Module 4: Resource

Management for Health

1
 Enabling Objectives
 At the end of this module participants will be able to:
 Validate priority areas for improving management of HRH
 Analyze how strategic HRH planning is linked to the
organizational mission, vision, and strategic priorities
 Comply with the principles underlying MCC health
professionals in the delivery of health services
 Describe health professional regulation systems of Ethiopia.
 Monitor health care financing schemes and financial
management
 Outline the techniques of managing logistics and
pharmaceuticals
 Apply effective ways of acquiring, maintaining and utilizing
health information
 Describe the appropriate ways of managing time and space 2
Module Description
 The module is designed to introduce
the basic concepts of;
 Human resource management &
regulations
 Health care financing
 Logistic management
 HMIS
 Time management
 Space management - in light of LMG
3
1. Human Resource for Health
Management

4
Outline:
• Management of human resource for health
 HR planning
 Recruitment and selection
 Job description and Induction
 Performance appraisal and management
 Training and development
 Motivating employees
 Health and Safety
 Health professional regulation systems
 Conflict management
5
Enabling objectives;

• At the end of this session, participants will be

able to;
 Analyze how strategic HRH planning is linked to
organizational mission, vision & strategic priorities

 Assess training needs for capacity building of

employees in light of the organization’s demand

6
Activity 1
Duration: 15 minutes
Group discussion:
In your team, discuss what HRH and
HRM is; functions of HRM in your
organization and major areas for
improvement.

From your professional experience,

discuss how human resource planning
helps to avert gaps like shortage and
turnover of health professionals.

What are the improvements and gaps

7
of HRH in Ethiopia?
 Basic Concepts of Human Resource
Management

• Human resource: people who work in an

organization

• Human resource for health: “all people

engaged in actions whose primary intent is
to enhance health” (WHO, 2006)

8
 The key functions of HRM

• HR planning

• Recruitment & selection

• Performance appraisal and Management

• Compensation /Benefits

• Training and development

• Health and safety

• Employee relations & Labor relations 9

10
 Human Resource Planning
• Forecasting HR need for an organization

• HR manager should balance HWF supply and demand

• Effective human resource planning requires need

assessment
• Begins with considering the organizational objectives
and strategies
• Assessments of human resource needs and supply
sources must be done and forecasts developed

• Use information accessible through HRIS 11

 The 4 methods of estimating HRH
requirement
• Several methods of forecasting demands are
available, such as;
 Managerial Judgment or Delphi method
 ratio- trend analysis
 Workload analysis
 Service targets
12
 Talent acquisition /recruitment & selection

• It is searching prospective employees and

stimulating them for the job of our organization
 Identification of existing sources of applicants

 Identification of new sources of applicants

 Stimulating & attracting candidates to apply for

the job
 Make a balance between internal and external
13
 Job Description and Orientation

Session objectives

At the end of this session, participants will be able

to:

• Analyze the organizational culture that helps to

socialize the new employees

• Define specific job requirements as per HF standards

14
 Group exercise:
• Reflect your experience when you arrived at your work

place for the first time.

- List what the organization /supervisor did for you with

regards to the work environment and system. Did you face

any challenges? How did you resolve them? Share your

team consensus points in plenary.

•Group exercise:
•Reflect your experience when you arrived at your work place for the first time. List what the woredas did for you with regards to the work environment
15
 Job Descriptions
• Defines what employees are expected to do
and how they should be prepared for their job
• Necessary so that both employees and their
supervisors can be held accountable for
performance
• Necessary for performance management,
review and appraisal
• Note--Every employee should be provided
16
 Employee JD includes;
• Job title
• Organizational location of the job
• Supervision given and received
• Materials, tools, machineries & equipments
required
• Designation of the immediate superiors and
subordinates
• Salary levels: pay, other allowances, bonus,
incentive wage, method of payment, hours of
work, shift, break etc. 17
 Job induction and orientation
•Job induction is the process of welcoming new
staff into their role within the organization
•The process includes the orientation stage,
which tends to be shorter and onsite.
•Job orientation is familiarization of a health
worker to the new working environment

18
 Benefits of orientation
• Removes fears:
 The job, its content, policies, rules and regulations
 The people with whom he is supposed to interact
 The terms and conditions of employment

• Creates a good impression - it makes the

newcomer feel at home and develop a sense of
pride;
 Adjust and adapt to new demands of the job
 Get along with people
 Get off to a good start
• Act as a valuable source of information 19
 Performance appraisal and management

 Is a formal system of periodic review and evaluation of

an individual’s job performance
 Performance is a result of three elements; effort,
abilities and role perception
 PA is useful;
 to create and maintain a satisfactory level of
performance
 to identify employees’ needs for training
 to facilitate fair and equitable compensations
 assesses employees’ potential for promotion
 encouraging performance among employees 20
 The Performance Appraisal Process

 Establishing Performance Standards

 Communicating standards to employees

 Measuring actual employees’ performance

 Evaluating factors affecting performance

 Comparison of actual performance with set

standards
 Discussing the appraisal with the employee 21
 Training and Development

Group exercise

 Discuss your experience about your organizations training and

development activities? continuing professional development

(CPD) implementation and its practical challenges in your

organization?

 Write your responses on a flip chart and present it to the plenary

 Time; 5 min
22
 Continuing professional development (CPD)

• is an organized learning experience taking

place in a definite time, to improve job
performance and growth
• The major goals of CPD are ensuring
quality health service by;
 competent health professionals and linking
CPD with License
23
 CPD activities include;

 Face to face training

 E-learning (online or offline)
 Publications and Attending scientific conferences
 Moderating panel discussion
 Structured health Education(HE) session
 Case reports
 Educational visit
 Knowledge sharing
 Modalities of CPD
 Live program
 Electronic Courses
 Blended courses 24
Health management teams are
responsible for;
 Ensure time and opportunities for health
professionals for CPD activities
 Integrate CPD in the annual performance
appraisal
 Undertake CPD need assessment for health
workers and support the implementation 25
 Training and Development

 Increase the possibility of improving job

performance and growth; consists of
three main categories:
- training
- education
- development
26
 Necessary conditions to establish Continuing education

• Creates an efficient, updated & motivated work force

• Available human resource training profile for various

health workers
• The health management team must conduct a
survey /situation analysis
27
 Merits of continuing education

• Avoid professional decay and continuing ignorance

• Motivates the health work force

• Improve performance efficiency and proficiency

28
Motivating employees
Group work
Time 15 min
As a health sector manager, share techniques
that you have applied to motivate your
employees.
What do you recommend to reduce staff
turnover and improve satisfaction in your
organization?
Present your findings to the plenary.

29
 Motivational theories appealing to
the health workforce
Session objectives
At the end of this session, participants will
be able to;
• Analyze different motivational theories taking
in to account to their work place context
• Promote staff motivation through appropriate
approaches 30
 Motivational theories appealing to
workforce
1. Maslow’s theory of hierarchical Needs
 The emergence of needs beyond physical and safety
needs are unpredictable
 Effective managers can anticipate emerging needs
based on individual need profiles
 The esteem level of needs manageable by provision of
satisfactory job environment & recognitions of work
31
2. Herzberg’s Two-Factor Theory

A theory of motivation based on job

satisfaction.
 A satisfied employee is motivated from
within to work harder

 A dissatisfied worker is not self-motivated

to work
32
 Implications of Herzberg’s Theory

 Satisfaction is not the opposite of dissatisfaction

 There is a need to think carefully about what
motivates employees
 Meaningful, interesting and challenging
(enriched) work is needed to satisfy and
motivate employees
33
 3. Vroom’s expectancy theory
 A model that assumes motivational strength is
determined by perceived probabilities of success

 Expectancy: one’s subjective belief or expectation that

one thing will lead to another
 One’s motivational strength increases as one’s
perceived effort-performance and performance-reward
probabilities increase the likelihood of obtaining a
valued reward 34
Relevance of Expectancy Theory to
managers
• Employee expectations can be influenced by
managerial actions and organizational experience
• Training increases employee confidence in their
efforts to perform
• Listening provides managers with insights into
employees’ perceived performance- reward
probabilities 35
 Factors promoting staff motivation

Environment, achievement
 Recognition, the work itself
 Responsibility, advancement
 Self-improvement
 Arrange salary, benefits & favorable working
conditions
36
 Health and Safety

 Individual reflection
 Time 15 min
 Does your organization have health and
safety policies? Are senior managers
committed to health and safety?

37
 Health and Safety
• Ethiopian labor proclamation 377/2003 article 98 sub
article 1 defines occupational disease is any
pathological condition caused by physical, chemical or
biological agents which rise as consequence of;
 the type of work performanced by the worker or
 the surrounding in w/c the worker is obliged to work
prior to the date in which the disease becomes evident
• The highest standards of health and safety is important
for elimination or minimization of hazards and risks
• Employer have the moral as well as legal responsibility
to minimize risk
38
Health and Safety…
• The biggest emerging health problem is stress
• 4 reasons why organizations take account of
stress:
 they have the social responsibility to provide a
good quality of working life
 excessive stress causes illness
 stress can result in inability to cope with the
demands of the job, which of course creates more
stress
 excessive stress can reduce employee
effectiveness and organizational performance 39
Stress can be managed and
prevented by;
 Job design
 Senior management commitment
 Participative approach
 Risk assessment and task analysis
 Work-related prevention and management
 Work–life balance policies
40
 Health professional regulation
systems
• The aims of a regulatory system, is to promote
good practice, prevent poor practice and
intervene unacceptable practice
• The credentialing mechanisms –
licensure/registration, certification and
accreditation are among the most frequently
used quality assurance tools function of health
care regulation

41
 Health professional regulation systems
• Main activities of Health professional regulations
system are:
 Conducting periodic task analysis study
 Create conducive environment for competency assessment
mechanism (item development, exam administrations)
 Ensure robust health professional registration, certification,
accreditation, licensing and re-licensing procedures across
the nations
 Improve Health professional regulation system periodically
based on the research findings
 Provide strong feedback to higher education institutions
and other related stakeholders, based on their performance. 42
 Session 5: Conflict management

Session objectives
At the end of this session, participants
will be able to;
• discuss the outcomes of conflict
• use conflict resolution mechanisms for
avoiding and managing conflicts

43
 Examples of positive actions of
conflict
1. Carefully analyze events leading up to the problem
2. Spot poor performance in sub-group team
3. Recognize that sub-group leader is at fault
4. Offer to retrain and support sub-group leader
5. Review leader’s training needs on regular basis
6. Review situation in 6 months to check success
44
 Some examples of negative actions of conflict

1. Ignore evidence and proceed as before

2. Lay blame indiscriminately on all team members
3. Blame all members of the project without cause
4. Leave project leader with no support
5. Deem that no further backup action is necessary
6. See project leader resign, citing lack of support

45
 Destructive and Positive Outcomes of
Conflict
Destructive Outcomes
o When consume much energy of people’s that
affect the work
o Conflicts can lead to conservatism and
conformity
o Destruction or neutralization of opponents
o Conflicts can lead to high turnover of staff and
absenteeism
o Conflicts can lead to distortion of information
and duplication of efforts 46
 Positive Outcomes of conflict
Conflicts can energize and motivate people
 Conflicts can lead to innovation and creativity
 Conflicts can promote inquiry into the efficacy
of organizational and personal policies and
values
 Conflicts can result in improved communication
 Conflicts can result in the development of
procedures for conflict management
47
 Six Steps to Managing Conflict
1. Clarify: on the nature of the conflict
2. Agree on the common objectives
3. Options: team members discuss their ideas
with the other team members
4. Remove barriers: they should systematically
try to remove barriers, one at a time
5. Agree on what best meet the needs of both
parties
6. Acknowledge: the win/win solution should be
recognized, credit should be given where possible
48
2. Health Care Financing &
Financial Management

49
Unit outline
• Overview of Health Care Financing
• Health care financing reform in Ethiopia
• Financial Management
• Financial Audit in the Health Sector

50
Group discussion
 Time allowed; 15 min

 In your team, discuss on the

implementation of each components of
HCF in your health facility?

 What are the successes on service

delivery for implementing HCF and
the challenges existing still?

51
 Components of HCF
• Facility governance
• Revenue collection and utilization
• Fee wavier and exempted service
• Private wing
• Outsourcing of non clinical services
• Cost revision and utilization
• Health insurance (CBHI)

52
 Health Care Financing

• Deals with mobilization, allocation &

utilization of funds for health care to
cover the health needs of the people

• It is concerned with where the money

comes, how it is collected how it is pooled
and how it is used to pay health service
providers
53
 Health Care Financing in Ethiopia
• The MOH has been implementing the Health Care
Financing strategy since 1998.
• The main objectives of the health care financing
includes:
– Mobilization of increased resources to the health
sector
– Promoting efficient allocation
– Effective expenditure management for allocative
equity
– Efficient utilization of available health resources
– Promoting and strengthening sustainable health care
54
financing
 Health Care Financing in Ethiopia
 The following are among the specific strategies of
the Health Care Financing

 Allowing health facilities to retain and utilize fees

 Rationalizing and systematizing rules for fee
waivers and exemption
 Taking steps to revise user fees and reforms on
facility governance
55
Major questions to be addressed on HCF

• What services should be produced to achieve

health goals?
• How much do they cost?
• Who pays?
• Who gets what?
56
 Elements of Health care financing

• Raising sufficient revenue in a sustainable

manner
• Pooling risk equitably and efficiently

• Purchasing health services to cover the

health needs of the community
57
Basic principles of resource mobilization

• Strive for sufficiency

• Focus on technical efficiency
• Ensure Equity
• Transparent management of resources
• Effective expenditure
58
 One Budget

• Bringing together all the sources of

money each received into one document
(ideally even into one, pooled account)

59
Health Care Financing Reform in Ethiopia

60
 Facility Governance, revenue retention
and utilization
The HCF reform strategy shall be
implemented at all levels of the health system
At facility level:
• Each Hospital shall be administered by
Hospital Governing board
• Each Health center shall be administered by
a Management board
61
 Role of RHBs in facility governance

• Ensure block budget provision to hospitals

• Provide technical assistance in setting proper
system for operation
• Create an enabling environment for hospitals to
obtain the necessary manpower, material and
finances
• Facilitate the establishment and functionality of
governing board
62
 Role of Boards in facility governance
• Approve short, medium and long term plans and
budget of the hospital
• Hires general manager, approves employment
and promotion of department heads
• Hire required employees and fire those found
unfit
• Determine responsibility and duty allowances
• Determine non-clinical services to be outsourced
• Set standards and follow operation of private
wing 63
 Revenue Retention and
Utilization
Sources of Facility Revenue collection mechanism

a. Block budget allocated by the government

b. Fees collected from health care & diagnostic services
c. Sale of drugs and medical supplies
d. Revenue collected from third parties

64
 Cont…

e. Fees collected from consultancy, trainings

and
research activities
g. Income from non-medical services and
goods
g. Direct aid in cash and in kind obtained
65
 Why private wing?

• To mobilize additional resources

• To improve quality of service in the non-
private wing sections
• To increase motivation and reduce attrition
of health workers
• To provide an alternative choices of care
66
 User fee setting and revision

• One of the key guiding principles cost-

sharing principle
• Setting health service fee is the
responsibility of the regional government
• User fees may be revised every five years

67
 Health Insurance

• Formal arrangements where insured

persons are protected

• A lawful provision relieving the public from

the unforeseen medical bills

68
 Rationale for health insurance

1. Elimination of catastrophic health expenditure

2. Improves utilization of health services

3. Creates risk pooling b/n different income groups

4. Improves the quality of healthcare services

69
 Cont…

5. Ensures equity in health care provision

6. Strengthen community participation in the

management of health services

7. Provides additional source of funds to the

health sector

8. Cost sharing 70
 Types of Insurance

• Social Health Insurance - a mandatory, non-for-

profit health insurance for formal sector

employees

• Community Based Health Insurance - Voluntary

HI organized at community level

• Voluntary Health Insurance - not rely on local or

71
 Financial Management

• Is the planning, directing, monitoring,

organizing and controlling of financial
resources in health facilities

• Its purpose is to assure adequate funding for

all health care services

72
Basic accounting procedures and cycle

Managers within the sector have to ensure:

• Different units of the health sector are
following proper financial management

• Revenue collection, utilization and reporting

systems should align with government
financial management
73
 Financial Audit
• An audit is the examination of the financial
report of an organization - as presented in
the annual report - by someone independent
of that organization

74
 Reports for Financial Audit

The financial report to be audited includes:

• Balance sheet
• Income statement
• Statement of changes in equity
• Cash flow statement
• Notes comprising a summary of significant
accounting policies
75
3. Supply chain Management
(SCM)

76
Outline
• Introduction to Logistics & Pharmaceutical
Management (IPLS)
• Inventory management and stock practice

• Logistics Management Information System (LMIS)

• Practices, Polices, law & regulations in

pharmaceutical logistics system (PLS)
• Quality assurance and good storage Practices
77
Introduction to Logistics and
Pharmaceutical Management
Activity
Duration: 15 minutes
Group exercise
Have you ever encountered any problem with
supply chain management in your organization?
Identify specific intervention areas that could be
manageable at your level.
Share your responses to the plenary.

78
 Overview of Supply Chain Management
(SCM)
• Supply chain includes any function that is
required to produce and deliver the final product
to customers

• Logistic mgt; refers to the specific functions that

need to be carried out by each of the SC partners
such as selecting products, forecasting demand,
procuring /ordering, warehousing/storing,
managing inventory, transporting from one level
to another & managing data 79
 The 6 rights of successful logistics
system

1. Procuring the right goods

2. In the right quantity
3. In the right condition
4. Delivered to the right place
5. At the right time
6. For the right cost
80
Pharmaceutical Logistics System
(IPLS)
It is a system of:
• Selecting
• Quantifying
• Supply-planning
• Ordering/procuring
• Distributing products from one level to another
81
 Types of Logistics Systems

• Allocation or “Push” System: the higher-level

decides what, when and how much of each
pharmaceuticals move down through the system

• Requisition or “Pull” system: the lower level

orders what, when and how much of each
pharmaceuticals, thus pulling or receiving
through the system
82
Components of the logistic cycle

83
Flow of pharmaceuticals and information
in the IPLS

84
 Roles and Responsibilities

IPLS implementation requires collaborative efforts of

professionals working at all Levels including;

• EPSA
• MoH - Relevant programs
• Regional Health Bureaus/ Zonal Health Department
• Woreda Health Office
• Health facilities
85
Inventory Management and stock control
Activity
Duration: 15 minutes
Group exercise
In your team, look in to your organization
inventory system and review:
 What challenges has your organization faced
related to logistics and storage of inventory
with actions taken to improve it?
Share your response to the plenary.

86
Inventory Management (Control) System

An inventory management is a system that

informs the store manager;
• How much stock is available
• When to order more stock
• When to issue
• How much to order or issue and
• How to maintain an appropriate stock 87
 Purpose of Inventory Management

 To make sure enough pharmaceutical

products are readily available, complete &
accurate information should be available at
each level of the logistics system:
• When they are stored (using inventory control
cards)
• Transported (using transaction records)
• Used (using consumption records) 88
Responsibilities in inventory & Storage of Logistics

• Allocating budgets to improve the storage

condition in health facilities
• Provide supportive supervision and training
in improving storage conditions
• Help facilities to distract damaged and
expired pharmaceutical products 89
Logistics Management Information

System (LMIS)

90
 Overview of Logistics Management
Information System (LMIS)
 It is an information system to make logistic
decisions such as;
 resupply
 Forecasting
 Quantification
 procurement
• The purpose of LMIS is to collect,
organize, and report information to other
levels in the system 91
 Movement of Logistic Information

• Flows in the form of reports, requests and

feedback
• The primary source starts at health facility level
• A copy of the report and request form will be
submitted to EPSA branch/hub every two months
• EPSA branch checks accuracy of reports, requests
and make immediate decisions
• Central EPSA receive reports & requests from
branches to make decisions
• Feedback reports may include: acknowledgments,
error corrections, correcting late reports etc. 92
 Essential Data of the Logistics System

• Stock on Hand: Quantities of usable stock

available at a particular point in time
• Consumption data: The quantity of
pharmaceuticals used during the reporting
period
• Losses/Adjustments: Losses are the quantities
of products removed from your stock 93
 Inventory Control System in IPLS
Level Review Maximum Minimum Emergency
Period Months of Months of Order
Stock Stock Point

Health Every 4 months 2 months 0.5 months

Centers andother (= 2 weeks)
Hospitals month

Health Monthly 2 months 1 months 0.25 months

Posts (= 1 week)

94
Quality assurance and good storage
practices

95
 Storage principles

• Pharmaceuticals should be protected from sunlight,

heat, and water; and store managers should follow
manufacturer’s recommendations for storing supplies
• All the necessary information is usually written on the
product carton and boxes
• There are standard storage procedures that should be
followed at all facilities
• Store managers can evaluate how well their storage is
performing against these procedures & look for ways to
improve
96
 Ensuring quality storage requires
the following
• Clean and disinfect the storeroom regularly
• Store in a dry, well-net, well- ventilated
storeroom out of direct sunlight
• Protect store room from water penetration
• Keep fire safety equipment available,
accessible, functional and train employees to
use it
• Maintain a cold storage, including a cold chain,
as required 97
 Cont…
• Limit storage area access to authorized personnel and
lock up controlled and high value products

• Stack cartons at least 10 cm off the floor, 30 cm away

from the wall and other stacks, and no more than
2.5m high

• Store medical supplies away from insecticides,

chemicals, old files, office supplies and other materials
98
 Cont…
• Store flammable products separately from other
products
• Store health commodities to facilitate FEFO (First
Expire First Out) procedures and stock
management
• Arrange cartons with arrows pointing up &
identification labels, expiry dates, and
manufacturing dates clearly visible
• Separate from usable commodities and dispose of
damaged or expired products 99
4. Health Management Information
system (HMIS)

100
Basics of Health Information Management

Activity
Duration: 15 minutes
Individual exercise
As a health manager you are expected to make informed decision, share
your experience where you used evidences for decision making and in
contrast share another experience where you made decision with
inadequate evidences. How was the outcome of the two decisions?
Group exercise
In your team identify challenges you encountered with the roll out of
Health Management Information System (HMIS). Show how
organizational activities are affected as a result of the challenges you
mentioned. Propose possible strategies to make informed decision to
improve organizational performance.
101
Health management information system (HMIS)

Information system; is a set of interrelated

components that collect or retrieve, store
and distribute information to support
decision & control
HMIS; is an information system designed to
assist in the management and planning of
health programs (WHO, 2000)

102
 Components of HIS

1. Health information system resources

(inputs)
2. Indicators
3. Data sources
4. Data management
5. Information products (outputs)
6. Dissemination and use
103
 Types and Sources of Health Data

There are two main types of data available;

• Quantitative; based on measurement of
quantity or frequency e.g. height, weight,
number of delivered
• Qualitative data; expressed in terms of
categories e.g. sex, ethnic groups

104
 Classification of data based on duration

• Routine health data; are health service-based data

collected at regular intervals, e.g.; number of
vaccinations given, deliveries attended
• Semi-permanent data; data that change in a long-
term duration, data on population in a district, number
of staff and beds
• Permanent data; data that are rarely changed. E.g.
geographical data (roads, rivers, location of a health
facility
• Non-routine data; special studies, qualitative and
quantitative rapid assessments and surveys, E.g. DHS
105
 Indicators & data quality
Indicators; are list of input, output, outcome and
impact & included in the M&E framework
• There are total 167 indicators to monitor and
evaluate the HSTP /56 to measure health system
performance and 111 related to program and
health outcomes)
• Data quality can be affected by technical factors,
such as data-collection tools, processes and IT
devices, and also organizational and behavioral
factors
• To ensure the reliability of different data sources
106
The relationship between the information cycle and management cycle

107
 Data collection tools

• All data collection tools such as registers, tally

sheets & formats should be developed
according to a standard
• Standardization helps to maintain data quality
as well as in making reports comparable across
all health sector
• HSTP will regularly assess reporting
mechanism, and implement interventions to
ensure accountability towards “Zero Tolerance
for Parallel Reporting” 108
 Data collection tools

The data collecting tools in your HFs are:

– S: Simple or easy to use (layout)
– O: No Overlap or no duplication on the
data elements
– U: Useful for calculating indicators
– R: Relevant for making decisions and
plans
– C: Clear or easily understandable (terms
used)
– E: Effective in making decisions 109
The HMIS Reform in Ethiopia

110
 Rationale for the reform

• Limited definition and implementation of HMIS/M&E

staffing standards
• Limited standardization of recording and reporting
• Unnecessarily high data burden, with duplicative
and poor quality
• Limited implementation of evidence-based planning
and monitoring procedures
• Limited consistency amongst health related
information sources
• Limited use of technology
111
 Basic principles of HMIS reform

• Standardize
• Simplify
• Integrate
• Institutionalize

112
Dissemination and communication
• M&E findings will be disseminated to
stakeholders on monthly, quarterly, and
annual reports
• Participatory review meetings are expected
every two months, quarterly, biannual, and
annual with all stakeholders
• Evaluation; joint FMOH-HPN Review
Mission (JRM), Mid-Term Review (MTR),
and Final Evaluation of the strategic plan 113
 What you need from the HIS

• The health needs of the people in their catchment

area
• The priorities of the country, province, district,
and communities they serve
• The quality and coverage of the services they
offer
• The resources they have used & available
• Progress in the implementation of their activities
114
 Information Revolution
• It’s main objective is to enhance the use of timely,
accurate & reliable information for decision-
making at the local level across the sector
• To bring about a radical shift in terms of
information management in the health sector by;
 Advancing the data collection, aggregation,
reporting and analysis practice
 Promoting the culture of information use
 Harnessing ICT

115
 Cont…

 Data visibility and access

 Data will be accessible for researchers

 Addressing the human element

 Strengthening verification and feedback

systems
 Multi-sectoral approach
116
5. Time management

117
Activity
Duration: 10 minutes
Individual exercise
Take a day in the past week as an example and list
what you did on that particular day.
Categorize the activities at personal and
organizational level so as to appreciate the amount
of time you spent on each activity. What led you to
spend your time on the listed tasks?
Share your experience to the team members.
Duration:20 minutes
Group exercise
Referring to the session on the Urgent and Important matrix
(Chapter II), discuss the methods that help you identify tasks in
your department/core process/case team that are important and
should be taken as a priority to be carried out. In relation to these
tasks, what are the different methods you have employed to 118
manage your time in your department/core process/case team?
 Managing Time

• Time is a precious commodity that cannot be replaced

• Once gone it is unrecoverable

• Our ability to manage our time is one thing that will
make a difference to what we achieve in life
• It is the ability to decide what is important in life, at
work and in personal life
• To prioritize certain jobs so that we complete the
tasks
119
 Importance of Time Management

• It gives us the ability to keep a balance in our

lives
• It is a skill that can be learnt, practiced &
improved
• It enables us to fix our undivided attention on
what needs to be done
• It is a skill that everyone needs 120
 Principles of time management

• Make a list
• Assign priorities
• Do first things first
• Allow no interruptions
• Keep at item one until time runs out
• Work item one until you finish with it
121
 How to use to-do a list successfully

• Get in the habit of writing a to-do list every day

• Be realistic & aware of the limitations of your time frame
• Don’t over schedule
• Allow a time cushion
• Review your list every morning
• Add more items as you do each item
• Before doing each item ask, ‘‘Why me?’’ Delegate when
possible
• Group related activities 122
 How to analyze your to-do list

Review each item for:

• Necessity
• Appropriateness
• Effectiveness
• Efficiency

123
 Making the best use of time at your
health facility

Time plans are written in various common

forms known as:
• Timetable
• Schedule
• Roster
• Program
124
 Making the best use of time at your health facility

A well-managed health unit may need the

following time-plans;
• A weekly timetable
• Several schedules showing the detailed dates on
which intermittent events occur
• Several duty rosters for different sections of the
work (e.g. night call, outpatient duties)
• A program of any special health activity (e.g. a
nutrition campaign)
125
• An annual overview of events
6. Space Management

126
 Space Management

Session objectives
• At the end of this session, participants will
be able to;
 Arrange working space so that work flows
smoothly to the convenience of clients and
staff 127
 Space Management
• two kinds of space
 the buildings and settings where health care is
given
 the geographical or catchment area served by
the health facility
 Good management involves carefully arranging
the space where different types of work or
activities take place
128
Activity; Duration -10 minutes
Group exercise
From your previous experience as an
employee, what key problems did you observe
in health infrastructure management?
- Construction
- Maintenance
- Rehabilitation/renovation
How did you solve those problems
encountered and reflect the solutions utilized
to tackle the problems? Do you think it is
linked with corruption, fraud, and rent
seeking behaviors?
Discuss in your team and share your 129
 Health Facility Construction and
Expansion
• HSDP I, mainly focused on health facility
construction, expansion, rehabilitation,
furnishing and equipping of PHC facilities: HPs
and HCs and to a certain extent hospitals
• As a result, the potential health service coverage
of the country increased from 45% in 1996/97 to
64.02% by 2003/04
• Recently the potential coverage of health center
and health post reached nearly 95%, but still all
level hospitals have gaps 130
 Common problems faced in Physical
Infrastructure Management

• Health centers are under-utilized

• New or rehabilitated health facilities often
require recurrent expenditure
• Constructions are in many cases completed
timely but with other arrangements lagging
behind 131
 Cont…
• Omission of some important components
in design level
• One type of constructional design for
setting with different climatic conditions
• In many cases, constructional designs do
not accommodate sewerage, disposal etc.
• Lack of expertise and resources at remote
location.
132
 Setting of Health Infrastructure
Priorities
 Setting health facility priority should
consider:
• Site for construction
• Status of medical equipment
• Utilities (water, electricity)
• Availability of qualified health 133
 Factors that Influence the Size and
Distribution of Health Services at a
health facility
• Frequency of the population to visit health facilities

• Services required when population arrive at the facility

• Capacity of staff members or equipment to satisfy the

requirements of the population
• Rate of admission of in-patients
• Average length of stay of in-patients in the different
wards
• Acceptable bed occupancy rate
134
 Maintenance and rehabilitation of
Health Facilities and Equipment

• Establish a guideline that indicate the

responsibilities of each level of the administrator
• Establish a maintenance information system
• Proper handling of medical equipment and
building
• Identifying and recruiting the necessary experts
to conduct prevent or basic maintenance
135
 Cont…

• Establishing 1o workshops at the health centers

and 20 workshops at regional /sub regional level
• The procurement of equipment should be
inclusive of an adequate number of the
respective basic spare parts

• Further service contracts with suppliers should

be proposed and funded should be in place

• Small workshops and maintenance stores 136

 Arranging workspace

 A good management carefully arranges the

space where different types of activities take
place

 Rooms which are unsuitably designed would

give little or no chance for managers to
organize or reorganize space utilization
137
Thank you!

138