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    Basic concept of health services management.

    Das AM

    IN TOUCH 1991 Mar; 10(98):3-11.

    In order to institute the Alma Ata Conference goals of health for all (HFA) and primary health care (PHC), the author has provided an overview of the tenets of basic management as it pertains to a health services system in Bangladesh. Central government structure is diagrammed. The internal operation is described as composed of administrative decisions; operational management; operational planning; organizing resources; motivating health personnel; appraising staff performance; coordinating; developing public relations; managing information systems; monitoring; conducting evaluations; identification and collection of data pertinent to evaluations; methods and techniques of data collection; reporting of background information; and objectives and methodology of evaluations, findings, and major achievements. Activity is evaluated based on relevance, progress, effectiveness, adequacy, efficiency, and impact. The author finds that Bangladesh's lack of any formal document on national health policy impedes the managerial process. Other inadequacies involve the lack of dissemination of the HFA country paper and unsuitable perceptions of the PHC approach; the deficiencies in the 5 year plans to address the main concerns of the PHC in the health care system such as community finances or inequitable resource allocation; the lack of preventive and integrated care in upazila health management; the lack of definition of responsibilities of institutions; the lack of motivated grass roots level workers who provide coordination with other sectors; the lack of micro or macro evaluations of quality of care; and management deficiencies. Supervision is incompetent. Linkage between formal and informal health sectors are missing. Skills are lacking in operational planning. Conceptualization of PHC is inadequate.
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