Leadership

Dr/ Heba Mahmoud Mohammed

Assistant professor of Public Health and community Medicine
ILOs
❑Definition of management
❑Principle of management
❑Function of management
❑How to lead a health team
❑Styles of supervision
Definition of MANAGEMENT
❑Management is getting things done
❑Management is getting things done through people
❑Management is the efficient use of resources
❑Management is to make decisions
SOME PRINCIPLES OF MANAGEMENT
I - Management by objectives:
defined as“ the intended results of the achievement of a program or activity”.
Criteria of good objectives (SMART):
• Simple and specific
• Measurable
• Achievable
• Relevant
• Time bound
II-EFFECTIVENESS:
Effectiveness is the degree to which a stated
objective is being achieved; it is something that
management tries to improve.
III-LEARNING FROM EXPERIENCE:
When a gap occurs between the objectives and results (or
achievement) management makes an analysis of how the
observed results were achieved, and discovers what caused
the gap.
Sometimes the causes cannot be removed in the short run;
these are usually called constraints; others can be removed
or remedied, and action is taken accordingly.
IV-DIVISION OF LABOR
Division of labor is one of the general principles of
management. When it is correctly applied, work must be
shared by, or divided among a number of different
categories of technically skilled people.
V - ECONOMY OF SCARCE RESOURCES
Sometimes, and often many resources are scarce and costly.
In managing the activities, we see that some commodities
tend to become scarce, either because their stocks are low
or demand for consumption are high. As a result, they
become more and more scarce.
When a commodity becomes scarce, people tend to be
more economized. It is applied by almost everyone in daily
life, with more or less success
VI- SUBSTITUTION OF RESOURCES
Often, when the resources that are normally used to
provide services become scare or too expensive, other
resources may be used to produce the intended results.
For instance: when a locally manufactured instrument
apparatus can substitute a similar but more expensive,
exported one, provided it can do the same function, it is
wise to choose the first one.
VII- CONVERGENCE OF WORK:
This means that work activities should be so designed and
directed as to support each other towards the achievement
of objectives. It also implies that working relations should
contribute to the success of each activity, and so to general
effectiveness.
VIII- FUNCTION DETERMINE STRUCTURE
The function of an organization determine the structure of its hierarchy i.e. the
qualification, the number and the relations of the work team. In other words, the
structure of a cement factory
work team is not the same as that of a health facility, and even within the
health facilities, the level of the health facility determine the structure of its
work team.
A major concern in working relations is to enable decisions to be made where
and when necessary, by the most suitable person.
IX - DELEGATION OF AUTHORITY
Delegation of authority takes place when somebody’s authority is
lent to another person, conditionally or not, so as to enable that
person to take responsibility when the occasion arises.
X- MANAGEMENT BY EXCEPTION
This means you should do two things:
First: Do not be overloaded with routine, unnecessary information.
Be selective. Keep your mind available for critical information, on
which you will be required to act. For instance
Second: Make BIG decisions first. Being overloaded with trivial
decisions may lead to neglecting of more important ones. In short,
management by exception means selectivity in information and
priority in decision.
XI- SHORTEST DECISION-PATH
The last management principle we shall review is the principle of the
shortest decision-path deals with the issue: Who should make which
decision? in addition to when and where, as well.
Applying this principle means that decisions must be made as closely
as possible in proper time and suitable place to the object of the
decision and to those affected by it.
This saves time and work (e.g., to transmit information) and also
ensures that decisions can take full account of the actual
circumstances which demand the decisions and in which they are
put into effect.
MAIN FUNCTIONS OF MANAGEMENT
Planning
consists of five steps as follows:
1. Looking at the current situation (situational analysis), through collection of
relevant data and facts.
2. Selecting the important problems (through problem prioritization)
3. Setting the smart objectives and targets
4. Reviewing the obstacles and limitations that may arise during planning, or
later during implementation.
5. Formulating the action plan.
II- IMPLEMENTATION
It is known as a course of action to implement a plan or part of a
plan. Stage by stage, the activities necessary to fulfill the plan are
implemented, so that gradually the work is completed; changes take
place and integrated into existing program(s).

Coordination: “is to bring things, parts, persons, functions, and

activities into proper relations”.
How to make a schedule for activities?
You should follow the following scheme:
Step 1: List all activities that are necessary to achieve the program objectives
(detailed activities);
Step 2 :Identify the main activities that would lead to achievement of the
objective;
Step 3 :Indicate the time-targets for each of the detailed activities listed; and
Step 4 :Identify the personnel who will be responsible for each detailed
implementing activities.
III-EVALUATION
Evaluation is defined as “comparing the achieved activities or results to the
predetermined dates or objectives to judge the activities or results match with date or
value of these predetermined activities or objectives”
Generally, the evaluation consists of the following five steps:
1. Decide what is to be evaluated and select the indicators of effectiveness;
2. Collect the information needed to provide the evidence;
3. Compare the results with the targets or objectives;
4. Judge whether and to what extent the targets and objectives have been met; and
5. Decide whether to continue the program unchanged, to change it, or to stop it, etc.
Leadership
 HOW TO LEAD A HEALTH TEAM?
I-Setting and sharing objective
People work well together when they agree with one another. To fulfill the objectives
of an organization those who work for the organization should know what its
objectives are. People who don’t know what those objectives are may waste much of
their efforts on activities that do not bring the objectives any nearer to organization.
It is very difficult, if not impossible, for real progress to be made in health care
without the active cooperation of everyone concerned
People like to make important decisions for themselves. They are much more ready
to work towards objectives they have themselves helped to set than towards
objectives that are set by others.
II- Motivating the team members :
Level 1: To obtain the necessities for life (food, shelter, clothing, rest and safety).
Level 2: To satisfy social needs such as the need for companionship, love, and a
position of respect.
Level 3: To develop a measure of personal satisfaction. People need to feel
comfortable with themselves and with what they make of their lives and of their
talents and abilities.
 How to use personal motivation to achieve work objectives:
The main six motivators in work are
1- Achievement :Most people like to do things well. They like to succeed. Satisfaction in success and in getting things done well
comes largely from achieving what people expect to be able to achieve, and what they aim at achieving. Thus achieving is a very
important matter for the worker.
2- Recognition :People like others to know of their success. It should be easy to praise good work and even to publicize it.
3- The work itself : People like do work that is constructive, that in their opinion is worthwhile and helpful to other people. The
staff of an organization like to do work that they can see as contributing to the objectives of the organization as a whole.
4- Responsibility :To have responsibility is to be able to take the consequences for a decision or an action whether they are good
or bad. Most people welcome responsibility; some people fear it. Most people like to make decisions about their own lives and to
accept responsibility for doing so.
5- Advancement: Advancement is a form of recognition. Recognition without reward is not very convincing. People prefer
recognition that comes in a tangible for such as an increase of salary or more responsibility, with freedom to use their own
initiative, which leads to job satisfaction.
6- Self-improvement: People like to become mature, to develop as people. Many people make great sacrifices to improve
themselves or to offer such opportunities to other members of their families.
 the six common causes of dissatisfaction are:
1-Inefficient administration: People like to work for an administration that is both efficient and just.
Waste of time and of resources is exasperating. Even if people do not complain, they do not like to be kept
waiting
2- Incompetent supervision: People expect their supervisors to be technically competent. They must
know the details of the work they are supervising.
3- Poor interpersonal relations: People should be treated fairly. Supervisors who have favorites, or who
are dishonest in reporting on the work of the staff, are disliked and the work suffers.
4- Personal qualities of the leader: People respond much better to example than to exhortation. “Do as I
say, not as I do” is a poor method of leading.
5- Inadequate pay :The absolute level of salary is not as important as its relative level. A salary is
satisfactory when the worker gets what he expects, what others doing the same sort of work are getting,
and what is generally regarded as being fair.
6- Bad working conditions: The work staff complains more about poor administration than about working
conditions.
III-Dealing with problems and conflicts of the subordinates
a) Helping to solve personal problems of staff:
b) Preventing and settling disputes: 1- Preventing disputes: The commonest cause of disputes in a work team is
confusion, i.e., people have different ideas about what is to be done and how it is to be done. 73

Such disputes can be reduced or prevented by the following:

Frequent meetings of health-team members.
Allowing people to express views openly and letting the whole group decide.
Sharing agreed objectives.
Having clear and detailed job description.
Having clear instructions and procedures to follow.
Distributing tasks fairly.
Making work-schedules that distribute work fairly.
IV-Delegating authority and responsibility
Advantages of delegation
Delegating some decision-making saves time for other duties;
When work is spread a large area, as in rural health work, the health workers on the spot must
be able to make decisions according to circumstances;
Delegation of responsibility saves long delays that occur when awaiting decisions from a
distance or from a central office;
Health workers who are allowed to make decisions enjoy their work more and become more
knowledgeable and skilful;
Disadvantages of delegation
If wrong decisions are made, the work may not be done or it may be done less
well;
If delegation is not done properly, a leader may pass all his work on to his team
and do little himself;
A leader may delegate decisions to persons with insufficient experience.

Delegate responsibility properly and for a good reason, and do not cause a
subordinate to become overloaded.
Rules for delegating authority and responsibility:
Be clear about exactly what is delegated.
Select the right person and make sure ha can do the work.
Explain to others that you have delegated work and to whom announcement.
Do not interfere unless asked to, and be prepared for some mistakes.
Give support as needed and follow up the progress of work.
V-Using different styles of supervision
Characteristics of different styles
Autocratic: Do what I say!
Anarchic: Do what you like!
Democratic : let us agree on what we are to do!
Bureaucratic: Do as regulations say!
Autocratic supervision tends to humiliate people and make
them irresponsible.
It may dry up their initiative. If it is unjustly applied, and it often
is, it makes people feel insecure. But remember that people
need a framework of authority within which to exercise their
freedom. On the other hand, democratic supervision helps
people to grow, to become responsible for their own work, and
to take initiative. People like to be consulted. However,
instructions must be carried out. Instructions must not become
subject to discussion.
A consultative (democratic) style is most suitable for:
Work that demands creativity, e.g., research;
With highly competent and experienced people;
With people who are known to be reliable; and
With people who are willing to take responsibility and make decisions.
In certain circumstances a supervisor must be authoritative (dictatorial), in the
sense that his instructions cannot be subject to discussion. Such an authoritative
style may be used for:
Tasks that demand coordination and consistency, such as dealing with large
numbers of people;
Tasks that are governed by strict policies or where immediate action is needed,
such as dealing with an emergency or controlling an epidemic;
People who have little understanding of the goals of the organization that
employs them;
People with limited skills or experience; and
People who are known to be unreliable.
Thank You