FUNDAMENTALS OF HEALTH SERVICES ADMINSTRATION

Provision of health service to people is a very important aspect that requires proper
management and administration so as to save lives and promote good health.
DEF .Administration Process of organising effective, efficient utilisation of resources
(manpower, material, money) so as to direct activities towards achieving certain goals of an
organisation.
H.S.A means mobilising and using resources efficiently in delivering effective public health
services through the development of budget, developing policies and implementation
directing and co-ordinating services in health services institutions.
GOALS OF HEALTH SERVICES ADMINISTRATION
1. Ensure delivery of quality services to clients.
2. Ensure proper use of available resources.
3. Ensure accountability in services delivered.
4. To ensure an uninterrupted delivery of services (health).
5. Equitable distribution of available resources.
6. Promote and maintaining good health.
7. Respond to the demands of the clients.
8. Promote and maintain good image of the organisation.
RESPONSIBILITIES OF A HEALTH SERVICE ADMINISTRATOR
 Is a public relations officer (promotes interrelations between public and health
workers.)
 Spokesperson of the institution.
 Procurement of materials.
 Recruitment and placement of staff.
 Does outward communication of the Organisation.
 Provision and allocation of accommodation.
 Allocation of duties
 Supervision of staff.
 Maintenance of equipment.
 Prepares annual budget.
 Keeps the asset register.
 Staff appraisal
 Maintains stuff discipline.
 Promote good occupational health and safety of workers.
 Disposal of absolute equipment.
 Burial of paupers.
MANAGEMENT

MANAGEMENT - is a set of principles relating to the functions of planning, organizing,

directing and controlling, and the application of these principles in harnessing physical,
financial, human and informational resources efficiently and effectively to achieve
organizational goals.

Elements of Management Process

Staffing

1. Planning

Planning is the primary function of management. It involves determination of course of

action to achieve desired results/objectives. Planning is the starting point of management
process and all other functions of management are related to and dependent on planning
function. Planning is the key to success, stability and prosperity in business .It acts as a tool
for solving the problems of a business unit. Planning plays a pivotal role in business
management. It helps to visualize the future problems and keeps management ready with
possible solutions.

2. Organizing

Organizing is next to planning .It means to bring the resources (men, materials, machines,
etc.) together and use them properly for achieving the objectives. Organization is a process as
well as it is a structure. Organizing means arranging ways and means for the execution of a
business plan. It provides suitable administrative structure and facilities for execution of
proposed plan. Organizing involves different aspects such as departmentalisation, span of
control delegation of authority, establishment of superior- subordinate relationship and
provision of mechanism for co-ordination of various business activities.
3. Staffing

Staffing refers to manpower required for the execution of a business plan. Staffing, as
managerial function, involves recruitment, selection, appraisal, remuneration and
development of managerial personnel. The need of staffing arises in the initial period and
also from time to time for replacement and also along the expansion and diversification of
business activities. Every business unit needs efficient, stable and cooperative staff for the
management of business activities. Manpower is the most important asset of the business
unit. In many organizations, manpower planning and development activities are entrusted to
personnel manager or HRD manager. Right man for the right job is the basic principle in
staffing

4. Directing (Leading)

Directing as a managerial function, deals with guiding and instructing people to do the work
in the right manner. Directing/Leading is the responsibility of managers at all levels. They
have to work as leaders of their subordinates. Clear plans and sound organization set the stage
but it requires a manager to direct and lead his men for achieving the objectives. Directing
functions is quite comprehensive. It involves communicating, leading and motivating.
Leadership is essential on the part of managers for achieving organizational objectives.

4. Coordinating

Effective coordination and also integration of activities of different departments are essential
for orderly working of an organization. This suggests the importance of coordinating as
management function. A manager must coordinate the work for which he is accountable.
Coordination is rightly treated as the essence of management. It may be treated as an
independent function or as a part of organisms function. Coordination is essential at all levels
of management. It gives one clear cut direction to the activities of individuals and
departments. It also avoids misdirection and wastages and brings unity of action in the
organization. Coordination will not come automatically or on its own. Special efforts are
necessary on the part of managers for achieving such coordination.

5. Controlling

Controlling is an important function of management. It is necessary in the case of individuals

and departments so as to avoid wrong actions and activities. Controlling involves three broad
aspects:
(a) Establishing standards of performance,

(b) Measuring work in progress and interpreting results achieved.

(c) Taking corrective actions, if required. Business plans do not give positive results
automatically. Managers have to exercise effective control in order to bring success to a
business plan.

Control is closely linked with other managerial functions. It is rightly treated as management
processes. It is true that without planning there will be nothing to control. It is equally true
that without control, planning will be only an academic exercise. Control is a continuous
activity of a supervisory nature.

6. Motivating:

Motivating is one managerial function in which a manager motivates his men to give their
best to the organisation. It means encouraging people to take more interest and initiative in
the work assigned. Organisation prospers when the employees are motivated through special
efforts including provision of facilities and incentives. Motivation is actually inspiring and
encouraging people to work more and contribute more to achieve organizational objectives. It
is a psychological process of great significance.

7. Communicating:

Communication (written or oral) is necessary for the exchange of facts, opinions, ideas and
information between individuals and departments. In an organisation, communication is
useful for giving information, guidance and instructions. Managers should be good
communicators.

They have to use major portion of their time on communication in order to direct, motivate
and co-ordinate activities of their subordinates. People think and act collectively through
communication. According to Louis Allen, ‘’Communication involves a systematic and
continuing process of telling, listening and understanding’’.

Management levels

The levels of management are basically stratified into three which are:

 Lower level/First line managers

 Middle Level managers

  Top level Managers

Top Level management

Middle level Management

Lower level management

1. Lower/first level managers

These are the first in the line of management. They link the employees/workers with the
middle level managers .Responsibilities include uniting and co-operating workers.

They also make short term plans .They include supervisor .They closely monitor the
employees and can make recommendations for promotion or demotion.

2 .Middle managers

These are divisional or departmental managers involved in such activities as purchasing,

production or marketing .They direct activities of lower level managers and sometimes also at
times of those operating employees.

Key responsibility is to direct activities that implement the organisation’s policies and
balance the demand of supervisors with the capacities of their subordinates.

3 .Top managers
These are a few or small group of executives. The top management is responsible for the
entire organisation. They formulate operating policies, long term plans and guide the
organisational interactions with the external environment.

PRINCIPLES OF MANAGEMENT AND ADMINISTRATION

FUNDAMENTAL PRINCIPLES

Fundamentals are the basics therefore fundamental principles are the basics or the foundation
of management. The fundamental principles relate to responsibility, delegation of authority
and communication.

1Delegation

It is necessary for effective management particularly as you go up the ladder. Delegation is

necessary as no one can do everything by himself/herself.

2 Communication

There must be established flow of information through the formal channels in an

organization. Management should ensure that subordinates have necessary information
concerning the organization this enables them to perform the duties well. Quick flow of
information facilitates problem solving.

MANAGEMENT BY OBJECTIVES (MBO)

It is a planning tool that can be used in an organization. It begins with goal setting and
continue through performance review. The key to MBO is that it is a participatory in which
everybody in the organization is involved. In MBO each department’s major areas of
responsibility are clearly defined in terms of measurements results or objectives. These
objectives are used in planning work activities by each department.

THE HUMANITARIAN PRINCIPLES

The humanitarian principles states that employees should be considered as humans thus they
also have rights, though they are workers. The principle deals with democracy, justice and
human relations.

1 Democracy
Management should be democratic to their subordinates. They should involve the subordinate
in the decision making as the decisions made by the management affect the employees. It
might not be practical to hear the decision of each individual in the organization but they can
have representatives. Involvement of subordinates in decision making motivates them in one
way or another.

2 Justice

Equity and fair play should be ensured by the management. Justice should be applied without
favour or fear within an organization. At the same time tr policy ansparency should avail.

3 Human Relations

Management should have interpersonal relations with the subordinates so as to get the best
out of all of them. This is usually common to managers with an open door communication
policy.

BUREAUCRACY PRINCIPLE

Relies on rules, set of a hierarchy, and clear division of labour and detailed procedure. Max
Weber (1864-1926) who was a Germany Social Historian is mostly closely associated with
the bureaucratic management theory, so named as he based his work studies on Germany’s
governmental bureaucracy. Bureaucracy is a principle that implies the following of the laid
down rules regulations of the organisation. There is a clearly indicated chain of command and
the subordinates to whom he/she is answerable. There is a clear system of promotion in a
bureaucratic management, the system usually favours the next person in the hierarchical line,
after following certain procedures and channels. The main limitation of bureaucracy is that it
is rigid and decision making takes a lot of time. Because of this it is difficult to respond
quickly to adapt changes in the environment in which the organisation is operating.

PRUDENTIAL PRINCIPLES

The principle illustrates the ability of management to utilize and control resources cautiously.
It expects the management to consider loyalty and economy in the running of the
organization.

1 Loyalty
The management should be loyal to the organization and ensure that subordinates are also
loyal to the organization; Respect of senior officials in the organization is one way that is
used to indicate loyalty to the organization.

2 Economy

Resources of the organization are also limited therefore each member of the organization
should utilize the resources in a manner that is loyal. This entails avoiding pilferage by
members of the organization.

PRINCIPLE OF CHANGE

The principle of change entails adaptability, flexibility and stability.

1 Adaptability

Every organization should be able to adapt to changes in the environment in which it

operates, for example the organisation should adapt to changes in technology. Changes in the
environment need to be explained to the employee so that they do not resist the change.

2 Flexibility

It implies to an ability to respond to changes quickly. An organization with a rigid structure

usually takes time to respond to changes.

3 Stability

the organization with a stable workforce is stronger and can survive for a long time.
Workforce stability can be archived through retention of personnel. Training of new workers
is time consuming and expensive.

LEVELS OF HEALTH CARE. (At which level are health services offered?)
Health care is the prevention, treatment, and management of illness and the preservation of
health through the services offered by health care organisations and professionals. It includes
all the goods and services designed to promote health, including “preventive, curative and
palliative interventions, whether directed to individuals or to populations”
PRIMARY CARE
  Primary care is available in clinics of rural and urban areas and caters for minor
ailments and surveillance is also done at grass roots and no admissions done here .
 Management involves a community based workers and village health workers
 On miner ailments e.g. miner cases common colds and flues. Also offers
comprehensive PHC package which include H.I.V testing, counseling, PMTCT,
material and child health care, water and sanitation, treatment of minor ailments,
health education, nutrition and provision of essential drugs. Health workers at this
level include nurses. E.H.T., nurse aids and grounds man.
 Complicated cases are referred from this level to the next level which is secondary
level
SECONDARY CARE

 Mostly deals with cases referred from primary level

 Also cares for specific problems and needs a medical practitioner.
 Admissions are also done at this level
 Mainly consists of district hospitals, private hospital, private surgeries, nursing
homes, rural hospitals, small mission hospitals with beddings
 Health workers at this level include doctors, nurses, laboratory scientists,
rehabilitation technicians, administrators, pharmacists nurse aids and general hands.
TERTIARY CARE

 Mainly consists of provincial hospitals e.g. Marondera, Mutare, Chinhoyi etc.

 Mainly deals with cases referred from secondary level.
 Admissions also done here.
 At this level there is use of more sophisticated medical equipment and specialists.
 Also responsible for referring patients to the next level.

QUARTERNARY CARE

 Last level in health care delivery system in Zimbabwe.

 This is also considered to be an extension to the tertiary care which handles more
complicated cases and is managed by specialist e.g. [transplantation of organs]
(plastic surgery).
 Such hospitals include Parirenyatwa hospital, Harare hospital and Mpilo.

RELATIONSHIP BETWEEN HEALTH ADMINISTRATION AND OTHER

DEPARTMENTS.
Health services department remains a key driver towards success of all health programmes.
The department links all departments.
 All departments forward requests to the health admin department.
 All departments forward complaints and requests
 H.S.A does appraisal for all departments.
 All departments forward plans and budgets to the H.S.A
  H.S.A Coordinates meetings and activities.
 H.S.A Facilitates communications in all departments.
 H.S.A Provision of all essential resources required by all departments.
 Ensures the functionality of all departments.
Identify and explain different departments and their roles at a hospital.
HEALTH SERVICES PROVIDERS IN ZIMBABWE
 Health services providers simply means institutions, organisations and individuals
rendering health services to the general populace.
 In Zimbabwe the major health service provider is the government through ministry of
health and child care
 Local authorities both urban and rural also play very important role in providing
health services
 Missions throughout Zimbabwe provide health services in clinics and hospitals.
 There is a significant increase in individual service providers in recent years as there
are hospitals, surgeries, clinics and pharmacies offering health services.
 There are other nongovernmental organisations and donors providing health services
in Zimbabwe.
Analyse each health service provider in terms of quality of service, payment for service
system and funding.
COMPLIANCE ISSUES
REGISTRATION FOR HEALTH INSTITUTIONS
 All health institutes in Zimbabwe, private or public are required to be registered
and licensed by the health professions authority as required by the health
professions act chapter 27: 19 of 2000.
 Institutions that must be registered includes the following, clinics, pharmacies,
Surgery and dental clinics and any other institutions offering health services.
FUNCTIONS OF HEALTH PROFESSIONS AUTHORITY IN ZIMBABWE.
 Administers the health profession act chapter 27 : 19 of 2000
 It is mandated to inspect all health institutions across the country.
 It keeps registers for all registered health institutions.
 Formulate, develop and implement measures and policies designed to coordinate and
integrate the functions and operations of the health professions and ensure the
provision and promote the enhancement of efficient professional services by members
of the health professions.
 It collaborates with all councils and advices all councils on matters pertaining to
practise, control, discipline, education, training and examinations and minimum
standards required from any premises in or at which members of any health
professions practise their professions or calling.
  Encourage dialogue between government, the authority and councils and implement
government policy on matters relating to health professions.
 To convene annual conference in terms of section 20.
 To mediate and settle any disputes arising from councils or council and a registered
person.
 The health professions authority is the umbrella board for seven councils namely
nursing councils Zimbabwe, Environmental health practitioner council, medical and
dental council, Pharmacist Council, Medical Rehabilitation Council, Allied Health
Practitioner and scientist council.
PROCEDURE FOR REGISTRATION OF HEALTH INSTITUTIONS.
STEP 1
 Upon completion of the intended premises, it should be inspected and a report posted
to a relevant council.
 At the relevant council, the report is forwarded to the practise control committee, to
check the appropriateness basing on minimum requirements.
 Once the practise control committee from the relevant council is satisfied with the
application, they will forward the same application to the health Profession authority.
 The health profession authority will carry out an inspection for the institution, after
the inspection a report is produced and tabled before the health profession authority
registration committee for consideration.
 Once the health profession authority registration committee is satisfied, they will
recommend the registration of the institution.
 The institution should pay registration fee which vary by the type of the health
institution.
 Once payment is done the institution will be issued with a registration licence for the
running year. The licence should be renewed annually.
HEALTH SERVICES INSTITUTIONS LICENCING AUTHORITY
A. MEDICAL CONTROL AUTHORITY OF ZIMBABWE
 It administers medicine control act Chapter 15 :03
 Regulates procurement, selling of registered medicines/drugs, and importation of
drugs, storage and manufacturing of medicine.
 Responsible for licensing all institutions that intend to procure, sell or manufacture
medicine.
B. MEDICAL AND DENTAL COUNCIL
 Responsible for registering all institutions that may intend to offer dental services.

C. ENVIROMENTAL HEALTH PRACTITIONERS COUNCIL.

 Responsible for preliminary inspection of all health institutions intended to operate.
 The main purpose for inspection is to ensure that minimum requirements have been
met.
  When satisfied write a recommendation report is produced and forwarded to relevant
authority for action.
 Also responsible for registering all environmental health practitioners.
D. LOCAL AUTHOURITY
Administers city by laws to check whether health institutions constructed complies with the
local authority by-laws in terms of location, sanitary requirements and infrastructure.
E. MEDICAL REHABILITATION COUNCIL
 Responsible for the licensing of all institutions intending to offer rehabilitation
services.
F. MEDICAL LABORATORY SCIENTIST COUNCIL
 Responsible for registering all institutions that may intend to offer laboratory
services.
G. NURSES COUNCIL
 Responsible for licensing of all institutions that may intend to offer nursing
service’s e.g. maternity clinics.
NB: COUNCILS DO NOT OFFER LICENSING BUT RECOMMEND THAT A
LICENSE BE ISSUED THROUGH THEIR PRACTICE CONTROL COMMITTEE.
Outline the procedure for registration of health personnel.
Justify giving seven reasons for the registration of health institutions and health
personnel.
DELIGATION
Is the assigning of duties to subordinates.
 Subordinates are given the right to make decisions and act in different situations.
 When delegating it is good to give the subordinates adequate decision making power,
to carry out the task effectively.
Delegation is important for the following reasons.
 It enables the managers to relieve themselves from other duties and carry out other
managerial tasks.
 It’s a way of training subordinates.
 Motivates subordinates.
 Enables employees to be committed to the objectives of the organisation.
 Allows equitable distribution of duties.
 Improves confidence of the subordinates.
PROBLEMS IN DELEGATION. :(From managers view).
 Some managers are corrupt such that delegation will reduce their corrupt activities.
 Some managers fear that subordinates can perform better than them after delegation.
 Some managers have an attitude that no one can do better than me.
 Some managers doubt the ability of their subordinates.
(from subordinate’s point of views).
 Other subordinates feel managers may over delegate.
 Some subordinates feel that they are not capable.
 Some subordinates feel fear of losing their jobs.
 Some subordinates are not rewarded for their efforts after good performance and they
are reluctant to take extra duties.
CRITERIA FOR EFFECTIVE DELEGATION.
 Define the task; confirm from yourself that the task is suitable for delegation.
 Do proper selection of what is to be delegated.
 Select the individual or team.
 Assess ability of the selected individual.
 Training- sometimes there is need to train the subordinates before delegation.
 Communication- Employees must be informed and understand the purpose of
delegation.
 State results required.
 Discuss and agree on the resources required to get the job done.
 Agree on deadlines.
 Adequate rewarding system must be implemented where subordinates performed
well.
 Managers must remain accountable.
SUPERVISION.
 A process of inspecting and directing performance of subordinates.
IMPORTANCE OF SUPERVISION.
 Identify weaknesses in the system and improve.
 Good for maintenance of standards.
 To check for appropriate use of resources.
 To improve performance of works and system.
 To check progress.
 To serve time and resources.
 Delegating duties
Support and Supervision
 Support, it is the exercise of giving extra effort or assistance to ensure a task is
successfully accomplished.
 Support means something is already being done.
 Supervision is a process of inspecting and directing performance of activities by
subordinates
Why do we need support and supervision in H.S.A
 To check for weakness and improve.
  Done to maintain standards.
 Identify challenges in running programs and rectify them.
 Improve performance of workers and system.
 Done to ensure efficient use of available resources
 Check if progress is meeting the targets stated
Programs that need regular support and supervision
a) Immunisation
 To check that vaccines are available and adequate and that the program is running
well.
 Supply requirements for the program transport, cards, manpower and vaccines.
 The most important thing in immunisation is to check regularly, the cold chain
maintenance.

b) supply of essential drugs

 This is done to check the stock control of drugs to check under stocking and
overstocking of drugs.
 Check use of drugs.

c) performance management
 done to check on performance of subordinates
 Update staff on new procedures.
 concerns and complains of workers and their duties

d) Water and sanitation.

 This include waste management, all health institution require a constant supply of safe
water and sound sanitation in order to function properly.
 Handling and disposal of medical waste is a critical issue that needs regular
monitoring and supervision.

LEADERSHIP
 Leadership is the ability to influence, motivate or direct others towards attaining a
certain goal.
 Effective leaders work with subordinates and core works to create vision and
strategies as means to achieve the organisational goals.
 The success of organisation depends on the leadership style that is there.
 Leaders exercise some power so as to influence their followers.
Types of powers
a) Legitimate power
 Here the influence is based on one’s position in the organisation and this is known as
legal power by virtual of position, or acceptance of set of rules such as constitution,
statutory instrument.
  Those who possess this type of authority are able to issue commands and are able to
be obeyed by others because subordinates or others who are bound to set regulations
which support the authority.
b) Reward power
 This is influence that comes from leader’s ability to satisfy the followers.
 Subordinates will satisfy the leader in the hope that their good behaviour will be
rewarded.
 The leader will reward favourable job assignments preferred vacations schedule,
promotions and training etc.
c) Cohesive powers
 Is the ability to use fear and punishment to subordinates
 Subordinate may respond to cohesive power by false finding reports on statements.
d) Referent power
 Is power based on follower’s identification of the leader.
 Leaders with admirable characteristics charisma or excellent reputation usually
possess this type of power.
e) Expert power.
 This power is based on the knowledge of a person.
 Subordinates works on recommendation based on his power or knowledge.
f) Traditional power
 Is type of power usually inherited.
 Subordinates are controlled by feelings of loyalty or obligation for long established
position.
LEADERSHIP STYLES.
1) Democratic
 This is subordinate centred leadership style.
 This is where leader makes decisions after consulting the subordinates.
It motivates the subordinates to want to make better and to achieve organisational
goals by being consulted, responsible and accountable.

2)Pseudo-Democratic
 Leaders claim to be democratic yet it is autocratic.
 The leader preaches democracy which he/she never implement.
 Leaders consult subordinates for suggestion and opinions that are never utilised.
 Invites subordinates to air their views, complains and concerns, just to understand
their feelings and do nothing to improve them.
 In the long run this leadership style demotivates workers.

3) Autocratic
 This is boss centred leadership style.
 Leader dictates on subordinates and makes decision for them and does not consult.
 The leader emphasis more on accomplishment of work and not concerned about
welfare of subordinates.
 This leadership style is more suitable in army.

4) Laissez faire.
 This is a free for all leadership style.
 The leader takes passive stance and with this type of leadership style there is low
concern of the work and employees.
 This style is suitable for people who are self-driven to achieve their goals such as
professional researchers and those who work on commissions.

5) Transactional.
 The leader is both concerned with organisational goals and the subordinates’ welfare.
 The leader tries to integrate the two.

6) Situational
 The leader links behaviour with groups ready to work.
 The prevailing situation usually determines the type of leadership to use.
 Leadership can be confusing while behaviour is changing unpredicted
.
7) Charismatic.
 This is where leaders influence others through power of personality, admirable
characteristic and excellent reputation.
 Acts energetically, by motivating others to move forward in achieving organisational
goals.
 More suitable where the organisation want to expand its position in the market place.
 It is also good when you want to raise team moral.

8) Transformational.
 This is type of leadership where leaders need to transform if it is not comfortable.
 Leaders serves as role model for all involved.

9) Traditional
 This type of leadership is inherited.
 It is based on the belief that power is restored in the leader in keeping what the
traditions of the past both leaders and subordinates share the same view.
 Followers are promoted based on favouritism and office politics.

10 LEGAL
 Type of leadership in which the authority of an organisation or ruling is
rational.
 The power of leader is guided by set of rules and regulations of the
organisation.
DERTEMINANTS OF LEADERSHIP STYLE.
a. TYPES OF SUBORDINATES OR WORK GROUP.
 Where there are professional, the assumption that they desire great initiative and
decision making. (Democracy).
 They feel frustrated if not involved in decision making. On the other hand a less
educated and a less competent group needs more guidance and greater authotarianism
 A group that lacks experience who find difficulty to make decision hence consulting
is not necessary
b. TASK
 The nature of work to be done also determine the style to use where the work done
is paid on commission. (LAISSEZ FAIRE)
 Where the work requires immediate results (Autocratic)
c. ENVIRONMENT
 Every situation have accepted norms, hence types of leadership is determined by
norms, tradition and culture of that environment.
d. QUALITIES OF THE LEADER
 Usually the personality of the leader will determine the type of leadership style.
e. TIME AVAILABLE
Usually when there is no time available it is difficult to use autocratic leadership style

PLANNING
 Is the process of deciding in advance what is to be done.
 A process of establishing goals and suitable actions to be taken in order to achieve
stated goals.
IMPORTANCE OF PLANNING.
 We plan so that we set goals.
 To aim at equitable distribution of resources.
 To mobilise resources (money, man power, material)
 To monitor and evaluate.
 Helps to maintain order in the way things are done.
 Allows scheduling of activities.
 Acts as a guide.
STEPS IN PLANNING
1 Establishing objectives
 Objectives are set from the general goal/broad objectives when formulating objectives
we must follow the S.M.A.R.T Concept.
 S- Specific be clear about something.
 Measurable- in terms of number.
 Attainable/Achievable –set objectives that you are able to do.
 Realistic/Results oriented-results should be seen.
  Time framed –when are results expedted.
2 Define the present situation
 Have a full/clear explanation of the current situation in terms of what is available at
the moment what current problems are we facing and the major causes.

3 Determine aids and resources

 look at the internal environment that is in the internal/external environment
 try to combine both internal and external environment in terms of resources in order
to solve problems

4 Develop a set of action

 Come up with possible action and select the most suitable this is set on all
alternative
 a decision have to be made and finally implemented

5 Decide about monitoring and evaluation

 It involves tracking down day to day activities of the organisation to check that they
confirm to organisation specifications.
 evaluation is the assessment/ performance of program to determine whether it is
on track of set objectives any deviations or identified and a major action being
taken.
Evaluation comes in two (2) forms
 Continuous evaluation and Terminal evaluations
 Continuous evaluations is done during implementation while terminal is done at the
end of the project.
Barriers to effective planning in H.S Administration
I. Lack of confidence
 CONFIDENCE- Means having assurance that something will succeed.
 If the administrator is not sure that the organisation will be committed to the plan
she/he will hesitate to set plans.
 The administrator may lack confidence on his or her ability to make plans and fails to
plan.
II. Lack of individual knowledge.
 The administrator should have adequate knowledge about the nature of his job.
 Lack of knowledge will result in no or poor planning.
III. Fear of failure.
 Fear of the unknown is probably a common phenomenon amongst people
administrators included.
 There is fear of failure, people end up to dealing with old activities rather than new
stuff.
IV. Dynamic environment.
  Environment is not constant but continues to change
 Rapid changes include technology and intense competition.

V. improper rewarding
 Administrator may go unrewarded for proper goal setting and achievement so
in future they tend to relax.
PLAN
A plan is a written document that indicate activities and how they are going to be carried out,
to achieve organisational goals.
TYPES OF PLANS
I. Strategic plan
This is the master plan of the organisation done by top management.
 This is a long term plan usually of 5 or more years.
 It is designed to meet the broad objective of the organisation to implement
the mission statement.
 It is usually set by top levels management.
 It includes mission and vision statement.
 Mission statement is a brief narration that justifies the existence of any
organisation include core values of the organisation what u want to do.
 Core values are principals for which an organisation stands and save to guide
the behaviour of each end everyone in the organisation eg. dignity
 Vision statement:thegovernment of Zimbabwe desires to have the highest
possible level of health and quality of life for all its citizens through the
combined effort of individuals community , organisation and the government
which will allow them to participate fully in the social economic
development of the country.

II. Functional plan.

 This is a mid- term plan that is integrated by the long term plan they
normally range from 1-5 years .
 These include-standing plans, standard operating procedures
a) Standing plans – Used to deal withorganisational activities e.g. policies, procedures
and rules.
b) Policies general guidelines -for decision making they are usually established
formally and deliberated by top managers who make seek policy because they
want to improve the effectiveness of the organisation and personal values
c) Standard operating procedures Refers to standing plan of detailed guideline of
having organisational activities that occur regular.
Operational plan
  These are short term plans which are less than year usually they are single use
plans
 They are not likely to be repeated once implemented

HUMAN RESOURCES MANAGEMENT

Staffing Process

Recruitment Selection Placement Incorporation

 Recruitment

It is the process of ensuring that there are qualified people for a position. Recruitment can be
internal or external .On internal recruitment existing employees are required to fill the vacant
or vacancies .Staff may move lateral or vertically. With external recruitment people to fill the
vacancies are from outside the organisation.

 Selection

It is the process of screening candidates who have applied for vacant positions .It starts by
looking for those who meet the required qualifications and then they are invited for an
interview for further screening .References on resumes may be conducted .The organisation
will select the best candidate basing on the results of the interview.

 Placement or employment

It is the offering of employment to the selected candidate. The candidate is placed within the
organisation.

 Incorporation

This is the introduction of new employed member to the workplace by communicating

information about rules and regulations specific to the department or position of employment.
Other internal or important information concerning the organisation and or the employment
should also be given to the newly employed.

Training
Depending with the nature of the vacancy ,at times after incorporation the potential candidate
is to be trained before actually being given a job.

Retraining

This is done to qualified employees who were once trained the aim is to improve their general
performance on their jobs .At times it is referred to as refresher course.

Compensation

It is a combination of salary, vacation time, paid health care and other benefits .It is often the
largest cost of the company .Various pay systems may be used as a form of compensation e.g.
hourly wages ,daily weekly fixed compensation weekly fixed compensation monthly.

PERFORMANCE APPRAISAL
 It is an evaluation in which the performance level of an employee is measured against
established standard to make decisions about promotion, additional training and
dismissal.
Performance appraisal consists of 6 steps
Step 1 Establish performance standard
 Set expected standards for each employee or subordinate.
 Make use of job descriptions.
 The standards must be understandable, subject to measurement and must be visible
Step 2 Communicate standards
 Employees must be informed what is expected for them.
 Employees should be well informed of how these standards
are to be meet.
 The manager should ensure these standards are well understood by each employee
 Managers should never assume that employees know what is expected from them.
Step3 Evaluate performance.
 Employees should be assessed regularly; they also need to be supervised.
Step 4 Discussion of results.
 Discuss the areas where employee performed well or where it needs improvement.
 Give room to employee to ask and seek clarification on matters relating to his duties.
 Assessment is done during the presence of the employee.
Step 5 Corrective action.
 Manager should give feedback to employee concerning the decision he has made in
relation to performance by the employees.
 Managers should highlight areas that need improvement in order to improve
performance.
 Managers should really specify what must be done by the employee.
 Always make reference to set standards.
 Highlight those issues, that need to be corrected.
 Managers can help employees by using PIP (performance improvement plan).
 Performance improvement plan is a detailed document explaining what an employee
need to change and detailed steps on how to accomplish the change.
Step 6. Use results to make decisions.
 Managers should make decisions from the results obtained, such decisions may
include firing or dismissal, promotion, compensation or facilitate further training of
employee.
 Managers can also use the results to improve working conditions that enable better
performance of employees.
 Performance appraisal does not only look on performance of an employee but it is
also an opportunity to assess the working environment of the employees.
NB: each employee or worker should be assessed individually.
 Performance appraisal reports should be made available and kept confidentially.
 Performance appraisal is good to make employees work hard as they know they will
be assessed.
 By rewarding hardworking employees, it will motivate others to work hard.
 By demoting lazy employees others will work hard to avoid demotions.
GRIEVANCE HANDLING PROCEDURE
 Grievance means any dissatisfaction or feeling of injustice on the part of a
member which is connected with the member/conduct with other persons in
the work place.
 Grievance procedure for members of same grades other than senior grades.
(Someone who has been lifted to another level).
 A member who has a grievance in which he is directly concerned shall seek an
interview with his immediate superior who shall grand a member an interview
at the earliest available opportunity.
 At the interview the member shall clearly state the nature of his grievance and
the immediate superior shall respond to it within 5 working days.
 If the response fails to satisfy the member, the grievance shall be brought to
the attention of the head office who shall within ten days call a meeting with
member and immediate supervisor.
 If the grievance remains unresolved, it should be brought to the head of
department.
  H.O.D calls a meeting with head of office, immediate supervisor and member
and a representative of ministry department responsible for personnel and
record in writing the grievance and the action agreed for the purpose of
resolving it and forward a copy to the head of ministry.
 In case of a disagreement at a meeting called, the head of ministry shall make
a decision on the grievance and communicate his decision to all the parties
concerned.
 If a member remains aggrieved he may request in writing through the head of
ministry that his grievance be submitted to the commission where final
decision is made.
DISCIPLINARY PROCEDURE
Disciplinary procedure is taken when a member violates rules and regulation.
GROUP WORK
Outline ten issues that constitute act of misconduct according to the legislation.
Outline the disciplinary procedure as required by legislation.
Outline role of health services administrator in disciplinary issues of staff, monthly staff
returns compilation and pay-sheet acquittals.
TRAINING
 Training is teaching, or developing in oneself or others, any skills and knowledge that
relate to specific useful competencies.
 Training has specific goals of improving one's capability, capacity, productivity and
performance.
 The fact that the employees are the most valuable asset, they should be trained well
enough as eventually, it will be benefiting the organization as a whole.
DISCUSSION
1 Identify and explain seven situations in the health sector that necessitate training of
employees
2 (i) State and explain eight different training techniques.
(ii) For each identified technique state advantages and disadvantages.
3 List ten ways in which an organisation will benefit from training workers.
OCCUPATIONAL SAFETY, HEALTH AND WELFARE
Definition
Occupational health is the protection, promotion and maintenance of the highest degree of
physical, mental, and social well-being of a worker in all occupations by preventing
departures from health, controlling risks and the adaptation of work to people and the people
to their jobs (ILO/WHO 1950).
Science and art of protecting, promoting and maintaining health, safety and welfare of people
engaged in work or employment by predicting, identifying and correcting areas with a
potential to cause departure from normal health and other related losses.
Health institutions pose serious threats to workers, visitors and patients in several ways due
the existence of several biological, chemical and physical hazards.
HAZARD
it is a situation that poses a level of threat to life, health, property, or environment.
A potential source of harm or adverse (any change in the body function or structure) health
effect on a person.
Discussion
1 Identify hazards commonly found in health institutions and their sources.
2 as a health services administrator elaborate ten measures you would take to ensure
safety of workers, patients and visitors in health institutions.
3 Outline ten challenges faced in ensuring safety of workers, patients and visitors in
health institutions.
4 As a health services administrator highlight ten measures you would put in place to
ensure
(i) Staff welfare
(ii) Workers are well motivated

ASSET MANAGEMENT
PROCUREMENT
Assets remain a key driver towards a sound sustainable health delivery system.
Procurement of assets in public health institutions is procedural which is as follows,
 Establish procurement needs
 Identify potential suppliers
 Compile schedules
 Place orders
 Receive goods
 Pay goods
CORPORATE GOVERNANCE
When procuring assets there is need for corporate governance. Corporate governance is the
system of rules, practices and processes by which a firm is directed and controlled.
Corporate governance essentially involves balancing the interests of a company's many
stakeholders, such as shareholders, management, customers, suppliers, financiers,
government and the community.
Good corporate governance is essentially about effective, responsible leadership
characterised by ethical values of responsibility, accountability, fairness and transparency.
PILARS OF CORPORATE GOVERNANCE
Accountability – being answerable to all an organization's stakeholders for all actions and
results.
Fairness - treat all stakeholders the same
Transparency- operating in such a way that it is easy for others to see what actions are
performed.
Responsibility - the state or fact of having a duty to deal with something or of having control
over someone
Explain the following procedures in asset management
1 Asset movement, asset numbering, registering assets and disposal of obsolete
assets.
2 Explain inventory sheets, master asset register, securities register and
maintenance plan for assets
TRANSPORT MANAGEMENT AND ACCOMODATION
GROUP WORK
Discuss the following as it applies to the above
1 vehicle registration, licensing and insurance
2 preparation of transport schedules, weekly vehicle status and monthly vehicle
status
3 accidents and incidents reporting procedure
4 accommodation policy, monitoring tenant adherence and monthly housing
returns
OFFICE MANAGEMENT
Office -a room, set of rooms, or building used as a place of business for non-manual work.
The office performs a clerical function such as information collection, recording analyzing,
distribution of information and executive function such as planning, policies formulation,
organization, decision making etc.
Uses also include processing, recording, storing and furnishing information. safe guarding of
assets, management of personnel.
The office mainly deals with the management of information.
Types of offices
1. Cellular Office

A Cellular Office is one of the most popular layouts in which the entire floor space is divided
into individual spaces or cubicles for one or more employees. It is sequentially arranged areas
that give employees their own private space.  

Cellular Office does not only promote focused working environment but also systemise
things in a better way.

In cellular office plan, individual rooms are created either by using ceiling stud partitions or a
window or a door. This means each will get their own separate space where they can operate
their work the way they want.  

The best part about this layout is that you can create small cubicles for your different
operational team –which is good for the team as well as company’s productivity.

 2. Open Office Layout

Most of the creative and IT companies use open office layout to promote smooth and
effective communication among employees while maintaining a high level of discipline.

Under this plan, an entire floor area is divided by low partitions where employees may have
their own desks or may share a table with other employees. However, each employee will be
given a separate chair and a computer, but the overall workspace will remain non-territorial.

Those who prefer this office layout says that it provides greater opportunities for effective
communication, transparency, collaboration while promoting employee relationships

 3. Co-working Office Layout

. In this layout, a worker may or may not have his own workspace. It simply approaches a
first-come and first-serve policy that encourages individuals to operate wherever they want to
within the premises.

In fact, you are free to choose your own space as per your requirement. Being an employer,
you can assign particular desks to your workers according to their assigned job.
The flexible working environment increases the possibility of collaboration while making
workers (even freelancers) comfortable.

In a nutshell, Co-working spaces are ideal for self-employed workers who don’t have an
office space for their own. With the payment of a small fee, these people can work in a
comfortable working environment.

4. Combination Office Plan

This is one of the most versatile office plan layouts that can help business owners to design
their offices the way they want.

If you want both the open and cellular layouts, then a combination office plan is perfect for
you. In this specific office plan, you can design your office in individual or separate cubicles
but use smaller space as compared to the cellular layout.

Instead of using doors or windows, use common office surroundings such as tables, couches,
and chairs. This will also give a glimpse of open office layout.

Discussion

Analyse advantages and disadvantages of each type of office layout.

Discuss factors considered when choosing best office layout.