Health service management

1. Course Name: Health system Management and
Leadership
BY: Getabalew Endazenaw (PhD, Associate prof.)
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2. COURSE OBJECTIVES
After completing this Module, students will be able to:
Grasp basic principles of health management
Identify organization and health care delivery system of Ethiopia
Distinguish Principles, strategies and components of primary health
care
Practice planning, implementation strategy and monitoring and
evaluation of health programs
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3. COURSE CONTENTS
UNIT 1: Introduction to Management
1.1. Health system
1.2. Building blocks of health system
1.3. Health system strengthening
1.4. Overview of management
1.5. Management theories
1.6. Skills, roles and functions of managers
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4. COURSE CONTENT…..
UNIT 2: Leadership
1. Leadership concepts
2. Leadership vs management
3. Leadership theories
4. Leadership styles
5. Leadership practices: Scan, focus, Align and
mobilize, Inspire
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5. COURSE CONTENTS….
UNIT 3: Health Planning
3.1. Overview of planning
3.2. Types of planning
3.3. Steps in Planning
Unit 4. DECISION MAKING
4.1. Decision making process
4.2. Factors affecting for Decision making process
4.3. Programmed and non-programmed decisions
4.4. Problem solving
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6. COURSE CONTENTS….
UNIT 5: Health Resources Management
5.1. Information Management
5.2. Human Resource Management
5.3. Logistics and supplies management
5.4. Financial Management
5.5. Time Management
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7. COURSE CONTENT…..
Unit 6: Managing Organizational Change
6.1. The nature of organizational change
6.2. Forms of change
6.3. Forces for change
6.4. Resistance to change
6.5. Managing resistance to change
Chapter 7-monitoring and evaluation
7.1. concepts of monitoring and evaluation
7.2. types of M & E
7.3. process of M & E
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8. TEACHING METHODOLOGY
•Interactive lecture
• Group or individual project work
•Presentation
• Independent self-reading
EVALUATION
• Participation and attendance………………….10%
•Group work and presentation …………………15%
•Project assignment……………………………….15%
• Written examination…………………………... 60%
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9. UNIT 1: INTRODUCTION TO HEALTH SERVICE
MANAGEMENT
Learning Outcome:
At the end of the unit the learners will be able to:
Explain health system
Describe the building bock of the health system
Describe the principles of management
Identify the roles of managers
Apply managerial skills
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10. WHAT IS HEALTH SYSTEM?
What is System?
A set of interacting or interdependent components
forming an integrated whole
A health system consists of all
The organizations
Institutions
Resources and people whose primary purpose is to
improve health
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11. HEALTH SYSTEM…
Fully functional health system:
Various management systems and subsystems are
connected and integrated:
to provide the best possible health services to all the
intended beneficiaries of those services.
Management systems:
The various components of the overall health system
that managers use to:
plan
organize, and
keep track of resources.
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12. HEALTH SYSTEM STRENGTHENING
What is health system strengthening?
Any array of initiatives and strategies that improves
one or more of the functions of the health system
What are the main components of health system
strengthening?
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13. HEALTH SYSTEM BUILDING BLOCK
Health System Building blocks as defined
by the WHO include (WHO 2007)
1. Service delivery
2. Health workforce
3. Information
4. Medical products, vaccines & technologies
5. Leadership and governance
6. Financing
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14. HEATH SYSTEM BUILDING BLOCKS
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15. MANAGEMENT ….
What is management?
Art, or science, of achieving goals through people.
Supervise or “looking over”
i.e., Making sure people do what they are supposed to do
Regulates man's productive activities
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16. MANAGEMENT OBJECTIVES
1. Ensuring organizational goals and targets are met
2. Looking after health and welfare, and safety of staff
3. Protecting the machinery and resources
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17. WHAT IS MANAGER?
Anyone in an organization who supports and is responsible
for the work performance of one or more other persons.
Administer and coordinate resources effectively and
efficiently to achieve the goals of an organization.
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18. CHARACTERISTICS OF PROFESSIONAL
MANAGERS
Managers are responsible and accountable
Managers balance competing goals and set priorities
Managers think analytically and conceptually
Managers are mediators
Managers make difficult decisions
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19. MANAGEMENT THEORIES
Modern management begun in the late 20th century
Early management movement was started during the
early 19th century after the industrial revolution.
Economic, technologic and cultural changes
Search for better ways utilize organizational resource
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20. SCHOOLS OF MANAGEMENT THOUGHT
Classical School
Scientific management.
Administrative Principles.
Behavioral School
Human Relationships Approach
Management Science School
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21. SCHOOLS OF MANAGEMENT THOUGHT….
Classical school:
A focus on developing universal principles for
use in various management situations.
Basic Assumption: People Are Rational
People will rationally consider the
opportunities available to them
Do whatever is necessary to maximize their
economic gain.
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22. 1. SCIENTIFIC MANAGEMENT: FREDERICK TAYLOR
(1856-1915)
Study the relationships between people and
tasks to redesign the work for higher efficiency
(Frederick T)
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23. SCIENTIFIC MANAGEMENT…
Four Principles to increase efficiency:
1. Study the way the job is performed now &
determine new ways to do it.
2. Organize the new method into rules.
3. Select workers whose skills match the rules set in
Step 2.
4. Establish a fair level of performance and pay for
higher performance.
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24. SCIENTIFIC MANAGEMENT….
Scientific Management: summarize
Contributions:
Pay for performance.
Careful examination of job tasks.
Importance of training and selection.
Problems
Assumed workers were robot without social
needs or human needs.
Assumed all individuals were the same.
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25. 2. ADMINISTRATIVE PRINCIPLES THEORY:
HENRY FAYOL (1841–1925)
Focus:
Organization rather than the individual.
Described the management functions of planning,
organizing, coordinating, and controlling.
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26. ADMINISTRATIVE PRINCIPLES THEORY….
Henri Fayol, developed a set of 14 principles:
1. Division of work: allows for job specialization.
2. Authority and Responsibility
3. Unity of Command: Employees should have only one boss.
4. Line of Authority: a clear chain from top to bottom of the
firm.
5. Centralization: the degree to which authority rests at the
very top.
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27. ADMINISTRATIVE PRINCIPLES THEORY….
6. Unity of Direction: One plan of action to guide the
organization.
7. Equity: Treat all employees fairly in justice and
respect.
8. Order: Each employee is put where they have
the most value.
9. Initiative: Encourage innovation.
10. Discipline: respectful employees needed.
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28. ADMINISTRATIVE PRINCIPLES THEORY….
11. Compensation of Employees : The payment system
contributes to success.
12. Stability of Employees : Long-term employment is
important.
13. General interest over individual interest: The
organization takes priority over the individual.
14. Common spirit: Share enthusiasm or loyalty to the
organization.
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29. BEHAVIORAL MANAGEMENT SCHOOL
Focuses on the way a manager should personally manage
to motivate employees.
Addresses the human dimension of work
viewed employees as individuals, resources, and assets
to be developed and worked with — not as machines
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30. THEORY X AND Y
Douglas McGregor proposed the two different sets of
worker molds.
A. Theory X - Classical Theory :
Assumes the average worker is lazy, dislikes work and will
do as little as possible.
Managers must closely supervise and control through reward
and punishment.
B. Theory Y- Human relationships Theory :
Assumes workers are not lazy, want to do a good job
the job itself will determine if the worker likes the work.
Managers should allow the workers feel freedom, and
exercise initiative and self-direction
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31. MODERN APPROACHES
Assumption: People are Complex
Respect the Classical, Human Resources, and
Quantitative schools.
Recognize that no one approach applies
universally in all situations, or the exclusion of the
others.
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32. LEVELS OF MANAGEMENT
What are the level of management?
1. Top level
Senior managers
Are executives, responsible for the performance of an
organization as a whole.
Ensure that organizational objectives / goals are established and
accomplished.
Chief executive officer, chief operating officer, president, vice
president…
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33. LEVEL OF MGT…..
2. Middle level
Develop and implement action plans consistent with company
objectives.
In charge of relatively large departments or divisions consisting
of several smaller units.
Report to top managers
Clinic directors, deans in universities, division managers, plant
managers, branch sales managers…..
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34. LEVEL OF MGT…..
3. Low level
Team leader or supervisor.
A person in charge of smaller work units composed of
hands-on workers (non managerial employees)
Department head, group leader, unit leader…
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35. FUNCTIONS OF MANAGERS
Five basic functions: planning, organizing, staffing,
leading, and controlling and
Two continuous function; communication and decision
making
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36. FUNCTION……
1. Planning
Involves determining the organization’s goals and defining
the means for achieving them.
Plan: a blueprint for goal achievement that specifies the
necessary resource allocations, schedules, tasks, and other
actions.
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37. FUNCTION…..
2. Organizing
After a plan is in place, a manager needs to
organize a team and resource according to the
plan.
Assigning work and granting authority to the
organized team.
3. Staffing:
Recruiting, selecting, training, and developing
employees.
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38. FUNCTION…..
4. Leading (Directing)
Coaching, motivating, communicating, guiding, and
encouraging employees to work in the desired direction.
5. Controlling:
A continuous process of measuring results against goals/ set
standards and taking corrective actions.
.
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39. ROLES PERFORMED BY MANAGERS
Managerial roles are activities associated with certain
management positions (in addition to management functions).
1. Interpersonal: involves human interaction.
Figurehead: Perform ceremonial and symbolic duties
Leader: Direct and motivate subordinates
Liaison: Maintain links both inside and outside organization
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40. ROLES PERFORMED…..
2. Informational: involves the sharing and analyzing of
information.
Monitor: Seek and receive information;
scan periodicals and reports;
maintain personal contact with stakeholders.
Disseminator: Forward information to organization
members
Spokesperson: Transmit information to outsiders
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41. ROLES PERFORMED…..
3. Decisional: involves decision making.
Entrepreneur: Initiate improvement projects;
identify new ideas and delegate idea responsibility to
others.
Disturbance handler: Take corrective action during disputes
or crises;
Resolve conflicts among subordinates;
Adapt to environments.
Resource allocator: Decide who gets resources;
Prepare budgets;
Set schedules and determine priorities.
Negotiator: Represent department during negotiations of
union contracts, sales, purchases, and budgets.
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42. SKILLS NEEDED BY MANAGERS
Skill: ability to translate knowledge into action that results in
desired performance.
A manager is required to have a certain skill to help other
employees become more productive.
How to acquire?
formal education, training, job experience, nature…
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43. SKILLS NEEDED…
1. Technical skill
o Ability to use a special proficiency or expertise to perform
particular tasks.
o Most important at lower levels of management.
2. Human skill
o Ability to work well in cooperation with others
oBuilding trust, enthusiasm and genuine interpersonal
relationships.
o Important at all levels of management.
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44. SKILLS NEEDED…
3. Conceptual skill
Ability to think analytically.
Break down problems into smaller parts, to see the
relations among the parts, and
Recognize the implications of any one problem for others.
Most important at top level of management.
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45. 3/23/2023 45
Management
level
Primary management
skills needed
Primary management
functions performed
Top Conceptual and human
skills
Planning, organizing
and staffing
Middle Balance of all three Balance of all five
First-line Technical and human
skills
Leading and controlling

46. READING ASSIGNMENT
Concept of management
Principles of management
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47. Thank You
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