Health Service Management

By:

Khalid abdurahman omar( Ambasa)

(MPH, BPHo.)

August , 2020
Introduction to Management
Management???

• What?

• Why?
Definition
• The process of directing, coordinating and influencing
the operation of an organization

To obtain the desired result/achieve the goal of an

organization.

• “It is an art of getting things done through others”

Importance of management
• It is essential for all kind of organization b/c every
organization requires
Making decisions

Coordinating activities

Handling resource

Evaluating performance
Administration Vs management?
Administration and management
• The terms are used interchangeably in different
organization

• But they are functionally different

• As you go down the hierarchical ladder the management
function increases and while administration function
decreases

• But a single person can do both functions

Major management functions
1. Planning
2. Organizing
3. Staffing Implementation
4. Leading
5. Controlling Evaluation
Functions

Planning Implemen
[P] tation [I]

Evaluation [E]
• The other continuous functions of management are

 Decision making

 Communication
Functions
• Why continuous????

 Communication and Decision Making

The relationship between functions of management
Communication

Planning Implemen
[P] tation [I]

Evaluation [E]

Decision making
Levels of management
• Generally managers are categorized into three levels.
 Top level

 Middle level

 Front-line: sometimes called as supervisory,

First line and operating level of management.
 Top

Middle Middle

Low Low Low

Top management:

• The CEO and/or president and his/her immediate

subordinates usually called vice-presidents.
• Responsible for overseeing the entire organization.

• Establishes long term goals and oversees the work of

middle level management.

• Creates and coordinates alliance/agreement and

partnerships with outsiders.
 Top Level…

President

Vice-president Vice-president Vice-president Vice-president

manufacturing marketing finance HR

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Middle level management:

• Includes managers above the rank of supervisory level.

• Supervise low level managers and report to senior

managers

• Develop objectives to implement top-management goals.

Middle level management

Vice president
marketing

Northern Southern
Central
Regional Regional
Regional
manager manager
manager

East Central Southern East Central Southern

district District District District District District
manager manger manager manager manager manager

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Front-line management:

• Supervisors, team leaders and team facilitators who

oversees the work of non-management people often
called operating employees.

• Plan for a short term, involving scheduling employees and

establishing detailed procedures to perform worker tasks.
First line management
Central
central
Group
group
manager
manager

Area Area Area Area Area

Area
manager manager manager manager manager
manager

workers workers

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Level…
• Regardless of title, level or orientation, managers have
several common attributes:

1. They are formally appointed to positions of authority

2. They are charged in directing and enabling others to do
their work effectively,
3. They are responsible for utilizing resources
4. They are accountable to superiors for results.
• The primary differences between levels of managers are
the degree of authority and the scope of responsibility
at each level.

• E.g. senior managers, presidents or chief executive

officers and vice –presidents in HSOs have authority over
and are responsible for entire organizations---all staff,
resources and individual and organizational results. CEO
are accountable to the governing body.
Management skills???
Management skills???
• Are competencies a manager holds to undertake the
roles effectively

• Ability to translate knowledge into action.

• Manifested in an individuals performance.

• Not necessarily inborn.

• Developed through practice and experience.

• A manager should posses 3 major skills; these are
1. Conceptual skill

2. Human relation skill, and

3. Technical skill.
1. Conceptual skill:
• Understand the complexities and issues within an
organization and the role and strength of management
within it

• Involves the formulation of ideas.

• Managers understand abstract relationships, develop

ideas, and solve problems creatively.
• Ability of a manager to take a broad and farsighted view
of the organization and its future.

• Allow the manager to view an organization as a whole

and to see how its parts relate to and depend on one
another.
2. Human relation skill:
• Consists of abilities to interact and communicate
successfully with other persons.
• Deals with people.
• A manager must be able to understand, work with and
relate to both individuals and groups to build a team
environment.
• The managers ability to work effectively as a group
member and to build cooperative effort within the group
depends on human relation skills.
3. The technical skills
• The ability to use knowledge, methods, techniques and
equipments necessary for the performance of a specific
task.
• Deals with things.
• It is the managers understanding of the nature of specific
jobs that people under him have to perform.
• Such skills can be acquired through training, education
and work experience.
 Managerial skills
Management skills by levels of management (Katz
1955)

Technical Human relation Conceptual

Top

Middle

Front line
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Principles & CONCEPTS of Management
 Concepts

• Effectiveness
• Efficiency
• Economy of scarce resource
• Work relation
• Information
Concepts…
Effectiveness
• A degree to which a stated objective/goal is being
achieved

Efficiency
• Refers to a balanced use of resources.
• Achieving the objectives/goal with a reasonable cost
Concepts…
Economy of scarce resource
• Resource are scarce and costly….thus we need to use it
economically

Work relation
• Work activities should be designed and structured so as
to support each other towards achievement of the
goal/objective
Concepts…
Information
• To make the right decision managers need
information which is
The right kind

At the right time and place

On the right hands

Principles of Management
1. Management by objective
2. Learning from experience
3. Division of labor
4. Substitution of Resources
5. Convergence of work
6. Functions determine structure
7. Delegation
8. Management by exception
9. Short Decision path
Principles
Management by objective
• The objectives should be clearly stated
• the objective should state
 What is to be accomplished?
 How much of it?
 Where it is to be done?
 When it is to be accomplished?
 With what?
Principles…
Learning from experience
• Analysis of the result between the achievement and
objective is made.
• For better experience there should be feedback

To learn from experiences

Principles…
Division of labor
• Balance of work among the different workers

Substitution of resource
• When resources are scarce or too expensive, different
resources may be substituted to achieve the goal
Principles…
Convergence of work
• The sum of each activity should be directed towards the
effectiveness of the organization

Function determine structure

• Function and duties of the individual members should be
clearly defined and known to all
Principles…
Delegation
A matter of entrusting part of your work to others usually
to immediate subordinates

Shortest decision path

• 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.
Principles…
Management by exception
• Selectivity in information

• Priority in decision [make big decision first]

Management roles
 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
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 inviting stakeholders
dinner, receiving visitors, officiating a luncheon, etc.
1.2. Leader:
• motivates subordinates, ensures hiring and training of staff.
• As a leader, manager creates the environment, works to
improve employees performance and reduce conflicts,
provides feedback and encourages individual growth, set an
example for others to follow.

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.
2. Informational roles

• flow from the interpersonal roles

2.1. Monitor:
• Managers gather information from their network of contacts,
including those established in their liaison roles
• seeks and receives wide variety of special information to
develop through understanding of the organization and
environment.
• As a monitor, a manager should constantly monitoring the
environment to determine what is going on.
• He/she should collect information both directly and indirectly.
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
3. Decisional roles

3.1. Entrepreneur:
• searches organization and its environment for opportunities
and initiates projects to bring about change.
• Sharing and initiating new ideas or methods that may improve
the work units operations.
• He/she should implement strategy and review sessions
involving improvement.
• the initiator of change, often taking risks
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.
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.
Health Planning
What is planning?
• The process of determining exactly what the
organization will do to accomplish its objectives

• A process that lays the base for future action

• Deciding in advance what to do, how to do, when to

do, where and who will do activities.
Planning is
• it is charting a course of action for the future

• it bridges the gap b/n where we are now and

where we want to go/be

• is deciding about what should be done in the

future
Health planning…
• The process of
• Defining community health problems

• Identifying needs and resources

• Establishing priority goals

• Setting out administrative action to reach the

goals
Planning…

• The planning process starts with assumption that the

future will be different from the present .
 What do planning answer?
• Planning answers the following questions:
• Where are we now? ------- assess the present
situation
• Why are we here for? -----problems at hand
• Where are we going?-------objectives
• With what? -----------------resources
• How? -------------------------strategies & activities
• When? -----------------------period of time

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Skills of planning

Planners need skills, like the ability to:

• Collect and analyze data.

• Critically and objectively evaluate problems.

• Apply general concepts to specific situations.

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• Manage complex processes.

• Communicate complex issues with various

people.

• Listen respectfully.
Stakeholders for planning
• Planning is a social activity – it involves
people.

• Successful planning requires effective

involvement of stakeholders.

• Planners should be prepared to work with

people from diverse backgrounds, interests
and abilities
Stakeholders include:

1.Users
2.Citizens/taxpayers
3.Impacted residents
4.Businesses
5.Employees/workers
6.Public officials
7.Affected organizations/interest groups.
8.Lawyers
 Decisions related to planning

• Decision on objectives
• describing or identifying the problems
• target population & their locations
• How much of the problem can be reduced

• Decision on resources
• identification, specification & quantification of resources to be utilized
• contribution of the health sector, the community & other sectors

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Decisions related to planning…
• Decision on activities
• Which type of activities?
• To whom? Target population addressed by the activity
• How much? The amount of each activity
• How, which & where? The approach, the time, the
frequency and the location each activity to be delivered
• By whom? Who does what?

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Scope of Planning
Is determined by:
• Target client
• Population, institution & program

• Level where the planning being undertaken

• Village /kebele/ district / zonal / region

• Level of comprehensiveness
• Curative, preventive, promotive & rehabilitative health care

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Features of Planning
• Is an intellectual activity

• Is a continuous process (cyclic /spiral)

• Is flexible as it is based on future conditions, which are

always dynamic

• Is collective undertaking requiring the participation of all

relevant stakeholders

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Features…
• Must be systematic & action oriented

• Is needed & practiced at all managerial levels

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A good plan should give:

• Clear vision, mission, goal & objective

• A clear picture of the tasks to be accomplished

• A clear summary of physical, human & technical resources

 Elements in planning
Vision

• A vision is a statement about what your organization

wants to become.

• It should resonate with all members of the organization

and help them feel proud, excited, and part of something
much bigger than themselves.

• It gives shape and direction to the organization’s future.

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• Visions are usually described in short statements.

• "To be recognized and respected as one of

the best Universities in Africa."
Mission
• Is a precise description of what an organization does.
• should describe the business the organization is in.

• is a definition of “why” the organization exists currently.

• Defines where the organization is going

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• e.g. We will produce outstanding financial returns by
providing totally reliable, competitively superior,
global, air transportation of high-priority goods that
require rapid, time-certain delivery.
Goals, aims, objectives & targets

• All are ways of describing the desired future direction

of a service though they differ in terms of breadth &
details

• Are end states/outcomes of a program

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Goal

• Is a broad statement and generally there is one goal for a

health system /HSO.

• Often referred as the ultimate outcome of the desired

state & hence formulated at a higher level

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Aim

• There are a number of aims related to a goal.

• Is usually specific to a particular health problem

• E.g. To decrease IMR by 5% in maroodi Regional by the year

2021.

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Objectives

• For each program aim there may be a number of

objectives which are specified in measurable terms

• Is planned or intended end result of a program or an

activity

• Is related to output & it is precise

• E.g. To decrease occurrence of malaria outbreak by 10% in

arabsiyo Town by 2021.

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Target

• For each objective, there may be various targets which

specify various points on the way to the attainment of
the objective

• Defined in relation to a point in time.

• E.g. To increase institutional delivery of mothers of abaarso
city from 60% to 80% by the year 2021

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Other elements planning…
• Policy

• Procedures/directions

• Budget

• Plan of action

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Types of planning
Based on time dimension (duration)
• Short term plans (1-2 yrs) ~~ tactical planning
• E.g. annual plans of immunization

• Intermediate plans (3-5yrs)

• E.g. replacing old medical equipments with new ones

• Long term plans (>5yrs) or strategic plans

• E.g. the 20 years HSDP

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Types of planning…
Based on the scope or breadth of activities
• Strategic Plan

• Is a top management plan and focuses on overall

organizational goal

• Referred as allocative planning

• Long term plans (>5yrs)

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Operational/Tactical plans
• Are plans used to implement strategic plans

• Short range planning that emphasizes on current operations of

various parts of the organization

• Are more limited in scope & address those activities and

resources required to implement strategic plans

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• Deal more with the implementation &
scheduling of actual work activities than with
the selection of strategies

• Contains substantial amount of details

• Referred as activity planning

 Planning Tools
• SWOT analysis
• Is a strategic planning tool that matches internal organizational
strength & weakness with external opportunities & threats
• E.g. In a health service organization:
• Strength – availability of resources & trained human
• Weakness – lack of managerial experience & obsolete facilities
• Opportunities – clear & supportive government policies
• Threats – adverse cultural believes towards modern medicine &
growing cost of essential drugs

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SWOT analysis matrix
Internal External

Positive Strength Opportunity

Negative Weakness Threats

 Steps of planning
Step1: situational analysis
• Is a process of gathering and analyzing information to
provide a synopsis of a particular situation at a given point
in time that can guide strategic planning and action.

• In simple terms, it is an effort undertaken by programme

planners to gather and analyze information that will help
them to design, implement and evaluate interventions.
 ...situational analysis
• In situation analysis, the kind of information collected
relates to
• who is affected
• why or how they are affected
• the severity of the problem
• resources and strategies that might be employed to produce
the desired outcomes.

• All relevant stakeholders should be involved.

...situational analysis
A good situation analysis has several benefits:
• Accurate and up-to-date information can provide a basis
for
• discussion and justification for action
• setting priorities
• identifying groups in special need for interventions,
• help that interventions are tailored to the specific needs,
experience, motivation and strengths of the target community.
 ...situational analysis
• Benefits (contd):
• provide a baseline against which to measure future trends in
infection rates and health problem related behaviours.

• essential for evaluating the results of the activities undertaken,

and for making improvements to on-going programmes.
...situational analysis
• gives improved understanding of the current situation from
various perspectives

• Answers the question “where are we now?”

• Outcomes:
• A common reference point for the rest of the
planning process

• Allows the selection of priority areas of concern for planning

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Situational Analysis…
Contents

1. Population characteristics

• Identify the target groups

• Determine population size by category

• Estimate overall population growth

• Determine religious, educational and cultural characteristics

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Situational Analysis…
2. Area characteristics and infrastructures

• Geographical and topographical situations

• Infrastructures –transport modes and routes, means of

communication, water supply and sanitary facilities, electric
supplies etc

• Socioeconomic situations-distribution of family income

• Public and private sector structure

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Situational Analysis…
3. Policy and political environment
• The national programs should be used as a guide

• relate actual situation in the area of concern with these

guidelines

4. Health need analysis

• two broad approaches:
• Medically perceived health needs

• Community perceived health needs

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Situational Analysis…
• Medically perceived health needs
• community health survey
• record review of health service contacts
• interview with health professionals

• Community perceived health needs

• survey of the attitudes and views of the community members
as to their health needs

• existing community structures

• E.g. village health/dev’t committees

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Situational Analysis…
5. Analysis of health services
• Analyze organizational structure and functions of health
services
• Service facilities
• Service utilization
• Service gaps
• Identify limitations/ bottle necks in organizational structure

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 Situational Analysis…

6. Analysis of resources
• Financial resources
• Personnel
• Material/equipment
• Space/building
• Time
• Information
7. Review of past implementation experience
• Finding out information or experience from activities
implemented in the past
• Success
• Short comings

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Step 2: Problem Prioritization

• is identifying priority health problems

• setting priorities for health services organization in the light of

competing needs and limited resources

• A problem is a difficulty or an obstacle seen to exist between

the present situation and a desired future situation
• It is perceived gap between what exists and what should exist.

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Problem Prioritization…
Grouping of problems

• Environmental problems
• Poor sanitary conditions
• Poor housing conditions
• Inadequate and unsafe water supply

• Diseases/health problems
• Malaria, tuberculosis, HIV/AIDS, malnutrition, respiratory
diseases etc…

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Problem Prioritization…
• Socio-economic problems
• Low per capita income
• Low literacy rate
• Cultural and religious beliefs and values

• Health services problems

• inadequate distribution of health services
• Poor quality and quantity of drugs
• Old medical equipments
• Lack of qualified personnel
• Difficulty in visiting out-reach areas

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 Problem Prioritization…
Criteria for problem prioritization

• Magnitude of the problem: the public health burden

• Degree of severity: consequent suffering, death and
disability
• Feasibility: in terms of cost effectiveness, social
acceptability and local sustainability
• Government concern: political acceptability with
consideration of equity and multi-sectoral approach,
consistency with government plan and budgetary system
• Community concern: how much does it relate to
community perceived health needs?

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Step 3: Setting Objectives
• Answers the question “where do we want to go?”

• Clear statement of objectives enables:

• to decide how to achieve them
• to evaluate how effective one is in achieving and
reaching objectives

• Objectives of a program must be ‘SMART’

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 Step 3: Setting Objectives…
• Specific- an observable action, behavior or achievement
• a rate, number, percentage or frequency.
• Measurable - A system, method or procedure has to
exist to the tracking and recording.
• It allows monitoring & evaluation
• Achievable – capable of being reached.
• likelihood of success but that does not mean easy
• The objectives need to be stretching and agreed.
• Relevant/realistic
• agreement with the general health policy
• relates to the problem to be solved or reduced.
• Its real importance to the organization & the society.
• Time bound (time specific)
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Step 4: Identifying Potential Obstacles &
Limitations

• The limitations may be :

• Resources
• Human –lack of motivation/skill
• Equipment –not available/Expensive
• Money- lack of budget
• Time- people may not be ready to invest their time
• Information- needed for implementation not timely/well
processed

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Step 4: Identifying Potential Obstacles…

• Environmental obstacles
• Geographical features, like, lakes, rivers, mountains
• Climate– affect the nature of health problems
• Technical difficulties
• Social factors- taboos, traditions

• Three groups of Obstacles

• Obstacles that can be removed
• Obstacles that can be reduced or modified
• Obstacles that can’t be changed

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Analysis of the obstacle
Objective Obstacle Analysis
Removed Modified Cannot be
changed
Analysis of obstacles and listing possible remedy

Definition Underlying Possible remedy

obstacle
Step 5: Designing Strategies
• Strategies are the tactics or techniques that should be
devised or adopted & utilized to facilitate the
achievement of objectives & targets
• Strategies are ways of achieving objectives & targets
• Potential strategies often include
• Technology to be applied

• Procedures to be used &

•
• Defining the role of communities and other sectors

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Step 5: Designing Strategies…
• For each chosen strategy, the corresponding activities
to be undertaken & the resources needed should be
detailed.
• What is to be done?

• Who will do the activities?

• Which resources are needed?

• How & When to do it? (beginning, end)

• Where will the work be done?

• The methods of controlling 106

Step 5: Designing Strategies…
Gantt chart
• is a bar graph with time on horizontal axis and the
activities/resources to be scheduled on the vertical
axis

• Columns of a Gantt chart

• list of the project activities
• a column that makes a filed time period showing when the
activities will occur
• Responsible bodies
• Resource column

107
 Gant Chart

Activities Time Responsible Resource Remarks

period body/ies
Sample Gantt chart

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Step 6: Writing Up The Plan

• Purpose of writing a plan

• To request funds or resources from the

government or funding agencies

• For monitoring & evaluating the

implementation process by all concerned

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 Step 6: Writing Up The Plan…

Contents of the plan document

• Summary of main points
• Introduction (General background and Statement of
the problem)
• Statement of the problem explains the rationale for
undertaking the project

• Objectives and targets should be clearly stated

• Strategies & activities should be clearly stated using

Gantt chart
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Step 6: Writing Up The Plan…
• Resources requirement
– The type and number of resources needed should be
documented
– How each of the resources are going to be utilized has to be
mentioned

• Monitoring & evaluation

– Mention how monitoring and evaluation is to be performed
– By whom?
– When?
– Indicators should be decided beforehand

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Exercise
• Prepare Strategic Plan on various programs for hargaisa
Administration, like,
• MCH
• EPI
• HIV/AIDS Prevention & Control
• Environmental Health
• Health Education

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Loading…
Organizing
Organizing…
 Organizing is the function performed after
planning.
 Organizing focuses attention on the structure
and process of allocating jobs

So that common objectives can be achieved.

Formal Organization

• A formal organization is often described by means of

'organizational chart'.
Uses of organizational chart
• Define broad area of responsibility
• Provide a basis for writing job descriptions
• Indicate channels of communication
• Clarify relationships between people
• Avoid complications caused by overlapping of functions
Elements of organizational structure
1. Division of labour
2. Decentralization
3. Authority
Division of labour

• The Concept of departmentation.

• Dividing jobs into departments.

Division…
Reasons and benefit
• Take advantage of specialization
• Facilitate control
• Aid Coordination
• Secure adequate attention
• Reduce expenses
• Recognize human consideration
Decentralization
• Dividing managerial work among the various executives

In order to reduce pressured from the top and secure

quick decisions on the spot.

• Under this concept the top man gives a limited

autonomy to some of his important executives to make
independent decisions on important matters
Authority and Responsibility
• One of the purposes of an organization is to show the
structure of authority, power, accountability, and
responsibility in the organization.

• Authority and power flow downwards, through

organization structure, from the chief executive to the
functional managers to the first line workers.

• Accountability flows upwards from the first line worker

to the departmental manager to the chief executive.
Authority and...
• Authority - is the right to do something or to tell someone else what
to do. Right to decide and command subordinates
• Power - is the ability to do something. In this role as a supervisor a
manager’s power may be seen in his ability to causes subordinates to
do what he wishes them to do.
• Rewards are the positive side of power and
• Punishment is the negative side of power.
Power
• We know that power corrupts people and for
this reason the executive power should be
limited through.
• Policies

• Job description and a system of check and

control.
Staffing

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 Staffing

• This management function includes recruitment,

selection, placement, compensation, training, growth and
development of all members of an organization

• is a continuing activity not a temporary exercise

• Main activities include

• Acquiring
• Retaining – compensate, train, motivate
• Separation – retire, resign, discharge

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 Staffing -

Recruitment
• Attracting people (from outside or inside) to form a pool
from qualified candidates for open job vacancies chosen.

• Discovering the source of human power to meet the

requirement of the organization.

• Source
1.Internal (training and development ).
2.External (employing).
• is a positive process (attracting job applicants)

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 Staffing - Recruitment

• External Recruiting
• Looking outside the organization for people who have not worked
at the firm previously.
• Newspapers advertisements , on-campus recruiting, employee referrals,
and through the Internet.
• Advantages of External Recruiting
• Having access to a potentially large applicant pool.
• Being able to attract people who have the skills, knowledge, and
abilities an organization needs.
• Bringing in new comers who may have a fresh approach to
problems and be up to date on the latest technology.

129
 Staffing - Recruitment …
• Disadvantages of External Recruiting
• Relatively high costs.
• Candidates may lack knowledge about the inner workings of the
organization & May need to receive more training.
• Uncertainty concerning whether they will actually be good
performers.

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 Staffing - Process of Recruitment
• Internal Recruiting
• Managers turn to existing employees to fill open positions
• Benefits of internal recruiting:
• Internal applicants are already familiar with the organization
• Managers already know candidates
• Can help boost levels of employee motivation and morale

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 Staffing - Steps for recruitment ---
• Candidates identified through means such as internal advertisement,
employment agencies, external advertisement, staff appraisal,
education and training institutions or unsolicited letters of
applications, depending on prevailing regulations.

• All applications should indicate post applied for.

• Applications should have relevant copies of certificates and

curriculum vitae.

• A shortlist of possible candidates should be made.

• An interviewing panel shall obtain and assess information on each

candidate to determine suitability for the job.
132
 Staffing -Selection

• Selection is narrowing the pool of candidates by choosing

from those who are recruited.

• Weeding out unsuitable candidates and finally arrive at the

most suitable ones.

• Means of filtering those personnel who are capable of

successfully execute a given task.

• Sources of information are

• Application forms
• Pre employment interviews and testing
133
Selection Tools

134
 Staffing - Selection interview …

• Candidates to be interviewed should be informed of the time, date

and place of interview well in advance.

• In conducting the interview, the panel will evaluate evidence of the

candidates’ capabilities in relation to the job description.

• During the interview the candidates should be informed about the

job and conditions of service.

• An interview form containing issues to look for will be used during the
interview process in order to ensure uniformity in the mode of
assessment

• The best will be selected in order of competency

135
 Staffing -Selection …

• The purpose of interview is to obtain information, to give

Information, and to determine if the applicant meets the
requirements for the position.

• The interviewer judges the applicant’s

1.dependability
2.Willingness and ability to work with others,
3.Interest in the job,
4.Adaptality,
5.Consistency with goals; available opportunities…

136
 Staffing - Selection … interview

During interview
•The manager should not give clauses about what pleases or
not pleases them.

•Should not be argumentative and should try to avoid

premature judgment.

•Should avoid hallo effect (e.g. judging upon appearance).

•Use the job description in determining the important

functional aspects that considered as leading questions to
detect the employee capabilities.
•What are the major recruitment problems in your work
area if any ? 137
 Job analysis

• Systematic process of determining the knowledge, skills and

duties required for performing jobs in an organization
• Helps to know what types of training, skills and experience
employees have; which are useful to recruit new employees.
• The information that is obtained through job analysis is the
source for developing a job description.
• The ways of conducting job analysis include:
1.Observation
2.Questionnaires
3.Interviews
4.Employee recording
5.Combination of methods
138
Job Analysis: A Basic Human Resource Management Tool

Tasks Responsibilities Duties Human Resource Planning

Recruitment
Selection
Training and Development
Job
Performance Appraisal
Descriptions
Job Compensation and Benefits
Analysis Job Safety and Health
Specifications Employee and Labor
Relations
Legal Considerations
Job Analysis for Teams
Knowledge Skills Abilities

139
 Contents of Job description

• Job title – standard title of the person. e.g. Nurse, Doctor, etc
• Date – the revised date of the JD currently on operation
• Job Summary – brief summary of major responsibility of the job holder.
• Duties – central and most important part
• details of activities, responsibilities and functions
• Relationships – shows to who one is accountable
−the titles of persons whose work is supervised by
• Qualification
• detailed description of basic and additional trainings
• Training and development
• The programs for further training and development
• Review and appraisal- frequency and process of appraisal

140
 Providing Contract

• A binding agreement between two or more parties.

• Indicates conditions to be fulfilled by both parties.
• Entails what employee need to fulfill job requirements and the
employer to abide to remuneration and other motivational aspects.
• Contracts are regulated by legal and civil service regulations in most
countries.
• Components of a contract may include:
• terms of service;
• expected output;
• remuneration package
• contract period;
• consequences and arbitration in case of breach of contract.

141
Induction/Orientation

• Includes activities that are carried out by the human

resources department and include:
1.Enrolling new employees in benefit plans,
2.Issuing identification card/badge and
3.Creating a database for the individual.
4.Informing about organization structure and
management process

142
Induction/Orientation …

•The induction training for employees should detail about:

1.The mission, vision and values of the organization.

2.The physical facility and organizational structure

3.Universal precautions and fire & safety programs

4.Employee health service and other HRD services

5.Organizational policies and benefits

6.Department's specific work methods

143
 Importance Of Induction/Orientation

• Builds employees’ sense of identification.

• Helps them gain acceptance by fellow workers.

• Gives them a clear understanding of what they need to

know.

• Familiarize new employees with the entire organization as

well as their own work area and department.

144
Retaining and maintenance activities of HRH
• To retain employees we need to undertake the following
personnel administrative activities:
1.Staff performance appraisal
2.Employee movement within - promotion and transfer
3.Disciplining
4.Compensation and benefits administration
5.Employee assistance and career counseling
6.Training - Process of acquiring knowledge, skill, concept,
rules or attitudes to increase performance of individuals.

145
 Training
• Process of acquiring knowledge, skill, concept, rules or
attitudes to increase performance of individuals.
• There are two types staff training.
1.on job (in-service)
2.off job (off service) training

• The purpose is to improve:

1.Job performance
2.Job satisfaction
3.Quality of service and quantity
4.Efficiency
5.Management
6.Innovation/creativeness 146
 Work place health and safety
• Major contributing factor for retaining a work force.

• Responsibility of the employers to provide a secure and

safe work place for their employees and customers.

147
Discipline (Corrective counseling )
Procedures
Should be based on facts with clear and demonstrable
justifications

Treated consistently.

Progressive and related to behavior

• Unrecorded oral warning
• Oral warning noted in the employment record
• Written warning noted in the employment record
• Suspension from the job- Eg 2 months
• Discharge .

148
 Separation from employment

Why employees leave HSOs/HO?

• Better salary
• Discharge
• Retirement or death etc

• Pre retirement planning :is to prepare employees for

changes at retirement

149
Monitoring
Monitoring

• Monitoring is the day-to-day watch on, or

continuous follow-up of, the on going
activities.
Monitoring…
• Monitoring is one of the tools for evaluation.

• It is regularly checking to see that program activities are being done

as planned.
• The goals of monitoring are:

• To identify any problem early,

• To solve without delaying the progress of the

program.
Key areas of monitoring

1. Adequacy of supply, materials and budget.

2. Training, type, relevance and quality.
3. Quantity and quality of work done.
4. Communication.
5. Supervisory activities.
Steps in Monitoring

1. Collect data to monitor

2. Summarize the data
3. Analyze
4. Action
Evaluation
Evaluation
• “Did we achieve what we set out to do?”

• Comparing the present situation with the past in order

to find out to what extent organizational purposes have
been achieved.
The results of evaluation are expected to show:

• What a program has been trying to do?;

• What actually happened?
• Where the differences/gaps between the plan and the
Actions has happened

• The reasons for the difference/gaps, and

• What needs to be done

Purposes of Evaluation

• To note the shortcomings, deficiencies, duplicities, etc. in

the system. Suitable corrective actions need to be
undertaken.

• To justify the governmental expenditure on a program by

demonstrating its worth and convincing the people that
their money is being well utilized.
Six general reasons why stakeholders may want programs to
be evaluated.

1. To determine the achievements of objectives related to

improved health status.

2. To improve program implementation.

3. To provide accountability to funders, community and

other stakeholders.
4. To increase community support for initiatives.

5. To contribute to the scientific basis for community

public health intervention.

6. To inform policy decisions.

The Process of Evaluation
1. Deciding when and how to evaluate: Planning
2. Selecting objectives and methods to be used: Planning
3. Carry out the evaluation: Data collection
4. Looking of the results: Data analysis
5. Using the results to improve the program: Report and
Application.
The General Approach to evaluate:
• Five Steps:
A. Deciding- what aspects of programs are to be
evaluated/measurecd?
B. Collecting- the information- evidence findings.
C. Comparing the results with targets/objectives.
D. Judging- target/objectives met.
E. Deciding to continue unchanged/changed steps and
finally giving feedback.
Types of evaluation

1. Process Evaluation/Program Monitoring

2. Impact Evaluation

3. Formative/ Diagnostic Evaluation

4. Summative/ Certifying Evaluation

1. Process Evaluation/Program Monitoring

• Document the implementation of a project and

explain cause and effect.

• Checking the progress

2. Impact Evaluation
• Document and explain cause and effect

• Focus on the immediate observable effects of a program

leading to the intended outcomes of a program,
immediate outcomes.

• Requires at least 5 years from the inception of a

program.
3. Formative/ Diagnostic Evaluation
• Any combination of measurements obtained and
judgment made before or during the implementation of
materials, methods activities or programs to control or
assure or improve the quality of performance or delivery.
• Is providing information on progress. It must therefore
be continuously possible.
• Is designed to inform about the amount still has to go
before achieving objectives.
• Measures the progress or gains made from the
beginning until completed.
• Enables activities to be adjusted in accordance with
progress made or lack of it. Therefore, it is a teaching
method.
• Is very useful in guidance and prompt to ask for help.
• Is carried out frequently.
4. Summative/ Certifying Evaluation

• Any combination of measurements and judgments that

permit conclusions to be dawned about impact outcome
or benefits of the program or method.
Who will conduct the evaluation?

• The evaluator may be someone associated with the

program or someone from outside.
• If some one trained in evaluation, who is personally
involved with the program conducts the evaluation, it is
called an Internal Evaluation.
Advantages:
• Making it easier to collect the relevant information,
• Less expensive.
Major Drawbacks:
• Evaluator bias or conflict of interest.
• An External Evaluation is one conducted by someone
who is not conducted with the program.
Advantage:
• Can provide a more objective outlook and a fresh
perspective, and it helps to ensure unbiased outcome of
evaluation.
Disadvantage:
• More expensive.
Practical problems in evaluation
1. The planner failed to build evaluation into program
planning.

2. Adequate procedures cost, time and resources.

3. Changes sometimes come slowly.

4. Some changes do not last.

5. It is often difficult to distinguish between cause and
effect.

6. Conflict can arise between professional standards and

do-it yourself attitudes.

7. Sometimes people’s motives get in the way.

8. It is difficult to properly evaluate multi-level

interventions.