Principles and practices of public health administration

47 Pages·2012·1.072 MB·English

by  Tandan M, Thapa J, Regmi B

Principles and practices of Public Health
Administration

2012

Tandan M, Thapa J, Regmi B
Table of contents:

Chapter I: Basic concept of Health, Administration and Management.......................................................................... 3
1.1 Health: ................................................................................................................................................................. 3
1.2 Public Health: ...................................................................................................................................................... 3
1.3 Administration: ................................................................................................................................................... 3
1.4 Concept of Management: .................................................................................................................................... 4
1.5 Characteristics of Management: .......................................................................................................................... 4
1.6 Health Management: ........................................................................................................................................... 4
1.7 Health administration or healthcare administration .............................................................................................
5
1.8 Public Health Administration: ............................................................................................................................. 5
1.9 Nepal’s health Administrations are: .................................................................................................................... 5
1.10 Difference between Management and Administration: .....................................................................................
5
1.11 Principles of Management by Henry Foyal: ......................................................................................................
6
1.12 Scope of PHA: ................................................................................................................................................... 6
1.13 Health services: ................................................................................................................................................. 6
1.14 Public Health Service ........................................................................................................................................ 7
1.15 Public Health Services: ..................................................................................................................................... 7
1.16 Objective of the health care system ...................................................................................................................
7
1.17 Public Health Practice: ...................................................................................................................................... 7
1.18 Function of Health Service management/ Administration: ............................................................................... 7
Chapter II: Models of PHA............................................................................................................................................ 8
2.1 Classical Model: POSDCoRB ............................................................................................................................. 8
2.2 Purpose /Aims of planning: ................................................................................................................................. 8
2.3 A good planner will have to decide on: ...............................................................................................................
8
2.4 Health planning: .................................................................................................................................................. 9
2.5 Purpose of health planning: ................................................................................................................................. 9
2.6 Level of Health Planning:.................................................................................................................................... 9
2.7 Key Elements of planning: ................................................................................................................................ 10
2.8 Types of Planning: ........................................................................................................................................... 10
2.9 On the Basis of time scale ................................................................................................................................. 10
2.10 Planning cycle /general Planning cycle: ..........................................................................................................
11
2.11 Why strategic Planning? ..................................................................................................................................
16
2.13 Benefits of Strategic Management .................................................................................................................. 16
2.14 Staffing Process: .............................................................................................................................................. 19
2.15 Human resource planning:............................................................................................................................... 19
2.16 Nature of directing .......................................................................................................................................... 22
2.17 Principles of Directing: ................................................................................................................................... 22
2.18 Keys to Successful Directing: ......................................................................................................................... 23
2.19 Delegation: ...................................................................................................................................................... 23
2.20 Dimension/Elements of Delegation:................................................................................................................ 24
2.21 Characteristics of Delegation of Authority:..................................................................................................... 25
2.22 Difference between documents and record: .................................................................................................... 32
2.24 Importance of Reports: .................................................................................................................................... 32
2.25 Importance of records: .................................................................................................................................... 32
2.26 Principles of Budgeting ................................................................................................................................... 33
2.27 Types of budget .............................................................................................................................................. 34
2.28 Budgeting process of Nepal ............................................................................................................................ 35
2.29 Types of Resources are ................................................................................................................................... 36
2.30 Scientific Model: ............................................................................................................................................. 37
2.31 Steps of LFA: .................................................................................................................................................. 39
2.32 LFA Steps........................................................................................................................................................ 40
2.33 Logical Framework Matrix: ............................................................................................................................ 42
Chapter III : Management Promotion Strategies ......................................................................................................... 44

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Chapter I: Basic concept of Health, Administration and Management

1.1 Health: Health is the ability to adapt and manage physical, mental and social challenges
throughout life. As defined by the World Health Organization (WHO), health is "a state of
complete physical, mental and social well-being and not merely the absence of disease or infirmity.
1.2 Public Health: Public health is “the science and art of preventing disease, prolonging life, and
promoting health through the organized efforts and informed choices of society, organizations,
public and private communities, and individuals.” Public health is “the science and art of
preventing disease, prolonging life, and promoting health through the organized efforts and
informed choices of society, organizations, public and private communities, and individuals.”
1.3 Administration: Administration is the process of purposeful and effective use of resources –
man-power, materials & finances for fulfilling a pre-determined goals.
Management is principally a task of planning, coordinating, motivating and controlling the
efforts of others towards a specific objective.
James Lundy
It is the art of getting things done through others/people
Management is the essence of all organized efforts. It coordinates resources to get job done to
achieve goals. Resources can be human, financial, materials.
Management knows exactly what you want people to do, and then seeing that they do it in the
best and cheapest way.
F.W Taylor
Act of managing something.
Administration encompasses all aspects of administering the correct policy and procedures
required to effectively run a business or program.

1.4 Concept of Management:
3
1. Process Concept:
➢ Focus mainly on jobs to be performed
➢ Regards management as function of planning, organizing etc

2. People concept
➢ Regards management s as a process of getting things done through people and
with People
➢ Human Resources, leadership, communication are focused.
3. System concept:
➢ Deals with balancing jobs and people- related to organization external and internal
environment.
➢ Involves efficient use of resources.

1.5 Characteristics of Management:
➢ Universality
➢ Integrated approach
➢ Multi - Discipline
➢ Art and Science
➢ Purposeful
➢ Group Action
➢ Dynamic and continuous process
➢ Activity based
➢ Management as a profession

1.6 Health Management:
It is principally and process of health planning, coordinating, motivating & controlling the efforts
of the people for improvement of the health status of the people (Community) by effective and
efficient use of resources.
Health Management is also refers to as management of health centers, which includes the
management of health of ntire population it serves. When the health center is well managed the
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community is healthier. Good management ensures that the improvement is shared by everyone,
young and old, poor and rich, poorly educated and well educated.
1.7 Health administration or healthcare administration is the field relating to leadership,
management, and administration of health care system.
1.8 Public Health Administration: Management of Public health organizations or agencies
Public Health Administration is concerned with the management of public health programs,
which interact with the residents of the community or region.
1.9 Nepal’s health Administrations are:
– Ministry of Health
– Regional Health Directorates
– Regional Zonal Hospital’s Administration
– District hospital/ DPHO office – PHCCs, Hps, SHPs.
1.10 Difference between Management and Administration:

Basic Difference Administration Management
1.Nature of Function It is thinking function It is doing Function
2. Type of work It is concerned with the It puts the policies and plans into
determination of objectives and action made by administration
major policies of an organization
3. level of Authority Top level activity operative level activity
4. decision Making Its influenced by the force of Decisions are influenced by values
public opinion government policies opinions and belief of managers.
and social values
5. status of performance Administrative group consist of Managerial personnel consist of
owners who invest capital and paid employee with specialized
receive profit in the form of knowledge
dividends.
6. Use It is used mainly in government, It is mainly used in business which
educational and social institutions. has economic motives.

1.11 Principles of Management by Henry Foyal:
5
• Management by objectives
• Division of labor
• Convergence to work
• Substitution of resources
• Delegation
• Esprite de crops ( there should be cohesiveness and team spirit)
1.12 Scope of PHA:
Major concerns of PHA are
1. as an activity
Public Health Administration hold all the activities of the government. Provides a number of Health
care and Health promotion services to the people. Besides, it has to manage government owned
health programs and regulate private organizations related to the field. Public health
administration covers every area and activities within the field of public health policy

2. as a discipline.
The POSDCoRB view, which denote: Planning, Organization, Staffing, Directing, Coordinating,
Reporting the Budgeting.
Actual (genuine) concerns: specialized techniques of their own which are not covered by
POSDCoRB e.g. techniques in health problem detection, maintenance of policy and procedure
which are much and more vital to well-organized health related activities.

1.13 Health services:
➢ Health services are designed to meet the need of the community through the use of
available need and resources.
➢ Health services are delivered by the “health system”.
➢ Health service should designed to meet the need of the populations

1.14 Public Health Service
Any organized community program designed to protect and promote community health.
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1.15 Public Health Services:
Health care means of improving the health of the population.
Health care is a public right it is the responsibility of government to provide public health care to
community
1.16 Objective of the health care system
Improve populations health is legitimate role and helpful for health gain promoting, maintaining,
monitoring, or restoring health.
1.17 Public Health Practice:
The application of multi-professional skills of community diagnosis and community organization
for health and of medical education or environmental therapy to maintain and improve the state
of well-being of the community.
1.18 Function of Health Service management/ Administration:
➢ POSDCROB Model (Classical Model)
➢ Other Models of PHA and Management

1. Classical Model
POSDCORB Model
-Luther Gulick
2. Traditional
PIE Model (Planning, Intervention, Evaluation)
3. Input–Output Model (Input-Process-Output) Models of PHA / management:

4. Management by Objectives (MBO)
-Peter Drucker in 1954
5. System Approach Model (Scientific Model)
6. Logical Framework Model

Chapter II: Models of PHA

2.1 Classical Model: POSDCoRB

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a) Planning: The beginning of management
Planning is a systematic method of trying to ensure that the resource available now and in the
future are used in the most efficient way to obtain explicit (clearly define) objectives. It is also
called as deciding in advance.
So, Planning means:
➢ Where we are going? (Objectives)

➢ With what? (Resources)

➢ How? (Efficient and appropriate implementation)

➢ When? (time)

➢ Degree of Formalization- Official (Explicitness, Systematic) about the process.

2.2 Purpose /Aims of planning:
The increasing demand for medical and health care services in the face of limited resources has
brought out the need for careful planning and management of health services. Therefore planning
is done:
• To match the limited resources with many problems
• To eliminate wasteful expenditure or duplication of expenditure • To develop
the best course of action to accomplish defined objectives.
2.3 A good planner will have to decide on:
A realistic planning requires the cooperation of all who have necessary information, knowledge
and power of decision. This stress that management is shared responsibility, and that each member
of the team has a shared of this responsibility.
- The objectives of what is being planned
- The approaches or strategy, for reaching the objectives
- The resources to be used
-The cost of activities
-The detail scheduling of implementation

2.4 Health planning:
Health planning is defined as “the orderly process of defining community health problems,
identifying unmet needs, surveying of resources to meet them, Establishing priority goals that
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are realistic, feasible and projecting administrative action to accomplish the purposed of
proposed program”
WHO
• Resources: manpower, money, materials, skills, knowledge, techniques, time etc.
• The resources can be wasted if there is no proper planning and management.
2.5 Purpose of health planning:

To meet health needs and demands of people.
Health needs may be – need for medical care, safe water supply, adequate nutrition,
immunization).

2.6 Level of Health Planning:
• Planning is done on many levels in health care field (also called as comprehensive or
area wide- deals with the interrelationship of various health providers in a given area
• E.g a hospital that participate in area wide planning may decide not to develop an open
heart surgery capabilities if adequate facilities already exist in the area.
• Planning is done at the level of the individual health service organization
• The determination of what is to be done and how it is to be done at the level of an
organization
• The development of these objectives and methods is the responsibility of top level
administrator although they need the participations of many other people to develop
them fully
• Planning is also done at many level within the individual health service organization.
• The manager of each department unit of organization must determine what is to be done
and how it is to be done in his unit
• This includes determination of objectives (what) and methods (how) that will guide the
actions of those people being managed as well as the use of resources that are available
to the manager.
• All these level of planning are important in overall scheme of health service delivery
• But, primarily concerned is the last level of planning within the health service
organization at the level of department and sub-parts.
• We will mainly focus on the determination of what is to be done (objective) and how it
is to be done ( metods)
• Before examination of these aspects of planning however it will be useful to set the
stage by describing planning at the level of the health service organization at this level,
planning is often referred to as strategy formulation

2.7 Key Elements of planning:
• Evaluation of present conditions
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