At this point, the organization or if a consultant is brought in,
a consultant together with the organization undertakes an organizational diagnosis.
Five major factors comprise an organizational diagnosis.
Just as we talked about community diagnosis and behavioral diagnosis,
we have organizational diagnosis.
Those five factors include the technical elements, the human element,
the environment which we've talked about a bit, space,
time coordinates and organizational policies.
Briefly, we'll look at each of the five components of an organizational diagnosis.
Technical factors include equipment,
the methods that are used to carry out the organizations function whether
it's laboratory tests or health education posters,
computer use, management information systems, management procedures,
everything from accounting of staff leave procedures,
issues in terms of wages, job descriptions,
quality, assessment of services,
costs of services, financial arrangements, contractual arrangements.
Again, the organization makes contracts with
other organizations in the environment that provide goods and services,
labor arrangements, issues of unions,
contracting again with employees,
specialized skill that are needed by the staff, administrative skills,
technical skills in terms of
epidemiological skills or surgical skills or education or nutritional skills,
and then also how the human resources are deployed.
The adequacy of staffing in different technical jobs.
The human element is concerned about individual personality
as well as the relationships among members of staff.
It looks at communication patterns,
formal communication within the organizational hierarchy,
informal communication among subgroups such as people
who may be from the same town or people who may be of the same profession,
they get together informally and discuss in
the organization's cafeteria issues of job satisfaction and motivation,
looking at the organizational culture, what are the norms,
the accepted behaviors and whether people keep to those,
and what things people value in terms of use of time,
in terms of their promotions.
Space-time coordinates are important especially as organizations get
larger and have branches in different parts of the district or town,
they may be large and have working shifts.
Some people maybe on morning,
some on afternoon and some on night duty,
and it's important also to consider time in terms of seasonalities.
Certain diseases like measles may be more common in the dry season.
Also so as Guinea worm.
And sequencing of activities to ensure that
preventive or treatment measures are in place at the right time and the right location.
Simple example of an immunization program,
we want to make sure that the vaccines are available at all the health outputs,
we want to make sure that people are notified before the vaccines come,
also want to make sure that people are not notified
so far in advance that if the vaccines don't come,
they won't be disappointed.
Sequencing in terms of training of people using
the cold chain properly making sure that equipment's available.
So all this issue of location and sequencing
of activities within the service area is very important.
The issue of decentralization becomes a central element for consideration here.
How much authority and responsibility are given
to the various substations and outreach components of the program.
Organizational policies are specifically the goals that the organization sets for itself,
what it aims to achieve.
These may be written down in terms of directives,
in terms of the bylaws that establish the organization.
There may be policy makers such as
advisory or management boards that actually from time to time set policies.
The policies may focus on issues such as personnel,
their working conditions, their terms of service,
resource management issues and policies that relate to the community,
who can use the service,
who is eligible for discounts,
for free services, relationships with other agencies,
collaborative agreements in terms of
inter agency committees in
the counties or local governments that involve health human services,
social services, transport, education such as that.
So, different kinds of statements by the organization,
in terms of what it hopes to achieve,
and then also statements that indicate how these things will be achieved.
Finally, we have our environmental factors and as indicated,
the organization functions within a community,
it functions within a region or locality,
and part of this broader environment is composed of laws and
regulations that may be passed by a county council or a state or national legislature.
There are community issues such as local culture and beliefs, acceptance of services,
gender issues that affect who can use services and when,
economic factors that would influence the ability of the organization to get resources,
the ability of people to pay for services.
Links again with the other sectors,
links with people who provide resources such as schools that train health workers,
such as companies that supply medicines and drugs.
So the environment, we're concerned about again the interface between
the organization and the community at large.