Unit 1B Lab

Leadership Concepts,
Principles and Practices in Public Health

Prepared by:
Diana Leah M. Mendoza, RMT, MPH
Clarenz Sarit M. Concepcion, RMT, MPH

Edited by:
Asst. Prof. Razel L. Kawano, Msc, DrPh
 Learning Objectives:
• Discuss organizational culture, philosophy and
performance in the practice of public health;
• Describe the elements of management
knowledge;
• Differentiate what is a leader and a manager
and their functions
• Describe the 5 functions of management and
decision making;
• Review the steps of managerial problem
solving.
Organizational culture, philosophy and
performance
• These are explicitly linked to organizational
effectiveness;
• Managers move culture in the direction of
values that furthers the organization mission
and vision;
• Organizational philosophy - has the ethical
context in which goods and services are
rendered.
Ethics audit includes:
• Staff survey
• Observations of staff/patient interactions;
• Review of staff commitment
• Selection
• Training
 Health Administration
• Sound administration is essential for the success of any
public health program whether on the national,
intermediate or the local level.

• Every program must have an overall (general) goal

which conforms with that of the nation’s policy, and
various objectives to be achieved according to a
definite plan.
 Goals versus Objectives

 A GOAL: is a long range specified state of

accomplishment towards the activity it is directed.

 AN OBJECTIVE: is a measurable state of accomplishment

aimed towards the goal.
 Leadership Functions
Initiating
• Briefing team on the aims and the plans
• Explain why aim or plan is necessary
• Allocating task to team member
• Setting team standards
 Leadership Functions
Planning
• Require skills seeking all available
information.
• Setting a vision, goals and objectives
• Thinking about work breakdown structure
and putting the whole lot together in a
schedule.
• Seeking all available information
• Defining group task, purpose of goal
• Making a workable plan (in the right decision
framework)
 Leadership Functions

Communication
• Brief the team on the goals and explain they key
issues behind the project vision.
• Providing latest data and information
• Clarifying particular needs and developing ideas.
 Leadership Functions
Personnel support
• Recognizing good performance
• Provide guidance, coaching and other advise as
necessary
• Leadership development within the team for
future success.
• Include any disciplinary action as necessary.

Delegation
• A lot to think a lot to organize by delegating
his/her work
 Leadership Functions
Supporting
• Expressing acceptance of persons and their
contribution
• Encouraging team/ individuals
• Disciplining team/ individuals
• Creating team spirit
• Relieving tension with humour
• Reconciling disagreements or getting others to
explore them.
 Leadership Functions
Informing
• Clarifying task and play
• Giving new info to the group, keeping them in the
picture
• Receiving information from the group
• Summarizing suggestions and other ideas coherently

Evaluating
• Checking feasibility of an idea.
• Testing the consequences of proposed solution
• Evaluating team performance
• Helping team or individual to evaluate their own
performance against the standards.
Managers performance include:
• Set standards
• Coordinate and integrate
workgroups
• Make decisions
• Design the organization affecting
performance
• Clear value systems
• Model appropriate behavior
 Managing has 4 main elements

1. Process that comprised of interrelated

social and technical skills functions and
activities;
2. Accomplish organizational objectives;
3. Achieves objectives through use of
people and other resources;
4. Does so informal organizational setting
 Management
• Management is the operational part of
administration.
• It is defined as:
• “ It is a set of interactive processes through
which the utilization of resources results in
the accomplishment of organization
objectives.”
• It is a “conversion mechanism”.
 Management Skills and Roles
Roles
Skills • Interpersonal roles of
• Technical Skills – ability to figurehead, leader and
use methods, process, and liaison derive authority of
techniques of managing. the manager.
• Conceptual Skills – mental • Informational roles include
ability to see how various monitor, disseminator, and
factors in a given situation fit spokesperson.
together and interact. • Designer role is similar to
• Human and interpersonal that of the management
skills – include cooperating function of organizing.
with others, understanding, • Strategist role, specific
motivating and leading. focus on how to adapt
their organizational
domains.
 Leadership and Management
Manager– is an individual who deals with all
functions of managerial, planning, organizing,
controlling, staffing and coordinating other
individuals for achieving best results of
organizational goals.

Leader – Carries out particular function as part of

task completion and the management of team.
 Management functions and decision making

5 management functions-
Planning
Organizing
Controlling
Directing
Staffing

These are all connected to decision making- an

inherent activity of managers within those functions
above.
 Managerial Functions

Planning

Control
Control Management Leading
function

Organize Problem solving

Management solving
Potential problem solving
 4 Basic Functions
1. Planning – relates to decisions on about the
present & the future. It relates to how resources
should be efficiently allocated.
2. Leading - deals with proper communication of
goals and plans and motivating employees how
to achieve them.
3. Organizing - managers have to decide the
optimum usage of resources.
4. Controlling - keeping a check on the progress
of plans and performance.
 Organization
• Definitions:

• “ Organization is any collection of persons,

materials, procedures, ideas or facts arranged
and ordered that the combination of parts
makes a meaningful whole that works towards
achieving organizational objectives.”

• “The process of organization implies to the

arrangement of human and non-human
resources in an orderly fashion to make a
meaningful whole that accomplishes
organizational objectives.”
The organizational process is classified into:

• Structural organization
• Functional organization
Levels of Organization Designs in
Public Health Organizations
Managing in the Health Services Environment

Health Services composed of

Health Services Organizations

Health Services Organizations

Clusters of workgroups (HSO’s Clinical staff

Workgroups (departments, teams)

Individual Positions
Adopted from: Rakich, Jonathan et.al., Managing Health Services Organizations and systems, 4th
ed., (Baltimore Health Professions Press 2000). p112
 Principles of organization:
• Departmentation
• Acquisition of human and non-human resources
• Specialization and division of labor
• Coordination
• Authority and responsibility
• Centralization and de-centralization
• Unity of command
• Line and staff
 Levels of
Administration

Central
level Ministry of health

Intermediate directorates of health

level

Local Level e.g. health office,

Hospital, health
care unit
 Elements of Administration:

• Planning • Reporting
• Organization • Budgeting
• Staffing • Supervising
• Directing • Evaluation
• Coordinating
 Staffing
• It is the process of “personalizing” the
organization, by hiring the right type and
adequate number of workers to each unit
for the time required for the program,
through the following steps:
• Identifying the type and number of personnel
• Recruitment
• Selection and appointment
• Orientation
• Job analysis
• Job description
• Job specification
 Budgeting
• Financial administration consists of a series
activities were funds are made available
for certain people in the organization
under procedures that will ensure their
efficient use.
• The main activities are:
• Budgeting
• Accounting
• Auditing
• Purchasing
• Budgeting:

It is the allocation of financial resources in

support for programs or projects for a
special period of time.
A budget is defined as “a balanced
estimate of expenditures and receipts for a
given period of time”.
 Accounting:

“It is recording assembly and

summarization of financial effects of
.
executive action a harmonious
relationship between budget and
account is important to current
comparisons, between goals set in
and accomplished.”
 Auditing:

“It is the investigation and report

on the fidelity and legality of all
financial transactions”.
 Purchasing

“It is the acquisition of the property

and materials needed in
administration”.
 Supervision
• Supervision refers to the day-to-day relationship
between an executive and his immediate
subordinates.
• Supervision aims at satisfying both:
• Work
• Workers
 Supervision
• Motivation is defined as: “an
externally induced behaviour
which occurs in order to bring
about or maintain need
fulfillment”.
• The following conditions if present
build high levels of motivation:

•Achievement •Organizational policy

•Recognition •Technical supervision
•Advancement •Interpersonal relations
•Working conditions •Salary and compensations
•Responsibility •Job security
 Supervision
• Styles of leader authority:
• Autocratic
• Consultative
• Participative
• Democratic
• Free rein

• Factors affecting style of supervision:

• Condition present
• Type of work
• Subordinates characteristics
• Personal characteristic of manager
 Evaluation
• Definition:
“systemic collection of information about the
activities, characteristics and outcomes of
programs, personnel, and products for use by
specific people to reduce uncertainties, improve
effectiveness and make decision with regard to
what those programs, personnel or products are
doing and affecting.”
 Types of Evaluation

Structure

Process Outcome
/impact
 Facilities/
Equipment/
Manpower/
organization
Structure
Types of evaluation

Evaluation Performance
of staff/ way
procedures
Program are done
planning
Program Program
impact Implementation

Measurable
Indicators +
Health related
Process or
impacts
Formative evaluation
Impact or
summative
Evaluation
Elements of Evaluation
• Relevance
• Adequacy
• Accessibility
• Acceptability
• Effectiveness
• Efficiency
• Impact
 Steps of Evaluation
(1) Describe the program in terms of objectives
expected. Objectives can be either outcome or
process objectives.
• Outcome objectives: “a statement of the amount
of change expected for a given health problem
for a specified population within a given time
frame”
• Process objectives: “a statement of the amount of
change expected in the performance and
utilization of interventions that impact on the
outcome.”
 Steps of Evaluation

• (2) specify the evaluation design.

• Define the purpose of evaluation
• Define the methodology of evaluation (census/
client records/ interviews/ surveys/ expenditures
reports).
• Define who will be making use of the data
(audience/ policy makers).
 Steps of Evaluation

(3) gather credible evidence (information):

Types of data include:
• Demographic description
• Indicators of health status (morbidity, mortality,
disability)
• Qualitative indicators ( community values,
public and private policies)
• Utilization indicators
• Expenditures
 Steps of Evaluation
(4) Analysis and justification of results

• What does the findings mean?

• How do they compare to the objectives?
• What is the degree of success of the program?
• What recommendations are indicated for
program improvement?
 Steps of Evaluation

(5) Taking action

Evaluation findings has to be used and shred for the
purpose of improvement of the effectiveness of the
program. “evaluations that are not or inadequately used
are simply not worth of doing”.

(6) Re-evaluation

Evaluation is an ongoing process.

Decision Making Process
 Approaches in making decision
1. Routine approach - previously utilized (i.e.
SOP)
2. Scientific approach (Kepner & Trogel)

In decision analysis:
Pay attention to the objectives for decision
Must: mandatory (must be achieve to guarantee successful
decision)
Wants: How the alternatives perform relative to each other
 Problem Solving

Decision
Making

Pre-decision
situation assessment

Post-decision
Identifying &
alternative
evaluating Alternative
solution,
alternative choice
implementation
solutions
and evaluation
 Problem Solving

• The circumstances that surrounding problem

solving are often complex, unstructured and
nonroutine thus, making it difficult and time
consuming.
• The process is essentially the same regardless of
problem type, scope, time involved, intensity of
analysis.
 Problem analysis
Divided into:
a. Problem recognition and definition – problem
solving under condition of deviation occurs
where actual results are inconsistent.
Ex: quality of service, increase customer
satisfaction, program objectives, improving of
staff performance.
3 stages: Gestation and latency
Categorization
Diagnosis
b. Developing problem statement
The four basic patterns of thinking of managers:
• Problem analysis
1. What is going on?
2. Why did these things happen?
• Decision analysis
3. Which course of action should we take?
• Potential problem analysis
4. What lies ahead?
Problem Solving Process Model
 Decision Making

Ends
Training
Means

Management
Programmed
Non- Administrative
programmed Operational

Planned
Technical SOPs
Interrelationship of decisions making and
the five management
Organizing
Developing intentional patterns of
relationships among people and
other resources

Planning Staffing
Deciding in advance Acquiring, maintaining, and
retaining human resources
what is to be done
Decision
Making
Controlling Directing
Regulating activities in Initiating work in the
accordance with plans organization
Decision Matrix for Evaluating Alternative Solutions
Decision Criteria Alternative Alternative Alternative
solution 1 solution 2 solution 3
Must meet these requirements 3 5 5
1. Solution effectively solves the problem
2. Feasibility of implementations 5 3 5

3. Cost benefit analysis 5 5 3

4. Advantage-disadvantage analysis 3 3 5

Wants to meet requirements 1 3 3

5. Political acceptability
6. Criticalness 1 3 5

7. Timeframe 1 3 5

8. Opportunity costs 5 1 3

9. Monetary costs 3 5 5

Total 27 31 39

Key: 5 = solution fully meets decision criterion Adopted from Arnolds, john et.al, The Complete
3 = Solution partially meets decision criterion Problem Solver. A Total Systems for Competitive
1 = Solution fails to meet criterion Decisions Making (NY John Wiley & Sons, 1992). P62.
“ The MUSTS decide who gets to play,
but the WANTS decide to win”.
Thank you!!