1. Leading is the process by which managers influence others to achieve common goals. It involves communicating with and energizing staff. 2. Managers have both position-based influence from their authority, and non-position based influence from relationships and personal qualities. Their ability to lead is limited in healthcare by professional autonomy. 3. Motivation refers to internal drives that cause behavior. Managers can influence motivation through reinforcement, by rewarding desirable behaviors. Understanding individual needs, job design, and environmental factors is important for effective motivational management.

1. NATURE OF
THE LEADING FUNCTION
by GROUP 5
Principles of Public Health Administration
TOPIC 5:

2. CONTENT
table of
Mary Joyce Ayoba
leading as a concept in ph administration
SOURCES OF INFLUENCE
limitations of influence in the health care setting
Concept of motivation, its elements and processes
meTHODS AND MANAGEMENT APPROACHES IN LEADING
PERFORMANCE APPRAISAL
Kyla Shayne Viernes
importance of motivation
theories of motivation
motivational management techniques
Joseph Dayrit
Angelle Florentino
Cyrile Kayle Pascual
Derose Teo
Hazel Ann Baligod
Lovely Magulod
Frexcelle Sunico

3. is the process by which a manager communicates with and influences others in
the pursuit of common goals.
Influence is a process by which behavior of staff/personnel are affected or
modified.
Leading is also described as an actuating function or a process of energizing or
moves organization forward in the attainment of goals, mission, vision or values
which the organization stands for.
Managers do not perform all the activities assigned to them. Instead, managers
are expected to accomplish them through other people.
Leadership ability is shown in the way manager interacts and provides direction to
the staff from day to day. It is the ability to conceive and execute fundamental
changes to enable their organization to respond to the needs and demands from
within and outside the organization.
LEADING

4. 1. POSITION BASED INFLUENCE 2. NON-POSITION BASED INFLUENCE
Your influence as a manager can be
derived from the authority of your
position i.e. your right to exercise
control and supervision over the works
of others.
It includes the capacity to reward and
punish those who do not comply or
conform to standards of behavior and
performance established by the
organization.
SOURCE OF INFLUENCE
the success in leading other members is largely determined by the kind and
degree of influence you have on other members.
It is the informal relations you have
established with others and the
qualities or traits you have which
others admire.
People are also sensitive to their other
needs as human beings (someone
who can be looked up for help).

5. Organizational culture of health care agencies is multidisciplinary. This
is because it is composed of a large number of professional staff
working as members of various health care teams.
For example, as a physician manager you may find yourself
supervising other professionals (e.g. doctors, nurses, dentists’
engineers, limit the therapists sphere etc.) of You in this r influence
position you on to may have administrative matters such as decisions
on programs thrusts, priorities, allocation of resources etc.) rather than
on the content and process of professionals’ work.
LIMITS OF INFLUENCE IN HEALTH CARE SETTINGS
O R G A N I Z A T I O N A L S T R U C T U R E
1 .

6. Despite limits of legitimate authority, you may have a great Deal of
influence beyond the technical nature of the job.
In many instances your ability to argue from a respected area of knowledge
or experience is very important because other professional health workers
may easily justify decisions and actions in their work situations.
2 . E x p e r t i s e a n d E x p e r i e n c e
3 . P r o f e s s i o n a l A u t o n o m y a n d E d u c a t i o n
The fact that professionals are educated and socialize towards autonomy
and direct accountability for personal/professionals to customers
sometimes gives rise to problems of coordination of services.
Thus, collaborative methods of influence are essential in getting members
to share their expertise and points of view in the solution of problems.
Collegiate participation and transparency in decision making is also
expected among professionals as equals.

7. Professional staff could also exercise collective control over
certain aspects of the work through committee work
organized to deal with specific areas of responsibility.
4 . C o l l e c t i v e C o n t r o l o f P r o f e s s i o n a l W o r k
5 . i n f o r m a t i o n s y s t e m
In health care, the relatively slow process by which work is
done and results achieved leads to lack of readily available
information to monitor and influence with performance.

8. Influence by authority is given to persons with the right to
influence others by virtue of their position, by law or
contract, expertise or relational factors.
The right to influence others is usually accompanied by
the recognition and acceptance of the right by the people
to be influenced. Otherwise the influence will be ignored.
METHODS OF INFLUENCE ACCORDING TO THE SOURCE OF INFLUENCE
1. BY AUTHORITY

9. In some instances someone gives orders without authority and so, uses
some means to threaten the other person's options if orders are not
followed.
The means employed include superior physical strength, sheer number
or punishment etc. Coercion may be illegal and is usually resisted.
Coercion however, can do things fast and there are instances when no
other method is possible, but it must be used sparingly if all because of
the drawbacks.
2. BY COERCION

10. This method is the most commonly used, consciously. It is getting people
to do what you want by making them feel that is what they want.
To do this, one uses knowledge about the other person and one's
relationship with them in order to get them to do what the influence once.
This is often done with the other person not being aware of it. When we
make others "feel like he/she decided something for himself /herself then,
we are manipulating them. Being used to it in dealing with others, we are
often unaware of it.
3. BY MANIPULATION

11. In collaboration the person being influenced recognizes and accepts the
need for change, considers the alternatives, decides on the alternatives
and acts on it.
On the other hand, the influence is primarily a consultant, or
adviser/resource person, giving information, pointing out the need for
change and helping as necessary.
4. BY COLLABORATION

12. a. Emulation which refers to striving to imitate with effort to excel, equal or
surpass. It requires no direct between individuals, but it is powerful means of
influence.
b. Suggestion which involves direct and conscious effort to bring on idea,
proposition or plan before a person's mind for consideration.
c. Persuasion by prevailing on a person through reasoning, advice and other
forms of inducements.
Specific Methods

13. This management approach operates on the principles by values (MV).
MV emphasizes the need to develop the ability to focus on values and to
selectively raise the level of consciousness on those values which the
organization wants its members to reflect on their working behavior.
"Doing the right things right" is more a matter of commitment to a set of
values or beliefs.
MANAGEMENT APPROACHES IN LEADING CURRENTLY BEING USED TO
INFLUENCE PERFORMANCE OF ORGANIZATIONS
1. MANAGEMENT BY COMMITMENT (MC)

14. Your ability to lead and inspire people towards a vision that is positive to
them is largely influenced by the extent to which you can translate such a
vision into concrete policies.
For example, the HFA goal and vision of health in the hands of the people is
a very abstract concept to some personnel unless they are translated into
policies such as empowerment of people and health through the primary
health care (PHC)approach.
PHC likewise must be operationalize by describing the activities involved in
developing self-reliance in health.
2. MANAGEMENT BY POLICY (MOP)

15. A widely used, misused and often misunderstood strategy, MBO maybe
describe as management philosophy whereby organizational leadership
sets major goals followed by process of developing sub-goals, and
programs at different levels in the organization.
3. MANAGEMENT BY OBJECTIVES (MBO)

16. QAP - is focused on the provision of quality health care of people as part
of a continuing program towards excellence. It includes the following:
Quality Assurance Program
Quality Assurance Program
1. Determining priority areas of performance.
2. Measuring performance against standards.
3. Making judgment about performance as basis for improvement.
Using the research approach, feedback on the evaluation can lead to specific
measures to correct the deficiencies in terms of on-the-job training and
various clarifications to improve skills and attitudes.

17. A P P R A I S A L
Performance
Performance
Applicable to both professional and non-professional health care providers
Performance Appraisal involves a systematic process of assessment of the
strengths and weaknesses of staff as bases for administrative decisions
and development
TOTAL QUALITY MANAGEMENT (TQM)
means to build quality into the health service. The
approach has been referred to as "Total Quality
Management"

18. The term motivation as used in our study of health administration refers to a concept and
a process.
As a psychological concept it refers to the internal mental state of a person which causes
the person to act.
As a process it relates to the initiation, direction, intensity, persistence and termination of
the behavior.
Being an internal psychological process, a manager cannot motivate the staff but, he/she
channels the needs/drives of staff to desirable behaviors and establish connections
between such behaviors and rewards.
Simply stated, motivation explains why people do what they do whereas influence
explains why people do what we want them to do.
And so, we say that motivation and the influence process are closely related. To
understand their relationship, we must understand the elements and process of
motivation.
NATURE OF MOTIVATION
NATURE OF MOTIVATION

19. For centuries philosophers, biologists, psychologists, and system theorists have
speculated why people behave the way they do.
An examination of the principal models and theories indicates that motivation is
generally thought of as a process by which a force causes action. The force is
based on the needs and wants of a person.
A manager can then say that staff have needs and wants which cause them to
behave in order to reach a goal
ELEMENTS AND PROCESS
ELEMENTS AND PROCESS
Since we cannot see the inside of people’s heads I placed the need and goal to
show that these call only be inferred from their behavior. We can only observe what
people do (behavior).
So, the needs and wants that motivate behavior of staff may often be hidden from
the manager or supervisor. How do we describe these two elements of motivation?

20. NEEDS
Some psychologists classify needs into two basic categories: primary and
secondary based on whether the need is physical such as hunger, thirst etc. or
learned such as the desire to be with other people or being loved by them.
PRIMARY DRIVES SECONDARY DRIVES
needs we are born with social in nature since we
learn them in our interaction
with others.
Other psychologists classify them in other ways because there is no agreement
on which needs are learned.

21. GOAL
refers to the ends towards which the
action is oriented with behavior being
directed to something a person values
or considers important.
SOME EXAMPLES
are money or a promotion, including the meanings or values which
a person attaches to these things such as status, power and
material things they can buy with money.

22. REINFORCEMENT
How can a manager enhance or help staff develop motivation that is likely to
contribute to behaviors that meet their personal goals and those of the
organization?
This brings us to one aspect of the process of motivation referred to as
"reinforcement".
These are forces within the individual such as values and the environment such as
rewards that reinforce the intensity of the drive and channel the direction of the
behavior.
Since many of these factors are within the control of managers and supervisors, we
can say that these conditions provide opportunities to modify or affect the behavior
of staff toward desirable ends/goals.
Reinforcement can be positive or negative. Positive reinforcement occurs when you
reward personnel for desirable behavior. Reinforcement takes place when actions taken
such as punishment reduces or correct undesirable behavior.

23. importance of motivation
importance of motivation
Management - a process that a new manager can learn and improve on. Learning to
understand staff motivation is one of them.
To do this, you need well-founded theories of motivation drawn from personal
experiences and from the best research findings available.
In other words, you need a model and theory to understand or explain your own behavior
and those of others. You can also use models to predict such behaviors insofar as possible
and use insights to produce the desired behaviors.
More specifically, understandings about motivation should help you to do the following:
1) Focus your attention on real/basic human needs as they might be observed on the job,
2) Clarify your own opinions and feelings towards motivation as a means or process to help yourself
and staff, and
3) Examine the assumptions about people and their motivations in real life situations within the
context of your organization. For example, if you can recognize that the needs and expectations of
your staff differ, you can "tailor" your interaction with them more suitably.

24. DIFFICULTIES IN UNDERSTANDING
HOW MOTIVATIONAL FORCES OPERATE
Needs and goals of staff cannot be seen. You can only infer it from behavior.
Hence, it is difficult and sometimes dangerous to label them for any person.
For example, we know that money is an incentive (or goal) for many people but, they
may need money for different reasons (e.g., meet basic necessities, gives status or
sense of power etc.).
Another is that a person usually experiences a wide range of inner drives or needs
which may conflict with one another.
For example, some staff want to take it easy while others want to do something to
prove their worth and value. Which direction they will take depends on their values
or ideals and the environment as the saying goes "all behavior has cause" and that
"organization gets what it rewards."
On the other hand, there are drives which demonstrate that people are mainly
motivated by needs inside themselves and therefore act even when no outside force
are present. Referred to as "self-initiating behaviors" (Schaefer, 1977) these are
behaviors which people might show on their own without outside influence.

25. Examples of self-initiating behaviors are activities or needs to exert energy,
needs related to creativity, innovation and change and self-actualization.
These behaviors help us to understand and express ourselves. Self-initiating
behaviors fulfil our needs through activities that are voluntary.
Organizations benefit from members who exhibit self-initiating behaviors. It
is therefore important for you to identify and learn to help all employees
develop or mature to this level of functioning to increase the effectiveness of
the organization in the long run.
This is a real challenge to any manager because failure to deal with these
drives may induce the staff to seek other employment that meets these
needs while helping in the attainment of organizational goals.

26. Elements of staff motivation
Elements of staff motivation
Motivational management techniques tend to focus on the characteristics of
staff/personnel, the design of the job and the quality of the work environment:
Understanding of the uniqueness of each of the staff enables a manager to
determine the most appropriate way to reinforce their motivation. For
example, knowledge about their current skills, goals or values should
indicate how these can be raised to higher levels to improve motivation.
To do this, it would be helpful to consider the following questions:
How do staff differ in abilities and aptitudes?
How do they perceive the job and work environment?
What are their attitudes, values and feeling?
What are their personal traits? lifestyle?
1 . I n d i v i d u a l i t y o f t h e S t a f f

27. Understanding the behavioral implications of the job will also help you in designing/
redesigning the job in ways to crafted or improve the motivation of health personnel.
The following are aspects of the job that must be considered:
Variety or opportunity to learn varied skills;
Wholeness or extent one can work on a complete or an entire job that leads
to sense of task importance and identity;
Human or social interaction allowed by the job
Autonomy or amount of freedom to decide what to do, how to do the work
and when work is to be completed as long as it is done within time assigned
and quality parameters,
1.
2.
3.
4.
2 . D e s i g n o f t h e T a s k s / J o b
Answers to these questions should help you find ways to create the conditions that will
enable your staff to develop skills actualize their personal goals. This is because
performance is a function of ability and motivation and role perception. We can show
the relationship of these three variables to performance this way:
Performance = f (ability x motivation x role perception)

28. In addition, characteristics of the work environment that are found to
have great influence on employee satisfaction and motivation include:
1. Organizational culture or patterns of behavior, beliefs and practices
2. Goal orientation and shared values among members
3. Supervisor-staff relations and leadership style
WORK
ENVIRONMENT

29. THEORIES OF MOTIVATION
Speculations and hypothesis about human motivation have gained
acceptance over the years because they are able to describe the content
and process of motivation.
They have come down to us as theories or set of generalizations which can
be used to describe events in reality situations and predict future events.
USEFULNESS therefore is the primary consideration in selecting the models
you can use in understanding on-the-job behavior.
As a manager, you need to be familiar with as many of the principal theories
of motivation that you can find. The following are the most popular and
useful in the work setting

30. Abraham Maslow's position is that people have needs or wants inside them which are
important to them at a particular time. He presents a hierarchy of needs starting from the
physiological needs, safety, the need for belonging and love, self-esteem up to the highest
level of self-fulfillment. Lower needs must be satisfied first before the next higher need
becomes dominant.
1. NEED HIERARCHY
This theory of motivation is useful in looking at
important personal needs of staff which you might
otherwise fail to consider. However, you must take note
of the fact that staff needs are not static but,
constantly change and that more than one need may
be operating simultaneously. And so, the hierarchy
must be seen simply as a progression through which
staff can move as individuals or groups as they mature
and develop with experience in an organization.
For example, as the needs of employees for a living wage are met they will start to look for other
things that make work more safe and challenging where their talents can be used to satisfy the
higher level needs.

31. 2. ERG THEORY
Other theorists like Alderfer built on Maslow's theory by further classifying the five
categories of needs into three broad categories namely:
e x i s t e n c e n e e d s ( E )
1 .
2 . r e l a t e d n e s s ( R )
3 . G r o w t h ( G ) n e e d s .
He added the frustration-regression process - an individual whose needs for growth
(e.g. progress to position of higher responsibility) is frustrated will have the lower or
relatedness need emerging as a primary motivating force.
What do you see are the implications of this theory of motivation to your role as
manager or supervisor?

32. 3. THEORY X, Y AND Z
Are you familiar with the theory X, Y, and Z assumptions about people? Do
you see any relationship between these three assumptions and the three
management approaches?
MC Gregor’s theory X and Y assumptions
about people provide the underlying
assumption for the traditional and human
resources management model
respectively.
While Ouchi’s theory Z assumption about
people underlies the human relations
model, the three models of management
do not argue for any one motivational
approach. Rather they identify situational
factors that rule out the possibility of one
approach.

33. 4. ACHIEVEMENT/AFFILIATION/POWER MODEL
Henry Alexander Murray who developed a
system of classifying needs of individuals
according to their strengths and potential for
motivating behavior identified the need for
achievement which he calls as the need to excel.
This is supported by MC Cleland's studies on the
importance of achievement motivation. His
findings show that successful managers tend to
set moderate to high goals, takes calculated
risks and want feedback.
More recently, the need for influence or power
over others and affiliation (warm, friendly
relations) have emerged as motors related to
behavior of successful executives.

34. Frederick Herzberg presented one of e most popular
motivation model in the work setting.
He found that certain aspects of the job itself such
as the sense of identity, significance and
achievement motivate performance hence, are
called “motivators".
Other things like policies, supervision, and other
aspects of the work environment which prevent
dissatisfaction are called "hygiene factors"
A major impact of this theory is that it has
stimulated redesign of jobs to maximize the
motivating force through job enrichment. The
purpose is to increase staff sense of achievement
and responsibility on the job and to enhance growth
and advancement.
5. MOTIVATION/HYGIENE MODEL

35. 6. EXPECTANCY MODEL
Victor Vroom's model - another useful theory in the work setting. The
model does not consider specific needs like the rest but, rather the
choices between alternative actions,.
Vroom believes that people perceive what they do as important in
achieving certain "outcomes". Thus, a person's motivation level is
based on the following:
The expectancy is defined as the probability the person sees of
accomplishing something and of being rewarded somehow for such
accomplishment) and valence is, how strongly the individual values
the accomplishment and the reward.
effort
performance
reward
V room's model is proposed as a guide in managing rewards in ways that employees see the
relationship between ability, effort and reward. The model also considers the concept of
reinforcement as described earlier.
These models and theories are useful to the extent that you can use them to describe and explain
things as they actually exist. And so, find out how good theorist you are by doing the following activity.

36. MOTIVATIONAL
MANAGEMENT
TECHNIQUES
You have so for been introduced to the
concept and theories of motivation.
In this section, we will focus on some
specific applications of the concepts and
models particularly in the work place.

37. 1. JOB ENRICHMENT
Job enrichment programs are based on higher level needs of workers such as self-esteem and
achievement. This was originally used in industry to overcome the motivational problems caused by
mechanization and mass production.
The resulting routinization of jobs led to boredom, lack of attention, fatigue etc., which resulted in high
employee turnover, frequent accidents and low productivity. Modification in job design and work practices
is used to introduce variety, autonomy and sense of accomplishment and identity among workers.
For example, work of health personnel can be designed in such a way that they plan and implement their
work, monitor their own performance and report on the final results. Feedback can be given so they know
how well they are doing. Herzberg concept of the work itself as motivator provides the bases of this
practice.
What makes such job enrichment practice more effective is that they go beyond providing variety. Job
enrichment program is based on the assumption that workers need to have responsibility, accountability
and pride in their work. ln health care as it in other organizations personnel like to participate in making
decisions and identify with the final product results or outcomes of health. Here, the need to delineate the
specific contribution of each member of the health care team becomes important.

38. 2. JOB ENLARGEMENT
Job enlargement - usually involves giving more work of the same
level or allowing employees to rotate or exchange job with another
person.
Job enlargement plans often permit health workers to do
additional tasks for which additional farming is given.
This also enables them to respond to the primary health care
needs of people in the essence of other in doing this, one needs to
as certain that they are competent to responsibilities.

39. 3. MANAGEMENT BY OBJECTIVES
3. MANAGEMENT BY OBJECTIVES
One example of a scheme where employees work with their supervisors in a
collaborative process in setting goals for themselves and the time limits for fulfillment.
In this way they know what goals are whether they are achievable and that their
achievement will be recognized.
This is one form of influence where the supervisor can channel the desire of employees to
set goals. Mc Cleland and Herzberg theories of motivation' are the basis of this concept.
These few examples are given to illustrate how concepts and models of motivation can
help you as a manager in making decisions about people and their work. They can be
useful as tools in carrying out your dual responsibility in meeting organizational goals
and important personal needs of members.

40. SELECTION OF APPROPRIATE MODEL
OF MOTIVATION
The various theories of motivation discussed so far all focus on causes of human behavior so they can be
related with one another. Each theory however, uses different psychological concepts to explain behavior.
For example, desire for excellence or achievement needs identified by Mc Cleland and Murray respectively
is related to positive reinforcement of successful experiences or performances. Expectancy theory is
organized around ideas such as valences, expectancies and outcomes. Expectancies are results of previous
learning experiences. Learning theory on the other hand explains the development of certain needs or
motives.
In selecting the appropriate model, you must remember that there is no one best theory of motivation
though some seem may be better suited to deal with some aspect of need or situation. For example, Landy
and Becker (1987) point out that the need theories may be better used to study employee satisfaction and
effort exerted to attain it. Expectancy theory focuses more on effort, performance, and system of rewards.
Expectancy theory can be used to predict job and organization choices. The goal setting theory can be
related to choice, behavior and performance.

41. One final suggestion is for you to consider as many model as necessary to explain and predict
behavior. In other words, you may end with an eclectic model in your effort to integrate insights
gained from experience in using different models to meet the needs of your staff and
organization.
On the whole, understanding the elements, content and process of motivation is useful in
analyzing your own work behavior and in others and dealing with performance problems
more effectively.
Can you now visualize how you will go about selecting the
model to use managing work behavior?

42. Thank You
FOR LISTENING!