Health Problems and Organizational Structure

Functions of Management

• Planning is the process of selecting appropriate goals and actions to pursue, determining the strategies to use, and deciding what resources are needed to achieve the goals.
• Organizing is establishing the relationships among workers to achieve organizational goals.
• Leading is articulating a vision, energizing employees, inspiring and motivating people, using effective communication skills, influence, and persuasion.
• Staffing is recruiting and selecting employees for positions within the company.
• Controlling is evaluating and improving performance by establishing standards, measuring, comparing, and making decisions.

Five Functions of Great Management

• Planning: Choosing appropriate goals and actions; using strategies and deciding on actions to take, as well as which resources are needed.
• Organizing: Forming worker relationships to achieve company goals.
• Leading: Developing a vision, motivating employees, and using influence, persuasion, and communication
• Staffing: Recruiting and choosing appropriate employees for different positions.
• Controlling: Measuring, evaluating, and improving performance by setting and meeting standards.

Session Objectives

• Define planning
• Define health planning
• Describe features of planning
• Discuss types of planning
• Explain steps of planning

Brainstorming

• What is planning?
• Why is planning important?
• What types of planning do you know?

Planning

• Planning is a coordinated, comprehensive process for efficiently allocating resources to achieve a specific goal.
• It entails compiling and analyzing information, brainstorming ideas, applying logic and imagination, and making judgments to determine the best course of action.
• Planning is an ongoing process of learning from experiences, adapting to changes, and educating stakeholders.
• Planning involves deciding on what needs to be done; it's a projected course of action in the future. It's concerned with both what's to be done and how to do it.
• Specific objectives covering a timeframe are defined. These are written and shared to minimize ambiguity.
• A true plan should be dynamic and evolve with ongoing changes.
• A plan offers a process or mechanism for finding a solution rather than the ultimate solution, and should contain the necessary principles to achieve organizational goals.
• "The plan is nothing; planning is everything." (Benjamin Disraeli)

Rationale of Planning

• Planning provides direction for managers and non managers
• It reduces uncertainty by allowing managers to look ahead, anticipate change, and develop appropriate responses.
• It minimizes waste and redundancies.
• Establishes goals used in controlling; Without planning, there are no goals against which to measure work effort.

Health Planning

• Defining community health problems, identifying needs and resources, setting priorities, and creating a plan to reach those goals.
• Planning assumes that the future will be different from the present; it's a tool for change.

Features of a Good Plan

• Clear vision, mission, goals, and objectives
• Clear picture of tasks
• Necessary resources (human, material, financial, time)
• Needs participation of government sectors, community, and NGOs (non-governmental organizations).

Vision

• A picture of a desired future for a country, organization, or individual.
• Enables people to play an active role in creating the future.
• Describes the intended destination of the group or organization.
• A visual image capable of being perceived.
• For example, “We see healthy children walking to school on safe roads.”

Mission

• A statement that describes the organization's purpose.
• Identifies the target population that is served.
• Outlines services offered.
• Examples: "Debre Birhan Hospital strives to provide preventive, promotive, curative, and rehabilitative health services to the people of Debre Birhan town and its surroundings so that the people lead a healthy and prosperous life."

Types of Planning

• Strategic/allocative planning: A process for defining the future direction of the organization over five years or more. This involves determining what an organization plans to be in the future and how it plans to get there. It is comprehensive and reflects long-term needs and directions within the organization; it's a top-level management plan centering on overall organizational goals.
• Operational/tactical/activity planning: Short-term plans for implementing strategic plans; focused on the current operations in the various organizational components. This strategy is limited in scope and includes activities and resources. This plan is concerned with the execution and timetabling of existing activities.

Steps of Planning

1. Plan the planning: Set up prerequisites, resolve issues, and establish the planning team.
2. Review of policy guidelines -Familiarize with government guidelines and conditions in relation to health plans. Ensure the health plan aligns with national health policy.
3. Situational analysis and problem identification -Understand the current situation; Identify health-related needs and available resources; Provides a common reference point.
4. Problem analysis and prioritization -Identify the gap between the current situation and the desired future state; Assess problems against prevailing conditions in the organization; Construct problems associated with their causes, and analyze causes followed by their consequences.

• Prioritization methods: Define problems, find possible causes, avoid confusing problems with causes, Analyze root causes using 5-why analysis or fishbone analysis, Focus strategies, targets, and objectives on root causes of the problems.

5. Setting objectives and targets: Formulate goals, aims, objectives, and targets that describe the desired direction of a service.

• Goals are broad, Aims are specific to health problems, and Objectives are defined in quantifiable terms that are measurable.
• Define Objectives using the SMART criteria (Specific, Measurable, Attainable, Realistic, Time-bound).

6. Formulate interventions: Identify, shortlist, and decide among different approaches and measures to address problems and needs; Identify any gaps or weaknesses in existing services, find solutions and resources to overcome limitations, and adapt interventions to local, political, and social conditions.

7. Determine resource requirements: Translate interventions and activities to the necessary resources (human power, materials, money, space, time, and information).

8. Budget preparation: Convert inputs, activities, targets, and support services into monetary values.

9. Monitoring and Evaluation: Determine how progress is made with the established goals.

• Formulate indicators and methods to verify success.

10. Plan of Action: Create a matrix format that contains the problems, objectives, interventions, activities, key personnel responsible, and the needed time, costs and outputs.
11. Writing up the Plan: Outline the plan’s purpose (e.g., carrying out the work, obtaining funds), and develop a summary of main points, including the introduction and problem statement. Outline objectives, strategies, resources, and evaluation.

Why Plans Fail

• Planning is not integrated into the entire management system.
• There's a lack of understanding of the steps in the planning process.
• Concerned parties are not involved in or contribute to the planning process.
• Management expects the plan to be completed with little effort.
• Too much attempted at once
• Failure to operate by the plan
• Inadequate input in planning
• Unforeseen (unexpected) changes in the environment

Organizing Principles

• Work Specialization (Division of Labor): Dividing complex jobs into smaller manageable tasks.
• Departmentalization: Grouping similar tasks into departments.
• Chain of Command: The path that authority flows through an organization.
• Span of Control: The number of employees a manager can oversee effectively.
• Centralization/Decentralization: Degree to which decision-making authority is distributed in an organization.
• Formalization: Degree to which an organization standardizes work roles and behavior.

Organizational Structures

• Mechanistic structures are rigid and stable, standardized jobs, high formalization, centralized.
• Organic structures are flexible, changing jobs and regulations, no high formalization, decentralized.

HRM Functions

• HR Planning
• Recruitment and Decruitment
• Selection
• Induction and Orientation
• Training
• Performance Appraisal
• Compensation and Benefits

Leading Theories

• Trait Theory: Focuses on identifying leadership characteristics.
• Behavioral Theory: Examines how leaders act toward followers.
• Contingency Theories: Focuses on the idea that the most effective leadership style depends on the context.
• Contemporary Leadership Theories: Includes Leader-Member Exchange (LMX) theory and transformational leadership.

Controlling

• The process of monitoring, comparing, and correcting work performance.
• Effective controls ensure activities meet goals.
• Managers use controlling to determine if organizational goals are met, and if not, why.

Purpose of Controlling

• Measure organizational performance
• Empower employees.
• Protect the organization.

The Control Process Steps

1. Measuring actual performance: Obtaining information.
2. Compare actual performance against the standard: Determine the variation.
3. Taking managerial action: Do nothing, correct actual performance, revise the standard.

Forms of Controlling

1. Monitoring: Daily observation and follow-up of activities, used to improve campaigns.
2. Supervision: Teaching and learning process for ensuring that workers execute work properly.
3. Evaluation: Systematic collection, analysis, interpretation, and use of data to evaluate programs and decide on future development. This involves determining the worth of programs against standards.

Importance of Evaluation

• Improve health status
• Enhance program implementation
• Provide accountability
• Increase community support
• Inform policy decisions
• Conduct formative evaluation (feasibility, appropriateness, and acceptability before implementation or during modification).
• Conduct process/implementation evaluation (determines if activities are implemented as intended).
• Conduct outcome/effectiveness evaluation (assessing outcomes or outcome objectives).
• Conduct impact evaluation (assessing program effectiveness in achieving goals).

This quiz focuses on key concepts related to health problem prioritization, socio-economic issues, and organizational structures within health services. Challenge your understanding of health strategies and the criteria used in formulating effective interventions. Test your knowledge on how organizational structure impacts health service delivery.