacist Pharmacist 1,9 9,9 Person Orientation (concern for people)Directing (Leading)Leadership can be described as the activity of influencingpeople to strive willingly to achieve the group objectives. Thisability may be formal (as in form of formal authority vestedwith an individual) or informal (as in form of power andability to influence people outside the formal structure of an 5,5organization).Leadership styles : This refers to the way in which a leaderwould influence the followers. Some of the leadership stylesare described below :(a) Iowa leadership studies : Lewin, Lippitt and White, in1939, studied different styles of leadership among 10 year oldboys in three groups. Three main types of leadership which 1,1 9,1emerged from their studies were :(i) Authoritarian leader : Where the leader was directive and Task orientation (concern for task)did not permit any participation from team members. Concernfor completing the task was of prime importance and eachmember of the team was told what to do and how to do. Summary(ii) Democratic leader : One who encouraged participation and Management is the art of getting things done through and withdiscussions by group members, he involved all group members people in formally organized groups. It is the art of creatingin planning and completing the task. the environment in which people can perform and individuals can cooperate towards attainment of organisational goals.(iii) Laissez-faire leader : Such a leader give complete freedom It is the art of removing blocks to such performance and ato the group members, did not provide any leadership, did not way of optimizing efficiency in reaching goals. It is a processestablish policies or procedures to complete the job. Under such consisting of planning, organizing, actuating and controlling,scenario, no member of the group influenced another member. performed to determine and accomplish stated objectives, by(b) The Managerial Grid Theory the use of resources like men, material, machines, methods,The Managerial Grid Theory proposed by Black and Mouton in money and markets. The basic principles of management are1978 indicates that leaders can be oriented towards both tasks Division of work according to the ability, capacity and aptitudeand persons. The managerial grid, based on the interaction of the workers; Well-defined responsibility; Discipline; Ordersbetween person-orientation and task orientation of a leader, is only from one superior; Preference of Organisational goals todepicted in Box - 6 : individual goals; Pre-determination of remuneration in formThe Managerial Grid shown here is characterized by the of pay and allowances for all personnel; Centralization offollowing qualities among the leaders : important policy decisions and key matters; Functioning in well defined functional chain of senior-subordinate relationships●● The (9, 1) leader is only concerned with task and has least (scalar chains); Unity of direction; Equity; Stability of working concern for welfare of his subordinates. Such a leader is • 320 •
  11. 11. period (tenure); Initiative among employees; and the Team functions are advisory nature to line managers whom theyspirit. Administration can be defined as ‘those functions in an support. A line organization consists of line personnel, whereorganisation, which are concerned with policy formulation, each position has direct authority over all lower positions.finance, production, distribution and ultimately control all No subordinate is under more than one superior, and thekey activities for meeting the organisational objectives’. It can scalar principle and principle of unity of command are strictlythus be assumed that policy-making, planning and decision adhered to. A functional organization is one wherein a workermaking are the basic components of administration whereas is accountable to two or more different executives for asupervision, implementation and operational aspects are given specific and specialized function. A combination of theconsidered components of management. product and functional structures, the matrix structures areTo successfully attain the objectives with optimum resources, the choice for large and complicated projects where the skillsrequires a series of Managerial processes which are Planning, of a functional man (manager) and specialized (technical)Organising, Staffing & directing, Decision making, Controlling knowledge (e.g. finance consultant) are both required. Underand Feedback. Planning is the fundamental and initial process the matrix structure, an employee is accountable & takes ordersin any activity. Setting the objectives is a major function of from two different superiors at the same time. Leadership canplanning. The basics of planning process in the health sector be described as the activity of influencing people to striveconsists of deciding Where are we at present (situational willingly to achieve the group objectives. This ability may beanalysis), Where do we finally want to reach (objectives formal (as in form of formal authority vested with an individual)& goals), How do we get there (resources & constraints), or informal (as in form of power and ability to influence peopleHow effectively we have performed the required activities outside the formal structure of an organization).(evaluation, monitoring & feedback), what new problems do Study Exerciseswe face and how do we overcome them (re- planning). Varioustypes of plans can be classified as Mission of an organization Long Question : Enumerate the basic principles of Management(described as the very reason why that organization exists), and describe the steps involved in Planning process.Strategy (any decision, plan or action which takes into Short Notes : (1) Management and administration (2) Line andconsideration the actions of competitors and other factors staff relationship (3) Steps in planning process (4) Concepts ofin external environment, with the aim of achieving the strategy, policy and program.objectives), Policies (guide to decisions), Rules (guides to MCQs :action), Procedures (chronological steps involved in performing 1. Following is a guide to Action (a) Policy (b) Rule (c)Programany action or taking any decision), Program (a series of actions (d) Objective.performed for achieving the organizational objectives within 2. A series of actions performed for achieving thethe scheduled time). organizational objectives within the scheduled time isAs a function of management, organizing deals with identifying known as (a) Policy (b) Rule (c) Program (d) Procedure.and grouping various activities, delegating authority and 3. The following are basic components of “Administration”command to managers, and coordination of various activities Except (a) Policy-making (b) Planning (c) Implementationand hierarchies in the organization. The process of organizing d) Decision making.can be described as a series of steps which include Detailed 4. Unity of direction and Unity of command are some ofdescription of various activities to be performed for achieving the important principles of (a) Planning (b) Organisingorganizational goals, Grouping of various activities in some (c) Staffing (d) None.meaningful manner, Delegation (comprising of authority, 5. A wider span of control will result in (a) Lesser levelsresponsibility and accountability), and Coordination (horizontal of management (b) Wider levels of managementand vertical). Some important principles of organizing are Unity (c) Independent of each other (d) None.of direction, Unity of command, Authority, Span of control, 6. The type of organization in which worker is accountableFlexibility, Management by exception and Scalar principle. to two or more different executives for a given specific andDepending on the type of organization and objectives to be specialized function is (a) Line (b) Functional (c) Matrix (d)achieved, every manager must decide how many subordinates None of the above.he/she can effectively supervise. Consequently, a wider span 7. The type of organization in which no subordinate is underof control will result in lesser ‘levels of management’. Seven more than one superior, and the scalar principle andimportant factors which determine the frequency and duration principle of unity of command are strictly adhered to isof superior-subordinate interaction are Training levels of (a) Line (b) Functional (c) Matrix (d) None of the above.subordinates, Clear delegation of authority, Clarity of plans, 8. The type of organization in which an employee isObjectivity in standards, Rate of organizational change, accountable & takes orders from two different superiorsCommunication techniques and amount of personal contact at the same time is (a) Line (b) Functional (c) Matrixrequired. (d) None of the above.In line and staff relationship, there is a direct relationship of Answers : (1) b; (2) c; (3) c; (4) b; (5) a; (6) b; (7) a; (8) c.command between superior and subordinate, whereas staff • 321 •
  12. 12. Functions of Personnel Management Personnel Management & Human 61 Resource Development The functions of personnel management include the following : Planning of the manpower requirement; Recruitment; Organising manpower resources; Selection; Classification of employees; Anuj Bhatnagar Staffing; Transfer & promotion; Manpower development; Training; Motivation; Recreation; Communication; CollectiveAny organization is entirely dependent on the people who bargaining; Employee discipline; Performance evaluation;work there, for its success, i.e. for achieving the organizational Employee counseling.goals. Broadly, four competency requirements have been Manpower Planning : Manpower planning is an essentialidentified for any organisation; Technical, Managerial, Human and integral part of any organisation which has to survive inand Conceptual. Human resources, unlike all others, have future. It can be defined as the ‘Strategy for the acquisition,to be nurtured and have almost unlimited potential. Since utilization, improvement and presentation of humanall organisations are made up of ‘people’, acquiring their resource of an organisation. It is aimed at meeting the futureservices, developing skills, motivating people for high levels requirements and assessing the availability of different typesof performance and maintaining their commitment towards of human resource available to an organisation and ensuresorganizational goals are essential in achieving these goals. that the organisation always has the right kind of the peopleHuman Resource Development (HRD) system uses various for the right job, at the right time. For example, as a Medicalmechanisms, as under, with the view to achieve these Officer in-charge of a hospital, it would be essential for you toobjectives. keep in mind, if your pharmacist is retiring next year, to start(i) Recruitment & training the process of recruiting another pharmacist for your hospital(ii) Potential appraisal & development before the present one retires. This is essential to ensure the(iii) Performance appraisal smooth functioning of your hospital.(iv) Career planning Broadly, manpower planning consists of Forecasting (estimating(v) Organisational Development (OD) future manpower requirement), Inventorying (analyzing the(vi) Rewards & compensation present manpower available and the extent to which they are(vii) Employee welfare employed optimally), Anticipating (projection of the present(viii) Human Resources Information resources for the future and assessing their adequacy) andPersonnel Management Planning (drawing up plans for recruitment, selection, training, development etc. to meet the future requirements).Personnel management (also known by several other terms suchas personnel administration, labour management, industrial Manpower planning for any organisation is a vital activity torelations, employee relations) is the functional front of HRD in ensure optimal utilization of presently available human resource.any organisation. Thus, personnel management : At the same time, it also forecasts the future requirements of(a) Is concerned with employees as individuals as well as trained manpower and ensures that right type of manpower groups. is available when needed. Human resource being the most(b) Covers all levels of employees including senior managers, important resource in any organisation, manpower planning clerks, technical workers as well as the ‘blue collar’ directly affects future of the organisation by anticipating workers. and catering for the redundancies and recruitment levels. It(c) Aims to help employees to develop their potential to the indicates the optimum training needs and infrastructure like maximum. accommodation, office space, recreational facilities etc based on(d) Is an inherent and continuous process in any the manpower projections. Manpower flow in an organisation organisation. is as shown in Box - 1.(e) Attempts to obtain willing cooperation of all employees to achieve the organizational goals. Box - 1 : Manpower Flow in an OrganisationObjectives of Personnel Management Promotion out(a) Achieve optimal utilization of human resources with the aim to achieve organizational goals. Transfer out(b) Maintain adequate organizational structure among Recruitment in Retirement members of the organisation. Termination/(c) Develop a feeling of involvement, commitment & loyalty discharge towards the organisation among the members.(d) Personal growth & development of individual workers Transfer in Resignations through opportunities for advancement. Retrenchment(e) Satisfy the individual needs through optimal Promotion In remuneration.(f) Develop high morale and better human relationships. Recruitment of Personnel : The success of any organisation naturally depends entirely on its workforce and the people • 322 •
  13. 13. who work for the organisation. Recruitment, thus, naturally 2. Identifying the sources of manpower : These could beassumes great importance to ensure that the right person is following :selected and employed. This section would deal with the issues (i) Internal sources are personnel already employed, (includingof recruitment, selection, placement and induction. past employees who quit voluntarily or on production layRecruitment : It is defined as the “process of identifying off, whom the organisation could retire for the newprospective employees, stimulating and encouraging them posts.to apply for a particular job in an organisation”. The aim of (ii) External sources that are not associated with therecruitment is to have an inventory of eligible and qualified organisation, selecting internal candidates for new postspeople from whom most eligible will be selected by the improves morale of the workforce and promotes loyaltyorganisation to work for it. for the organisation. External sources on the other handSelection : This is the process of “examining a large number of provide wide choice and bring in new ideas and enthusiasm.applicants for their suitability for a given job and selecting the However larger investments in training & induction havebest suited & qualified candidate(s) and rejecting the others”. to be made in case of external candidates. Selection of Personnel : Selection of personnel can be definedPlacement : It is the “determination of the job for which a as the ‘process of acquiring the relevant information about anselected candidate is best suited and assigning that job to him”. applicant, evaluation his qualifications & experience in orderProper employee placement improves productivity, motivation to match these to the job requirements’ and is thus the process& output by reducing absenteeism, accidents & turnover of of picking out the best suited individual for the organisation.employees. The ‘successive hurdles technique’ is often used for selectionInduction : This can be defined as “introducing the new process in organisation, which is depicted in Fig - 1.employee to the job and to the organisation with the view to‘sell’ the organisation to him so that he takes pride in his new Fig - 1job and association with the organisation”. This is also called Work history/Experience‘indoctrination’. Interview with superior Preliminary interview Physical examinationBefore we actually start ‘recruiting’ people, we have to clearlyknow what job is required to be done. For example, before Second interview Application formadvertising for an anesthesiologist for a hospital, we mustknow that he would be required to provide anesthesia in Employment ReferemcesOT during surgeries and would also be required to manageseriously ill patients in ICU. Only then can we plan ourrecruitment effectively. This process is carried out by job Testinganalysis. It can be defined as “a systemic compiling of detaileddescription of tasks, determination of relationship of the job totechnology and to other jobs and examination of knowledge, Rejectionsqualifications and employment standards, accountability andother requirements”. Simply put, job analysis indicates theactivities and accountabilities associated with any job. It is the Training & Development of Personnel : We have seen thatprocess of examining a job to identify its various components after an individual is selected & inducted into an organisation,and the circumstances in which it is performed. The information he/she has to learn how the assigned work can be done mostgathered from job analysis is used to make vital decisions about efficiently and effectively. This is done through trainingorganizational design & planning, recruitment and selection of programs. Training is defined as a “short term process utilizingpersonnel and all other managerial functions. Ideally, all jobs a systematic and organized procedure by which non-managerialin an organisation need to be analyzed, but the complexity personnel acquire technical knowledge and skills for definiteof the process will depend on the complexity of the job. For purpose.” Designed primarily for non-managerial personnel,example, the job analysis of a safai worker’s job in a corporate training is essentially of short duration and for a specific jobhospital can be simple description of the steps required to be related purpose. Development, on the other hand is a “longtaken to sweep an OPD. However, job analysis of a cardio- term educational process utilizing a systemic and organizedthoracic surgeon in the same hospital (including his position procedure by which managerial personnel get conceptual andin the hospital hierarchy) is very complex. theoretical knowledge. Thus, development pertains not only to technical knowledge and skill, but also to theoretical andThe step-wise process of recruitment : These include the conceptual concepts; and involves education and long-termfollowing steps development. Training of personnel is undertaken by both “on1. Preparation for recruitment : Identifying the ‘job the job” as well as “off the job” training methods.specifications’ (based on job description) to decide what type ofpeople, with what characteristics should be invited to apply for Performance Appraisal as an Element ofthe job. These will include specifications of physical, medical, HRDmental, social and behavioural attributes for the job. Performance Appraisal (PA) is an important managerial tool by which an employee’s performance, accomplishments and • 323 •
  14. 14. behavior are evaluated for a given period of time. This becomes Important Issues in Employee Compensationimportant for any organisation to achieve the maximum possible Employee compensation and wages paid to employees areutilization of human resources available. Thus performance the foremost issues for any manager. Over a period, theseAppraisal is an important managerial tool for monitoring and issues have become more complicated with the involvementmeasuring the performance of employers, with the overall aim of legislature, issues of equity and justice and also nationalto improve performance and enhance individual efficiency to economy. The wages for employees, which was initially onlybenefit the organisation. PA is therefore an important method an issue decided by the employer, is now an inescapablefor collecting, reviewing, analyzing and recording information component of the socio-economic texture of a country.about performance of an employee. Basic Wage and Dearness AllowanceMethods of Performance Appraisal Basic wage is the stable wage paid to employee, which is basedAs managers and leaders of men, all doctors should be able on the statutory minimum wage and is aimed at providing notto objectively and successfully assess the performance of their only basic sustenance for family of four, but also provide forsubordinates, whether in a PHC or in a tertiary health care social amenities like education, health, recreation etc. Dearnesscentre. Ideally, all performance appraisals should be based on allowance was first conceptualized after First World Warpre-determined and objective performance standards; should subsequent to the steep and uncontrolled increase in cost oflead to improvement of the subordinate by means of a joint essential household commodities, the basic idea being to offsetperformance review and should be based on more than one the rising cost of living by giving some additional monetarychannel/ method of assessment, as explained subsequently. relief over and above the basic wage.Performance appraisal becomes more important where work The flat rate system of DA administration provides a one-timeperformed can not be directly measured in terms of tangible standard payment to the employee to offset the inflation. Ongoods and where individual characteristics affecting productivity the other hand, the consumer price-linked system, thoughand performance must be determined. It is important to specify complex is more realistic because it attempts to offset the actualthe job performance criteria to be measured. The following increase in cost of living. In one form of DA based on consumermethods are used for PA in most organisations. price-linked index, a specified rate of DA is determined for(a) Global Assays & Rating where the assessor, in an essay every point increase in consumer price index, irrespective of form, provides an overall impression of the performance the income, and thus employees of all pay-scales get the same of the ratee during a specified time period. This method amount of DA, thereby giving higher proportion of basic wage may have serious disadvantages in the absence of specific as DA to the lower paid employees. The other system is based on performance criteria derived from a job analysis procedure income groups where the actual DA admissible (as a proportion undertaken well in advance. of basic pay) steadily reduces with each higher income group.(b) Trait Rating Scales usually include a list of personal traits of an individual, such as loyalty, leadership qualities, The Concept of Social Security sincerity, courage of conviction etc, which are required to Social security programs are essentially instruments of be rated on a numerical scale. Trait Rating Scales tend to social and economic justice and forms one of the major be unreliable if elements of halo effect, leniency/ strictness pillars of a welfare state such as ours. The International or central tendency creep into the evaluation process. Labour Organisation (ILO) has defined social security as “the(c) Ranking Procedures involves an overall assessment of protection which society provides for its members through a performance and classifying the employees into categories series of public measures, against the economic and social (such as Top 10%, Bottom 10%, Exceptional, Unsatisfactory distress that otherwise would be caused by the stoppage or etc). This procedure, even through it prevents rating-errors substantial reduction of earnings resulting from sickness, like central tendency, but is not based on specific and maternity, employment injury, unemployment, invalidity, old objective rating criteria. age and death, the provision of medical care, and the provision(d) Behavioural Anchored Rating Scales (BARS) are based of subsidies for families with children”. on objective parameters on which the behaviour of an In India, a number of legislative measures such as ‘The employee is assessed. Although the performance appraisal Workmen’s Compensation Act 1923’, ‘The Employees’ State in such a case tends to be more job oriented, it still faces Insurance Act 1948’ etc have been passed as social security the problem of identifying which actual behaviour matches measures, which are described in the section of occupational with which (objectively determined) performance scale. health.(e) Objective and Goal-setting procedures focus on the outcomes and the output of an employee, as a measure of Motivation performance appraisal. Goals and targets are previously As a doctor and manager of men, you are often faced with a set, most often by the manager and the performance situation where one wonders about “what is motivation” ? We appraisal of a subordinate is undertaken based on the may erroneously label people who have no motivation as ‘lazy’. extent to which these objective have been achieved. Today we know that motivation is the result of interaction between the individual and the situation. We may get easily bored reading a textbook but may finish an interesting novel in • 324 •
  15. 15. a single sitting. Motivation can be defined as the willingness shown that need structures are not necessarily organized ason the part of an individual to exert extra effort for attaining proposed by Maslow and that satisfied needs at a particularorganizational goals, which is determined by such an effort’s level may not necessitate movement to the next level.ability to satisfy some individual need (tangible or intangible). 2. Theory X and Theory Y : Proposed by Doughlas McGregor,In short, when an individual is motivated, he ‘tries hard’. this theory broadly divides human being into inherentlyBut this effort has to be also channelised in the direction negative (Theory X) and inherently positive (Theory Y)that would benefit the organization. Therefore, motivation is individuals. Under ‘Theory X’ the basic assumptions are thatdependent both on the intensity and quality of the effort. In individuals are inherently dislike work, will attempt to avoidaddition, there is also a component that satisfies some tangible it whenever possible and hence must be coerced or threatenedor intangible ‘need’ in the individual. The motivation process with punishment to achieve organizational goals, since theycan be summarized as : inherently dislike work. ‘Theory Y’ in contrast, proposes that the individuals would inherently consider work to be as natural Unsatisfied need Tension Drives Search as rest or recreation and will naturally exercise self control if behavior they are committed to the organisational goals. Reduction of Tension Satisfied Need When McGregor’s theory is superimposed on Maslow’s Hierarchy of Needs theory, it is evident that Theory X assumesTheories of Motivation that lower-order needs such as physiological needs and safety1. Maslow’s ‘Hierarchy of Needs’ Theory : Abraham Maslow needs dominates individuals whereas Theory Y assumes thatpostulated that a hierarchy of five needs exists inside every higher order needs dominate individuals.human being, which are (Fig - 2) : 3. Herzberg’s Motivation–Hygiene Theory : Fredrick Herzberg, after asking workers for situations when they felt exceptionally Fig - 2 : Maslow’s ‘Hierarchy of Needs’ Theory good or bad about their jobs, came to the conclusion that certain variables (intrinsic factors like achievement, recognition, responsibility & growth) are always related to Self job satisfaction and certain variables (extrinsic factors like actualisation company policies, administration, interpersonal relations and working conditions) are always related to job dissatisfaction. According to him, factors responsible for job satisfaction Esteem needs are distinctly different from those that are responsible for job satisfaction. Hence, when managers remove the factors responsible for job dissatisfaction, workers are merely placated Social needs rather then motivated in the true sense. Herzberg emphasized that if we want to truly motivate individuals, focus should be on achievement, recognition, responsibility and growth, which Safety needs individuals find inherently rewarding and motivating. Summary Since all organisations are made up of ‘people’, acquiring their Physiological needs services, developing skills, motivating people for high levels of performance and maintaining their commitment towards organizational goals are essential in achieving these goals.(a) Physiological needs such as hunger, thirst, sex, shelter & Personnel management is the functional front of Human other bodily needs. Resource Development HRD in any organisation. Thus, personnel(b) Safety needs like protection from physical & emotional management is concerned with employees as individuals as harm. well as groups, covers all levels of employees, aims to help(c) Social needs like needs for affection, belonging & acceptance employees to develop their potential to the maximum, inherent etc. and continuous process in any organization, and attempts(d) Esteem needs including internal needs (self respect, to obtain willing cooperation of all employees to achieve the autonomy & achievement) and external needs (status, organizational goals. The functions of personnel management recognition and attention). include the following : Planning of the manpower requirement;(e) Needs for self actualization i.e. to become what the Recruitment; Organising manpower resources; Selection; individual is capable of becoming, achieving one’s full Classification of employees; Staffing; Transfer & promotion; potential & self fulfillment. Manpower development; Training; Motivation; Recreation;According to Abraham Maslow, from motivational viewpoint, Communication; Collective bargaining; Employee discipline;if a need is substantially satisfied, it ceases to motivate a Performance evaluation; Employee counseling. Employeeperson and he moves on to the next plane of hierarchical need. compensation and wages paid to employees are the foremostMaslow’s theory of hierarchy of need was widely accepted issues for any manager. Over a period, these issues haveinitially but has not been validated by research, which has become more complicated with the involvement of legislature, • 325 •

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