3_Management Functions in health sec.pptx

1
Management
Functions
By: Birhanu D (, MSc)

objectives
After completion of this session, students will be able to:
 Discuss the basics of planning
 Discuss the steps of strategic planning
 Develop an action plan
 Describe business planning
 Discuss the functional elements of organizing
 Analyze different organizational structures in the health
systems
 Sketch organizational chart
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Health Planning
 Planning is a systematic process of identifying
and specifying desirable future goals and
outlining appropriate courses of action and
determining the resources required to achieve
them
 Health planning is simply a planning
pertaining to health and health care system
 A plan functions like a blueprint: it defines the
steps and decision points required to achieve a
desired result
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Attributes of planning
 Futuristic :
• anticipate the future (clear vision/mission, goal &/or
objectives )
 Decision making :
• determine what is to be done, when, where, how, & for what
purpose, choosing among the alternatives.
 Dynamic & Continuous:
• because planned activities are affected by internal & external
factors.

Attributes of planning
 Practical (attainable)
– It is doable (technically)
– Required resources are obtainable
 Fulfill the minimum conditions
 Desirable
– Socially acceptable
– Involvement of stakeholders
– Acceptable to all stakeholders
– economically sustainable

Types of plans
 Plans can be classified on different bases or
dimensions.
 The important ones are:
— Repetitiveness
— Time dimension, and
— Scope/breadth dimension

Types of plans . . . .
Classification of Plans Based on Repetitiveness
1. Standing Plans : can be used again and again
 Include mission or purpose, goal or objective, strategy,
policy, procedure, method, and rule.
2. Single-used Plans: not used up once the objective is
accomplished
─ Used only once
─ Include programs, projects and budgets

 Classification of Plans Based on Time
1. Long-range planning
– The time may range usually from 5 - 10 years
– Distant future
2. Intermediate-range planning
– Ranges between long & short- range plans
3. Short-range planning
– Complementary of long- range plans
– Constitute the steps towards the implementation of long-
range plans
– Ranges from 1 to 2 years

Classification of Plans Based on
Scope/Breadth
1. Operational ( tactical) plans - activity
planning
2. Strategic Planning - allocative planning

Steps of strategic planning
process
 Strategic planning asks and answers four questions:
1. Where are we now? (situational analysis: SWOT)
2. Where do we want to go? (mission, vision,
strategic objectives)
3. How will we get there? (strategies)
4. How will we know we are getting there?
(measuring implementation, monitoring progress)
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1. Analyzing the external and internal environments
 The first stage of the strategic planning process asks:
where are we now?
 The SWOT analysis enables us to answer this
question by carefully scanning the trends and
conditions – internal and external, positive and
negative – that can impact the ability of our
organization to fulfil its mission and build a bright
future
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Analyzing the environment...
 The SWOT analysis is a tool that helps identify
opportunities and threats (OT) in the external
environment that are most relevant to your work and
the strengths and weaknesses (SW) within the
organization: the systems, structures, and cultural
factors that can enhance or obstruct organizational
effectiveness
 The SWOT analysis helps you prepare for the next
planning steps.
 The SWOT analysis results allow you and your
organization to gauge where you are relative to where
you intend to be
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SWOT Matrix with Impact Ratings
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External Environment Internal
Environment
Opportunitie
s
Strengths
Threats
Weaknesses
Favorable
Factors
Negative
Factors

2. Articulating the mission
 Mission begins the answer to the second strategic planning
question: where do we want to go?
 an organization’s mission is its purpose, its reason for being
 the mission statement describes clearly and concisely why the
organization exists
 the mission provides orientation, consistency, and meaning to
the organization’s decisions and activities at all levels
 a well-framed mission will guide your organization’s work over
the long term and inspire your staff
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3. Creating the vision
 Next ask: where are we going? - Constructing the
desired future
 It is the moment to dream, to decide what our
organization wants to be in the future and how it
wants to be viewed by the outside world
 The image of an organization’s desired future state
that a team, organization, project, or program can
move toward by taking action
 The vision should align with the mission
 A vision is more powerful when a larger number of
people from various organizational levels develop it
together: include key actors from every work group in
the process of developing the shared vision
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Creating the vision...
 The vision is like a guiding star
 The vision:
 Fosters a shared commitment to the future you want
to create
 Powerful picture of a desired state that provides a
broad perspective and inspiration to keep working,
overcome obstacles, and struggle to achieve results
 Guides and focuses the organization’s efforts
 Helps to align, inspire, motivate, and secure the
commitment of each working group and individual
within the organization
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 Objectives:- the desired results help to transform your
organization’s mission and vision into actionable,
measurable pursuits.
 Objectives become the criteria against which it is
possible to measure achievements
 To serve their purpose, objectives must be SMART:
 S = Specific
 M = Measurable
 A = Appropriate to the scope of activities/importance
 R = Realistic within the allotted time
 T = Time bound, with a specific date for completion
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4. Establishing strategic objectives

Establishing strategic objectives...
 They derive from the organizational vision
 Strategic objectives are important because they:
 Allow the organization’s vision to become a
reality;
 Serve to direct organizational, departmental
and individual plans;
 Provide orientation on the use of the
organization’s resources;
 Basis for supervising, monitoring, and
evaluating results
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5. Formulating strategies
 Strategies are statements of what is to be done
 It answers the question “how will we get there?”
 There are almost always alternative routes
toward the achievement of strategic objectives
 To find the best strategies for your organization
involves considering all possible strategies and
then choosing one or more that will best
contribute to the achievement of the
corresponding strategic objectives
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6. Measuring the implementation of the
plan
 It is crucial to monitor and measure whether and how
well an organization strategic objectives are achieved
 The backbone of measurement is results
 These may be outputs and outcomes/impact
 The achievement of those outputs and outcomes is
determined by indicators – measurable markers of
change
 The indicators in the plan will allow to regularly monitor
progress toward your desired results and to evaluate
the actual results achieved
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7. Converting the strategic plan into an
operational plan
 Produce annual operational plans that will translate
strategic objectives and strategies into
comprehensive packages of activities.
 Operational plans refer to the strategic objectives
and strategies from the strategic plan
 Should list selected activities for each strategy, & then
for each activity specify the elements/ components of
an operational plan
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Components of an Operational Plan
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an operational planning template
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Strategic
Objectives
Strategies
Activities
Person
Responsible
Indicator
Resources
Needed
Schedule
1 2 3 4 5 6 7 8 9 10 11 12

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Organizing
 Organizing is the process of making sure the
necessary human and physical resources are
available to carry out a plan and achieve
organizational goals
 Organizing also involves assigning activities, dividing
work into specific jobs and tasks, and specifying who
has the authority to accomplish certain tasks
 Another major aspect of organizing is grouping
activities into departments or some other logical
subdivision

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Organizational structure and design
 Organizational structure refers to the lines of
authority, communication, and delegation
 An organizational structure is the formal framework
by which job tasks are divided, grouped, and
coordinated
 An organization's formal structure is depicted in its
organizational chart
 organization chart: visual display of an
organization’s positions and lines of authority
 Organization chart clarify chain of command, span of
control, official communication channels, and linkage
for all departments

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Organizational structure and design...
 When managers develop or change an organization's
structure, they are engaged in organizational design,
 Organization design is the creation of an
organization's structure - the overall layout of
departments, positions and interrelationships
 It involves decisions about four key elements:
1) Work specialization,
2) Departmentalization,
3) Chain of command,
4) Span of control,

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Organizational design…
 Work Specialization: is the degree to which
tasks in an organization are divided into
separate jobs
 Departmentalization: Once jobs have been
divided up through work specialization, they
have to be grouped back together so that
common tasks can be coordinated
 Chain of command: the vertical line of
authority that clarifies who reports to whom
throughout the organization

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 Span of Control/span of management
 The number of people who report directly to a
manager represents that manager’s span of control
 Managers with a narrow span of control oversee the
work of a few people,
 whereas those with a wide span of control have
many people reporting to them
Organizational design…

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Types of organizational structures
 There are different types of organizational structures
 It is important to find an organizational structure that
works best for the organization, as the wrong set up
could hamper proper functioning
 Organizational structures are depicted using different
types of organizational charts

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Delegation
 It is the assignment of direct authority and
responsibility to a subordinate to complete tasks for
which the manager is normally responsible
 When a manager delegates work, three transfers
occur
 First, the manager transfers full responsibility for
the assignment to the subordinate
 Second, the manager gives the subordinate full
authority over the budget, resources, and
personnel needed to do the job
 for delegation to work, delegated authority must
be commensurate with delegated responsibility

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Delegation…
 The third transfer is the transfer of accountability
 The subordinate is not accountable for to do the job
 In other words, managers delegate their
managerial authority and responsibility in exchange
for results
 What you cannot do is delegate accountability
 You are still accountable for the results obtained by the
members of your team collectively and individually

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How to be a more effective delegator
 Trust your staff to do a good job
 Avoid seeking perfection
 Give effective job instructions
 Follow up on progress
 Praise the efforts of your staff
 Provide the required resources
 Ask questions, and assist employees to help them
complete the work assignments as expected
 Delegation is a process that starts from the point
when no freedom of action for the individual to
whom work has been allocated and ends with full
devolution (the individual is completely empowered
to carry out the work)

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The advantages of delegation
 Enables you to focus on those aspects that require
your personal experience, skill and knowledge
 Relieves you of routine and less critical tasks
 Frees you from being immersed in detail
 Extends your capacity to manage
 Reduces delay in decision-making
 Empowers and motivates your staff by extending their
responsibilities and authority and providing them with
greater autonomy
 Develops the knowledge and skills of your staff and
increases their capacity to exercise judgment and
make decisions

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When to delegate
 You should delegate when you:
 Have more work than you can carry out yourself;
 Cannot allow sufficient time to your priority tasks;
 Want to develop a member of your team;
 Believe that it will increase someone’s engagement
with their job;
 Think that the job can be done adequately by the
individual or the team to whom you are delegating.

Monitoring and Evaluation
 Monitoring and evaluation are key management
functions of an organization
 Monitoring is used to regularly track changes in
indicators – measurable markers of change over time
 Monitoring measures progress toward results by
collecting information on inputs, activities,
outputs, and sometimes short-term outcomes
 Common procedures for program monitoring
include tracking service statistics and reviewing
records and training reports
 Regular, systematic monitoring provides
information for planning purposes and a reliable
basis for an evaluation
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 Evaluation, on the other hand, is used to assess
the effectiveness of efforts to improve services
and to prevent and manage priority health
problems
 Evaluation measures outcomes/impact
 It assesses the extent to which your organization
achieves its desired results and helps you
understand why the results were or were not
achieved
 Evaluation also provides an opportunity for
continuous learning from experience
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Monitoring and Evaluation…

 The differences between monitoring and evaluation lie
in their purposes, time frames, and sources of
information
 difference in purpose
 Monitoring is driven by a management need,
whereas evaluation is driven by the need to
document outcomes of an intervention and report to
a donor or other stakeholder
 Monitoring thus focuses on operational
implementation, while evaluation focuses on the
effects of the activities on the health of the target
population
 Evaluation attributes for results, explain cause & 39

 Difference in time frame when each is used
 Monitoring is an ongoing, routine process used
throughout an intervention
 Evaluation requires the collection of baseline and
post-intervention data that allow you to compare
changes during the period of the intervention and,
sometimes, after a suitable follow-up period – it is
episodic
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 Difference in information sources
 Monitoring data usually come from what is readily
available: the HIS or routine service records
 Outcome and impact indicators require
measurements at the beneficiary or population
level, which must be obtained through an
evaluation
 you would need to conduct a survey to collect the
data
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Levels in the Results Chain
 The results of health services and programmatic
interventions can be measured at different levels
 Many M&E guidelines are based on a chain of five
levels of results: inputs, activities, outputs,
outcomes, and impact.
 The table below summarizes the results levels that
can be monitored and evaluated.
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Levels in the Results Chain
Results chain Definition Examples
Inputs
The materials and resources
needed to carry out your team
or unit’s implementation plan
and achieve the desired result.
 human resources
 financial resources
 equipment
 facilities
 policies
Process
(Activities)
The activities carried out
through your implementation
plan
 meetings
 training
 supervision
 services
Outputs
The immediate product of an
activity.
 number of staff trained
 number of clients
 number of products
 improved supervision
 quantity of products
distributed
Outcomes
A short-term change in a
population group as a result of
a set of activities.
 change in knowledge
 change in behavior
 change in practices
 improved services
Long-term changes within a
 change in disease rates

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3_Management Functions in health sec.pptx

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