BASIC PRINCIPLES OF PUBLIC HEALTH
ADMINISTRATION AND MANAGEMENT
Lecturer:
Dr. ROSA MARIE N.FLORES
FPAFP, DFM, MPH
Definition:
• PUBLIC HEALTH
♦ The science and art of preventing disease,
prolonging life, promoting health and efficiency through
organized community effort for:
- sanitation of environment
- control of communicable diseases
- the education of the individuals in personal
hygiene
♦ the organization of medical and nursing services
for the early diagnosis and preventive treatment of
diseases and the development of social machinery to
ensure everyone a standard of living adequate for the
maintenance of health so organizing these benefits as
to
enable every citizen to realize his birthright of health
and
longevity.
♦The organization and application of public resources to
prevent dependency, which would otherwise result from
disease or injury. (Hanlon/Pickett)
♦ The art and science of maintaining, protecting, and
improving the health of the people through organized
community efforts. (American Medical Association)
ADMINISTRATION (Definition)
♦“The guidance, leadership and control of the efforts of a
group of individuals toward some common goal.” (Wm
Newman)
♦“A process by which the potentials of men and
materials are synthesized and activated for the
achievement of defined goals.” (Freeman & Homes)
♦“The organizational activities that involve goal formation
and accomplishment, performance, appraisal, and the
development of an operating philosophy that ensures the
organization’s survival within the social
system.”(Duncan, W. J )
Differentiate between organization, management and
administration:
♦ Organization-social units formed together to obtain a
specific goal
♦ Management-how people worked together to attain a
common goal
♦Administration
- overall
- includes policy making
♦Public Health Practice:
- The application of multiprofessional skills of
community diagnosis and community organization for
health and of medical education or environmental
therapy to maintain and improve the state of well-being
of the community.
♦ Public Health Service
-Any organized community program designed to
conserve and promote community health.
COMMUNITY (Definition)
♦“A body of people having common organization or
interests or living in the same place under the same
laws.”
PREVENTION (definition)
♦“Anticipatory action taken to reduce the possibility of an
event or condition occurring or developing or to minimize
the damage that may result from the event or condition if
it does occur.” (Torjman)
MANAGEMENT
♦ Has been applied since the beginning of civilization
and community living ( and not an invention of the 20th
century).
♦ WHENEVER PEOPLE WORK TOGETHER IN
GROUPS: to grow crops, to buy and sell, to wage war, to
build a temple, etc, THERE HAS BEEN MANAGEMENT.
MANAGEMENT (Definition)
♦There are many ways of defining management
depending on the criteria used in looking at it.
♦Management could be a process, an art , a science , a
class of people or a resource.
♦ It creates and controls and is a universal activity.
♦ is “GETTING THINGS DONE”
- the underlying principle to this definition is
“Commitment to achievement.”
- Commitment to purposeful action, not to
action for its own sake.
♦ “Getting things done through the efforts of other
people and that functions bring closer into
planning and control.”
♦ How people work together to attain a common goal.
♦ Management
-Is “SAYING WHAT ONE WANTS TO BE DONE AND
THEN GETTING IT DONE”
- in other words management
ensures that objectives are specified / stated
specifically what is to be achieved , and then that they
are achieved .
Management (Definition)
♦ An art.
- Is the art and science of working and
through the people to attain a common
organizational objective.
- Management problems could also be
solved thru individual styles based on
creativity, judgment intuition, and
experience rather than the systematic
methods of service .
♦Art of securing maximum results with a minimum of
effort so as to secure minimum prosperity and happiness
for both employer and employee and give the public the
best possible service.
MANAGEMENT ( Definition cont’d)
♦It is a process, it is the series of systematic, sequential
or overlapping steps in designing and maintaining an
environment in which the individual working together in
groups efficiently accomplishes selected aims.
♦ As a process it has 3 important features:
- dimension of time thus it is dynamic
- integrates efforts of a group and
- requires skill for conflict resistance
♦ The process of allocating an organization’s inputs
(human and economic resources) by planning,
organizing , directing and controlling for the purpose of
producing outputs (Goods and Services) desired by its
customers so that organization objectives are
accomplished in the process, work is performed with and
through organization personnel in or ever-changing
business environment.
♦Process by which the execution of a given purpose is
put into operation and supervised. (Terry)
♦ Process involving the coordination of human and
material resources towards accomplishment of objective.
Simultaneously, it involves the judicious use of the
resources. motivation of people , provision of
leaderships, planning and controlling.
MANAGEMENT (Definition cont’d)
♦ Practice of consciously and continually shaping
organization.
♦Consists of all organizational activities (human
resource) that involve goal formation and
accomplishment , performance , appraisal and the
development of an operating philosophy that ensures the
organization’s survival within the social system.
♦ This basic definition can be expanded to mean :
1. Managers carry out the managerial functions of
planning, organizing, staffing, leading, and controlling
2. Management applies to any kind of organization
3. It applies the managers at all levels of the
organization
4. The aim of all managers is to create a surplus
5. Managing is concerned with productivity, which
implies effectiveness and efficiency.
♦All systems require management for effective and
efficient performance.
MANAGEMENT (Definition cont’d)
♦A profession:
Skills in designing, instituting and controlling the
process can be taught and learned thus management
evolved as a profession.
Universities today now offer degrees in management
and some programs like health administration require
management courses. Its formal study includes
discussions of the theories and practice of management
♦A science:
A substantial portion of management can be
accomplished thru the scientific method : empirical
measurement of data, causal links among phenomena,
logical organizational structure and conclusions that can
be validated experimentally,etc.
It is interdisciplinary drawing its strength from the various
disciplines as the focus of management is both physical
and human.
♦A resource:
Management is in itself a resource together with
capital, materials and labor. The knowledge and practice
of good management is in itself a wise investment in an
organization. Upon it depends the success or failure of
an enterprise.
♦An elite or class of people:
-in this sense management is that group within a
organization that has the legal authority to direct and
control the organization.
♦The M’s of Management:
-Man
-Money
-Materials
-Methods
-Mission
♦ Managerial Process: (Definition)
-is defined as planning, directing and controlling the
organization and weaving together its various parts see
that all factors will function properly and all persons
cooperate for a common purpose.
-is the art of getting things done through people by
proper allocation and choice of human resources,
materials funds and methods.
♦ Manager (Definition)
- the person who allocates human and material
sources and directs the operation of an organization.
- plans for the future and tries to determine the most
efficient way to achieve the objectives
-motivates employees and to increase overall
efficiency, effectiveness and productivity
Differentiate between organization, management and
administration:
♦ Organization - social units formed together to obtain a
specific goal
♦ Management - how people worked together to attain a
common goal
♦Administration
- overall governing power of an organization/enterprise
responsible for the policy and major decisions concerned
with the political, economic/financial matters as well as
the well-being of the organization and its people (more
popularly known as “management”, see above definition)
- refers to the activities of group(s) or individuals who
makes decisions, plan, organize, direct and control
resources in order to achieve the objectives of the
agency accdg to the specified quality, time, method, and
expenditures.
The Role of Doctors in Public Health Administration
• The medical profession is one of the most
important contributors as well as one of the most
important problems in Public Health.
• Many programs in Public Health requires the
work of physicians– the management of TB and
 STDs, prenatal and early childhood care, and II.A. Cooperation system (Chester Barnard)
clinical work in ambulatory care programs. II.B.New concept of authority (Barnard)
• Physician involvement is desirable although not III System Theory
mandatory in planning, organizing, and in IV Contingency Model
managing Public Health Programs. -flexible
-states that no one way of managing that will apply best
The difference between Public Health and Private Health to all situations
Administration
• Public Health Programs are by definition public ♦Functions of Management:
although some of the activities may be In 1926, Henry Fayol wrote that the functions of a
purchased from the private organization, profit manager are to plan organize, command, coordinate,
making and not for profit, impinge on the health and control.
of the public both in a positive and a negative • These functions are often modified however the
way, but the administration of the public health original list of Fayol remains as the basic outline
programs involves the use of public funds on for management functions. Some authors want
behalf of public health. to be more detailed, while others combine the
functions in one entity.
PUBLIC SECTOR CHARATERISTICS:
1. The profit measure is absent. Planning} Planning} Planning} PM
2. They tend to be service organizations rather than Implementing}P I E Organizing} POLCE Management}
product oriented Evaluation} Leading}
3. They tend to have legislative constraints on their goals Controlling}
and strategies Planning} Evaluating}
4. They are less dependent on their clients for their Organizing} POEA
revenue. Actuating} Planning}
5. They tend to be dominated by professionals Evaluating} Organizing}
6. They have different governance structure, often Staffing} POSDCORBE
elected Planning} Directing}
7. They are often lead by people not specifically trained Organizing}POMA Coordinating}
for administrative leadership. Managing} Reporting}
Appraisal and Control} Budgetting}
• Private sector has one overriding objective: to Evaluation }
maximize profits.
• There are two factors: FUNCTIONS OF MANAGEMENT
1. managerial accounting and ♦Planning
2. financial accounting - is a set of objectives associated with objective setting,
• The one dominant goal is the famous bottom policy-making, decIsion-making , looking for alternatives
line: the excess of revenues over costs. and strategies, procedures for attaining objectives within
• In the public sector, the bottom line is the public the organizational framework.
welfare.
- is the formulation of the steps to be taken by an agency
Theories of Organization at some future period to achieve a desired state/solve
I. Classical Theory the problem, which the process itself specifies as its
-rigid objective.
-emphasizes on the
formal structure of - attempts to answer questions before they actually
the institution. arise, anticipating as many implementing decisions as
There are 3 schools of thought which could explain the possible by foreseeing possible problems, ad deriving
structure of an organization and its relation to its principles and setting rules for solving them.
subordinates: - Involves an analysis of the current and future state of
I.A. Bureaucratic model (Max Weber) the internal and external environment of the organization
I.B.Scientific management (Tayl;or) which in turn should lead to the choices of objectives.
I.C.Principlres of Administration School (Fayol,Guick and
Urwick) - Always result in an output- --a written plan
- Control device: Plan
II. The Neoclassical Theory -Continually identifies expectations for people,
-the organization is seen as a social structure: an programs, or projects and measure the process and the
intricate web of human relations band together by a rate of progress towards the goal.
system of sentiments -Lack of plan is viewed as an attempt of the manager
-advocated group-oriented behavior and cooperation to control and great flexibility best reigns over a situation
over competition and individualism as the basis for - Budget – an expression in monetary terms of the plans
human social action of the agency.
- Before planning one must have a goal.
3 Components of planning
♦Analysis of current and future state of the environment
♦Formulation of policies. strategies, programs,
procedures and rules
♦ Resource requirements
Principal Areas of Planning
♦Objective-process that requires global vision,
diplomatic skill and considerable good fortune.
♦ Tips for planning about objectives:
a. Determine what problems there are and which of
them merit priority attention
b. Decide who is at risk from the problem or is exposed
to are affected by it where they live and work
c. Most importantly- extent to which it is intended to
reduce the problem, the target time for achieving the
reduction
♦ Activities
♦Tips for planning about activities:
a. Decide activities that are needed , whom the
activities are directed
b. Determine the timing. sequence, frequency, location
of activities and assignment of task and responsibility.
♦ Resources
♦Tips for planning about resources
a. Determine the nature of resources (staff, equipment,
supplies)
b. Determine the amounts of each resource
c. Know where the resources should come from and be
sent (logistic consideration)
Planning Steps
♦ Step 1. Look at the situation (fact finding community
diagnosis)
♦ Step 2. Recognize important problems
♦ Step 3. Set objectives (establishing priorities)
♦ Step 4. Review obstacles and limitations
♦ Step 5. Schedule activities (establish activities,
personnel, equipments, estimating financial support
needed (budget) phasing activities)
♦WHAT TO DO?
♦ HOW TO DO IT?
♦ WHEN TO DO IT?
♦ WHO WILL DO IT?
-means the identification of the problems
-involves selecting of objectives and strategies,
policies, and procedures for achieving them.
- policies relating to authority process, programs of
production, management, succession, etc.
♦ Confusion have arisen about who should plan and
when all managers plan, whether they are at the top,
middle or
bottom of the organizational structure
♦ Organizing
- is concerned with the division of labor and
corresponding assignment of duties and the
establishments of lines of authority and of
communication.
- Activities are analyzed and the appropriate
groupings of said activities are determined
- Responsibility for each group of activity and
corresponding authority is then assigned.
- Relationships of the different activity groups
are then identified and lines of communications are
established.
♦Directing
- this function initiates and maintains actions towards
the objectives of the organization.
-effective directing requires delegation,
communication, training and motivation.
-for better acceptance the term has just been changed
to leading and directing
-leading is influencing people so that they will
contribute to group goals
♦ Coordinating
- closely related with the directing process is the
orchestration of all activities into the whole scheme of
operation.
-coordination begins by seeing to it that all the parts of
the organization are bound together by common goals
and objectives.
♦ Monitoring and Control
- Monitoring means keeping tract of the work being
done and seeing to it that it is done in accordance with
the quality and other specifications set in the plan; the
latter refers to controlling.
- it is greatly dependent on the feedback
mechanism thru an established information
system.
- a plan of work with the appropriate indicators ,
indicating progress in time is a useful is a useful
tool in monitoring.
- Control activities relate to measurement of
achievement .
- Means of control are budget for expense
inspection records, records of labor hours cost.
♦Evaluating
- this function is a systematic way of learning from
experience and using these learned to improve current
and future activities.
-its basic concept is to improve health programs and
structures in the delivery of health.
-after everything has been planned and implemented
there remains the task of evaluation.
-this serves to check whether one’s project went
according to plan if the objectives have been met and if
one’s project lacked resources or not.
-after reviewing all that has been done, one must
particularly take note of the errors committed and the
time and other resources not put to maximal use so that
the next time a project is set up, these pitfalls may be
prevented
General Principles of Management
♦ Principles of management are fundamental truths
explaining relationships between 2 or more sets of
variables.
-They are descriptive or predictive but not
prescriptive.
1.Principle of Unity of Command
- Employees should receive orders from one superior
only.
- the more often the individual reports to a single
superior , the more likely that the individual will feel
sense of loyalty and obligation and the less likely that
there will be confusion about instruction.
2. Division of Work
- this is the specialization that economists consider
necessary for efficiency in the use of labor e.g. the
assembly lines
3. Authority and responsibility
- Fayol finds the two related with responsibility arising
from authority.
- authority is derived from the position, and
personal factors like intelligence, experience, moral
factors, past service, etc .
Principle of Line of Authority
- in any organizational hierarchy , there is a chain of
command from the highest to the lowest levels which
has operational authority.
- This is the authoritative side of the hierarchy
with hiring ,firing, promotion, transfer, etc.
- This principle is best illustrated in military
organizations with chain of command from
general to private
• Principle of absoluteness of Responsibility:
- An administrator cannot escape responsibility for the
actions of his subordinates . It cannot be delegated.
4. Discipline
- it is the respect for agreements which are directed in
achieving obedience, applications, energy and onward
marks of respect .
-Fayol says that discipline requires good supervisors at
all levels
5. Unity of Direction
- this principle says that each group of activitis with the
same objectives m8st have one head and one plan
6. Subordination of Individual to general interest
- when the two are different, management must
reconcile them
7. Renumeration
- pay and methods of payment should be fair and afford
the maximum satisfaction to employees and employer.
8. Centralization
- Fayol refers to the extent to which authority is
concentrated or dispersed
9. Scalar chain
- there is a “chain of superiors” from the highest to the
lowest.
-it should not be needlessly broken but can be circuited
if to follow it scrupulously would be detrimental.
-the clearer the line authority from the ultimate
management position the more effective will be
responsible decision-making and organizational
communication
10. Order
- Fayol follows the simple adage” – a place for
everything (everyone) ,and everything (everyone) in its
(his) place.
11. Equity
- Loyalty and devotion should be elicited from
personnel by a combination of kindness and justice on
the part of the managers.
12. Stability of Tenure
- Fayol finds unnecessary turnovers to be both the
cause and effect of management
13. Initiative
- it is the thinking out and execution of a plan.
-Fayol exhorts managers to sacrifice vanity to allow
subordinates to exercise it
14. Esprit de corps
- in union there is strength .
- it is also extension of the principles of unity of
command and emphasizing teamwork and
communication
15. Span of control
-there is a limit in each supervisor to the number of
persons who can be effectively supervised
The Goals of Administration and Managers:
- Very often said that the aim of business managers is
simply to make profit. But profit is really a measure of
surplus.
-For many firms, an imp’t goal is the long-term
increase in common stocks
-In all kinds of organizations, business or non-
business, the logical and publicly desirable aim is to
create surplus.
- Thus managers must establish an environment
where everyone knows who is responsible for
what results, and obstacles to performance
caused by confusion and uncertainty of
assignments are removed and therefore people
can accomplish group goals with the least
amount of time, money, materials, and personnel
dissatisfaction or to accomplish as much as
possible with available resources.
Management Functions at Different Organizational
Levels
♦ Managerial Levels
- There are various managerial levels in an
organization.
- At any level of the hierarchy in the organization,
someone is given the responsibility for the work
at that level. He is also given authority to
accomplish the given responsibility.
1. First Line Management /Operational Management
- deals directly with the unit functions.
- the people in charge at this level are sometimes
called Unit Head/Supervisor/Foreman.
First Line Management (cont’d)
 - concern of management at this level are
technical leadership to workers in the unit, thus
manager has to be technically competent in
guidance, training, quality control, and
communication between rank and file and middle
and top management;
-translates administrative plans into schedules,
assignments, clinics, visits
-operational planning

♦Middle Management (Intermediate Level)

-is between the first line management and top
management.
-management at this level interprets policies,
strategies, and broad directives. (overall implementation
of policies)
-much of the time of middle managers is spent on
communicating between the first and top levels of
management
-administrative planning

♦ Top Management (Central or National)

- responsible for charting the direction of the agency
(broad general direction of programs) and formulating
approaches to be adopted.(directional planning or policy
making of health policies)
-National Health Programs and Projects

♦ All managers at the different organizational levels carry

managerial functions.
♦ However time spent for each function may vary.
♦ Top- level managers spend more time on planning and
organizing than do lower-level managers.
♦ Leading takes a great deal of time for the first time
supervisors although in modern corporations of today, it
has been found that leadership functions at top level
management has greatly increased
♦ Time spent on controlling does not vary much among
managers at various levels