HEALTH ADMINISTRATION

Definition: Health Administration may be defined as “A branch of Public

Administration which deals with matters relating to the promotion of health,
preventive services, medical care, rehabilitation, delivery of health services, the
development of health manpower and the medical education and training”. The
terms “administration” and “management” are now used interchangeably and
considered synonymous.
MANAGEMENT
In simple words management means getting things done through other people.
Definition: Management may be defined as “the process of getting the right
things done, in right way, in right time, by right persons with right (optimal)
amount of resources and with effective use of resources to achieve the pre –
determined objectives of an organization “.
FUNCTIONS OF MANAGEMENT
It is easy to remember the functions of management by the word POSDCoRBE
i.e. Planning, Organizing, Staffing, Directing, Co – ordinating, Reporting,
Budgeting and Evaluating.However the modern approach is to describe only
three functions of management as follows:
1. Planning.
2. Implementing which includes organizing and staffing.
3. Control which includes Directing, Co – ordinating, Reporting, Budgeting
and monitoring and evaluation.
A brief description of the functions of management or a health care
manger is as follows:
1- PLANNING: A Simple definition of planning is “the determination in
advance of a line of action by which certain results are to be achieved”. It is a
blue print for taking action. The steps involved in the
“Planning cycle” of a health plan are as follows:
(a) Analysis of the health situation.
(b) Establishment of the objectives and the goals.
(c) Assessment of resources needed and available.
(d) Fixing priorities in order of importance or magnitude of the health problems
and examining alternative courses of action.
(e) Preparation of plan of action and write – up of the formulated plan..
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(f) Training of the required personnel and programming and implementation of the
plan.
(g) Monitoring i.e. a continuous process of day to day follow – up of activities
during their implementation to ensure that they are proceeding as planned and
on schedule and to take corrective action if needed.
(h) Evaluation to verify whether the objectives are achieved or not.

2- ORGANIZING: It is the process of putting the framework or structure of the

organization in place. It involves the identification of the work to done, the
division of work, to assign activity to each group in the organization and to fix
responsibility.

3- STAFFING: It is concerned with the utilization of human resources in an

organization and includes manpower planning, recruitment and placement or
putting the right person for each defined job.

4- DIRECTING: It is a continuous function of a manager of providing day – to

– day supervision of the subordinates as to whether the given work or given
instructions are carried out or not and helping the subordinates to improve their
skills and performance.

5- CO – ORDINATING: It includes coordinating the work assignments,

authority, responsibility and inter–relationships. In other words, it is tying
together different parts of an organization so that they work in harmony with
each other to achieve the objectives of the organization.

6- REPORTING: The work done by each individual, group or team,

departments and organization needs to be reported to the next higher level from
where a feed – back is to be given to the concerned lower levels. It is a part of
the process of monitoring and control.

7- BUDGETING: It is the function of providing money or financial resources

for the activities of an organization which is essential for achieving its
objectives as no organization can work without this important resource.

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8- EVALUATING: While monitoring is confined to day – to – day or ongoing
operations, evaluation is mostly concerned with the final outcome and with
factors associated with it and is also an important function of management. It
makes possible the re – allocation of priorities and of resources on the basis of
changing health needs.

9- CONTROL: It means “applying necessary corrective measures so that the

performance takes place as planned”. It is based on monitoring and evaluation.

MANAGEMENT SKILLS
Three types of skills are necessary for a manager:
(i) TECHNICAL SKILL: It is the ability to use knowledge, methods, techniques
and equipment necessary for the performance of specific tasks. The need for
this skill is maximum at the lower or supervisory level and decreases gradually
at the middle and top levels of management.

(ii) HUMAN SKILL: It is the ability and judgment in working with and
through people including an understanding of motivation and an application of
effective leadership. It is a very crucial skill required equally at all levels of
management.
(iii) CONCEPTUAL SKILL: It is the ability to understand the complexities
of the overall organization including its future course. The need for this skill is
minimal at the supervisory level but increases as one goes up the ladder and is
maximum at the level of top management.

MANAGEMENT TECHNIQUES
There are many techniques of management which have been developed by the
experts of management science to help the managers of any organization to
achieve its stated goals more efficiently. These techniques are based on the
principles of Behavioral Sciences and Quantitative methods. A brief
description of these techniques is as follows:
(A) TECHNIQUES BASED ON BEHAVIOURAL SCIENCES:
1- ORGANIZATIONAL DESIGN: Organizational design is the “established
pattern of relationships among various positions”. Good organizational design
is necessary to meet the health needs and demands of the community and it
saves the wastage of valuable resources.
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2- PERSONNEL MANAGEMENT OR HUMAN RESOURCE
MANAGEMENT
(H. R. M. ): H. R. M. means “ the skilful and effective use of human
resources”. It involves assessing the manpower needs, proper methods of
selection, training, placement and motivation of health personnel, division of
responsibilities and roles and effective design of “health teams”. It helps in
finding the right man for the right job.

3- COMMUNICATION: Communication is fundamental and vital to all

managerial functions and is important for decision making and planning as well
as facilitating co-ordination, co-operation and motivation among the
subordinates and for good public relations. By the establishment of suitable
vertical and horizontal communication channels, we can improve the work and
efficiency in health sector.

4- INFORMATION SYSTEMS OR HEALTH INFORMATION SYSTEMS

(H. I. S.) H. I.S. Is a planned and organized approach to the transferring of
information within an organization for better results and it should be tailored to
suit the management needs of the individual health services. The functions of
H. I. S. are collection, classification, analysis, transmission, storage, retrieval,
transformation and display of information. It helps in monitoring and
evaluation of health programmes. Computers are being increasingly used to
improve the health management information systems.

5- MANAGEMENT BY OBJECTIVES (M. B. O.): In this technique,

objectives are fixed for different units and sub – units of the organization based
on the organizational objectives. Each unit and sub – unit prepares its own plan
of action accordingly, usually on a short – term basis depending on the period
during which the objectives are to be achieved.

(B) TECHNIQUES BASED ON QUANTITATIVE METHODS: These are

derived from the field of economics, operations research and budgeting and
have a great role in the management of health services. These techniques are as
follows:

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 1- COST –BENEFIT ANALYSIS (C. B. A.): In this technique, we compare
the economic benefits of a programme or an intervention with its cost or
expenditure involved in it. It is a very useful technique of management to know
whether an intervention or programme is economically sound or not and to
select the best out of several alternate choices available. However the scope of
the application of this technique in the health sector is rather limited as the
benefits are mostly in terms of the births or deaths prevented or illness avoided
or overcome which can not always be expressed in monetary terms. Further the
time – lag between the intervention and the benefits. I .e .the “lead time” may
also be long.
2- COST – EFFECTIVENESS ANALYSIS (C. E. A.): It is similar
to the C. B. A. technique except that the benefits are expressed in relation to the
achievement of objectives or results such as number of lives saved or morbidity
prevented and not in monetary terms. Hence it is better than C.B. A. for
application in the field of health.
3- COST – ACCOUNTING: In this technique, the financial records
are maintained to know the costs of each programme or function or purpose. Its
uses in health services are cost – control, planning and allocation of resources and
to calculate and compare the cost of different programmes or their components.
4- INPUT – OUTPUT ANALYSIS: It is an economic technique
which has two components i. e. input and output. Input in health sector refers to
all activities which consume resources and output refers to such useful outcomes
as cases treated, lives saved, immunizations done and morbidity prevented, etc.
From an input – output table, it is possible to calculate as to how much inputs are
needed for producing a unit of output and the effects of changing the inputs.
5- MODEL: This technique is also called Simulation Study. Model is an abstract
representation of the reality and not the reality itself. It helps in the decision
process to predict the outcome by a known mix of combination of
interventions.

6- SYSTEMS ANALYSYIS: The main purpose of the systems analysis is to

help the decision makers to choose an appropriate course of action and finding
the most cost – effective alternative. The various steps involved in this
technique are identifying and investigating the problem, searching out the
objectives, finding out the alternative solutions, evaluation of the alternatives in
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 terms of cost – effectiveness and if necessary, re–examination of the objectives
to identify the most cost – effective alternative. The system can be an
information system, a hospital supply system, an outpatient clinic, a
community health care system or any other system having management
problems. A system also may be made of independent sub- systems.

7- NETWORK ANALYSIS: It is a management technique whereby objectives

are identified, the activities and tasks involved in attaining the objectives are
determined and the inter – relationships between tasks, activities and objectives
are presented graphically in the form of a network and used as a basis for
determining the sequence of activities and tasks and the allocation of resources.
The two common types of network techniques are Programme Evaluation and
Review Technique or P. E. R. T. and the Critical Path Method or C. P. M.

- P. E. R. T. : The essence of P. E. R. T. is to construct an Arrow Diagram

representing the sequence of events and to calculate the time by which each
activity must be completed and to identify those activities which are critical.

Staff Staff
recruite 2 months trained
d
STAR
T
4 months

Plan
service 1 month

2 months Equipme Start

Equipmen nt
t ordered
providin
10 months installed
1 month g
service

Terminal event

- C. P. M. : It is also similar to P. E. R. T. The longest path of the network

is called the “Critical Path” and if any activity along this path is delayed,
the entire project will be delayed and hence the name. It lays emphasis mainly
on activities and is generally applied to the projects that are repetitive in nature.
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Network analysis

8- PLANNING – PROGRAMMING – BUDGETING SYSTEM: (P. P. B. S.) :

This technique helps decision makers to allocate resources so that the available
resources are used in the most effective way in achieving the objectives of the
organization. It calls for grouping of activities into programmes related to each
objective. Another approach is known as “Zero Budget Approach” or “Zero
Based Budgeting (Z. B. B.). It starts from scratch i. e. all budgets start at zero
and every year is taken as a new year. Previous year is not taken as a base to
allot budget for any activity.

9- WORK SAMPLING: It is a systematic observation and recording of

activities of one or more individuals carried out at random intervals. It provides
quantitative measurement about the type of activity performed and the time
needed to do a specific job. It helps in standardizing the methods of performing
various jobs and determining the manpower needs in an organization.

10- DECISION MAKING: It is one of the most important activities in

management and is just like differential diagnosis in medical practice. Decision
making is a solution of selecting the best course of action out of the several
alternatives available or possible. The decisions should be made at the level
where the best decisions can be made and not necessarily at the top level.
The decisions should not be made with incomplete data.