Mizan-Tepi university

College of health science and medicine

School of public health
Department of public health

By Mr. Temesgen G. (BSc, MPH in HSM)

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 Session objectives
At the end of this session all students able to:
• Define management and other health service
related terms
• Analyze effectiveness & efficiency
• Review the levels, roles and skills of managers
• State the principles of management

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 outlines
• Definition of terms • Management level
• Types of • Managerial role
management • Principle of
• Managerial skill management

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Activity (5 minutes)

❑What is:
✓ Health?
✓ Health care?
✓ Health services?
✓ Health service organization?
✓ Health Systems?
✓ Organization?
✓ Goals?
✓ Efficiency?
✓ Effectiveness?
✓ Management?
 Definition of terms
➢ Health: is state of complete mental, physical and social well being and

not merrily the absence of disease and infirmity.

➢ Health care : is the total societal effort, undertaken in the private and

public sectors, focused on pursuing health.

➢ Health service: is Specific activities within the larger domain of health

care undertaken to maintain or improve health or to prevent decrements of

health.

➢ Can be preventive, promotive, curative or rehabilitative in nature

Definition of terms…

➢ Health service organization: is an organizational structure within

which the delivery of health services is made directly to consumers.

➢ Health systems: the sum of the health service organizations and

resources whose shared primary purpose is to provide comprehensive

and more coordinated health services for improving health.

➢ Organization: a collection of two or more people who work together

in a structured way to achieve a specific goal or set of goals.

 Goal

• Goal is the purpose that an

organization strives to achieve.

• Goal is the fundamental element

of an organization.
 Importance of goal
1. Goals provide a sense of direction:
– It provides guidance and a unified direction for people in the
organization.

– It shows the employees where the organization is going and

why getting it is important.

– Without goals, individual and their organizations tend to muddle

along, reacting to environmental changes without a clear sense
of what they want to achieve.
Importance of goal
2. Goals focus our efforts
➢ Every person and every organization has limited resources and a wide
range of possible ways to use them.

➢ In selecting a single goal or set of related goals, we establish priorities

and commit the way we will use our scarce resources.

3. Goals guide our plans and decisions

➢ People at organizations face similar decisions, which are clarified by
asking, What is our goal?

➢ Will this action move us toward or away from our organizational goal?
Importance of goal

4. Goals help us to evaluate our progress

➢ A clearly stated, measurable goal with a specific deadline

becomes a standard of performance that lets individuals and

managers alike evaluate their progress.

➢ Thus, goals are an essential part of controlling.

 Concept of efficiency and effectiveness

Efficiency

• “Doing things right”

• The ability to minimize the use of resources in achieving

organizational objectives.

• Is about reaching ends by only the necessary means or the

least wasteful use of resources.

Efficiency…

Basic concept of efficiency:

– Do not waste resources

– Produce each output with a least cost/resource

– Produce the types and amounts of output which

people value most.

– Reading assignment
• Read about Technical and Allocative efficiency???
Effectiveness

• “Doing the right thing”

• The degree to which a stated objective is being or has

been achieved.

• It is something that management tries to improve.

 Efficiency and effectiveness in management

Which one is the concern of a manager? efficiency or effectiveness

Efficiency (Means) Effectiveness (Ends)

Resource Goal
usage attainment

Low waste High attainment

Management Strives for:

Low Resource Waste (high efficiency)
High Goal Attainment (high effectiveness)
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 Activity (5minutes)

➢ Suppose the Bench-sheko zonal Health department planned to

immunize 2000 children under the age of five years during the first six
months of 2022.
➢ The budget set was 50,000 birr.
➢ After implementing the campaign, it was found that the actual budget
used (including shifting funds from other sources) was 100,000 birr.
➢ The region immunized 2000 children during the planned six-month
period.
➢ Do you think this region utilized its resources efficiently? Why?
➢ Do you think they were effective? Why?

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 Overview of Management
• Management is a critical element in economic development.

• By bringing together the four factors of production [men,

money, material, and machines],

• Management enables a country to experience a substantial

level of economic development.

• A country with enough capital, manpower and other natural

resources can still be poor if it does not have competent
managers to combine and coordinate those resources.
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 Overview…

• Principles of management are now universally

used not just for managing business
organizations, they are also applied to various
other types of organizations such as
educational, health, military and government.

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 what is management?

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 What is Management?

• It is impossible to provide a single, comprehensive, universally

accepted definition of management.

• Management is the process of planning, organizing, leading, and

controlling an organization’s human, financial, physical, and

information resources to achieve organizational goals in an

efficient and effective manner.

Management cont.…

• A process of reaching organizational goals by

working with and through people and other
organizational resources.
• It is the process of accomplishing predetermined
objectives through the effective use of human,
financial, and technical resources (Longest Jr.,
Rakich & Darr, 2000).
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Who is a manager?

➢ A manager is someone who coordinates and

oversees the work of other people so that

organizational goals can be accomplished.

➢ A manager’s job is not about personal achievement-

it’s about helping others to do their work.

 Types of managers
Classification based on their level in the hierarchy

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1.Top / Senior managers
• Mangers responsible for the overall management of the
organization.
• Top management lays down the objectives and broad
policies of the organization.
• They issues necessary guideline for preparation of
department budgets, procedures, schedules etc.
• They prepares strategic plans & policies for the
organization.
• They appoints the executive for middle level i.e.
departmental managers.
• They controls & coordinates the activities of all the parts
of the organization.
• They are also responsible for maintaining a contact with
the outside world.

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2. Middle managers
• They execute the plans of the organization in accordance with
the policies and directives of the top management.
• They make plans for the sub-units of the organization.
• They participate in employment & training of lower level
management.
• They interpret and explain policies from top level management
to lower level.
• They are responsible for coordinating the activities within the
division or department.
• they also sends important reports and other important data to
top level management.
• They evaluate performance of junior/lower managers.
• They are also responsible for inspiring lower level managers
towards better performance.
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3. First-line (first/ low level), supervisory managers

▪ Assigning of jobs and tasks to various workers.

▪ They guide and instruct workers for day to day activities.

▪ They are responsible for the quality as well as quantity of production.

▪ They communicate workers problems, suggestions, and recommendatory

appeals etc to the higher level.

▪ They communicate higher level goals and objectives to the workers.

▪ They help to solve the grievances of the workers.

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 Cont..
▪ They supervise & guide the sub-ordinates.

▪ They are responsible for providing training to the workers.

▪ They arrange necessary materials, machines, tools etc. for getting the

things done.

▪ They prepare periodical reports about the performance of the workers.

▪ They motivate workers.

▪ They are the image builders of the organization because they are in direct

contact with the workers.

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 Common attributes to all managers regardless of their title
and level

• Formally appointed to positions of authority by the

organization.

• Directing work efforts of other subordinates.

• Responsible for utilization of organizational resources.

• Accountable to superiors for work results.

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The difference is in the scope of activities they oversee.

• The primary differentiation between levels of

managers are :

➢The degree of authority

➢ Scope of responsibility and

➢ Organizational activity.

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Classification based on scope of activities

▪ General Manager:

▪ responsible for all functional activities

▪ e.g. CEO, president etc.…

▪ Functional Manager:

▪ responsible for one organizational functional area/activity

▪ e.g. finance manager, HR manager etc.…

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 Managerial skills

Three basic types of skills for successful management

1. Technical Skill

2. Human Relation Skill

3. Conceptual Skill

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Managerial Skills…

1. Technical Skill
➢ The ability to use procedures, techniques and
knowledge of a specialized field using specialized
knowledge and expertise in executing work-related
techniques and procedures.

➢ Related to things: process or physical objects

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 Managerial Skills…

2. Human skills/Interpersonal Skills

➢The ability to work with, understand and

motivate other people
➢The ability to understand, alter, lead, and
control the behaviours of other individuals
and groups.
➢Builds cooperation among the team.
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Managerial Skills…
3. Conceptual skill
➢ Ability to see the organization as a whole.

➢ The ability to think strategically, analyze complex situations, and

understand the bigger picture.

➢ A manager with this skill has the ability or better understand how
various functions of the organization complement one another.

➢ The relationship of the organization to its environment.

➢ How changes in one part of the organization affect the rest of the
organization.

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Managerial Skills…

Which skill is equally needed by all managers?

➢ Because the common denominator is people at all

levels, an inability to work with people, not a lack of

technical skills, is the main reason some managers fail

to reach their full potential.

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 Management level and skills

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 Management roles
• A role is an organized set of behaviors.

• Is a set of expectations that managers should play.

• Henry Mintzberg defines 10 roles that managers are

expected to play and group them in to 3 categories.

1. Interpersonal roles

2. Informational roles

3. Decisional roles

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 Mintzberg’s managerial roles

Decisional role Interpersonal

➢Entrepreneur roles
➢Disturbance handler ➢Figurehead
➢Resource allocator ➢Leader /influencer
➢Negotiation
➢Liaison

Informational role
➢Monitor
➢Disseminator
➢Spokesperson

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 Management roles…
1. Interpersonal roles
• Interpersonal roles provide managers with
opportunities to gather information based on the use of
formal authority.
1.1. Figurehead:
– Performs symbolic routine duties of legal or social nature.
– As a figurehead, a manager routinely performs certain
ceremonial duties including attending inauguration ceremony,
addressing the media or taking people to dinner, entertaining
visitors, officiating a luncheon, etc.
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 Interpersonal roles…
1.2 Leader
– Motivates subordinates, and ensures hiring and
training of staff.

– As a leader, a manager creates the environment,

works to improve employee performance and
reduce conflicts, provides feedback and encourages
individual growth, sets an example for others to
follow.
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 Interpersonal roles…
1.3. Liaison:
– Involves dealing with people outside the organization,
such as key partners with whom good working
relationships are required.
– Maintains self developed network of contacts and
informers who provide favors and information.
– In addition to superiors and subordinates, managers
interact with others-peer level managers in other
departments, staff specialists, suppliers and clients.
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 Management roles…
2. Informational roles
• Flow from the interpersonal roles
2.1. Monitor:
– As a monitor, a manager should constantly monitor the
environment to determine what is going on.
– Managers gather information from their network of contacts,
including those established in their liaison roles
– Seeks and receives a wide variety of special information to
develop through understanding of the organization and
environment.
– He/she should collect information both directly and indirectly.
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 Informational roles…
2.2. Disseminator
– Transmits information received from outsiders or subordinates to
members of the organization, that would not ordinarily be
accessible to them.
– Involving knowledge transfer among staff in the workplace

2.3. Spokesperson
– Transmits to outsiders information about organizations policies,
plans, actions, results.
– Deals with external clients, professionals and interested parties

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 Management roles…
3. Decisional roles
3.1. Entrepreneur:

– As entrepreneur, should create and control change

within the organization.

– This means solving problems, generating new

ideas, and implementing them.

– The initiator of change, often taking risks.

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 Decisional roles…
3.2. Disturbance handler:
– Dealing with disputes and strikes
– Initiates corrective action when organization faces
important, unexpected disturbances.
– Implementing strategy to resolve disturbances and crisis

3.3. Resource allocator:

– Fulfills responsibility for the allocation of organizational
resources of all kinds-in effect, makes or approves all
significant decisions.

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 Decisional roles…

3.4. Negotiator:
– Represents the organization in major negotiations.

– Items to be negotiated include

• contracts with suppliers,

• trade-off for resources inside organization and

• agreements with labor organizations.

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 Principles of management
1. Management by Objective
2. Learning from Experience
3. Division of Labour
4. Substitution of Resources
5. Convergence of Work
6. Functions Determine Structure
7. Delegation
8. Management by exception
9. Shortest Decision-path
10. Management by Walking Around
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Principles of management….

1. Management by Objective
Management sees that objectives are specified and then that they
are achieved.
The objectives should include:
➢ What is to be accomplished?
➢ How much of it?
➢ Where it is to be done?
➢ When it is to be completed?

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 Principles of management…

2. Learning from Experience

– Analysis of the results between the objectives and
achievement made.

– For better performance there should be feedback to learn

from experience.

3. Division of Labour
– Management attempts to bring about balance of work
among the different work and the different people
concerned.
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Principles of management…

4. Substitution of Resources
– Often when the resources that are normally used to provide
service became scarce or too expensive, different resources
may be used to provide the intended results.

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Principles of management…

5. Convergence of Work
❑ Working relations should contribute to the success of
each activity and so to general effectiveness.
❑ These working relations of activities are:
➢The logical relations with each other
➢Time relations or sequence
➢Spatial relations between activities
➢Functional and structural working relations between
people.

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Principles of management…
7. Delegation

➢ Delegation is the downward transfer of formal

authority from superior to subordinate.

➢ Factors to consider in delegation

➢ Experience, ability, urgency, availability, past performance,

motivation, risks/rewards

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Principles of management…

8. Management by exception

➢ Do not be overloaded with routine and unnecessary

information, be selective and make big decisions first.

➢ In short management by exception means:

✓Selectivity in information and priority in decision

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 Principles of management…

9. Shortest Decision-path

This principle deals with issues like:

➢ Who should make which decision?

➢ When and where?

➢ Decision must be made as closely as possible in time

and place to the object of decision and to those affected

by it.

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Principles of management…

10. Management by Walking Around

➢ Also known as management by wandering around

➢ Direct participation by the managers in the work-related affairs

of their subordinates.

➢ Managers spend a significant amount of their time making

informal visits to the work area and listening to the employees.

➢ The purpose of this exercise is to collect qualitative information,

listen to suggestions and complaints, and keep a finger on the
pulse of the organization.
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