Block 6

~
Management of Subcentre
• - < ••• • ~. " ~ ~ • '.. •
6
-'...
I
"~T~iT CFIlGfCfq;) crc£fGll ~ ~ CJ>«fi ~ 3fR
3ffi3l ~ ¥ ~at HlCbc151 q5l 3fTCTGIT cm 3mfR
:HT ~ I~ Cf2IT 3fGi!:r Cbl'lori ~ 3CCfGiii urrm
(!ci CTJf.m:r Rlt\tdid 13n q;) ~ q;«l gQ' ~
q;) ~ :z:r<iRl :EtR 30lCft ~ I"
- $fGG 21 tJifdt
"Education is a liberating force, and in our age it is also

a democratising force, cutting across the barriers of caste
and class, smoothing out inequalities imposed by birth
and other circumstances. 11
. lndira Gandhi
I
·
I
l@j...
Indira Gandhi
Igno
lHEPEoPle's
UNIVERSITY
BNS-117
Maternal andChild
Health Care
National Open University
School of Health Sciences
Block
6
MANAGEMENT -OF SUB CENTRE
UNIT 1
Concepts of Management 5
UNIT 2
Management of Resources 24
UNIT 3
Problem Solving and Decision Making 39
UNIT 4
Work Plan at Subcentre 45
UNIT 5
Health Management Information System 58
UNIT 6
Management of Records in Subcentre 70
I
EX~ERTCOMMITTEE (PRE-REVISED)
Course Committee Dr. Margret Dean Dr. Sudhansh Malhotra
Dr. S. Krishnan Coordinator, CNI, New Assistant Commissioner
H-002, Yamuna Apartment Delhi Dept. of Family Welfare
Alaknanda, New Delhi Prof. A.K. Agarwal Ministry of health & Family Welfare,
Ex. Director New Delhi
Ms. Kartiyani
Ex. Nursing Advisor School of Health Sciences Dr. Subhash Sharma
D-2, Kavcri Apartments IGNOU, New Delhi Assistant Professor, State Institute of
New Delhi Or. (Mrs.) Pity Koul Health and Family Welfare, Jaipur
Ms. B. Bhauacharya Reader . Dr. N.H. Antia

Ex. Principal School of Health Sciences Director, FRCH, Pune
RAK College Nursing IGNOU, New Delhi Dr. Prakashamma
Andrews Ganj, New Delhi Ms. Mridula Das Director, Academy of Nursing Studies
Ms. Krishna Kurnara Gulani Deputy Nursing Advisor Hyderabad
Reader, College of Nursing Dept. of Family Welfare Ms. Seema Deodhar
Jamia Hamdard University Ministry of Health & . , FRCH, Pune
New Delhi Family Welfare, New Delhi
• BLock Preparation and Editorial Team

Dr. M: Prakashamma (Hyderbad) Ms. Sanyukta Kapoor (New Delhi) Ms. Renuka Das (Orrissa)
Ms. Neerja Sood (New Delhi) Ms. Rose Thomas (Indore) Ms. Pity Koul
Reader, SOHS, IGNOU, New Delhi
COURSE REVISION COMMITTEE

Prof. Raj Rani Dr. M. Prakashamma Prof.(Dr.) Pity Koul
Principal. College of Director, Academy of Nursing Director & Programme
Nursing. AIIMS Studies, Hyderbad Coordinator, School of Health
Jodhpur Dr. Manju Chuggani Sciences, JGNOU. New Delhi
Mrs. Santosh Mehta Principal. Rufaida College of Ms, Prannati Barua
Principal, RAK, College of Nursing, Jamia Hamdard Principal of Nursing Amity
Nursing, New Delhi University, New Delh University, Maneswar
Dr. Mol\y Babu Ms. Sarla Takoo Gurgaon
Lecturer. RAK. College of Principal, L.B. College of
Nursing, New Delhi Nursing, Batra Hospital
New Delhi
BLOCK PREPARATION TEAM

Modifications updating Unit 1,2,3,4,5 & 6 Mrs. Reeta Devi
Mrs. SunitaPatney . Prof. (Dr.) Pity Koul Asstt. Professor (Sr. Scale)
Faculty, RAK College Director & Programme & Programme Coordinator
of Nursingh Coordinator, School of Health (29.09.2015 till date)
New Delhi Sciences, IGNOU, New Delhi SOHS, IGNOU, New Delhi
CO-ORDINATION
Prof. (Dr.) Pity Koul Mrs. Reeta Devi
Director & Programme Coordinator 'Asstt. Professor. (Sr. Scale) & Programme
School of Health Sciences Coordinator (29.09.2015 till date) .
IGNOU, New Delhi School of Health Sciences, IGNOU, New Delhi
PRODUCTION
Mr. T.R. Manoj
Assistant Registrar (P)
SOHS, IGNOU, New Delhi
March,2016
© Indira Gandhi National Open University, 2016
ISBN: 978-93-85911-71-2
All rights reserved. No part of this work may be reproduced in any form, by mimeograph or any other
means, without permission in writing from the Indira Gandhi National Open University.
Further information about the School of Health Sciences and the lndira Gandhi National Open University
courses may be obtainedfrom the University's office at Maidan Garhi, New Delhi-I 10 068.
Printed and published on behalf of the Indira Gandhi National Open University, New Delhi by
Prof. Pity Koul, Director, School of Health Sciences.
We acknowledge the reference of material and figures from various sources like NNF, AIlMS, WHO,
UNICEF, IGNOU, Govt. of India etc.
Laser Typeset by: Tessa Media & Computers, C-206, A.F.E.-ll, Okhla, New Delhi.
Printed at: Akashdeep Printers, 20-Ansari Road, Daryaganj, New Delhi-l 10002
BLOCK INTRODUCTION
As a health care provider, you have to perform a key role in health care delivery
of the country at grass roots leveL How effectively and how efficiently you perform
your role, will depend on your ability to manage the sub centre, in terms of
planning, organizing and managing the resources, solving day to day problems,
providing relevant health information and maintaining records/reports. This block
will enable you to gain knowledge and skills, related to all the above mentioned
areas.
In this block there are six units: Unit 1 explains the Concepts of Management.
Unit 2 focuses on Management of Resources. Unit 3 deals with Problem Solving
and Decision Making. Unit 4 relates to Work Plan at Subcenn e. Unit 5 describes
Health Management Information System. Unit 6 focuses ('n Management of
• Records in Subcentre.
We hope this knowledge will help you to manage the subcentre in an effective
way.
I
UNIT 1 CONCEPTS OF MANAGEMENT
Structure
1.0 Objectives
1.1 Introduction
1.2 Management
1.2.1 Meaning and Definition
1.2.2 Characteristicsof Management
1.2.3 Levels of Management
1.2.4 Principlesof Management
1.3 Functions of Management
1.3.1 Planning
1.3.2 Organizing'
1.3.3 Staffing
1.3.4 Directing
1.3.5 Coordinatingand Controlling
1.3.6 Recordingand Reporting
. 1.3.7 Budgeting
1.3.8 Evaluating
1.4 Factors Contributing to Effective Management
1.5 Let Us Sum Up
1.6 Glossary
1.7 Model Answers
1.0 OBJECTIVES
After completing this unit, you will be able to:
• Explain the meaning and importance of management;
• Enumerate the levels of management;
• Explain the principles of management;
• Discuss the functions of management; and
• Identify the factors contributing to effective management.
1.1 INTRODUCTION
While working in the health centre or may be in the hospital you must have .
observed different management pattern, which may have been efficient with
good working conditions, conducive environment and satisfaction or inefficient
with minimum working conditions, stressful environment and dissatisfaction.
Have you ever thought about it, why is it like this? Let us try to understand it, by
learning about management that will help you to be an efficient worker.
Have you ever thought that you are also the managers at your work place? This
is true because you are the first and foremostresponsible person for health care
5
I
Management of Subcentre ofa community in a defined area. To achieve your organization's objectives you
plan, organize and provide health care services to people, supervise and give
training to dais and voluntary health workers.
In this way you, as the manager get the work done by eo-workers and manage
the resources at subcentre. It is essential to understand the basic concept of
management for efficient working environment and to achieve set objectives
within limited resource available.
Management is a function of all those working at top to lower level and principles
of management can be applied at all levels from Ministry of Health (at the top
level) to health workerf at village level). The basic characteristics of management
activities are same in all organization. In this unit you will learn the meaning and
importance of management, the level of management and required skills. We
shall also discuss the principles and functions of management. In the last section
you will learn about factors contributing to effective management.
1.2 MANAGEMENT
Management is the process ofputting policies, plans and procedures into action
to that coordinates the effort of people to accomplish goal and objectives within
available resources efficiently. As a health worker your goal is related to
implementation of health & family welfare programmes.
1.2.1 Meaning and Definition

• Management has been defined as the purposeful and effective use of resources
manpower, money and material for fulfilling and achieving the objectives.
• Management enables efficient use of limited resources, avoids wastage and

brings about discipline. In health care organization knowledge of
management is important to provide quality care and achieving objectives
through co-ordination of human and physical resources.
In simple words management is defined as an art of getting things done by

others.
•
Physical
Application resources
Human like building
of Objective of
Through resource Utilize money,
Management To achie the
that is material,
Knowledge prganization
health equipment
by managers
workers and time
at all levels
Fig.I.1: Coordination between health worker, material, money and time in health centre
system
1.2.2 Characteristics of Management

The following are the characteristics of management.
6
Process of getting things done by others: For example, female health worker Concepts of Management
guides, trained dais to register antenatal mothers and provide follow up care in
the village.
System of authority: 'Managers at all levels needs authority to carry out their
responsibility. For example, the female health worker has the authority to treat
minor ailments at the subcentre.
Dynamics process: It is a changing process with changing environment. New

plans, policies and programmes are to be worked out, as needed according to the
situation. For example, health needs of the community are always changing.
Health worker solves the old problem and new ones start appearing. Managing
these problems in a health centre need the health worker to make new.plans to
solve these problems.
Utilization of resources : ~se oflimited resources like man, money and material
and time to achieve objectives. For example, health worker (female) has to provide
maternal health services with the supplies provided to her at the subcentre.
Universal phenomenon: The principles and function of management applicable

in all aspects of life, in every organization at all levels.
Goal oriented : Basic aim of management is to achieve goals objectives. No

objectives means no management. Objectives should be measurable, observable
and feasible. The objectives stated below in relation to provision of maternal
ca:e by health worker (female) illustrates the above characteristics of the objectives.
Social process: It involves establishment of interpersonal relationship with all

the workers. Superiors and subordinates to get the work done. For example health
worker (female) hasto have good relationswith health assistant, trained dai,
members of the mahila mandal and local leaders for smooth functioning and to
achieve the desired goal.
Exercise influence: Manager influence the behaviour of workers and uses power,
position, competence and resources to plan, supervise, support, guide and give
rewards and punishment. For example, health worker (female) teaches the dias
to improve their performance.
To summarize we can say that management is a wheel to moye the organization

and it is needed for survival and growth of an organization.
It helps in assessing the needs and solving problems of the community.
It also directs the human resources, which is important and crucial resources of
any organization. Only human resource can utilize money, material and time to
achieve objectives.
The employees personnel needs to be fulfilled, so that they work with full capacity,
cooperation and give better performance.
Check Your Progress 1
i) Fill in the blanks:

-'
a) Management is a function of those working at To
.............................. levels
b) For achieving objective of the organization And
................ resources is important 7
I
Management of Subcentre c) Responsibility cannot be undertaken without .
d) Establish by all level of managers with workers to get
the work done.
e) Objectives should be , And .
ii) List down six characteristics of management.
a)
b)
c)
- d)
e)
f)
• 1.2.3 Levels of Management

Every organization has many positions in its structure from top to lower levels.
Each position has authority, responsibility and jobs to perform. These positions
are classified into levels of management. Broadly, an organization has three levels
of management e.g., top level, middle level and the lower level.
An example of District Health Organization will help you to understand levels
of management and functions at different levels.
Level Pest . Functions

TOP • Chief Medical Officer • To make over all plans, policies and set
(CMO) objectives
• DeputyCMO • To make decision on vital issues
• District Programme • Providing directions, leadership to
Officer the organization
• District Public Health • Evaluate and monitor the activities.
Nurse (DPHN)
MIDDLE • Medical Officer In • Prepare departmental plans, set
charge of Community objectives, make decision to
Health Centre and. implement programmes.
Primary Health Centre
• Specialist • Perform managerial functions to
carry out activities
• Health Assistant Male • To communicate policies, issue
and Female orders and instructions to lower level
managers
• Coordinate activities of various work
units at lower level
• Evaluate the activities
• Supervise and motivate the worker
LOWER • Health worker male and • Prepare schedule for activities to be
female i' carried out at subcentre. ,
• Utilize the resources, complete work
in time
• Record and report
8
Management is a result oriented process. To get results, application of Concepts of Management
management knowledge and certain abilities are required at each level. These
abilities are known as management skills. There are three types of skills:
i) Conceptual skills - Decision making, problem solving, critical thinking.

ii) Human/interpersonal relationship skills - maintaining interpersonal
relationship, communication, understanding, building team spirit,
motivation, improving capabilities.
iii) Technical skills - practical skill, management of resources, training of
worker.

i) Fill in the blanks
a) The level of management are , and .
b) Abilities required at each level are known as .
ii) Place a tick mark (-/) against the appropriate answer:
a) The District Public Health Nurse will be considered at:
1) Lower level
2) Top level
3) Middle level
b) The Health Assistant in a Primary Health Centre belongs to:
1) Middle level
2) Lower level
3) Top level
c) Working out daily schedule for the work is the responsibility of:
1) Middle Level Manager
2) Lower Level Manager
3) Top Level Manager
d) To make overall plans, setting objectives and making decisions is the
responsibility of
1) Top Level Manager
2) Middle Level Manager
3) Lower Level Manager
iii) List down three functions at each level
a) Top Level
................................................................................................................. 9
I
Management of Subcentre b) Middle Level
........................ , ., ~ , .
c) Lower Level
.
................................................................................................................
.
iv) List the three types of managerial skills required at each level of Management.
a) .............................................................................................................. ~.
b)
c)
v) Fill in the blanks

a) Conceptual skills are required more at the ; : level
b) Technical skills are more required at the ~ level
1.2.4 Principles of Management

"Living together is beginning, keeping together is progress, working together is
success". Principles of management are universal and dynamics. These principles
are related to functions of management (Functions are dealt in Section 1.3). The
Principles of Management are:
I). Equity: Equity means fairness, justice or impartial treatment to all worker,
this helps in good working environment and motivating workers to work
for an organization. For example, equal salary and other benefits for same
.category of workers.
ii) Initiative: Encouraging and allowing the workers to carry out an activity,
with the authority of the positions in the organization. Initiative on the part
of the worker can bea source of strength for an organization. For example,
the health worker (female) is encouraged to teach mothers about nutrition
for children.
iii) Espirit decorps : Espirit decorps means the spirit of loyalty, devotion and
belongingness which unit people to work together to achieve objecti ves of
organization.
iv) Stability of tenure or worker: Worker should be allowed to continue her

tenure without frequent changes; this gives security to the worker. Change
10 only in emergency or when given a higher responsibility or promotion.
· .
v) Division of work: Job is divided and specified among various individuals. Concepts of Management
The manager is concerned with managerial work and workers with non-
managerial work. This helps in acquiring skills and increasing output. The
manager sees that none is overloaded with work and workers implement
and plan as per directions. This helps in acquiring skills and increasing
output.
vi) Authority and responsibility: Both go hand in hand.authority should go

with responsibility. The health worker (female) isresponsible to provide
antenatal care to mothers in the families and is accountable for her actions
to the mothers as well as her superiors.
vli) Discipline: Discipline means rules, regulations, manners, observed at work

place. Discipline in an organization depends on efficiency of leader or
manager and good supervision at all levels. Penalties sholl d be used with
care and misuse of power and position should be avoided to ensure discipline.
viii)Unity of command: Worker should receive orders from one superior. If

two superiors give orders to same worker. It is difficult for a worker to
decide whose order to follow first, this will create frustration,
misunderstanding and annoyance of superior. For example, the health worker
receives orders from health assistants only.
ix) Unity of Direction: It means efforts of all the workers of the organization
should be directed towards achievement of objectives of an organization.
There should be one overall plan to achieve objective. Departmental
objectives and plans should be made within framework of overall plan and
objectives
x) Remuneration. of personnel: Payment system be fair and satisfactory

according to work, efficiency and risks involved.

i) List any six principles of Management.
., , .
ii) Explain the following in your words:

a) Authority and responsibility
b) Unity of Command
•••••• '•••••• " •••••.•••.••••••••• ,••••••••••• '•••••• ! •••••••• ";, •••••..••••••••••••• ~•••• ~'." ;'•• " ••• ~•• ~••••••.••••••••• 0.
'••• '.0 ••••.•••••••••••••••.••••••• "!_ ~ .", •••• AI •••••• ~ •• ,. ~ ••••• '.' .0•.... ,... , ... ".,", .. ;, .'~ ......• ,., .. ,',. ,.... ~.. , ,., ..... 1"1
I
1.3 FUNCTIONS OF MANAGEMENT
In this section, you will learn about functions of management. As you know,
management is a process of utilizing resources to achieve the objectives, it consists
of many functions, which are carried out in a sequence. Basic functions of
management are planning, organizing, staffing, directing, co-ordinating,
controlling, recording and reporting, budgeting and evaluating.
Let us now discuss each function briefly.
1.3.1 Planning
Planning is the forecast and pervasive function of management. Planning is
decision making process which helps in developing a framework for allocation
of resources when planning, planner makes decision in advance about what is to
,be done, when, where, how and. by whom it is to be done. Planning process
• involves analytic and critical thinking process .
•. Planning is a thinking process of coping with uncertainty by formulating
future course of action to accomplish specified results. It means determining
what is to be done, how, when and by whom it is be done.
• An element of planning is present behind every human activity. Students

plan their studies, the head of the family plan their expenditure, the health
worker in health centre plans her daily work schedule. In this way some
kind of planning is seen everywhere.
• Planning is goal oriented i.e., defines objectives or goals of an organization

and develops plans to achieve them. It involves choosing best action.
• Planning is thinking process. It is concerned with problem-solving. Planning

is pervasive i.e., it is done at all levels by all categories of workers
• Planning is part of activity at all levels from top to lower level.
• Planning is continue. It is ongoing, process of assessment and reassessment

of objectives, and replans, thus evaluation is part of planning. It can be of
long term or short term.
Importance of Planning
• It helps in handing and solving the problems and to manage any unpredictable
conditions ..
• Ensures effective control and co-ordination in an organization.
• Promotes creativity and innovation of ideas, which help in future

development.
• Leads to integration of functions, helps in achieving objectives by effective

use of all.
Steps in planning
• Analysis: Analysis of situation by collecting information, for example health
worker (female) analyze the problem situations of family by collecting
information about family member, educational, socio-economical and
environmental factors of the family.
12
r • Forecasting: Forecasting the future needs or problems to be solved. Health Concepts of Management
worker (female) anticipates which problem may arise in the family due to
I
lack of awareness about its nutritional requirements.
• Setting priority: Setting priority and objectives. The most urgent need is
taken first for providing care to family and objectives are stated to give
direction to activities.
• Formulating: Formulating possible alternative actions to solve problems

of the community/family. There may be number of actions to solve the
problem.
• Selecting action of choice: To overcome the given problem so that it is

most effective to achieve objectives of care, keeping the cost at the minimum.
• Formulating the plan and policies, estimating resources and establishing

evaluation procedure is another step in planning. To implement a given
nursing action, it requires certain tools/equipment/supplies. In planning, it
is estimated as to what resources are required. Planning also involves devising
evaluation method to measure achievement of objectives.

i) Define Planning
ii) Place 'T' against the statement which are true, and 'F' against those, which
are false
a) Planning is concerned about present (TIP)
b) Planning provides basis for all other functions (TIP)
c) Planning is a top level manager's function (TIP)
d) Planning is not a problem solving process (TIP)
e) Evaluation is a part of planning (TIP)
1.3.2 Organizing
Organizing is a process of identifying and grouping the work, assigning duties
or responsibilities and delegating authority, among worker, to accomplish the
goals of an organization. For example, in order to deliver effective RCH services,
you are given different tasks and responsibilities to achieve the goal of RCH.
Activities are directed and controlled by medical officer and health supervisors.
Characteristics and Importance

• It is mechanism through which the managers direct, coordinator and control
the activities to get the work done to achieve objectives. For example,
Medical Officer at PHC, CMO at district level.
13
I
Management of Subcentre • It is a goal-oriented process.
• It deals with group efforts to achieve goals/objectives.
• Brings about order and discipline based on principle of division of work.
• Provides opportunity to lower level managers to make decisions at their
level.
• Establishing and delegating authority among worker' relationship of superior
and subordinate.
• Well planned division of work and delegation of authority
Organizational Chart
Organizational chart is the diagrammatic representation of the different positions
in an .organization showing hierarchy-and channels of communication. It shows
relationship between different positions and departments. Knowledge about
organization chart will help you to:
-. Understand about your position and relationship to others.
• Understand to whom you are responsible and who is responsible to you.
• Understands formal and informal channels of communication pattern
• Classify various personnel in an organization and give details about
, departments.
'.'
• Guide new employees.

A sample of organization chart of District Health Services is given in Fig. 1.1 &
Fig. 1.2 below:
Secretary .Health
I
Director Nursing Services
I
Joint/Dy, Director Nursing Services
I I I
ADNS
Community Nsg.
ADNS
NRg.Equcation & Res '. ADNS
Hospital Nsg. Serv,
I I. I
DADNS DADNS DADNS
Community Nsg. Nsg. Educations & Res NRg. Service
I I I
Dist. Nsg. Officer Principal School of'Nsg, Nsg. Suptd.
I I I
P.H. Nsg. Officer SeniorTutor Dy. Nsg. Suptd.
I I I
P.H.N. at PHC Tutor Asst. Nsg. Suptd.
I I I
LHV (HSF) Clinical Instructor Ward Sister
I I
LHV Staff Nurse
I
ANM
Fig. 1.1: Recommended Organisational Setnp at State/Union Territory Level
14
Director Nursing Services Concepts of Management
I
Dy. Director Nursing Services
I
Asst. Director Nursing Services
I
Dy. Asst. Director Services
I I I
DMO District Nursing Officer DHO
I
I I
P sst. Dist. Nsg. Officer As t. Dist. Nsg Officer
(Hosp.&Nsg. Edu.) (Community)
1------ I
Nsg. Supt./Dy. Nsg. Suptd. Dist. P.N.O
I Principal Tutor I
Asst. NSg. Suptd, PN Supervisor (CHC)
I
I
Ward Sister
PN (PHC)
I
LHVIHS
Staff
I urse
Tutor
I
Clinical Instructor
I
LHV
I
ANM
Fig. 1.2: Recommended Organisational Setup at District Level
1.3.3 Staffing
Definition: Staffing may be defined as the function, which provides an organization
with adequate and competent manpower resources for its various activities.
• Staffing is concerned with the recruitment and management of workers in

the organization.
• To carry out responsibilities, positions are filled with suitable workers with
knowledge and skill. This means staffing function takes care of manpower
requirement of the organization.
Organization can be functional and operational only by recruiting and selecting

skilled manpower. Can you think about an organization only with machines and
equipment and without human beings No, because machines and equipment
require skilled manpower to achieve the goals of an organization.
Therefore, effective performance by workers helps in achieving objectives within

available resources. Capabilities of workers are to be developed by motivation,
training and supervision by top-level manager.

Define staffing
15
I
Management of Subcentre 1.3.4 Directing
Definition: Directing is concerned with guiding, supervising, motivating and
influencing workers to achieve objectives. Directing is a continuous process.
Directing function is performed by all level of Managers/ Supervisors. Supervisor
has to directthe activities ofthe subordinate's work to achieve the objectives. It
helps in achieving co-ordination. Activities of all the workers are integrated to
achieve objectives with the help of directing.
It serves as a means of motivation. Workers can be motivated to work, willingly
with full capacity.
By supervision and instructions discipline is maintained, as it is need for smooth
functioning and achievement of objectives. It helps to cope up with changes.
Workers can be taken into confidence and persuaded to accept the changes through
dynamic leadership and effective communication.
Elements of Directing
a) Unity of direction: There should be common direction to all worker for
similar activities, for example, the health worker is- directed to provide
immunization to children according to national immunization schedule.
b) Unity of command: Worker should get instruction from one superior only.
c) Direct supervision: Manager should maintain direct contact with the worker
through observation, guidance and teaching.
d) Participative leadership: Manager should involve workers in making
decisions. Superior should respect workers views.
e) Follow up: Once directions are given, the manager should follow up whether
the directions are being carried out or not.

i) Define Directing
•
......................................................................................................................
ii) List down three elements of directing
1.3.5 Coordinating and Controlling

Coordinating
Meaning : Organization consists of many departments and large number of
workers which contribute to its functioning. In order to have effective functioning,
16
activities of all departments and individuals are to be coordinated.
Definition: Coordination is the process of bringing about unity and harmony in Concepts of Management
the functioning of all departments and sub-system. .
Coordination involves integrating objectives and activities of separate units in
order to achieve organizational objectives.
Techniques of Achieving Coordination
Following measures are helpful in achieving coordination
a) Coordination through leadership: Effective leadership encourages
participation of groups in making decision and communication among
workers, which help in coordination.
b) Communication network: Formal and informal communication, vertical,
horizontal and diagonal communication helps in connecting people and units
together, as they exchange views, information. This in turn helps in coordination.
c) Authority relationship: In line authority relationship, superior controls the
activities of the subordinate and this brings coordination in functioning.
The health assistant (female) exercises control over the activities of the
female health worker.
d) Defined objectives: Clear and well-understood objectives will lead to a
unified purpose and this brings about coordination.
e) Group decision making: Committees are formed for group decision making
to solve problems of different departments. Members of all departments
make decisions together to solve the problems. This help in unifying,
integration and coordination.
Controlling
Concept: In health organization it is very important to have effective control,
system, because workers are dealing with human beings and if they do something
wrong, it can be very drastic and peoples life willbe in danger.
• Controlling is a basic function of managers to achieve objectives through
exercising control over work of workers.
• Controlling the work of all workers is also essential to utilize resources
effectively and avoid unwanted effects.
Definition: Controlling is a process oftaking necessary preventive and corrective
actions, which ensures effective and efficient use of resources and increases
efficiency of the workers for achieving organizational objectives.
It brings about discipline in the organization. Follow up/Corrective actions are
taken to minimize adverse effects. Controlling also verifies whether the activities
performed are in conformity with the plans and resulted expected.

i) Define coordination
ii) Enumerate the measures to be adopted to bring about coordination
iii) Fill in the blanks
a) Management control is a basic function of To
achieve objectives through exercising control over workers by "taking
necessary , And . Actions
b) Controlling facilities effective use of .
17
I
Management of Subcentre 1.3.6 Recording and Reporting
Records are the "Written documents about facts or information"
Health records refer to the information about an individual and family

Such as family history, individual history of illness, socio-economic aspects,
and psychological and environment factors, which influence health of an
individual.
Health records are means of communication between past and future. Records
are written daily, weekly, monthly, and yearly. Compilation of information or
data, which are recorded daily, weekly, monthly is called report. Report is an
important management tool for future action, which gives summary of activities
performed by you in each month. '
• For further details on records and reports refer Unit 6 of Block 2.
1.3.7 Budgeting
Budget is a blue print of projected plan of action and expenditure of an
organization for a definite period of time.
Definition - Budget is a financial interpretation of a policy to be pursued to

attain objectives in a given period.
It is a formal expression of plans, policies and objectives laid down in advance
for the organization as a whole.
Purposes of Budgeting
• It is helpful in financial planning and decision - making.
• It helps in communicating financial objectives and cost of activities to achieve
these objectives.
• It is a feedback for actual expenditure against budget allocation.
• It shows relationship between organization, objectives and fmancial planning.
Salient Features of Budgeting
• Top management is ultimately responsible for planning, implementing and
evaluating the budget. Although middle and lower level managers make
departmental plans and implement them.
• Budget should be prepared by anticipating the future, keeping in touch with.
the present and relating with the past. It should be flexible to accommodate
uncertainties and variable cost of services. ,
• Budget should be in the forin of financial statements i.e., in numerical forms,
not described in words.
Steps in Preparing a Budget
• Examine the past performance to know about achievement of objectives, its
success or failures.
• Setting objectives for more coming year, starting them in the form of services
to be provided.
• Estimation of increase in cost of various aspects including any change in
payment system.
18 • Preparation of budget report and submit for review by top level manager.
• Review of budget plan and submit to finance committee. Concepts of Management
• Modification by finance committee and then approval by board.
1.3.8 Evaluating
A community health service starts with planning and ends with evaluation of the
programme.
• Evaluation is the process of collecting data, presenting them in a convenient
form, and using them to form judgements of make decision about an activity.
• Evaluation performs three fold functions of approving, providing and
improving the programme, It provide useful information on what has been
achieved, so that one could decide regarding its desirability for continuation.
Evaluation serves to monitor the progress of an individual or a programme,
provides continuous feedback to the supervisory staff. .
The basic steps involved are as follows:
• Decide what is to be evaluated
i) Health worker must plan, what she plans to evaluate regarding health
care services
ii) Must set some criteria or standard of evaluation i.e., 80% deliveries to
be conducted in the health centre
iii) She need to plan ways to evaluate i.e., checklist questionnaire interview etc
iv) After collecting date regarding effectiveness of health care, she needs
to analyse the results of health services
v) Once it has been assessed, she must take action i.e. if poor health care
services she needs to improve after getting the result.
vi) Again she assess the effectiveness of health care services
• Establish standards of evaluation
• Plan the methods of evaluation
•. Analyze the result
• Take action
• Re-evaluate
• Decide what is to be evaluated - your need to plan for evaluation of health
needs to be assessed, for example how many children are Vaccinated against
BSG, Pantravalent etc
1.4 FACTORS CONTRIBUTING TO EFFECTIVE

MANAGEMENT
Now you have understood that management is a process to achieve objectives of
an organization. Certain factors play important role, which contribute to effective
management. These factors are given below:
Knowledge of Organization: Manager should be familiar with philosophy,

purpose •.objective, policies, plans, rules, hierarchy system and resources of an
or~anization,
Knewledge of Management: The manager should be aware of principles and

process of management.
19
I
Management of Subcentre Result Oriented : Manager should be able to achieve tire end results within
resources available in scheduled time.
Enforcement of Rules and Regulations : Manager should enforce rules and
regulations without partially and give clear-cut instruction for work.
Technical Skills: Manager should have knowledge of equipment and operation
of machines, so that in emergency, he can use them, correct any minor faults and
teach workers how to handle and use them.
Communication Skills : Manager should be an efficient communicator to
interpret instruction, plans and policies to the subordinates and communicate
the results and other information to superior.
Human Relations Skills : Getting things done by other requires maintaining
interpersonal relationship, motivating the workers, and encouraging them to do
work. Respecting and understanding their needs and behaviour leads to better results.
Development of System: This involves manpower-planning, recruitment,
placement, providing equipment, material, furniture, stationery, good working
atmosphere, working schedule, routines, job responsibilities, welfare services,
maintenance of equipment, records, condemnation of old material and equipment,
ind~nting and stock keeping, continuous supply of equipment, drugs, vaccines,
and stationary. It is necessary to develop system for managing a department.
List down four contributing to effective management.
1.5 LET US SUM UP

In this unit, you have learnt meaiimg and importance of management.
Management is important for purposeful and efficient use of resources. As a
manager, you should use the Tesourcd to get the job done on time. The levels of
management e.g., Top Level, Middle Level and Lower Level are explained with
personnel and their functions. Further you have learnt the principles and functions
of management. Management helps in effective and efficient utilization of
resources to achieve the objectives, and helps in assessing and solving the needs/
problems of the community.
1.6 GLOSSARY
Authority Right to make decision or giving orders.
Accountability "Answerable for an action which is being
performed. It can be carrying out an order or
taking decision.
Communication Transmission of information from individual to
individual, from group to group or department
20 to department.
r
Concept Means general idea or understanding about a Concepts of Management
I
complex thing/phenomena, e.g., management
is a complex or abstract term.
Decision Choice between alternatives
Function Group of activities with common purpose.
Functional Authority Authority arises from expert area of function.
Leadership Art of influencing, guiding, inspiring others.
Line Authority Authority flows directly from superior to the
subordinate
Motivation A drive or need that compels to take an action.
Objectives Objectives or goals are the 'desired end or end
results of action taken. Objectives should be
achievable and measurable e.g., immunizing
100 per cent antenatal mother against tetanus
in a_village.
Responsibility Task to do .e.g, trained dais can conduct normal
Deliveries at home.
1.7 MODEL ANSWERS

.•. -.~ -.----;.•... ,. ~
..---~-~. -~--. - -

i) a) Top lower
b) Coordination, human and physical
c) Authority
d) Interpersonal relationship
e) Observable, measurable, and feasible
ii) a) Process of getting things done by others
b) System of authority
c) Dynamic process
d) Universal phenomenon
e) Utilization of resources
f) Goal oriented
Check Your Progress 2 .

i) . a) Top, middle, lower
b) Managerial skills
ii) a) 2
b) 1
c) 1
d) 1
21
I
Management of Subcentre Hi) a) Top level
• Make over all plans, policies and set objectives
• Make decision of vital issues
• Evaluate and monitor the activities of all departments
b) Middle level
• Prepare departmental plans, set objectives
• Communicate policies, issue orders and instructions to lower level
managers.
• Coordinate activities of various work units at lower level
c) Lower Level
• Prepare schedule for activities
• Utilize the resources, complete work in time.
• Record and Report
iv) a) Conceptual Skills
-, b) Interpersonal relationship skills
c) Technical skills
v) a) Top
b) Lower

i) a) Division of work
b) Authority and responsibility
c) Initiative
d) Unity of command
e) Unity of direction
f) Stability
H) a) Work assigned to workers is performed and the worker is answerable
for action taken.
b) Receiving orders from one superior to avoid confusions.

i) Planning is a thinking process of coping with uncertainty by formulating
future course of action to accomplish specified results.
ii) a) F
b) T
c) F
d) F
e) T
22
I
Check Your Progress 5 Concepts of Management I
• Goal oriented process
• Deals with group efforts to achieve objectives
• Based on principle of division of work
• Establishes and delegates authority, relationship of superior and subordinate
and channels of communication .
.Check Your Progress 6

Staffing may be defined as the function, which provides an organization with
adequate and competent manpower resources for its various activities.

i) Directing is a process of guidance, the inspiration, supervision and motivation
of workers to achieve objectives.
ii) - Unity of command
Unity of Direction
Direct supervision

i) Coordination is the process of bringing about unity and harmony in the
functions of all departments and sub-system.\
ii) a) Coordination through leadership
b) Communication network
c) Authority relationship
d) Group decision making
e) Defined objectives
) iii) a) Managers, preventive and corrective
b) Resources
iv) - Pre- control
Current Control
Post control

• Knowledge of organization -
• Knowledge of management
• Communication skills
• Technical skills
23 '
I
UNIT 2 MANAGEMENT OF RESOURCES v ,
Structure
2.0 Objectives
2.1 Introduction
2.2 Management of Personnel
2.2.1 Meaning of Personnel Management
2.2.2 Functions of Personnel Management .
2.2.3 Meaning and Importance of Personnel Policies
2.2.4 Characteristics of Good Policies
c.'
2.3 Management of Finance

2.3.1 Meaning and Purpose of Financial Management
2.3.2 Definition and Purpose of Budgeting
2.3.3 Salient Features of a Budget
2.3.4 Steps in Preparing a Budget
2.3.5 Meaning and Purpose of Auditing
2.4 Management of Materials
2.4.1 Meaning and,Objectives of Materials Management
2.4.2 Material Management System
2.4.3 Inventory Control
2.5 Management of Time
2.6 Let Us Sum Up
2.7 Glossary
2.8 Model Answers
2.0 OBJECTIVES
• Describe meaning and functions Of personnel management and policies;
• Explain meaning and purpose of financial management;
• Describe the meaning and objectives of materials management
• Define inventory control and its procedure; and
• Explain the meaning of time management and type of time plans.
201 INTRODUCTION
In the preceding unit you have learnt about meaning, importance and functions
of management. Management is a process of working with and through people
to achieve organizational objectives by efficient and effective use of human and
physical resources. Management isa part of daily routine of an organization and
to perform the daily activities, resources of all kinds are required i.e., men, money,
materials and time. Efficiency of manager and organization depends on efficient
management and use of resources to achieve the objectives .
.-/--,.
24
It is essential for you to understand the basic concepts of management of men, Management of Resources
material, money and time, so that you are able to apply this knowledge in your
practical field to provide quality care to people. In this unit you will learn about
management of personnel, materials, money and time.
2.2 MANAGEMENT OF PERSONNEL

Personal management is a method of developing potential of employees so that
they get maximum satisfaction out of their work and give their best efforts to the
organization.
Personal management is concerned with human resources of the organization.

This involves planning, organizing; directing, controlling and coordinating the
activities of personnel at work and their selection, development and maintenance.
2.2.1 Meaning of Personnel Management

Personnel Management is an art of acquiring, developing and maintaining a
competent work force in such a manner as to accomplish maximum efficiency
and economy in the functions and objectives of organization. It means preparing
staff well for the assigned job so that objectives are achieved and quality care is
provided.
2.2.2 Functions of Personnel Management

Functions of personnel management are:
Manpower development: The basic function of personnel management is the
management of human work force to plan, utilize, direct and develop the efforts
of people to attain individual and group goals.
Job Satisfaction : Personal management is a method of developing the

potentialities of employees so that they get maximum satisfaction of their work
and give their best to the organization. In other words, if one gets job satisfaction,
she in return does the job well.
Good working environment : good working environment and structure are

provided for maximum efficiency.
Staff Selection: Suitable staffs are recruited, their needs are determined and
they are trained and retained .
. Staff development: Staff is developed through training, career advancement,

and welfare facilities.
Problem solving: Joint consultation system is used for solving problems.

Communication: Effective communication system and interpersonal relations
are established in the organization.
Personal policies : personal policies are formulated which help in better

organization of services.
2.2.3 Meaning and Importance of Personnel Policies

Policies are written document of an organization
25
I
Management of Subcentre Policies are basic rules established to carry out functions, with defined objectives"
Policies are based on institutional philosophy, purpose, values and principles.
They are guides to action.
• All organizations have written policies developed by top-level manager

• Policies set the pattern for planning and implementation
• . They provide guidelines for relationships in the organization, .e.g, role of
subordinate and superior.
• Policies serve as standards for evaluating the performance of staff.
• Policies provide guidance for new personnel.
Policies play a key role in the proc~.ss of total management. To carry out any
function, policies are to be set before hand. For example, in personnel
management, to carry out the function of recruiting, selecting and placing a staff,
policies have to be worked out before hand.
2.2.4 Characteristics of Good Policies

Characteristics of a good personnel policy are given below:
i) Flexibility: It should not be rigid, it should be adjustable to any change but
fit into overall policies, e.g., salary structure is reviewed from time to time.
ii) Stability: It should be stable and permanent, e.g., the leave pattern is usually
stable, although some changes have to be made when needed.
iii) Responsive to recent trends: It should adjust to recent trends and norms.
For example, the qualification for each category of workers need to be revised
iv) Precision and Certainty: It should be clear, complete in all respects and,
should not create conflict. For example, policies are written documents.
v) Uniformity: It should be applicable to all the units and to all the employeesj
For example, providing house allowance to all the employees.
vi) Protection of interest of all : Interest of top, middle and lower level
managers should be taken into consideration.
vii) Acceptability: Workers shouldaccept these policies willingly and these

should match with their capabilities, interests, aspirations and beliefs.
viii) Communication of policies : All the employees should be aware of the

policies and they should be written and available. These policies need to be
communicated to the lower level managers by the higher level.
Advantages of Personnel Policies

• It has two important values to the employees and to the employer/ supervisor .
. It is safeguard for actions and decisions and relives her from the responsibility
of asking her supervisor for guidance at every step good personnel policies
help to give the employees a sense of security and individual worth.
• It serves as guidance of action
• Time saving
• Avoid dissatisfaction by avoiding false hope to employee.
26 • Helps in smooth running of work of the organization.

r Check Your Progress 1 Management of Resources
I i) Define Personnel Management.
.
...................................................................................................................... .
ii) List down the functions of personnel management.

.......................................................................................................................
iii) Define personnel policies.
iv) List five characteristics of Personnel Policies.
2.3 MANAGEMENT OF FINANCE

Managing money is a difficult and complex activity. Health workers at subcentre
level have very less responsibility in spending money they are asked to keep
records of whatever little amount they spend.
2.3.1 Meaning and Purpose of Financial Management

Financial management is an activity of management that is responsible for
obtaining and-effectively utilizing the funds necessary for efficient working and
achievement of objectives. There are two types of money Te. invisible and visible.
27
1
Management of Subcentre Visible cash is given in advance and is replenished as and when necessary. It is a
definite amount for definite period. In case of emergency, whole of it can be
spent and will be replaced by authorities e.g, if a health worker is given Rs. 50/
- for a month, she has to enter details of expenditure in cash register and submit
receipts to accounts officer. Money will be reimbursed and then total amount
will be again i.e., Rs 50/-. You need to keep original receipts to avoid any problem.
However, invisible money is discussed in table 2.1
Table 2.1: Invisible and visible money
1. Invisible Money 2. Visible Money

Money not seen or handled by health workers Money that is seen or handled.
e.g. the Government allocated to each health The cash given to health
centre an amount ofRs 10,000 to draw drugs workers to spend in small
from Central Store. The health centre applies amount e.g, stamps, bus fares,
for these drugs from store with a requisition telephone call, matchbox,
or indent. In this way actual money does not candles, paper, envelopes,
pass through the health centre but written photocopy, and kerosene etc.
account of each requisition is kept. Allocation This varies from place to
of amount is for a definite purpose e.g. drugs, place. Bills are kept and
equipment, linen etc. and has to be spent for records are maintained.
specified purpose.
Whenever you spend money, note it clown immediately in the cash register -
write Bill No., Date, items purchased, amount paid, and amount balance.
Maintain a file for bills, if possible keep photocopy of bill, as you will be
submitting original Bill in the office. A person who has sold the thing should
sign the Bill. A sample recording of bill is given in table 2.2
(In emergency, one has to spend money for spending on various items,
Table 2.2: Cash Record of money spent and balance
Date Bill No Amount Amount Details of Amount spend on items Amount

Received Spend Paper Stamps Photocopy Envelope Balance
Rs. Rs. Rs.
01.10.99 Rs 50/- Rs 10/- ,Rs 5/-
12.10.99 60896 - Rs20/- - Rs4/- Rs 16/-
16.10.99 71814 - Rs 25/- Rs 15/-
,
Total 50/- 45/-
I
15/- 4/- 16/- 10/- 5/-
2.3.2 Definition and Purpose of Budgeting

Meaning: Budgeting is "plans estimates" or Forecast etc. that connects the future to
the present as well as past. When preparing budget for the future one has to always
take guidance from the past experience and know the present budgeting is most
important lost of management which enables them to obtain synthesis of the past,
present and future.
Budget is an instrumentused by management inplanning its futureactivitiesforrnanaging
income and expenses.
Definition: Budget is a financial interpretation (document) of a policy to be pursued

to attain objectives in a given period.
28
[
It is a formal expression of plans, policies and objectives laid down in advance Management of Resources
I for the organization as a whole.

( ,
Budget is a blue print of projected plan of action and expenditure of an
organization for a definite period of time. Refer unit 1, sub - section 1.3.7.
Budgetary control: It is concerned with measuring and comparing actual results
as provided in the budget by
I)! Anticipating cash need
2) Establishing standards
3) Taking action
4) Measuring results and compare actual
~
5) Find deviation
6) Correct the errors and find results.
\
Purpose of Budgeting
• It is helpful in financial planning and decision-making.
• It helps in communicating financial objectives and cost of activities to achieve
these objectives.
• It is a feedback for actual expenditure against budget allocation.
• It shows relationship between organization, objectives and financial planning.
2.3.3 Salient Features of a Budget

Some of the salient features of a budget are given below:
• Top management is ultimately responsible for planning, implementing and
evaluating the budget Although middle and lower level managers make
departmental budget plans and implement them.
• Budget should be prepared by anticipating the future, keeping in touch with

the present and experience the past. It should be flexible to accommodate
uncertainties and variable cost of services.
• Budget should be in the form of financial statements i.e., in numerical form,

not described in words.
2.3.4 Steps in Preparing a Budget

After going through the features of a budget we will see what are the steps in
preparing a budget. Steps in preparing a budget are:
• Examination of the past performances to know about achievement of
objectives, its successes or failure.
• Setting objectives !or forecoming year, stating them in the form of services
to be provided.
• Estimation of increase in cost of various aspects including any change in
payment system.
• Preparation of budget report and submit for review by top-level manager.
• Review of budget plan and submit to finance committee.
• Modification by finance committee and then approval by board. Refer
-Fig. 2.1 for steps in preparing budget. 29
I
Management of Subcentre Examine the Past & Present Performance
Approval by board ~
Set Objective
~ ~
Final Submission Estimate increase of cost
.~
~
Prepare budget report
Modification by Committee
-
\l?7:' ~
Modification by Committee
«» Review budget
Fig. 2.1: Steps in preparing budget
2.3.5 Meaning and Purpose of Auditing

Meaning of Auditing
Auditing is a systematic examination
!i
of the books and records of the
organization, in order to ascertain or verify and to report on the facts regarding
its financial operations.
Auditing is an instrument of financial control.
Audit is the examination of all practices related to financing or services,
material, machines, workers or any other activity that involves cost.
Purpose of Auditing
• Assessment of the quality of services carried out.
• Assessment of the activities in relation to policies and plan.
• Assessment of accounts maintained for various purposes.
• Safeguard against carelessness, fraud and losses.

i) Define financial management.
30
ii) Define Budgeting. Management of Resources
iii) List down three purposes of budget.
iv) List purpose of auditing

......................... ~ : .
2.4 MANAGEMENT OF MATERIALS

Definition of Material Management: A system of planning, organizing, directing,
coordinating, controlling and maintaining adequate equipment .
and supply
.
whereby there will be right quality and quantity of stocks of materials, properly
stored, easily retrievable and distributed for the use, whenever required at the
given time.
For providing quality care, right material of right quality in right quantity, should
be available at right place and at right time.
Lack of proper material n:anagement in the hospitals and district health system
leads to ineffective implementation of health programmes. A good and systematic
material management can improve efficiency. The non-availability of drugs,
equipment and material supplies causes dissatisfaction among health workers
and community.
!"aterials are of two types:

• Consumable materials are used within short time. They are disposable items
e.g., stationary, cotton, dressing, etc.
• Capital materials last for long time and need maintenance e.g., microscope,
refrigerator, furniture, vehicles, etc.
31
I
Management of Subcentre 2.4.1 Meaningand Objectives of Materials Management
Meaning
Material management is concerned with planning, organizing and controlling the
flow of material, from their initial purchase through internal operations to distribution
or service points. In health care organization, materials management is an essential
function .'
Objectives
• Low Cost: To get good quality material at low price.
• High inventory turnover: Use the material in the stock before processing new
ones so that minimum money is blocked in inventories.
• Low storage cost: The cost of storing the material should be minimized in terms
of space, cost.
• Maintaining quality of purchase: Material of standard specification and good
quality should be purchased.
• Maintain cordial relations: Maintain cordial relations with the suppliers to get
supplies of good quality material in time and to avail 'after sale service' of the
equipments.
2.4.2 Material Management System

Four main procedures are used in management of materials (Fig. 2.1). These are
'described below:
• Ordering
• Storing
• Issuing
• Maintaining and Controlling
For example in most of the primary health centres main stock registers for
medicine, equipment and supplies are maintained.
Example: Stock Register for DPT Vaccine

SI. Date Requisition Total
•Total Total Remarks Signature
No. 'No Quantity Quantity Quantity r ifany ,
'.
Received Issued Balance
1 5.6.99 09018
-
20 vials 15 vials 5 vials - .
2 10.10.99 11945 10 vials - 15 vials -
3 12.10.99 - - 9 vials 6 vials - .• <
2.4.3 Inventory Control

Inventory control is the process of deciding what and how much of items are to be
kept in stock. It determines the time and quantity of items to be procured.
Inventory control is a management function. Inventory control system should exist at

all levels of management depending on need and requirement at each level. It is used
to maintain investment in materials for the-purposes of obtaining a maximum financial
return.
32
Materials management involves unlimited transactions every year. To avoid confusion Management of Resources
Inventory Control Procedures are used to keep precise control over items. For this
purpose items are classified into groups. One widely used classification is the ABC
analysis, other are VED and SDE methods.
ABC Analysis
This means "Always Better Control" orAlphabetical Approach. ABC analysis depends
on annual usage of items.
Inventory is classified into 3 categories according to their usage:
A item having high annual usage
B item having average annual usage
C item having a low annual usage
II!! ."""':.
A
':l '-
....'
10-15
ft.
'!nt.r. h'" '"
70-80
B 20-25 15-20
C 60-70 5-15
It is seen that large number of items consume small percentage of resources and vice
versa.
A A list of few but high value items, e.g. an incubator
B A list of medium value item, e.g. Sphygmomanometer etc
C A longer list but oflow value item i.e., iron, folic acid tablets, vaccines, syringes
and needles.
VED Analysis
This analysis is based on critical value of an item and its affect on the functioning of the
organization.
V Stands for Vital items without which organization cannot function. Certain items
should be always available in stock, controlled by top management e.g., life
saving drugs, oxygen cylinders etc.
E Stands for Essential items without which organization can function but quality of
services will suffer. These are controlled by middle management e.g., bandages,
disposable syringes and needles etc.
D Stands for Desirable item without which organization can function, without any
affect on services provided but their presence would add to the quality of services.
These are controlled by lower management e.g., health education Material
(projector, video films).
SDEAnalysis
This system is based on availability of items in the market.
S Items are scarce in the market means in lesser amount
D items are difficult to obtain but are available 'at a few places
E items which are easily available in the market
33
I
Management of Subcentre Process of purchase
• Identification of item for purchase
• Receipt and analyze the requisition
• Call for Quotation and select best item
• Receipt the order
• Payment & maintain all records
• Issue for consumption.
• Maintenance and repair
• Disposal or condemnation
Role of nurse in material management

1) Ensure regular and adequate flow of material
2) Set standards and quality of items and safety of material
3) Avoid
, wastage and breakage
.
4) Follow the policies, procedure and routine for indent of items
5) Maintain emergency and buffer stock
6) Maintain proper inventory and stock of all item
7) Arrange for condenination of broken and old item
8) Evaluate the system of material management ,

i) Define material management.
•••••••••••••••• ; ••••••••••••••••••••••••••••••••••••••••••••••••• 0 •••••••••••••••••••••••••••••••••••••••••••••••••••
ii) Enumerate four main steps in material management.
iii) List down the three types of inventory control procedures.
34
I
Management of Resources
2.5 MANAGEMENT OF TIME
Time is a very scarce resource, which cannot be stored and cannot be utilize
later. But if used with other resources efficiently can lead to achievement of
objectives. Adequate planning of work according to available time will make
sure that all activities are carried out and maximum problems are solved.
Time plans in a Health Care Organization

Time is a non renewable resources and one should use it efficiently. Schedule
helps to use time efficiently.
• It helps in overcoming confusions, delays and overlapping
• It helps to spend time for important activities or on a priority basis.
• It helps in saving time by coordinating various activities
• It helps to motiva~e workers as a team to complete work in time
• It helps in division of work among workers
• It helps to undertake urgent or unexpected work and complete it.
Time plans are written in the following forms:
i) Timetables: Timetables are made for regularly recurring events, e.g., OPD,
home visits, meeting, training, record maintenance and group health
education etc. You have to block time for these activities. There may be
daily, weekly or monthly events e.g. daily OPD and home visit, weekly
meeting, record maintenance and you may plan monthly training
programmes.
ii) Schedule: Schedule is made for intermittent activities and where they take
place i.e. different or some activity takes place in a different place; e.g.,
mobile van visits to different villages on the same day every week.
iii) Programme: Programme is made for any special health activities e.g., well
baby show, family welfare camp. It lists activities that will take place in the
future and includes what will be done, where it will take place, who will do
it and when it will occur. For example, special health check up programme
for school children in a district X on a given date, month and time.
iv) Roster: Roster is duty plan for different staff at different or same time. To
distribute the work evenly during working hours, duties are changed monthly
so that all accept it.

i) Explain time management.
..................•............................................................................. : .
35
1
Management of Subcentre ii) List down types of time plan.
2.6 LET US SUM UP

In this unit you have learned about- management of resources - men, money,
material and time, without which it is impossible to carry out any management
activity.
'Nowadays personnel management or human resource management is getting

importance. Its aim is to make use of human force to achieve objectives by using
resources and providing good working atmosphere. Personnel management's
function is to recruit, select, give training, put a person onjob, develop, promote
or transfer the employees. Further we have discussed the most important function
of this department that is to make personnel policies, which are flexible stable,
acceptable and communicated to all the employees.
Financial management is the second important function that you have studied
under budgeting and auditing process. Auditing is an essential aspect of financial
management. It helps the management to keep check on finances, type of services
provided and objectives achieved. Auditing is a safeguard against misuse of
finances.
Inventory management is vital to material management. Material management

is a crucial aspect as supply of material is limited. In case drugs or dressing or
any other material is not available in time, it is very difficult to serve and convince
people.
At the end we have also discussed the most expensive and non-renewable resource I
that is time. Time plans are explained in the form of timetable, schedule, )
programme and roster.
2.7 GLOSSARY
Administration Process of achieving the set objectives of an
organization through policies, plans and procedures.
Concept General idea or understanding about a complex thing
phenomenon.
Development To develop overall capabilities of an employees.
Management Process of putting policies, plans and procedures into
action.
Material Equipment, apparatus, supplies, drugs used in an
Organization.
36
I
Objectives Objective or goals are the desired end or end results Management of Resources
of action taken .:
Orientation Introduction of new employees' to the organization.
Performance Periodic and annual systematic evaluation of an
Appraisal Individual employee.
Placement To place a selected candidate on the job i.e. process
of determining job.
Recruitment Process of identifying sources of human force,
attracting and motivating them to apply for the job.
Selection Process by which suitable candidates for Employment
are identified
2.8 MODEL ANSWERS

. i) Personnel management is a method of developing the potentialities of

employees so that they get maximum satisfaction out of their work and put
their best efforts to the _?rganization.
.ii) - Determine staff needs, recruit, train and retain them.
Developing and deploying staff through training and career
advancement.
Provide good working environment.
Formulating personnel policies
Developing effective communication system.
iii) Policies are basic rule established to carry out functions and as aguide towards
achievement of accepted objectives.
iv) - Flexibility
Stability
Uniformity
Acceptability
Precision and certainty
i) Financial management is an activity of management that is responsible for
determining and effectively utilizing the funds necessary for efficient working
achievement of objectives.
ii) Budget is a financial interpretation of a policy to be pursued for that period
to attain given objectives
iii) - Helpful in financial planning and decision-making.
Translates objectives into expenditure.
Feedback for actual expenditure against budget allocation.
37
I
Management of Subcentre iv) - Safeguard against losses and carelessness
Assess quality of services
Assess activities in relation to plans and policies
Assessment of accounts maintained
i) Material management is concerned with planning, organization and control
of goods, services and equipment from purchase point to distribution or
service point.
ii) a) Ordering
b) Storing
c) Issuing
d) Maintaining and Controlling
Hi) a) ABC analysis
b) VED analysis
c) SDE analysis
i) Time is a very important, non- renewable resource, it has to be managed by
all the managers to achieve the objectives by planning the programmes in
advance, follow the programme schedule to carry out the activities. Plan
time and take timely action to march towards your goal with your team.
ii) a) Timetables
b) Schedules
c) Programmes
d) Rosters
38 1
I
UNIT 3 PROBLEM SOLVING AND DECISION
MAKING
Structure
3.0 Objectives
3.1 Introduction
3.2 Meaning and Definition of Problem Solving
3.3 Steps in Problem Solving or Decision Making
3.3.1 Identify the Problem
3.3.2 Identify all Possible Solutions
3.3.3 Select one Solution
3.3.4 CarryOut ~nd Follow Up the Solution
3.4 Problem Solving in the Community

3.4.1 Types of Problems Encountered in the Community
3.4.2 Support System for Solving Problems in the Community
3.5 Case Study of Problem Solving Process

3.6 Let Us Sum Up
3.7 Model Answers
3.8 Further Reading
3.0 OBJECTIVES
After completing the unit, you will be able to:
• . Define the problem;
• . Describe the steps of problem solving; and
• Identify the problem in the community and solve them.
3.1 INTRODUCTION
You may be coming across many problems at home or work place in daily routine
and you mus~.qe solving these problems. What steps do you follow? Can you
think about them? If yes, then relate them with the steps of problem solving
described below. Are they identical or different? Try to learn about problem
#
solving in a systematic way because you will be using it frequently. In any

organization where people work together problems may occur and supervisors/:
administrators have to solve these problems and take decision at all levels of
management. Therefore, at lower level you also have to take decision or solve
the problems. In this unit we shall discuss about steps of problems solving process.
3.2 MEANING AND DEFINITION OF PROBLEM

SOLVING
Problem solving is a creative and thinking process. It involves selection of a
particular course of action out of various alternatives for solving a problem.
39
I
Management of Subcentre Decisions are taken to solve problem. It is an important supervisory activity.
Supervisors Administrators at all levels manage the affairs by making decisions
and implementing them to solve problems.
Problem means the difference existing between a prevailing situation or condition

and the desired situations. A problem occurs when you have need that is not
being met. A situation becomes a problem when we think it can change. A problem
is a state of dissatisfaction, e ..g, state of illness causes dissatisfaction and state of
well being leads to satisfaction as shown.
Here, ill health is a problem; one is dissatisfied in this situation. It needs change
so that one gets well and is satisfied. To reach the state of well being some action
needs to be taken by the individual or in other words, this problem needs to be
solved step by step. .
.'
3.3 STEPS IN PROBLEM SOLVING OR DECISION

MAKING
Generally people solve problems in one or other way. People with experience
use common sense, to solve problems without considering the steps of problem
solving. As you know problem solving involves logical and sequential step to
solve the problem. Problem solving involves following four steps. .
3.3.1 Identify the Problem

The first step in making a decision is to decision is to clearly the situation that is
causing the problem. .
Problem has to be recognized first. Often problems are mistaken for symptoms,
which are signs indicating that a problem may exist, you may have to gather
enough information to recognize the problem. You should discuss with village
people, community leaders, or those involved. You should review records and
reports that relate to the problem and collect all the facts and opinions of the
community. These facts will help YQuto identify the problem more clearly. For
example, if a child suffers from repeated episodes of diarrhoea, you need to find
out all related information about water supply, personal hygiene, and
environmental sanitation.
Relevant and reliable information has an important role in taking decision to
solve problem. Information is required not only to identify and define the problem
but is required for all the steps involved in the process of the problem solving.
3.3.2 Identify all Possible Solutions

The Second step in making decision is to make a list of the solutions to the
problem. This is the creative phase of the problem solving process. It involves
creative thinking and innovativeness and you have to identify and list a set of
alternative solutions to solve problem. Each alternative solution should be
evaluated in terms of the problem and availability of man, money, material,
resources and time. For example, if a village road is to be constructed, you may
take little time and accordingly use limited man, money and material. But if it is
pulse polio immunization day you have to cover maximum number of children
on that day. Since you have a limited time you have to use maximum resources
such as man, money and material. (Refer an example of case study in Section
3.5)
40
I
Problem Solving and
3.3.3 Select one Solution Decision Making
Once you have identified a problem and listed the possible solutions, the final ~
choice is made by selecting an alternative, which is less time consuming, efficient,
result oriented, objective oriented, within resources, acceptable, simple and
practical. Experience and judgement helps in selecting the best solution. So you
should use your judgement to select a solution. Knowledge and experience
improves judgement and decision': With practice and experience" you will improve
your ability to select the best solutions to problems.
3.3.4 Carry Out and Follow Up the Solution

Once you have chosen the best alternative solution. You 'have to make plans to
carry out the selected solution. It involves series. of actions and utilization of
resources. To implement solutions it is necessary to allocate resources etc. To
secure cooperation and acceptance for implementing solutions, you should take
other people into confidence. Once you have taken the decision you have to
follow it up. You would like to know if the problem has been solved by the
decision made by you and how did this particular solution work out. This feedback
will help you to improve your problem solving skill and make you a better decision
maker. Almost all decisions will generate some resistance. Those affected by
your decisions may give a list of suggestions. Try to listen to them and if your
decision is wrong. You should admit your mistake.
Then the entire_process must be repeated from the beginning i.e.,

1) Identify the problem and set the objectives \
2) Identify all possible solutions

3) Select one of the best solution
4) Carry out and follow up the solution

i) Problem solving is defined as a .
....................................................................................•....... ~ .
'-,
ii) Decisions are made of all levels to ......................................•... the problem.
iii) List the steps of problem solving .
.......................................................................................................................
41
I
3.4 PROBLEM SOLVING IN THE COMMUNITY
Problem solving in the community is very important. While working in the
community you corrie across many problems, but all problems are not realistic
or you can say that actual problem is different than it was imagined. It is essential
to follow, the steps in problem solving. These four steps are followed in almost
all' decision-making situation. The more complex the problem, the more time
and efforts you wilIneed to spend on each step. Good decisions require judgement
thatcomes only with experience. Mutual tolerance and appreciating others ideas
encourage creative thinking and help in problem solving.
3.4.1 Type of Problems Encountered in the Community

Different types of problems encountered in the community are:
• Insufficient drugs and vaccines
• Inadequate working conditions
• Lack of transport
• Lack of utilization of centre services and support from the community
• Late and inaccurate submission of reports.
3.4.2 Support Systems for Solving Problems in the Community

There are various support system for solving the problems in the community.
These are:
• Services of other sectors in the areas should be available

• Transport facilities should be available
• Local people and leaders must support and-participate in health activities .
• Health centre building is a must for carrying out health activities
• Inform~tion system should be well. developed
.
• .Regular supplies of instruments, drugs etc. should be ensured
,?
r=
• I~~mmunity resources should be fully utilized.
• Staff should be regularly trained •
3.5 CASE STUDY OF PROBLEM SOLVING

PROCESS
Read the following case, study you will get an idea about steps of problem solving.
On scrutiny or records of PHC, in an area, it was observed that monthly reports
are not submitted by subcentre staff in time and these reports are not accurate.
Now how you will identify this problem. You will identify this problem by
collecting the following information:
1) Identify the Problem

• Reports are not submitted accurately in new performa
• Proforma is just sent to all centres without explaining the need and
format of the proforma
• Proforma is very elaborate and complicated
42
I
Analysis of Information Problem Solving and
Decision Making
Now you will try to find out how this problem has occurred:
• No one has explained about change in proforma
• No one in the district was clear about the reporting proforma
• Supervisors themselves were confused. They were not able to guide the
workers as there were new additions in reporting
• Medical Officers and Dy. CMOs have not oriented staff about changes
• Proforma copy was handed over to supervisors and workers to make
report.
• Supervisors and workers had to get it Photostat from their own pocket
2) What all possible solutions are:
• . Medical of.ficers to be explained aboutchanges, so that they can guide
workers.
,
• Supervisors to be oriented about writing report on new proforma.

• Workers and supervisors to be instructed and explained about filling up
the proforma.
• Enough copies of proforma to be given to workers.
• Supervision and evaluation of reports to be done at block and district
level.
3) Selection of one solution
Select one solution. As supervisors are 1st level managers so you should
supervise and guide health workers and help them'to fill up the proforma
and prepare reports
4) Carry out and follow up the solution
Health workers were taught how to fill up the proforma and prepare reports.
Demonstration and return demonstration were taken.
3.6 LET US SUM UP

In this unit you have learn regarding problem solving and decision-making
process. Problem solving is decision making. It is a thinking process. You have
to make decision, which requires judgement, and good judgement comes with
experience. Further the steps of problem solving are explained in detail. An
example of application of these steps is given for your reference and further
clarification.
3.7 MODEL ANSWERS

i) Problem solving means the difference existing between a prevailing situation
or condition and the desired situation. It is to solve routine and complex
problems, to resolve crisis and conflicts, and to handle unexpected situations.
ii) Solve
43
I
Vlanagement of Subcentre iii) a) Identify the problem
b) Identify the solutions
c) Selection of a solutions
d) Carry out and follow up
3.8 FURTHER READING

Health Centre Management, Supervising and Supporting Mid Level Health
Workers, Health Manpower Development Staff, University of Hawaii, 1983.
I
44
c
UNIT 4 WORK PLAN AT SUB CENTRE
Structure
4.0 Objectives
4.1 Introduction
4.2 Work Plan: Meaning and Relevance
4.3 Steps Involved in Developing a Work Plan
4.3.1 Understanding the Community
4.3.2 Collecting Facts for Assessing Needs
4.3.3 Analyzing Facts and Needs
4.3.4 Developing an Action Plan
'.
4.3.5 Implementing the Plan
4.3.6 Evaluating and Re-planning
4.4 Guidelines for Preparation of Work Plan
4.4.1 Developing a Database for Planning
4.4.2 Activities at Subcentre
4.4.3 Ascertaining Felt Needs of Population
4.4.4 Defining the Workload Norms
4.4.5 Consulting Other Concerned Personnel
4.4.6 Strategies for Implementation for Work Plan
4.4.7 Organizing and Providing Services
4.4.8 Recording and Reporting
4.5 Let Us Sum Up
4.6 Glossary
4.7 Model Answers
Annexure
4.0 OBJECTIVES
• Explain the meaning and relevance of work plan;
• Analyze the nature of work plan;
• Describe the specific steps in planning work at subcentre level; and
• Develop a work plan keeping components of different programmes of
subcentre in mind.
4.1 INTRODUCTION
Different services are provided to the community from subcentres under the
health and family welfare programme. To ensure quality of care to the community
under various programmes of the subcentres, it is essential to have a proper
work plan. Health personnel working in various programmes of the subcentre
should develop work plan so that services are offered efficiently and at the fixed
time. Familiarity with the plan and the programme components is one of the
important indicators of success for a health worker. 45
I
, Management of Subcentre Planning is an important component of subcentre management. As a health worker
in charge of the subcentre your activities involve a wide range of tasks from
assessment of the requirement for vaccines, drugs and supplies and programme
of special activities to develop, implement and evaluate an action! work plan for
each village. Planning is also necessary to schedule your work so that all villages
under your care are covered with services.
The community need assessment under Reproductive Child Health (RCH) is

one method for identification of needs for services in order to develop a plan and
provide the required services to people. In this unit we shall discuss about work
plan, steps in planning work, and guidelines for preparing work plan.
4.2 WORK PLAN: MEANING AND RELEVANCE

Sub Centre is the most important institution in providing health care. The Success
or. failure of health care depends upon the attitudes, perception and ethics of
health workers and volunteers working in subcentres. Subcentres are pivot around
which are important schemes revolve. Health Centres can really communicate
efficiently with community, volunteers and people.
There is need to strengthen the health centre to grab the benefits of health care.
World Health Organization had also recommended it.
The First line health workers are the major work force at the primary level. They
provide a substantial part of the promotive and preventing components of the
essential health care package. The staffing pattern at periphery, health unit is an
important indicator of the effective functioning of PHC.
Work plan at subcentre is the process of determining the course of action which
will meet various health needs of the people served by the subcentre. Subcentre
work plan forms the basis of decentralized planning. It provides the health worker
with the required data for various services as needed by the population living in
the area of subcentre.
Work plan of subcentre contains the list of services to be provided through the
subcentre. It also contains the methodology to calculate the needs of people with
respect to all services. Objective of the plan is to improve the coverage and
acceptance of various health and family welfare services provided through the
subcentre. Work plan will help you to keep track of the activities that you have to
carry out in your area of service. In short, it is a tool to enhance the,effectiveness
of your functioning as a nurse ANMlfemale health worker.

1) What do you mean by work plan?
•••••••••••••••••••••••••••• '" •••••••••••••• " ••••••••••••••••••••••••••••••• ~•••• ~••••••••••••••• '! ••• , •••• ~~!. t •• t·
••••• 0$ ••••••••••••••••••• 0.0 ••••••••••••• 0 •• 0 ••• 0 ••••••••••••••• 0 ••••••••••• o ••••••••••••••••• ~ ••• , ~ •• ,. ~~ •••• O! ,.~!t
••••••••••••••••••••••••••••••••••••••••• ' ••••••••••••••••••••••••• !•••••••••• ~:~••: ~.~.!••: •••••••••••• t· ••••••••••••
•• • • • • •• • •• •• •• • • • • • •• • • •• ••• •• •• • • • '.' •••••••••••••••••••••••••••••••••••••••• ~ •• !. ••••• , • " •••• " •••••••••••• , •••••••••
46
I
2) Explain the relevance of work plan in improving the coverage and acceptance of Work Plan at Subccntre
various health care programmes provided through subcentres.
4.3 STEPS INVOLVED IN DEVELOPING A WORK

PLAN
Developing a work plan involves at least six important steps. Each of these steps
are interrelated in the sense one step is not completely distinct from other. The
steps involved in developing a work plan are 'discussed below:
1) Understanding the community

. 2) Collecting facts and conducting a need assessment
3) Analyzing facts and needs to decide priorities
4) Developing plan of action
5) Implementing the plan
6) Evaluating and re-planning
Let us understand each one of the steps
4.3.1 Understanding the Community

Each community is unique as the heritage" cultural patterns and life style of the
people of communities are different. You should learn about the nature ofthe
community and the prejudices, antagonisms, superstitions, customs, health problem
and general attitudes prevailing in the community. Understanding the community's
point of view about health habits is a baseline for building the programme.
Understanding the community is an integral part in providing health facilities and

services for the promotion and maintenance of health to meet the total health
needs of every person in the community.
4.3.2 Collecting Facts for Assessing Needs

The following outline of facts about the community is essential to organize a
work plan:
o Socio-economic and demographic factors such as education, accupation, light

and size of Family etc.
it) Mortality and Morbidity rates: Details regarding common causes of death in
community in recent past, number of births, number of maternal deaths,
number of infant deaths, cause of maternal and infant deaths, details of people
suffering from different diseases and the status of immunization among school
and other children.
47
I
Management of Subcentre iii) Resources: Different resources available in the community including
hospitals and other social agencies and the type of services offered by these.
iv) Other information: Consisting of nutritional status of children, type of crops

and vegetables cultivated and eaten, source of water supply and sewage and
refuse disposal system.
In short you have to conduct a detailed community need assessment before you
develop a plan of action. Some of the data need to be collected once in a year like
estimation of pregnancies, births and number of infants, dates and times of fairs,
festi vals and other important events in the area.
4.3.3 Analyzing Facts and Needs

.Objectives analysis of the total situation is a point of reference for work and
.schedule planning. Collected facts should be analyzed to identify factors that
influence health and can promote the health programmes keeping in mind the
specific health rieeds of people. Such an analysis will help to determine the areas
of work to be emphasized and to set priorities in the work. Analysis of data will
also reveal the specific characteristics and needs of the community. This will
help in setting goals.
4.3.4 Developing an Action Plan

Work plan should be developed on the basis of above mentioned steps containing
long term and short term goals. Planning of activities undertaken in short term
goals should deal with immediate problems.
Yearly, monthly, weekly and daily work plan can be developed. Example of such
a subcentre action plan is given at the end of this unit (i'~nnexure). When the
health problem and the factors that contribute to health problems are pinpointed,
you are ready to plan a time and activity programme. The work plan developed
in such a fashion will list out the.activities to be undertaken by you according to
the time of administration of the activities.
4.3.5 Implementing the Plan

The next step in developing a'work plan is to try the plan. If you get satisfactory
results, it means that the plan is good. However, it is to be borne in mind that the
first plan generally needs adjustment and rearrangements. Similarly, the work
plan must also be flexible to meet changing conditions and needs. To determine
the impact of services, it is necessary to formulate a master list of activities that
reflect achievements and that it measures some obvious results.
4.3.6 Evaluating and Re-planning

After implementing the action plan, we have to evaluate to determine the
achievement of the ob, ectives or short term goal. Information revealed in a planned
system, provides facts and a basis for re-planr+ig. When you understand that the
services carried out according to the work plan do not provide satisfactory results
then you have to replan. The basis of replan should be findings of the evaluation.
of services. The limitations, difficulties and problems encountered in
administration of services envisaged in the work plan should also be' kept in
mind when you replan the work. It is advisable to bring the other partners of
48
I
health team like health supervisors, anganwadi workers, multipurpose health Work Plan at Subcentre
workers etc., together and revise the plan in accordance with their experience
and recommendation.
4.4 GUIDELINES FOR PREPARATION OF WORK

PLAN
Subcentre work plan forms the basis of decentralized planning. It provides the
requirements of various services by the population living in the area of subcentre
as their felt need. Preparing a work plan at the subcentre level should fulfil the
following pre-requisites
4.4.1 Developing a Database for Planning

The most important pre-requisite for developing a work plan is to develop a
database for planning at sub centre level. The basis of work plan is data collected
pertaining to the community and people covered under a subcentre. The ground
realities of the area cannot be ignored while delivering services. The content of
a database required for planning at subcentre could be as given below:
a) General Information
• Geographic location of the village and its landmarks, resources etc.
• Population characteristics and no. of villages
• Population below poverty line
• Rate of literacy at different age group and communities
• Number of under-privileged people (e.g., ~C/ST)
, migrant labourers
• Common religious communities and important festivals
b) Demographic Features
• Total population, age, sex, sex ratio
• Average age at marriage
• BirthlDeath rate.
c) Programme Performance
• Performance of family welfare programmes over the year couple
protected protection rate, fertility.
• Performance of MCH, Antenatal rate, post natal rate, delivery services
over the year
• Listing of polio, neonatal tetanus,and measles cases and their
investigation
• Data on performance of other health programme
• Data on epedemic outbreaks
• Medical emergencies and health programme
• Information on eligible couples to enhance small family norms
• Profile for FP acceptors - Family Planning for population control
49
I
Management of Subcentre cl) Infrastructure - Health
• Number of private practitioners (qualified and quacks) in the area.
• Number of Hospitals/Nursing homes with bed strengths
• Number of Block PHC/CHCIPP centre and referral hospital
• . Cold chain equipment available/status
• Supplies of drugs and other equipment
• Number of health personnel in each category - TBA, AWW
• Other health facilities like health camps, dispenceries etc
e) Infrastructure - General,
. "
• Roads/ other means of transport
• Electricity supply
• Drinking water
• Education/adult education facilities
• Ration shop
• Panchayat system
• Post Office
• Banks
• ICDS
• NGOs (Non Government Organizations working for health and
development)
• Access ability to subcentres
4.4.2 Activities at Subcentre

No work plan can be developed without having adequate knowledge about the
different services to be offered from the subcentre. A work plan in brief is the
time schedule telling what activity will be done at what time. The different services
to be offered from a subcentre along with suggested norms are given below:
which is mainly concerned with MCH
1) Antenatal registration (MCH, Nutritional Counseling and prophylaxis for

nutritional anaemia)
2) Early antenatal registration (i.e. within 16weeks)
3) Detection and referral of high risk pregnancies
4) Detection and treatment of anaemic mother
5) Tetanus Toxoid for antenatal mothers
6) Visiting antenatal mothers, minimum three times.
7) Examination and referral of antenatal mothers.
8) Conducting institutional deliveries
9) Conducting home deliveries by trained persons
10) Visiting postnatal cases, minimum three times
50
11) Reffera1for Medical Termination of Pregnancies (MTP) Work Plan at Subcentre
12) Recording of birth weight and noting infants with birth weight below
2.5 kg.
13) Referral of high risk new borns
14) Conducting immunization session (BCG; DPT, Polio and Measles)
15) Recording of children fully immunized
16) Giving vitamin A (5 doses) to children between 9 months and 3 years
.17) Referral of adverse immunization events
18) Holding joint sessions with Anganwadi workers, Dais, women group
19) Listing out eligible couples using permanent and spacing method
20) Reporting cases of polio, measles,' neonatal tetanus, acute respiratory
• infections and diarrhoea.
21) Referring Reproductive Tract Infection/Sexually Transmitted Diseases cases
22) Referring gynaecological problems
23) Referring infertility cases
24) Recording of vital events viz, births, deaths, live births, neonatal deaths,
infant deaths, child deaths, maternal deaths, marriages and marriage of girls
below 18 years.
(
4.4.3 Ascertaining Felt Needs of Population I
Success of work plan depends upon assessment of health need of people. Hence it is
important to find the actual and probable problems ofthe people.
The felt needs ofthe population should be ascertained clearly for preparing the
subcentre work plan. Which they are willing to take up from delivery point. For
example, not more than 60% of pregnant womenin areas of subcentre are willing
to be registered at sub centre for antenatal care. Although 100% pregnant women
should get antenatal services, the felt need for ANC shall only be 60%. We must
plan for making the services available as per the felt needs ofthe population
•
A detailed format should contain the list of services to be provided from subcentre.
It should also contain the methodology to calculate the area requirement with
respect to all the services. The assessment of the felt need ofthe population should
be done by you after visiting all households in the area.
4.4.4 Defining the Workload Norms

Norms are being suggested by central government at national level and by the
state government at the state level for various activities to be undertaken at the'
sub centre level. The norms have been fixed based on the availability of health
infrastructure and the needs of the population. Once these norms are set, you
should calculate your own workload. Estimating ones workload is a must for
effective work plan. For example, the number of pregnant women in a community
can be determined. Determining what activities can be undertaken at what time
and in which population is an important pre-requisite in preparing a work plan.
Moreover, defining workload is an important pre-requisite for the success of an
action plan. Refer practical mannual for activities undertaken at Sub centres.
51
I
Management of Subcentre 4.4.5 Consulting other Concerned Personnel
While doing the exercise of preparing subcentre work plan there is a need to
associate following categories of personnel
1) Personnel of the Health Centre (e.g. doctor, supervisor and health worker
male(HWM)
2) Private medical practitioners in the area
3) Medical practitioners of the indigenous system of the medicine
4) Grass roots level workers in other departments like Anganwadi workers,
ICDS staff, primary school teachers, TBA
5) Pradhans of Gram Panchayat and other community leaders
The advice obtained in consultation with all the above should be taken into
Account while formulating. the subcentre work plan as it would enhance the
. process of implementation of subcentre activities
4.4.6 Strategies for Implementation of Work Plan

Specific strategies for implementation of activities mentioned in the work plan
should be adopted for the success of the health care and family welfare services
offered at the subcentre level. These strategies should encompass the following
areas:
a) Availability of the paramedical and medical personnel at the subcentre at

the time indicated in advance
b) Organizing meetings with Panchayat members, schoolteachers, women's
groups, youth clubs, -andAnganwadi workers etc. to spread health care and
family welfare messages
c) Raising local resources to supplement the support given by the government
to augment the supply of medicine
d) Organizing Swasthy Melas with community support
e) Utilization of local NGOs and private practitioners in preventive and
promotive healoth education •
f) Type of information, education and communication (IEC) activities to be
organized.
4.4.7 Organizing and Providing Services

The different activities to be provided based on health needs should be planned
in the beginning of the Year and indicated in the work plan. Accurate, clean and
timely records and safeguards for our accountability of workdone.
The places where these services will be made available should also be indicated
in.the plan along with the days. Similarly the days of immunization, timings of
follow up of contraceptive acceptors etc. may also be clearly indicated in the
plan. Once the services to be offered are organized.: a format of work plan may
be prepared. An example of the format of monthly work plan can be developed
in subcentre is given at the end of the this unit (Annexure-I),
52
Work Plan at Subcentre
4.4.8 Recording and Reporting
Records and reports provide an evidence of work performed by you. These also
helps in evaluating and reviewing work plan. You have to give adequate
importance to records and reports. You can refer the Annexure provided in the
end for pre~aring Sub centre acti~n plan. Refer Unit 6 of this block on management
of records in subcentre for details. .

i) List the different steps in peveloping a work plan
.': •••••••••••••••••••••••••••••••••••••••••••••••••••••••••.•••••••• ; ••••••••••••••••••••.••••••••••••••••.•••••••• J •••••
......................................................................................................................
. . ,
ii) Enumerate iniportance pre-requisites of developing a work plan at sub-centre

level. I
........................................................................... )
j
'
"
.
.......................................................................................................
.)
\
, ~ .
4.5 LET US SUM UP

In this unit we have discussed the meaning and relevance' of work plan at subcerttre
level. We have seen that subcentre work plan forms the basis of decentralized
planning. Work plan provides us the requirement of various services by the
population living in the area of subcentre, as their felt needs. Work; plan is the
time schedule, which enables you to carry out yourfunc,tioning effectively keeping
in mind various health care and family welfare services. We have also discussed
six steps in developing a work plan. We have seen that these six steps are not
discrete stages in preparing an action plan but continuous stages. At the end of
the unit different guideline's for developing a work plan are discussed. Eight
important guidelines have been explained in detail and a model format of a
monthly work plan is given.
4.6 GLOSARV
Felt Needs of the Population: Number of services which people demand and
are willing to take up from the delivery point
,
Requirement of the Area The demand of service for 100% coverage of
a programme in given area
Subcentre Activity Various programme 'to be carried out at
subcentre level under the health care and family
welfare services
53
I
Management of Subcentre· Wn-k load Norms Targets fixed for the performance of various
tasks.
Work Plan Work plan is the design of activities to be
performed at subcentre level by health
functionaries. It deals with what activity will
be undertaken at what time.
Work Plan Consultation Discussion preceding the preparation of work
plan to make it more effective and successful.
.
Work Plan Strategies The specific approach adopted to facilitate
implementation of services/programmes.
4.7 MODEL ANSWERS

i) Work plan is determining the course of activities which meet various health
needs of the community
ii) As work plan contains the methodology to calculate the felt need of the
people, and is based on elaborate study of the area and the evaluation of
past plans, it ensures proper coverage and will help in improving the
acceptance of various health care programmes provided by the subcentre.
i) a) Understanding the community
b) Collecting the facts
c) Analyzing the facts to reach at findings
d) Plan the programme
e) Implement the plan
f) Evaluating and Re-planning
ii) a) Developing a database for planning at subcentre
b)
c)
.
Gaining knowledge about services to be ..
offered at subcentre level
Ascertaining the requirement of the area and felt need of the population
d) Defining the work load norms for ANM
e) Consult with other concerned personnel
f) Chalk out strategies for implementation of work plan
~) Organize and providing services
h) Recording and reporting
54
I
SUBCENTRE ACTION PLAN* Annexure-I Work Plan at Subcentre '
A) General
PHC: ------------------------ Subcentre: ---------------
Population of Subcentre _ Name ofANMI ------
(rounded to nearest thousand) Female Health Worker
B) Services
SI. Services Felt need of the population of the Method of assessing
No. subcentre demand of the area
of subcentre
Coverage Methodology (Example Annual Month
norm of a state with birth rate
1996-97 of 20% and 5000
• population per
subcentre)
1\ ) (2) (3 (.L) ~S' (6)
1 A.N. Registration 100% Population x ,BR = 5000
MCH, Nutritional x 20/1 000=66
Counselling and
Prophylaxis for Add 10% pregnancy
Nutritional wastage = 10/100 x 100
Anaemia =10
2 Early AN 60% of the 110 x 60/100 = 66

Registration (i.e. AN Mother
within 16 weeks)
3 Detection and AN 110 x 15/100 = 16.5

referral of high Mothers = 17
risk pregnancies
(15% of AN
mothers will be'
high mothers)
4 Detection and 50% of AN 110 x 50/100=55

treatment of Mothers ,
anaemic mother
5 TT to AN Mothers 100% of 110 x 2 =220

AN mothers
registered
6 3 visits completed Minimum 3 CSSM schedule of AN

AN Mothers visit to be visits to be followed 110
given mothers to be completed
with minimum of 3 visits
7 Institutional 33% ofthe 100 x 33/100 = 33

Delivery (GH + expected
PHC + HSC + PNH) delivery .
8 Skilled attention a 95% of the 100 x 95/1 00 = 95

delivery (Institution expected
+ Health Worker + delivery
"
Trained Dai) J
55
9 Growth 95% of 100 x 95/100=95
Monitoring of new birth weight
born live births recording
10 Detection and 10% of the 100 x 101100 = 10

referral of high live birth s
risk new 'born
11 Infant Immunization 100% of the 100

(BCG, DTP, OVP infants
Measles) (DPTI
OPV Boosters) (D1
at 5 years)
12 Vitamin A solution 100% of the 500 >< 5 doses = 2500

for the children from children up
• 9 months 3 years to? years
, every 6 months
13 Diarrhoea cases 100% of 100 x 3 x 5 =1500

treated with ORT episodes "
each child in 0-5

years age groupis
likely to get 3
episodes of
diarrhoea in a year
14 ARIIPneumonia 100% • Each child in 0-5 years is likely
cases (up to 5 years) to get 2 episodes of ARl in a year.
10% of ARl cases are likely to
pneumonia cases
15 FP Acceptance Acceptance a) Number of couples with 3 or
of Contrace- more children
ption by all i) Number already accepted
eligible a permanent method
couples in ii) Number expected to accept
c
the area permanent method during
t, the year
b) Number of couples with 2
•
children
,
i) Number already accepted
a permanent method
ii) Number expected to accept
. a permanent method
iii) Number expected to
continue with/accept a
spacing method
IUD
. OP
Condom
c) Number of couples with less
than 2 children
i) Number expected to continue
with/accept a spacing method
IUD
OP
Condom
56
9
C) Equipments WOl'\{ Pian at Subcentre
1) IUDKit Available/ not available
2) xamination Table Available/ not available
3) Weighing Machine Available/ not available
4) BP Instrument Available/ not available
5) Delivery Kits Available/ not available
6) Steam Sterilizers Available/ not available
7) Syringe and Needles Available/ not available
8) Immunizations Cards ' Available/ not available
D) Facilities and Help Available to Subcentre

1) Number of Trained Dais Available
2) Number of Anganwadis Working
3) Number of Voluntary ORS Depot functioning
4) Number of Private Medical Practitioners (MCH, ISM&H) ---
5) Number of Primary School Teachers Male __ Female _
6) Number of Pan ehayat Members Male Female _
57
r
UNIT 5 HEALTH MANAGEMENT
INFORMATION SYSTEM
Structure
5.0 Objectives
5.1 Introduction
5.2 Concept in Health Management Information System
5.2.1 Meaning and Importance
5.2.2 Difference between Data and Information
5.2.3 Requirements of Health Information System
5.2.4 Uses of Health Information
•
5.3 Components of a Health Information System
5.4 Sources of Health Information
5.4.1 National Level Demographic and Epidemiological Information
5.4.2 Services Delivery and Utilization Information
5.4.3 Population Survey Information
5.4.4 Health Manpower Information
5.4.5 Qualitative Information
5.5 Vital and Basic Health Statistics
5.5.1 Uses of Vital and Health Statistics
5.5.2 Sources of Vital and Health Statistics
5.5.3 Important Vital Statistical Rates and Indices
5.6 Role of Health Worker in Maintenance of Records of Vital Events
5.7 Let Us Sum Up
5.8 Glossary
5.9 Model Answers
5.0 OBJECTIVES
After completing this unit, you will be able to: I
!
• define the Health Information System;
• differentiate between Data and Information;
• discuss the requirements of Health Information System;
• describe the sources of Health Information; and
• explain the uses of Health Information and vital health statistics.
5.1 INTRODUCTION
You have learnt in the previous unit about the work plan. Work plan is developed
on the basis of needs of community and the results of past services provided.
Health Information System (HIS) helps in assessing the needs of the community
and evaluating our work. Health information provides the link between the various
department and personnel. It ensures that all sections have similar baseline data
58 and links policy makers, managers and services providers.
I
In this unit we will discuss the requirements, components, uses and sources of Health Management
Information System
HIS. When developing or using a Health Information System, nurses and
community health worker must ensure that the rights of both client and staff are
protected when information is organized.
5.2 CONCEPT IN HEALTH MANAGEMENT

INFORMATION SYSTEM
Let us read the health management information system in details as given below:
5.2.1 Meaning and Importance

A Health Information System (HlS) in defined as "a mechanism for the collection,
processing, analysis and transmission of information required for organizing and
operating health services, and also for research and training.
The main objectives of HIS are to:

• provide reliable, relevant, up-to-date, adequate, timely and reasonably
complete information for health managers at all levels (i.e., central,
intermediate and local)
• help all the health personnel participating in health services of a country to
share the technical scientific information
• provide the data that will shot the general performance of the health services
from time to time
•. assist the planners in studying their immediate functioning and trends in
demand and workload
5.2.2 Difference between Data and Information

Before proceeding further, it is necessary that we know the difference between
"data" and "information"
Data: Data is a collection of facts and observations, which carry little meaning.
When considered alone. The data, which is collected from operating health care
system or institutions-is not adequate for planning.
Information: The reduced, summarized and adjusted data can be termed as in

information. We will have to reduce, summarize, arrange and adjust the data for
variations such as age, sex, composition of the population so that it would be
possible to compare them later on when required.
In other words we can say that Information is more than raw data or facts describe
places, things and events. Information is "data that has been processed into a
form that is meaningful to the recipient and is of real or perceived value in current
or prospective decisions.
Let us take the example of a good dish. The several ingredients e.g., raw vegetable,
species etc. are like the raw data. They are important but cannot be used on their
own. When they are all put together and processed, the result is delicious dish,
which can be consumed by many.
Information is processed data - made ready for some one to use it meaningfully.
Information is present in tables, charts, graphsetc.
59
I
Management of Subcentre 5.2.3 Requirements of Health Information System (HIS)
According to WHO Expert Committee the HIS should fulfil the following
requirements:
• The system should be population based.

• The system should avoid the unnecessary accumulation of data in disorderly
way..
• The system should be problem oriented
• The system should employ functional and operational terms (e.g .. episodes
of illness, treatment regimens, laboratory tests).
• The system should express information briefly and imaginatively (e.g, tables,
charts, percentages)
• The system should make provision for feedback i.e., it should provide basis
for evaluation.
5.2.4 Uses of Health Information System

After going through the requirements of health information system lets go through
its uses: The uses of health information system are given below:
i) To know about the problems and needs of the people and their health status
ii) For comparing the local, national and international health status
iii) For planning, administration and effective management of health services
and programmes
iv) For assessing whether health services are accomplishing their objectives in
terms of their effectiveness and efficiency
v) To assess the attitudes and degree of satisfaction of beneficiaries
vi) For research into particular problem of health and disease

i) Define Health Information System?
...................................................
,
, .
...................................... ,; " .
'\
.................. ~ , .
•.~•.•.•••.•••••••••.•••.•.•••••••••••••.•.•.•••.•.•••.•.•.
! •••.•••.•••.•••.•••••••••••••••••••.•.•••.•••••••••••.•••.•••.•••.•••.•.•.•.•.•••••••••••••••••••••••.•••••••••••.•.•.•.•••.•••.•••.•••.•.•.•••.•••.•••.•.•.
~.,
ii) What is the difference between information and data?

,
.................................................................................................... ~ .
60
I
Health Management
5.3 COMPONENTS OF A HEALTH INFORMATION Information System
SYSTEM
A comprehensive health information system should have information and
indicators on the following: .
i) Demography and Vital events
ii) Environmental Health statistics
iii) Health status: mortality, morbidity, disability and quality of life
iv) Health feSOUfG~S: facilities, beds, manpower
v) Utilization and non-utilization of health services; attendance, admissions,
waiting lists ..
• vi) Indicators of outcome of medical care
vii) Financial statistics (costs, expenditure related to the particular objective) .
.... ''''''~''.'--'-'~-'''~''''~'' ~"-'~ -_. "~".- -.- . ,._".-- ~ .- ..... _ .. '
5,4 SOURCES OF IIEALTH INFORMATION

Information requirements will vary according to the administrative level at which
planning is to be made e.g., information requirements for public health
administrator will differ from Hospital Administrator. These different contexts
will require different sources, which are as follows:
Do you know that you are already collecting this information in your day to day
activities,
5,4.1 National Level Demographic and Epidemiological

Information
Census, registration of vital events, Sample Registration System (SRS),
registration notification of diseases provides national level data. Vital statistics
are also summarized and presented at national level.
Census
Census is an important sources of health information. It is massive undertaking
to contact every person of the population in a given time and collect a variety of
information. It needs considerable organization, a vast preparation and several
years to analyze the results. Main drawback of census is that the full results are
usually not available quickly. Census is usually done in India every 10 years.
Population census provides basic data such as age and sex of population needed
to compile vital statistical rates, other health, demographic and socio-economic
indicators.
Registration of ViUiI Events

Registration of vital eveQts li~ births/deaths is complete and accurate. It can
serve as a reliable source of Health Information. The Central Births and Deaths
Registration Act was passed in 1969 and came into force from 1sI April 1970.
The time limit to register birth is 14 days and death in 7 days. .
Besides these now the marriages and pregnancies are also registered at the level
of subcentres. 61
I
Management of Subcentre . Sample Registration System (SRS)
This is a dual Record System. The births and deaths are registered at the grass
roots level, and at the same time an independent survey is conducted by
investigator supervisor every 6 months, to collect information. After introduction
of this system from 1960, more reliable information of birth and death rates, age
specific fertility and mortality rates, (infant and adult mortality etc.) have become
available.
Notification of Diseases
Primarily it started with notification of infectious diseases with purpose of
preventing and controlling after notification. It is a valuable source of morbidity
data. The incidence of certain diseases of national and international importance,
are to be notified, recorded and reported through Village Health Guides and
Multipurpose Health Workers.
Limitations of Notification are that some cases escape notification due to non-
recognition e.g., rubells, non-paralytic polio etc. The accuracy of diagnosis
becomes difficult in rural areas due to non-availability of facilities. Notification
provides early learning about new occurrence and outbreaks of diseases. Now
notification has been extended to cancer, congential malformations, mental illness,
stroke and handicapped persons.
5.4.2 Service Delivery and Utilization Information

These include hospital and healthy facility data, population data.
Hospital Records
It provides information only of patients who attended the hospital. Hospital
statistics are considered a poor guide to estimate the disease frequency. But the
hospital record can give a lot of useful information about activities and utilization
of health care.
A detailed study of the hospital data will provide information on following aspects:
a) Geographical sources of patients
b) Age and sex distribution of diffetent diseases and duration of hospital stay
c) Period between disease and hospital admission
d) Association between diseases
e) The distribution of patients according to different social and biological
characteristics
f) The cost of hospital care
Disease Registers
Registers are not meantfor notification of disease only but are permanent record
of the diseases, cases, followed-up and tabulations on frequency and survival
should be entered. Morbidity registers are made for some diseases, which serve
as a valuable source of information about the duration of illness, case fatality"
and survival such as for tuberculosis. For collecting information survey is done
in the particular area.· ~-
62 •
Surveillance is defined as "the continuous scrutiny of the factors that determine Health Management
Information System
the occurrence and distribution of disease and other conditions of ill-health. In
many countries where some diseases are more common, surveillance system are
set up to report on the occurrence of new cases and the efforts to control the
diseases. These programmes help in collecting useful morbidity data for the
particular disease.
Record Linkage
The term record linkage is the process of bringing together originating in different
times or places relating to one individual medical record linkage as the name
suggest implies to collection and maintenance of more important records related
to health of each individual in a population. In record linkage a large valume of
data can accumulate. Hence, in practice it has been applied only on a limited
scale.
5.4.3 Population Survey Information

A Health Information System should be based on population. The information
provided by the above sources are not sufficient so, population surveys must be
conducted to supplement the routinely collected statistics.
Health survey (surveys relating to any aspects of health-morbidity, mortality etc.

should be carried to collect information related to the health of people. The types
of surveys carried out are given below:
a) Survey for evaluating the health status a population, i.e. community diagnosis
of problems of health and disease. It is information about the distribution of
these problems over time and space that provides the fundamental basis for
planning and developing based services.
b) Surveys for instigation of factors affecting health and disease e.g.,
environment, occupation, income, factors associated with onset of illness
etc. These surveys are helpful for studying the natural history of disease and
obtaining more information about disease etiology and risk factors
c) , Surveys relating to administration of health services
Health surveys can be classified into four types:
a) Health interview (face-to-face) survey
b) Health examination survey
c) Health records survey
d) Mailed questionnaire survey
5.4.4 Health Manpower Information

It is very important to collect the information on the health manpower. Such
information is regarding the number of physicians, dentists, pharmacists and
nurses etc. The records maintained by the State Medical/Dental/Nursing councils
and Directorate of Medical Education have this information
5.4.5 Qualitative Information

Till now, the HIS concentrated on statistical data. A lot of non-quantifiable data
is also necessary for health planners and decision makers like information on
63
I
5.5.3 Important Vital Statistical Rates and Indices ' Health Management
Information System
The common vital statistical rates and indices used in community health are
discussed below. They determine the health status of the country.
Crude Birth Rate: It is defined as "the number of births per 1000 population in
a given year." Crude Death Rate: Number of Deaths per 1000 population in a
given year
Sex Ratio: Number of females per 1000 males in a population
Population Density: Number of persons per Sq. km of total surface area
General Fertility Rate (GFR): Number oflive births per 1000 married women
in reproductive age group (15-49 year)
Total Fertility Rate (TFR): Average number of children that would be born to
• women if she experiences the current fertility and morbality patterns throughout
her reproductive age (15-49 years).
Net Reproductive Rate (NRR): Average number of daughters that would be

born to a woman if she experiences the current fertility and morbality patterns
throughout herreproductive age (15-49 years)
Infant Mortality Rate (IMR): Number of deaths of children below one year of
age per 1000 live births in a year.
Neonatal Mortality Rate: Number of infants dying within the first month of
life (under 28 days) in a year per 1000 live births of the same year.
Post-neonatal Mortality Rate: Number of infant deaths between 28 days to

one year of age per 1000 live births in a given year.
Pre-natal Mortality Rate: Number of late foetal and deaths of neonates weighing
over 1000g at birth within 1st week of delivery per 1000 live births
Maternal Mortality Rate (MMR): Number of deaths of women while pregnant

or within 42 days of termination of pregnancy from any cause related to pregnancy
and child birth per 1000 live births in a given year.
Life Expectancy at Birth (Expectation of Life): Average number of years 'a

newborn child is expected to live under current mortality conditions.
There are some other important health indicators, which show the health of .
community. These are used to compare the health of a community with that of
another community or country. These are:
Morbidity indicators such as incidence and prevalence rates

Disability rates
Nutritional status indicators such as heights and weights of children and
prevalence of low birth weight
Health care delivery indicators such as doctor-population ratio and nurse
population ratio.
65
I
Management of Subcentre Methods of Data Collection
The data can be obtained by various resources
1) Questionnaire: One of the most commonly used method of date collection. It
is toll in which the questions are formed in predetermined fashion, which are to
be filled up by respondents. Questionnaire can be filled up either by person or
send by-post.
2) Interviewing: Very common method used for illiterateperson, interview is direct
conversation between interview and interviewee. In interview the interviewer
asks the set questions to interviewee and get the responses which are recorded
simultaneously.
3) Observation: It is an effective tool for collecting information by observation
skills while taking to person. .
4) Surveillance: Surveillance is supervision and close observation especially
for suspected persons. Epidemiological surveillance is common observation
of the factors that determine the occurrence and distribution of disease
surveillance it means for collecting factual information which is not otherwise
available from other sources.
5.6 ROLE OF HEALTH WORKER IN

MAINTENANCE OF RECORDS OF VITAL
EVENTS
As you know that the reporting of births and deaths in villages is done by the
village Chowkidar, Dias and other leaders of the community. You as a health
worker during home visits can find out what events have taken place since your
last visit. When you visit a home, you must find out, about births and deaths and
keep a record of the same.
You must educate the community on the importance of registration of these events.
You must tell them that:
i) Birth registration is necessary so that you can provide services to the newborn
and look after the mother and advise her about her own health and care of
the newborn.
•
ii) Death registration is necessary to find out the causes of deaths particularly
in infants and during pregnancy and child birth so that required services are
provided to mother and infants. Dais can be retrained and referral system
can be strenghthened.
You should prepare charts and graphs showing the work being done in the various
fields of health service delivery in your area. These charts should be displayed in
the subcentre. They will show at a glance how your work has been progressing
and will help in self-evaluated of your activities.
The important maps and charts, which you should maintain are listed below:
Map of each village in the area showing
• Number of houses
• Roads
66
• Location of subcentre, Panchayat Ghar, Police station etc. lIealth Management
Information System
• Houses with pregnant women
• Houses with children below 5 years
• Houses with eligible couples
• Location of village Health Guide
• Location of Dias
Bar Diagram charts can be prepared(year wise and month wise) indicating the
following
Immunization
• Total no of children immunized
• • BCG Vaccination
• DPT Vaccination - 3 doses
• Poliomyelitis Vaccination - 3 doses
• Measles Vaccination
• Tetanus toxoid in pregnancy
• Immunization to school children (T.T., D.T., Typhoid)
Family Planning
• No of eligible couples
• No of cases who have undergone vasectomy
• No of cases who have undergone tuberctomy
• No of cases who have undergone IUCD insertion old/new
• No of cases given oral contraceptive old and new·
• No of cases given other contraceptive old and new
Vital statistics
• Number of births: MalelFemale
• Number of deaths by age and sex
• Number of pregnant women
Maternal and Child Health

• No of antenatal cases registered
• No of deliveries performed by
TrainedDai
Untrained Dai
Central Staff
Others
67
I
Management of Subcentre Check Your Progress 3
List six sources of Vital Statistics
5.7 LET US SUM UP

Health Management information system is one of the important tools of operating
health services. The functions of planning, organizing, controlling and evaluating
health services from time to time is carried out with the help of HIS. The primary
objective of a health information system is to provide reliable, relevant, up to
date, adequate, timely and reasonably complete information for health managers
at all levels. It also helps sharing of technical and scientific information by all
health personnel participating in the health services of a country a.id also to
provide data that will show the general performance )f the health services. It
also helps the planners in studying their current functioning and trends in demand
and work load.
In this unit we have discussed the requisites of health information system, its
components and uses and also the sources of the health information, Further we
have discussed basic health statistics, sources and uses of vital and health statistics.
Important vital statistical rates and indices are given to enable you to revise how
to calculate: Maintenance of records of vital statistics is also explained.
5.8 GLOSSARY
Data Collection of cats and observations which
carry little meaning when considered alone.
Disseminated Spread, distributed
Health Information System: A Mechanism for the collection,processing,

analysis and transmission of information
required for organizing and operating health
services, a.id also for research and training.
Information Data that has been processed into a form that

-is meaningful to the recipient and is real or
perceived value in current or prospective
decisions.
68
Health Management
5.9 MODEL ANSWERS Information System
i) A mechanism for the collection, processing, analysis and transmission of

information required for organizing and operating health services, and also
for research and training
ii) Data is collection of facts and observations, which carry little meaning when
considered alone, whereas, information is the data that has been reduced,
summarized, adjusted and become meaningful.

The Source of HIS are:
•
a) Census
b) Registration of Health Information
c) . Sample Registration System
d) Notification of disease
e) Hospital records
f) Disease register
g) Record linkage
h) Epidemiological data
i) Other health services records
j) Environmental health data
k) Health manpower information
1) Population surveys
m) Other routine statistics related to health
n) Qualitative information

a) Census
b) Registration of births, deaths and marriages
c) Notification of infectious diseases
d) Records of healths and health centres
e) Health Surveys
f) National Sample Survey
69
I
UNIT 6 MANAGEMENT OF RECORDS IN
SUB CENTRE
Structure
6.0 Objectives
6.1 Introduction
6.2 Principles and Importance of Writing Records
6.2.1 Principles of Writing Records
6.2.2 Importance of Writing Records
6.2.3
-
Uses of Records
6.3 Types of Records
•
6.3.1 Family Folders
6.3.2 Records of Different Services
6.3.3 Communicable Diseases and Vital Events
6.4 Report
6.5 Baseline Survey
6.5.1 General Information
6.5.2 Information Maps/Charts
6.6 Let Us Sum Up

6.7 Glossary
6.8 Model Answers
6.9 Further Reading
Annexure
6.0 OBJECTIVES
After completing this.unit, you will be able to:
• Explain records and follow principles of record writing
•
• State the importance of record keeping;
• Maintain various types of records and reports in subcentre;
• Prepare reports; and
• Discuss about baseline survey and records of the area.
6.1 INTRODUCTION
You have to perform multiple function in the community as a health worker. You
need to keep a record of all these activities. 'Records as you know are the "Written
documents about facts or information". Health records refer to forms on which
information about an individual and family such as family history, individual
history of illness, socio-economic aspects, psychological and environmental
factors, which influence health, are noted.
All health records show health problems and other factors that affect the individual
in maintaining health. Health records are means of communication between past
70
I
and future. Records are written daily, weekly, monthly and yearly. This unit will Management of Records in
Subcentre
help you to understand the importance of preparation and maintenance of different
records and reports. We shall also discuss about principles and types of records
and reports. At the end we shall focus on baseline survey.
Meaning of Health Records and Computer

Records: Health records are means of providing information about health of an
individual family or community. These may be regarding socio-economic,
psychological and environmental conditions. Records are effective means of
communication between family and health worker.
Computer : The electronic data processing and other automated system are
assuming an increasingly, important role in other man.~gements and the
management of health services. Properly used data processing reduced clerical
work for professional to make information available in a short time, community
• health worker must have knowledge of data processing and its use in planning
health care programmes
Records must be used in planning and evaluating the health care services to the
community. The analyzing of data and studying the implication for ones own
work will place the individual worker in total pictures of health records.
. ,
Computer provides general advantages over paper based records system,
information can be stored in smaller area, search and analytic tasks can be
performed and information can be obtained more efficiently but improper use
can magnify the weakness of the organization.
6.2 PRINCIPLES AND IMPORTANCE OF WRITING

RECORDS
As a community health worker you know about the necessity of record keeping
which will help you to work as per the needs of the individual, family and
community. Delivery of Health services is not complete until all activities are
recorded.
6.2.1 Principles of Writing Records

Different principles of writing reports are given below:
• Record should be written clearly, accurately, appropriately, legibly and up-
to-date
• All entries should be brief, true, complete and of relevant facts or information
• Record should be written immediately after performing an activity to avoid
possibility of forgetting
• Recording should be confidential
• Keep sentences short and clear with simple languages
• Replace the records in proper place after recording
• Consult your supervisor in case of difficulty in coi:npleting records and writing
the reports in given performa
71
I
Management of Subcentre 6.2.2 Importance of Writing Records
After going through the principles of writing records lets go through the
importance of writing records. The importance of writing records are:
• Records help to collect baseline data of an individual and family

• Records give information about activities performed by you
• Records give statistical information about health
• Records help in assessment, planning and contribution of nursing services
for individual and family
• Records helps in research
• Records is a legal document
• Records is a basis of review and evaluation of your services

i) Health records refer to:
ii) Fill in the blanks:
a) Health records are communication between and .
b) Records are written , weekly, monthly and yearly.
. c) Records is a basis for review and of services
d) Health records give : Information
e) Record is Document
f) Health records are useful for purpose
iii) List the principles of record writing:
a)
b)
c)
d)
e) .......................................... ~ .
6.2.3 Uses of Records
Various uses of records are given below:
• Give direction towards appropriate action
• Prevent duplicacy of services
• Help in planning your activities
• Guide towards professional growth
• Indicate about quality and quantity of work you have performed
• Help to plan your day-to-day work in orderly manner
• Supervisors can review your performances and do correct evaluation after
going through records
• Help an organization or agency at the time of need as legal evidence.
72
I
Health authority of a state in which you are working decides the numbers and Management of Records in
Subcentre
types of records to be kept. It is also important for you ro know how, when and
where to fill the records as well as what to include in prescribed proforma or
forms supplied to you.
As a health worker (F) record keeping starts from the time you assume duties at
subcentre and continue through your service as per the job descriptions.

i) State the uses of record keeping:
a)
b)
c)
d)
ii) Tick either true or false against the following statements
a) Health records help the organization/agency (TrueIFalse)
b) Record is not useful for health supervisor (TrueIFalse)
c) Duplicacy of services may occur due to record writing (True/False)
d) Quality and quantity of work can be judged through (TrueIFalse)

Records.
iii) State four important points filling up the records:

a)
b)
c)
d)
6.3 TYPES OF RECORDS

You may have to maintain different types of records in subcentre. These are
explained in following sub-sections.
6.3.1 Family Folders

Family is a unit for services. Family records in a family folder should contain the
following information:
• Socio-economic status of the family

• Number of family members - age and sex wise
• Immunization status of children
• Nutritional status of mother and children
• Pregnant women in the family
73
I
Management of Subcentre • Use of FP methods by eligible couples
• Environmental sanitation and housing condition of the household
• Presence of communicable diseases of any chronic illness in the family
Individual health cards: Health records of each individual to be maintained if

anybody suffered and received treatment.

List the information you will include in your family folder.
a)
b) \.: " ,..,..
c) .......................................................................................................... ~.
~ .
d) .
e)
6.3.2 Records of Different Services

Immunization Records
Immunization of children is very useful weapon for control of some communicable
diseases. Immunization cards must be up-to-date, so that primary and booster
doses can be given in accordance with the schedule.
Ensure that mothers should bring the cards with their children for vaccination on
due dates. You are also responsible to include information in weekly and monthly
reports.
Iron and Folic Acid Tablets and Vitamin A Records

Record the beneficiaries who are given Iron and Folic acid tablet/syrup and
vitamin A
Solution as well as record of supply received, issued and in balance.
You are also required to submit a monthly report, which includes:
•
a) Statement of beneficiaries of Iron and Folic Acid
b) Statement of beneficiaries of Vitamin A solution
c) Position regarding the receipts, issue and stock of vitamin A solution
d) Position regarding the receipts, issue and stock held of Iron and folic acid
tablet/syrup.
Records of Mother and Child Care
You are also required to maintain records of.;
• Number of pregnant women registered by YOQ.
• Number of deliveries conducted by you.
• Number of postnatal mothers and infant attended by you in first six weeks
after delivery
• Number of children below 5 years
74
I
These are important information regarding MCH care and must be recorded. Management of Records in
Subcentre
Mother and child card should also be maintained
Family planning services Records

• Number of eligible couples registered
• Number of cases undergorie vasectomy
• Number of cases undergone tubectomy
• Number of cases undergone IUD insertion
Re-insertion cases
• Number of cases (new, old) given NirodhlCondom
• Number of cases given oral pills.
• Number of cases given other contraceptives
• Number of cases who had failure/side effects
• Number of MTP cases referred.
Records of Referrals
When your patient requires immediate referral, make sure that you fill the referral
slip/card and then sent it with the case to referral hospital or primary health
centre. Date and time of referral description of signs and symptoms and treatment
given must be recorded on the referral slip. Keep a record of the referral in
register in your subcentre.
Health Card
You will see some of the cards are carried by the clients/patients such as:
• Road to Health weight card
• Antenatal Cards
• TBlLeprosy treatment cards
• School children health cards
• General clinic patients cards
These are brought in each clinic day and you have to record it as per the need.
Patients retained cards help you to save your time in clinic and also it is valuable
during referral services. It is an aid for you to give health education to patients
and it also encourages individual! mother to know about health progress and
attend the clinic in due time.
Number of other record registers to be maintained at subcentre level
• Survey register
• Store register
• Drug register
.• Inventory register
• Daily dairy
• Referral register
• Depot holder register (like village health guide, Dai, Gram Sevak and Gram
Sevika)
• Health Worker's movement register
75
I
Management of Subcentre 6.3.3 Communicable Diseases and Vital Events
Records about communicable diseases in your areas for notification of notifiable
dieases in right time and other records maintained by health worker (M)lhealth
assistant (M&F)
Records of vital Events e.g., births, deaths and marriages should be maintained.
During home visit you must ask births and deaths and keep the records if any
have occurred since your last visit
a) Birth Registration
It is necessary for you to register births as you to give care to the newborn
and at the same time look after mothers.
, b) Death Registration
•
It is necessary as a part of communicable diseases surveillance operation
and find out causes of death particularly infant, pregnant, mother and child.
If doctor does not certify death, then possible cause of death is to be recorded.
It is also your responsibility to inform people where and when birth and death
are to be registered.

i) Name the person of your area who can be depot holder\
a)
b)
c)
ii) List all the record of MeR care

a)
b)
c)
d) •••••••••••••••••••••••••••••••••••••••••••••• t •••••••••••••••••••••••••••••••••••••••••.••••••••••••••••••••••
iii) List the records of Family Planning Services
iv) Vital events include

a)
b)
c)
76
I
v) Fill in the blanks : Management of Records in
Subcentre
a) Your responsibility is to inform the people where and when birth and
death is to be .
b) Occurrence of communicable diseases is to be to the
health authority.
vi) List the patient's retained card, which you will deal at subcentre level
a)
b)
c) .................................................................................................................
6.4 REPORT
Health authority would now how much work you have performed during the
month. So you are also required to supply information, which ate compiled by
you at the end of the month.
Compilation of information or data which are recorded daily, weekly, monthly is

called report. Report is an important management tool for future action which
gives summary of activities performed by you in each month.
Purpose of preparation of Report

• of services given over a specified period of time by you.
• It also illustrates progress towards achieving target! goals.
• It is an aid, for studying health conditions of the individuals/family/
community.
Reporting system includes
Example:
• Number of women registered for prenatal care
• Number of eligible couples motivated for family planning method
/
• The types of ailments you h~ve treated during the month

• Number of educational activities you have organized within your area
• Number of home visits you have carried our during the month
• Number of cases you have referred for further treatment to primary health
centre, community health centre, district hospital or any other referral
hospitals.

i) Fill in the blanks
a) Compilation of : which was recorded by you daily,
monthly, is called report.
b) Referral card is essential for physician to , the disease
and accordingly.
c) Date and .' of referral card need to be given
77
I
Management of Subcentre d) Treatment, which is given by you in should be written
in referral card/slip
ii) Tick true or false against the following statements
a) Preparation of report does not illustrate progress towards
. Achieving goal. (True/False)
, b) Report indicates about our performances (True/False)
c) It is not possible to know family health condition through
Report. (TruelFalse)
d) Educational activities are not included in your report (True/False)
e) Regarding family planning motivation, no information
is given through report " , (Tr.uelFalse)
f) Referral cases are included in Report (TruelFalse)
'6.5 BASELINE SURVEY

You need to carry out baseline survey to record various information about your
work area.
6.5.1 General Information

General information ofthe village (door-to-door survey) provides health related
information of the assigned area, While collecting general information of your
area, your job is to get to know the area, the people, their health practices and the
environment
Objectives of Collecting General Information

a) As a basis for adequate planning for your activities as per needs
b) To ensure that the desired population coverage is achieved
c) To find you exact location of houses, schools, wells and other water points
etc.
d) To collect demographic data such as:
i) Total Population
ii) Family size distribution
iii) Age &roup distribution
iv) Sex distribution
e) To collect social data such as
i) Educational level
ii) Religious grounds
iii) Population movement
iv) Habits and customs
v) Social structure of the community
f) To list the communication and transport available
i) Public transport
78
I
ii) Water communication (river/lake) Management of Records, in
Subcentre
iii) Pathways (Roads)
iv) Telephone facilities
g) To collect health and family welfare data such as:
i) Immunization status of the population
ii) Nutritional status of mother and children
iii) Number of pregnant mothers
v) Number of eligible couples for family planning
vi) Users of family planning methods
vii) Incidence of communicable diseases etc.
h) To list the channels of communication
i) Indigenous > Kirtan Mandli, temple notices, drums, cultural
prograinmes, puppet show etc.
iii) Modern - TV, Radio, Newspapers etc.
Preparation for Survey

Door to door survey is realistic basis for colleting factual information in a
prescribed form. You as a health worker should proceed as follows:
a) Acquire the forms in sufficient numbers

b) Conduct the survey and fill up the forms with remarks relevant to survey
c) On completing the survey: chart the information-on a map of the area, which
will give information at a glance.
d) Keep your chart and map up to date.
Factual information must be available if work is to be properly planned and time

should be spent in collection of information.
i) State the reason for collecting general information

iii) Fill in the blanks:
a) General information helps to find out exact of houses of
your assigned areas.
b) General information helps you to ensure coverage, of desired
c) This information will help in planning of your .

iv) Health data includes:
a)
b)
c) .. ." .. ..... .... " .....
" " " " "" "" ."." . .
"." " .,," ." .. ." .. .. . . . .
,,, " .
"" " " " " " ". ~" "" " "" ." ... ,," .. "" "." ." ." ... " ." ..... " ." ...
d) ................................................................................................................
e)
79
I
Management of Subcentre 6,5'.2 Information Maps/Charts
Map of your area should contain the following information:
• Map of houses'
• Roadways, p~thways, waterways
'. Location of subcentre, Anganwadi, School, Police Station, panchayat ghar,

post office and market places
'. Location of depot holders (Nirodh)
• Location of practicing dais/private practitioners
• Any other important information
If the houses of your area are not numbered then number them as it will be easy
to locate different houses in time. Border the map, you have to prepare charts/
graphs, bar diagram, charts (months wise/year wise) showing the work is being
done in the various field of health services. It should be displayed in subcentre
which will show 'at a glance how your work is progressing and also helping in
evaluation of your activities. The following charts/graphs may be displayed in
the health centre by you.
a) Immunization Chart
• Number of children covered under UIP
• BCG. vaccination - single dose given'
• DPT vaccination -Three primary doses given
• Poliomyelitis vaccination -three primary doses given
• Measles vaccination -single dose given
• Tetanus toxoids 2 dozes given tb pregriant mothers
b) Vital Statistics Graph/Chart

y'
Number of Birth :" Male,

Female
Number of Death: Age
Sex
Number of death of pregnant women.
c) Maternal and Child Health Chart
Number'of antenatal cases registered : .
Number of deliveries performed : Trained personnel : .
,
Untrained personnel \ .
Number of mothers given Iron-and folic acid tablets : .
Number of children under five years given Iron and Folic acid and Vitamin
A solution L Solution/tab.
80
I
•
Management of Records in
6.6 LET US SUM UP Subcentre
In this unit management of records at subcentre level is given in details
Records are written documents, which are essential to meet the health needs of
individual/family and community. You will be able to assess the health problems
and plan your activities as per the needs.
Before writing health records, you should know the principles to follow during
record writing and the necessity or record keeping. It is essential for you to know
how, when and where to fill up the records and what are the data you will include
in prescribed proforma or forms supplied to you.
Record keeping starts from the time you assume duties and continue until you
are in subcentre. General and specific information are important which will
indicate demographic status, social status and communication facilities including
health information. For baseline data collection, door to door survey is essential.
After baseline data collection, you will be able to prepare maps, charts etc. of
your assigned area. For each family, you will maintain family folders including
individual card, mother and child health records. Incidence and prevalence of
communicable diseases including vital statistics are to be recorded as it is an
important health indicator.
As you know anaemia is common among mother and children, you have to keep
record of Iron and folic acid tablets distribution.
Family planning is national programme, so you have to keep eligible couple

records up-to-date including protected couples, of those who are using temporary
and permanent methods of family planning.
At the end we have discussed in short about reports. You also have to compile all
the information and prepare monthly return or reports.
6.7 GLOSSSARY
•
Evaluation The systematic assessment of achievement of stated
objective in terms of its effectiveness of performance,
which gives feedback.
Health Status The general term for the state of health of an individual
Family and community.
Protected Couple Who adopted family planning methods
6.8 MODEL ANSWERS

i) FOlTIlSon which information about an individual and family are noted such
as:
ii) a) pat and nature
b) daily
81
I
Management of Subcentre c) evaluation
d) statistical
e) legal
f) research .
iii) a) Records should be written clearly, accurately, appropriately, legibly and
up-to-date.
b) Records should be brief, true, complete and relevant
c) Records should be written immediately after action.
d) Keep sentences short, clear, in simple language.
e) Records should be confindential

i) a) Records give direction towards action
b) Records prevent duplicacy of service
c) Records help for planning your activities
d) Records indicate about quality of work performance.
ii) a) True
b) False
c) False
d) True
iii) a) How
c) When
d) Where
e) What

a) Number of family members
b) Socio-economic status
c) Immunization status
d) Use of FP methods
e) Enviommental sanitation status
i) a) Village Dai
b) Gram Sevak
c) Gram Sevika
ii) a) Number of pregnant women
b) Number of deliveries
c) Number of Postnatal mothers
d) Number of children between 0-5 years
82
I
iii) - Number of eligible couples registered Management of Records in
Subcentre
Number of cases undergone vasectomy\
Number of cases undergone tubectomy
Number of cases undergone IUD insertion
iv) a) Birth
b) Death
c) Marriage
v) a) Registered
b) Notified
vi) a) Road to health card
b) Immunization card
c) Antenatal card
d) TB/Leprosy Treatment card
i) a) Informaiton
b) Diagnose, treat
c) Time
d) Emergencies
ii) a) False
b) True
c) False
d) False
e) False
f) True
i) Your job is to get the know the area, the people, their health practices and
the environment.
ii) a) Location
b) Population
c) Activities
iii) a) Immunization status
b) MCH Status
c) Family Planning Status
d) Nutriotional Status of mother and children
e) Incidence of communicable diseases.
83
I
6.9 FURTHER READINGS
Byme, Monika, et al., "Record Keeping" , Community Nursing in Developing
Countries (A manual for community Nurse) English Language Book Society,
Oxford University Press, 2nd ed., Page 71, 1986).
Chalkey, A.M., "Records and Reports", The text book for the health worker
(ANM). Vol.1, Reprinted, No. 27., pp 20-27,1989.
Dhillon, R et al., "Record Keeping". Handbook for Delivery of Care to Mother

and Children in a Community Block, Ministry of Health & Family Welfare.,
Government oflndia, Oxford University press, pp. 280, 282, 283, 287, 1983.
"Monthly Report of HW (F)", Manual for Health Assistant (F), Ministry of Health
and Family Welfare, New Delhi Government of India, pp 31-34, 1982 .
."Records and Report", Manual for Health Worker (F), Vol .1, Ministry of Health
& Family Welfare, New Delhi, pp 31-34, 1982.
Tattersall, E.R., "Records", Nursing management in practice, Low Price Edition,

English Language Book Society, pp 90-91, 1984.
84
Block 1 Reproductive Health
Unit 1 Concept of Health and Primary Health Care
Unit 2 National Health Programmes in MCH
Unit 3 Introduction to Reproductive and Child Health
Unit 4 Sexuality, Fertility and Infertility
Unit 5 Sexually Transmitted Diseases and Human Immuno Deficiency
.Syndrome and Acquired Immuno Deficiency Syndrome
Block 2 Essential Maternal Care
Unit 1 Review of Reproductive System
Unit 2 Antenatal Care and Normal Pregnancy
Unit 3 Intranatal Care: Management of Normal Labour
Unit 4 Postnatal Care
Uhit 5 High Risk Pregnancies
Block 3 Essential Newborn Care and Child Health
Unit 1 Essential Care of Newborn and Management of Low Birth Weight Baby
Unit 2 Vaccine Preventable Diseases and Immunization
Unit 3 Growth and Development
Unit 4 Nutrition for Children and nutritional deficiency diseases
Unit 5 Accidents and Hazards among Children
Unit 6 Adolescent Health
Block 4 Integrated Management of Neonatal and Childhood Illness
Unit 1 Assess and Classify Sick Young Infant
Onit 2 Identify Tr~atment and Treat Sick Young Infant
Unit 3 Assess and Classify Sick Child
Unit 4 Identify Treatment and Treat the Sick Child
Unit 5 Counsel the Feeding
Block 5 Communication Skills Supervision and training
Unit 1 Principles, Methods Media of Communication, Information Education
and Communication (IEC)
Unit 2 Social Mobilisation Skills, Campaigns and Camps .
Unit 3 Leadership Skill
Unit 4 Principal and Concepts of Supervision and Training
Unit 5 Monitoring and Evaluation
Block 6 Management of Sub-centre
. Unit 1 Concept of Management
Unit 2 _ Management of Resources
Unit 3 Problem Solving and Decision Making
Unit 4 Work: Plan at Sub-centre
Unit 5 Health Management Information System
Unit 6 Management of Records in Sub-centre

Block 6

Uploaded by

Copyright:

Available Formats

You might also like

Block 6

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Block 6

Uploaded by

Copyright:

Available Formats

~

"Education is a liberating force, and in our age it is also

Ms. B. Bhauacharya Reader . Dr. N.H. Antia

• BLock Preparation and Editorial Team

COURSE REVISION COMMITTEE

BLOCK PREPARATION TEAM

1.2.1 Meaning and Definition

• Management enables efficient use of limited resources, avoids wastage and

In simple words management is defined as an art of getting things done by

1.2.2 Characteristics of Management

Dynamics process: It is a changing process with changing environment. New

Universal phenomenon: The principles and function of management applicable

Goal oriented : Basic aim of management is to achieve goals objectives. No

Social process: It involves establishment of interpersonal relationship with all

To summarize we can say that management is a wheel to moye the organization

Check Your Progress 1

i) Fill in the blanks:

• 1.2.3 Levels of Management

Level Pest . Functions

i) Conceptual skills - Decision making, problem solving, critical thinking.

Check Your Progress 2

v) Fill in the blanks

1.2.4 Principles of Management

iv) Stability of tenure or worker: Worker should be allowed to continue her

vi) Authority and responsibility: Both go hand in hand.authority should go

vli) Discipline: Discipline means rules, regulations, manners, observed at work

viii)Unity of command: Worker should receive orders from one superior. If

x) Remuneration. of personnel: Payment system be fair and satisfactory

Check Your Progress 3

ii) Explain the following in your words:

• An element of planning is present behind every human activity. Students

• Planning is goal oriented i.e., defines objectives or goals of an organization

• Planning is thinking process. It is concerned with problem-solving. Planning

• Planning is part of activity at all levels from top to lower level.

• Planning is continue. It is ongoing, process of assessment and reassessment

• Ensures effective control and co-ordination in an organization.

• Promotes creativity and innovation of ideas, which help in future

• Leads to integration of functions, helps in achieving objectives by effective

• Formulating: Formulating possible alternative actions to solve problems

• Selecting action of choice: To overcome the given problem so that it is

• Formulating the plan and policies, estimating resources and establishing

Check Your Progress 4

Characteristics and Importance

• Guide new employees.

Fig. 1.1: Recommended Organisational Setnp at State/Union Territory Level

• Staffing is concerned with the recruitment and management of workers in

Organization can be functional and operational only by recruiting and selecting

Therefore, effective performance by workers helps in achieving objectives within

Check Your Progress 6

Check Your Progress 7

ii) List down three elements of directing

1.3.5 Coordinating and Controlling

Check Your Progress 8

Health records refer to the information about an individual and family

• For further details on records and reports refer Unit 6 of Block 2.

Definition - Budget is a financial interpretation of a policy to be pursued to

• Modification by finance committee and then approval by board.