• management is a process of making decisions as to how resources will be generated, developed, and used in pursuit of particular organizational objectives
  • macro- how resources allocated among activities
  • micro- what approaches are used in delivery of services
• includes personal management, cost accounting, control of financial management and logistical considerations

• leadership
  • scanning
  • community engagement
  • settin direction
  • governance
  • staff, work climate development
• management
  • planning, staffing
  • structuring
  • management systems

     alternatives and options

     community into program activities

     aspiration, and end for the organization’s work

    over an organization for mutual benefit

health management and context

• poor planning, waste of resources, and time
• poor quality of care, mistakes
• services not adequately rendered, if at all
• medicine/tx and supplies not delivered
• staff not performing well; low staff morale
• poor budgeting and failing to spend on what is the highest priority

increase morbidity and mortality

• developing organizational structure is an important management function
  • functional
  • divisional
  • matrix

planning: strategic and operational

• strategic planning
  • where is institution now
  • where is institution going (objectives)
  • with what
  • when
  • degree of formalization about process
• operational or activity planning
  • settin time frames for implementation of activities in the shorter term

• SWOT analysis
• situational analysis
• logic models
• decision matrices

• social, political, economic, geographic factors
• lack of funds
• poor timing of inputs
• resistance to change
• neglect of institutional or legal requirements
• unexpected results

• top down buerocratic
• poor budget
• failure to include key groups like managers and users

• biggest challenges
• must bring people together and move everyone collectively toward common goal
• managers can motivate employees by
  • asserting authority, coercion
  • giving rewards, promotions
  • posessin credentials and exhibit knowledge
  • lead by example and earn employees trust

• foster employee buy in of the mission activites of the institution
• communicate with employees
• continue education for employees
• create positive working environment so employees self motivated and invested in their work
• include employees in decision making when appropriate

• usually clinicians
  • little to no management training
  • leads to GH programs and outcomes that lead to poor outcomes (take people out of areas of expertise)

• procure materials, supplies
• distribute and deliver materials, supplies
• challenges
  • supplies
  • pilferage and spoilage
  • conflict
  • transportation unreliable, poor infrastructure

• budgets- statements of intended expenditure
• cost benefit analysis- prioritizing investment
• resource allocation
• sustainability- look at long term

financial management is a means, not an end

• relationships and resources are interdependent and connected parts of a system rather than as separate units allow for
  • seeing interrelationships rather than units
  • see patterns of change rather than events
  • see the structures that underlie complex situations

• monitoring and evaluation is critical
• must undertake evidence based decision making

Example: MOH and decentralization of power/authority, geographic decentralization, purchaser-provider relations

Patterns of relationship among people and other resources

      Example: public-private partnerships, international organization involvement, donor community, local community participation

         Example: Horizontal and vertical levels of supervision and authority; divisions, departments, units can be based on function or occupational groupings etc.

• The Lewin Group's evaluation report on the  Management Academy for Public Health shows that public health agencies have garnered $6 million in revenue from training that cost $2 million to provide, a three-fold return on investment.
• CIGNA introduced business reengineering into its organization and saved more than $100 million over 5 years.
• TQM trainings at Motorola “Based on two systematic studies, Motorola estimates that it earns $30 for every $1 invested in quality training”
• GE invested US$380 million in Six Sigma ± mostly for training in 1997. In the same year, GE received about US$700 million in documented benefits from increased productivity.
• The Institute for Healthcare Improvement ‘s 100 000 Lives Campaign launched in December 2004. The campaign engaged over 3000 US hospitals .The campaign estimates that, as of April 2006, participating hospitals had saved over 84 000 lives (based on 83% of participating hospitals submitting mortality data).