General Description
This course is designed to help the students understand concepts of management in general and health service management in particular as well as to provide the students with opportunity for the exposure to the health care delivery systems in the country. This is expected that the course will help the students acquire knowledge and skills to perform the managerial tasks that they are supposed to carry out as a medical officer or a district health officer. The course comprises management theory and management of health service at zonal, district and community level in the public and private sectors.
The course mainly uses two teaching learning approaches: i) lecture on theoretical aspects of the course and, ii) field placements at the District Health Offices and other different health service facilities.
1. Theoretical aspects
Specific objectives
A. Management theory
Students will be able to
- explain the concept and purpose of management, relevance and importance of management in health services delivery
- describe principal management theories, management styles, and different components of management:
- Human resource management (need assessment, training, retaining, personnel evaluation, supervision, motivation,)
- Financial management (concepts and importance)
- Logistic management (concepts and importance)
- Information management (concepts, importance, methods)
- explain planning cycle and planning process (e.g. need assessments, target setting, resource allocation, priority setting, evaluation)
- describe general principles of budgeting
- describe organization theories, leadership in organization
- explain the concept and process of supervision, evaluation and monitoring
- describe the ethical aspects of management (e.g. proper and improper use of authority, concept of corruptions, responsibilities and accountability of managers towards employers, superiors, juniors, consumers and nation, social responsibility of managers)
B. Health financing/health economics
Students will be able to
- describe concept of health economics, importance of health economics in health services.
- Describe different available alternative financing mechanisms; identify the best mechanism of financing for a particular health programme.
- be familiar with evaluation of health programmes.
- explain the concept of cost minimization, cost effectiveness, cost benefit and cost utility, per capita gross domestic production (GDP), gross national production, economic growth rate, quality adjusted life years (QALY), disability adjusted life years (DALY), burden of diseases.
C. Health care system
Students will be able to
- describe the concept of health care system
- explain the goal of health care system
- describe the factors influencing the nature of health care system in a country.
- explain the difference between health care system and health service delivery mechanism.
- explain the concept and rationale of reform of health care system.
D. Health care system in Nepal
Students will be able to
- describe the main features of National Health Policy; characterize the nature of health care system in Nepal
- describe the health service delivery mechanisms in Nepal.
- Public sector
- Private sector for profit and for not profit
- Informal sector like traditional, indigenous, self care
- describe organizational structure of health sector in Nepal (MOHP, Departments, Divisions, etc.)
- describe hierarchical structure of health sector (central, regional, district, village and community level), functions and facilities at each level, roles and responsibilities of health service providers at different levels, particularly, the role of district health officer.
- describe the concept of Local Self Governance Act (LSGA)
- describe targets of health sector
- Five year plans
- Second long term health plan
- Millennium Development Goals (MDG)
- describe different strategies to achieve the targets/goals
- Maternal and Neonatal Health (MNH) strategy
- Reproductive Health (RH) strategy
- Safe Motherhood strategy
- Disease Control strategies (TB, STD/AIDS, Malaria, etc.)
- Population policy
- Other relevant policies and strategy
- Community Drug Programme (CDP)
- describe the major partners in health sector and critically analyze their role in health development in Nepal (NGO/INGO, donors, multilateral agencies)
- describe rule and regulations related to health in Nepal
- Drug Regulation Act
- Food safety Act
- Consumers Act
- Abortion Act
- Ethical guidelines of Nepal Medical Council and NHRC
- Other relevant Acts, Regulations.
2. Field placement: Experiential learning on health service and clinical management
Specific objectives of field posting
Students will be able to
- Collect the relevant information from different sources, analyze, and interpret them, communicate with the people, appreciate and work in the team.
- Describe the health service delivery mechanism at the regional, district and community level,
- Describe health service management, administration and planning process at the district level, role of different partners (for example, DDC, VDC, NGO, INGO, private sector, traditional service providers, etc.) in providing health services in the district, relationship of health office to these partners.
- Prepare the district health profile including organization structure, health work force, health programmes, health problems and issues, etc.
- Analyze prevalence and epidemiological trend of health problems in the district.
- Critically analyze the health service management in the district and produce alternative solutions
- Prepare a five-year plan to address a particular problem or issue in the district based on the local situation.
- To disseminate the information and effectively advocate for issues at the different levels
Methods: The objectives above mentioned will be achieved using multiple methods in the field placement
Students will be posted in the field for 9 weeks in small groups by rotation to the various health institutions at the zonal and district levels — 3 weeks in each institution. Prior to posting, they will be given orientation to the objectives of the programme and activities to be conducted. Students will also prepare their specific objectives and plan of action and arrange their logistics during this period.
The students will build rapport with different officials of health and other institutions. They will visit different health service facilities and other relevant institutions like DDC, VDC, NGOs, INGOs, local groups, etc., participate in different activities, and interact with different people. The students will collect information from different sources, analyze and interpret them and present at the district to relevant audience.
District Health Officer, Medical Superintendent and the faculty of the Maharajgunj
Campus will supervise the students during the filed placement.
Students will present the objectives, process, main findings and learning reflections of the field placement in the campus.
Finally, the groups will submit the field report, which comprises the following components:
- Objectives and methods
- District health profile
- Epidemiological/ trend analysis of a disease in the district
- Critical analysis of management issue in the district
- Five year planning to address one of the problems or issue in the district.
