10.1 INTRODUCTION TO GOOD MANAGEMENT
Th e aim of good management is to provide services to the community in an appropriate, effi cient, equitable, and sustainable manner. Th is can only be achieved if key resources for service provision, including human resources, fi nances, hardware and process aspects of care delivery are brought together at the point of service delivery and are carefully synchronized. Critical management considerations for assessment and planning, managing the care process, human resources, interacting with the community, and managing information are covered in the Planning, Human Resources, Integration and Monitoring chapters. Th is chapter fi rst discusses good management and leadership in general, then outlines relevant considerations for managing relations with patients and the district team, as well as fi nances and hardware and management schedules.
10.2 MANAGERS AND LEADERS
Management and leadership are important for the delivery of good health services. Although the two are similar in some respects, they may involve diff erent types of outlook, skills, and behaviours. Good managers should strive to be good leaders and good leaders, need management skills to be eff ective. Leaders will have a vision of what can be achieved and then communicate this to others and evolve strategies for realizing the vision. Th ey motivate people and are able to negotiate for resources and other support to achieve their goals. OPERATIONS MANUAL FOR STAFF AT PRIMARY HEALTH CARE CENTRES l 265
Managers ensure that the available resources are well organized and applied to produce the best results. In the resource constrained and diffi cult environments of many low – to middle-income countries, a manager must also be a leader to achieve optimum results.
What are the attributes of a good leader? Leaders oft en (but not necessarily always):
■ have a sense of mission;
■ are charismatic;
■ are able to infl uence people to work together for a common cause; ■ are decisive;
■ use creative problem solving to promote better care and a positive working environment.
Leadership is creating a vision
Managers who have these leadership qualities are a credit to the services they manage. However managers must ensure that day-to-day processes run well to produce the desired results. Certain attributes are required for a manager to be eff ective, including:
■ clarity of purpose and tasks;
■ good organizational skills;
■ ability to communicate tasks and expected results eff ectively; ■ ability to negotiate various administrative and regulatory processes; ■ good delegation skills.
Management is getting things done266 l CHAPTER 10 l LEADERSHIP AND MANAGEMENT 10.3 CONDITIONS FOR GOOD MANAGEMENT
Certain conditions are important for creating good management, including: ■ managers and team members need to be selected on merit;
■ managers need to earn the respect of their staff , patients, and supervisors; ■ managers need to have the knowledge, skills and understanding of the role, tasks and purpose of the services they deliver;
■ basic support systems function well; clear staff administration rules and regulations; well planned and timely delivered supplies, equipment and drugs; clear and transparent fi nancial processes; and well planned and monitored activities.
Management is getting things done through balanced involvement of people As a health facility manager there are important questions to discuss with the district management team and to ask yourself:
■ What exactly am I supposed to do as a manager?
■ Will the resources needed be here and be on time?
■ How free am I to take decisions, e.g. to move staff around? ■ How can I balance my managerial and clinical duties?
■ How can I reduce the time spent on the many routine reports I need to write?
■ What and where are the tools and techniques to help...