Human Resources Management in Health

Abstract

In many developing countries, poor health systems are one of the major barriers to accessing essential care. However, poor countries are not alone in experiencing health system problems. In some rich countries, a significant proportion of the population does not have access to care because of inequitable social protection systems, while in others, expenditures are escalating due to inefficient use of resources. This requires a paradigm shift in governance and organization, financing and resource allocation, accountability frameworks, and public health system interventions. The World Health Organization (WHO) Strategy on Human Resources for Health to 2030, adopted by Member States at the World Health Assembly in May 2016, recognized the need to strengthen the capacity of institutions at subnational, national and international levels and take necessary measures to ensure that they effectively exercise governance of human resources for health actions. [25]. Because, for the WHO, health workers are at the heart of any health system, and remain the essential capital on which action must be taken, to lead the entire system towards the expected results [20].

However, being a good professional in the health and/or medico-social sector-doctor, pharmacist or nurse-does not necessarily make one a good manager. Management is not an innate discipline, but it is learned. It requires new skills such as human resources management, team management and cohesion, economic and financial management of the department, pole or pharmacy [4]. Also, any manager who wants to succeed in a competitive environment must consider the fact that Human Resources are a key factor in competitiveness. Because what differentiates a successful company from a non-successful company is, above all, people: their enthusiasm, their creativity, everything else can be bought, learned or copied. Hence the importance of giving human capital management a place in any company in general and, more particularly, in a hospital organization where we are dealing with humans called upon to watch day and night to save human lives. And to be able to save a life, you must first be alive yourself. An invitation to ensure the well-being, both physical, social and psycho-spiritual, of the key element, essential to the management of any organization, which wants to be successful in a competitive environment: people.

Keywords: Management, Human Resources, Health, Hospital

Introduction

Health Systems have gradually evolved over the years, transforming into increasingly complex structures that require actors capable of effectively managing the organizations that compose them. In many developing countries, the poor state of health systems is one of the main barriers to accessing essential care. However, poor countries are not alone in experiencing health system problems. In some rich countries, a significant share of the population does not have access to care because social protection systems are not always equitable, while in others, there is an escalation of expenditure due to inefficient use of resources [23]. This requires a paradigm shift in governance and organization; financing and resource allocation; accountability frameworks; and public health system interventions [30].

The World Health Organization (WHO) Strategy on Human Resources for Health to 2030, adopted by Member States at the World Health Assembly in May 2016, recognized the need to strengthen the capacity of institutions at subnational, national and international levels and take necessary measures to ensure that they effectively exercise governance of human resources for health actions. [25]. Because, for the WHO, health workers are at the heart of any health system, and remain the essential capital on which action must be taken, to lead the entire system towards the expected results [20]. However, being a good professional in the health and/or medico-social sector-doctor, pharmacist or nurse-does not necessarily make one a good manager. Management is not an innate discipline, but it is learned. It requires new skills such as human resources management, team management and cohesion, economic and financial management of the department, pole or pharmacy [4].

Managing the performance of healthcare organizations is a daily challenge. The healthcare system is indeed faced with issues of coordination of its components in a logic of efficient mobilization of the resources allocated to it, such as considering the quality of services for patients and/or communities. Management practices are evolving and there are more stakeholders in the management of healthcare organizations, so it is sometimes difficult to acquire knowledge and skills that integrate this complexity [12]. Hence the need to set up a continuous capacity building project for any stakeholder within the management system of a healthcare service, with a view to continuously improving its performance [20]. As a result, healthcare managers are strongly challenged. Indeed, planning, controlling and managing organizational change, necessary for improving performance, are at the heart of the manager’s job [18], called upon to constantly acquire new skills in Human Resources Management, with the aim of promoting judicious decision-making using a strategic vision, thus contributing to improving the provision of quality services.

Some Generalities on the Management of Organizations

As Henry Mintzberg points out, organizations are omnipresent in modern societies. Individuals who are typically born into a health organization, are trained for years in educational organizations (from daycare to university), and then are employed in professional organizations that pay them a salary that allows them to become clients of various market organizations and users of multiple public organizations [8].

The requirements of modern administration, characterized by results-oriented management, require managers of any organization- whether public, Para public or private, in the daily execution of the missions assigned to them-to adopt new management techniques/ methods and practices. This is to enable an always optimal and up-to-date implementation of the organization’s mission project, towards the achievement of pre-established objectives.

Management: A Science or an Art?

Management is a science and an art that allows the manager to ensure that what needs to be done is done in the best possible conditions of costs and deadlines. It is the art, but also the technique of organizing talents [13]. It is therefore a set of knowledge and prac tices that allow the manager of a structure to ensure that the organization achieves its objectives, with a concern for effectiveness and efficiency. Effectiveness always seeks to achieve good results regardless of the cost of the means to be mobilized, while efficiency is played out in the speed and optimization of the resources used, to achieve the same objectives, with efficiency [15].

“Efficiency is doing things well, while effectiveness is doing the right thing,” said Peter Drucker, often referred to as the “Father of Modern Management” [29]. While improving efficiency is about doing things faster, using fewer resources, and in fewer steps, effectiveness means aligning improvements in the way things are done with the company’s high-level goals. So, advocating efficiency at all costs is pointless: you must increase efficiency, which requires adopting a more targeted and strategic approach. And while the scientific approach is characterized by the repetitiveness of experiments (identical experiments, equivalent results), in management, each situation is unique and rarely repeats itself. Under these conditions, management would be like an art.

Knowledge can easily be taught, but since management combines knowledge with know-how, as well as interpersonal skills, the mission seems much more complex, and calls on both the personal charisma of the manager, and his ability to seize any situation that presents itself to him, as an opportunity to learn, even from his worst mistakes / idiocies / stupidities / etc. Which requires a lot of humility, to accept lowering oneself, when one has completely screwed up in a business / failed in any company, ... And invites us to know how to circumscribe one’s territory, in an environment where one can find oneself in turn, in the position of Top Manager, above everyone, Local / Intermediate Manager, in an entity / mission that is entrusted to us within the big ship (Major of the Maternity service, for example), or even simple executor, at the lowest level, in the operational base. Positions that can also be translated in terms of:

a) Macro-environment (above oneself) can represent the Board of Directors (BoD) and corresponds to the actors in the system who have decision-making power over oneself.

b) Meso-environment (Top Management in the structure) represents the territory where we are.

c) Micro-environment (below oneself), represents all the actors/ stakeholders over whom one can exercise one’s authority

What Does it Mean to be a Manager?

It should be noted that common usage does not always dissociate the terms “management “ and “ administratio “. But, if management constitutes an action/way of managing (Le Robert); the manager, the one who manages/administers a specific area in compliance with the rules/procedures defined elsewhere; management is the art of leading or directing organizations as well as the individuals who constitute them. Also, in the context of this seminar, it is more a question of “Management”, as management and piloting human, material and financial resources, applied to a company or an entity thereof, with a view to achieving its objectives. And you will understand why the expression “ Human Resources Management in a hospital environment “, instead of Human Resources Management (HRM) in a hospital environment, and which I intentionally transpose into “ Human Resources Management in Health “ (HRM), to open up the debate more widely, and avoid being restrictive with the expression “hospital environment”, which can be exclusive for seminarians, not “hospital staff”: Managers of Dispensaries/Health Centers; Students in health sciences, Teachers in the field of health sciences; ..., all in charge and / or in preparation for the role of HRM, in health structures.

Managing also involves:

a) Not only knowing how to do the right things, but also how to get others to do the right things well.

b) Getting the right things done well by people who understand them, in other words, by people who do not have the same level of experience or skills as you.

c) Knowing how to define what is expected of people (for what objective, in relation to what rules, in relation to what ethics, etc.).

A manager is not in a technical exercise of expertise (accounting management, development of development plans, etc.), but is called upon to effectively mobilize the resources made available to him, with a view to achieving pre-established objectives. Ignoring all the attributes that may be granted to him, being a good HR manager means knowing:

i. Assess your current HR capacity.

ii. Anticipate your HR needs.

iii. Develop HR talent management strategies.

iv. Analyze and evaluate the results of your HRM strategy

Health Management

Health Management integrates concepts related to the management of health organizations, to promote wise decision-making using a strategic vision, thus contributing to improving the provision of quality services to users. Its purpose can be summarized in the routines that govern the work of managers of organizations, in terms of: strategic planning; management; control; and evaluation of the organization’s activity [1]. The strategic activity then makes it possible to take stock of the initial situation, in order to identify the elements that influence the development of the organization, in terms of strengths and opportunities, as well as weaknesses and threats in its environment.

Strategic Planning

Etymologically, the strategist is the one who leads an army in ancient Greece. We owe it to illustrious generals, at very different times, to have sought to define a strategy through the art of leading and winning a war [11]. Strategy refers both to a management practice based as much on an empirical approach as on a rational process, but also to an academic discipline whose autonomy can be contested as it borrows concepts from other disciplines, economics in particular. Traditionally, we can distinguish three levels of intervention of strategy in an organization:

i. Corporate strategy: refers to the company’s policy, its mission, its scope of activities and the overall allocation of resources associated with these activities.

ii. Strategy by field of activity or competitive strategy (“business strategy”): refers to a product/market pair and is interested in the way in which activities develop on their own markets.

iii. Functional strategy: deals with how the different components of the company, the operational units, will implement the strategic decisions made at the global level or in strategic activity areas [10].

More broadly, strategy consists of an allocation of resources that commits the organization in the long term by configuring its scope of activity, with the objectives of meeting the expectations of stakeholders and obtaining a competitive advantage [9]. Strategic planning thus involves reflecting on the organization’s missions, its activities, its organization, but also its resources and skills, based on these three questions: what do we do? how do we do it? with whom do we do it?

Management

Referring to what we have specified above in terms of management of an organization, it is more a question here of “ management “ as management and piloting human, material and financial resources, applied to a company or a unit thereof to achieve its objectives. And in the health field, this management will consist among other things of direction and governance, human resources management.

Management and Governance

Leadership and governance is a core function of health systems, which involves: developing strategies and policies to achieve health system goals; gathering and implementing usable information; exerting influence through coordination with partners and other sectors, and advocating for improved health; ensuring good governance to achieve health system goals; ensuring that the system can adapt to meet changing needs; and using legal, regulatory and health policy instruments to guide health system performance [22] . Leadership and governance involve ensuring the existence of frameworks for working on strategic policies and that these are combined with supervision, regulation, attention to the system design and effective accountability [21]. In each country, the exercise of leadership and governance is determined by context and history, but general elements of good practice can be defined, for example:

i. Ensure that health authorities take responsibility for leading the entire health sector (not just public sector service delivery), are prepared to deal with future challenges (including unforeseen events or disasters) and are able to address current problems.

ii. Define, through transparent and participatory processes, policies, a national health strategy and plan that provide a clear direction for the health sector (articulating the country’s commitment to high-level policy goals (health equity, people-centeredness, sound public health policies, effective and accountable governance); developing a strategy that translates the implications of these goals in terms of financing, human resources, pharmaceuticals, technology, infrastructure and service delivery into relevant guidelines, plans and targets; and establishing mechanisms for accountability and adaptation to changing needs);

iii. Ensure effective regulation through a set of guidelines, mandates and incentives that are supported by legal measures and enforcement mechanisms.

iv. Establish effective political dialogue with other sectors.

v. Establish mechanisms and institutional arrangements to ensure that donor funding is channeled and aligned with country priorities [24].

Without strong policies and leadership, health systems cannot spontaneously respond in a balanced way to the needs and expectations of populations, nor can they use their resources optimally. Keeping them on track requires a strong sense of direction that allows for coherent investment in the various components of a health system, in order to provide the type of services that achieve the desired results [24].

Human Resources Management

Health personnel refer to Human Resources (HR) in health, having as in any organization the dual specificity of concerning people (particular production factor), at work (performing a particular activity), without whom the health system cannot function Gamassou, et al., (2018). These are health service providers – preventive, curative, promotional and/or rehabilitative – who constitute the very heart of the health system, as a resource responsible for offering services to the beneficiaries of the system, with a view to achieving the primary objective of the latter: improving the health of populations.

Health workforce management can be defined as the set of activities that aim to develop the collective efficiency of people working within the health system. Since efficiency is the extent to which objectives are achieved, Human Resource Management (HRM) in health will have the mission of leading the development of these resources with a view to achieving the system’s objectives Moreno, et al., (2008). It thus defines HR strategies and means, organizational operating methods and support logistics in order to develop the skills necessary to achieve the objectives of the health system. It therefore consists of managing the people working within the health system and amounts to providing this system with personnel who are qualitatively and quantitatively capable of enabling it to produce quality services.

Health workers are essential to the health of the population. Effective health workers are those who respond to people’s needs and expectations. They are equitable and achieve the best possible outcomes with available resources and in all circumstances. Health workforce development is not the same in all countries, but there is a need to improve recruitment, education, training, distribution, productivity, performance and retention [24]. This involves: ensuring that there are adequate numbers, diversity and skills of staff in the right proportions across the workforce; establishing payment systems that provide appropriate incentives; establishing regulatory mechanisms to ensure that staff are deployed and distributed in line with needs across the system; setting employment standards, implementing support systems and creating conducive work environments; to establish mechanisms for all stakeholders (health worker advisory groups, donor coordination groups, private sectors, professional associations, communities, patient/consumer groups) to cooperate.

High-performing health workers are those who work responsively, fairly and efficiently to achieve the best possible health outcomes [21]. By demonstrating responsiveness, fairness and efficiency, they strive to achieve the best results, given available resources and circumstances Achouri, et al., (2014b). For WHO, health workers are at the heart of any health system and remain the essential capital on which action must be taken, to lead the entire system towards the expected results [20]. Although all its constituent elements are essential for its proper functioning, “health systems cannot function without health workers; improving the coverage provided by health services and realizing the right to enjoy the highest possible standard of health depend on the presence, accessibility, acceptability and quality of health workers” [25]. There is therefore no doubt that the mobilization of qualified health professionals for any health system is essential for the development of quality health services. However, the question of the qualification of health professionals in line with the real situations they will encounter in the field constitutes a major challenge. The development of a Global Consensus on the Social Responsibility of Medical Schools highlighted the need for medical schools to adapt their teaching to the present and future needs of their country Kane, et al., (2018).

Formerly called personnel management, Human Resources Management (HRM) refers to the practices deployed to administer, mobilize and develop the human capital involved in the company’s activity [26]. Its role is to translate the company’s overall strategy at the human resources level. To achieve this, the HRD (Human Resources Department) must ensure its attractiveness, the development of its skills and its loyalty.

Attractiveness

Attractiveness refers to the appeal that new personnel profiles have for an organization. A company is attractive when it spontaneously attracts new profiles and employees are proud to work for it. Different factors can boost a company’s attractiveness: its employer brand and its human resources management policy (training, employee well-being, career development, etc.); its financial and management policy (integrity of the manager, reinvestment strategy, etc.), the quality of its products and services, its brand image with consumers, its values, etc. [14].

A report from the national inter-union of intern’s sheds light on the motivations of professionals: out of five items in the questionnaire, the question of working conditions almost systematically comes out on top among interns’ concerns. Their requests are oriented in several directions: work-life balance, material working conditions (hours, shifts, parking spaces), training. And the question of remuneration is central, with strong competition from the private sector [10].

Skills Development

The ability of employees to carry out their mission effectively throughout their professional career requires developing their skills, starting by assigning them to a job adapted to their current skills, then allowing them to acquire new ones [3]. Competence can be broken down into knowledge (knowledge), know-how (practices), and interpersonal skills (attitudes, relational behaviors) [10]. A prospective approach to managing HR (Human Resources) professions and skills that is effective must be carried out with foresight, and consists of:

a) Analyze the prospects in terms of skills management (anticipate retirements, identify sensitive professions or those likely to become so, develop management tools – age pyramid).

b) Rely on local managers and on GPMC (Forecasting of Jobs and Skills) referents clearly positioned within the institution.

c) Develop, when it comes to internal skills, training to enable new staff to be qualified.

d) Promote an attractiveness policy to attract the skills needed by the organization.

e) Retaining internal skills by building professional paths and developing personal paths.

f) Ensure that professionals’ skills are maintained through a training policy adapted to their different profiles [10].

Thus, a professional is qualified as competent when he can act in his professional practice, by mobilizing different resources to manage different professional situations and solve different problems, in order to satisfy any recipient of the organization’s services. It is by enriching individual competence that the organization increases the effectiveness of its collective human capital and therefore, the performance and efficiency of the organization [4]. Conversely, if managerial practices are unsuitable, the organization loses its capital through employee disinvestment, absenteeism and turnover.

Loyalty

The evolution of employee mentalities and their expectations makes employee loyalty more difficult today, yet it is essential. The job market and workers’ expectations are constantly changing. Whatever it is, the abandonment of temporary positions, and even that of employees on permanent contracts (CDI) is a warning signal for any organization. Demotivated employees not only harm the atmosphere, but also, and above all, the productivity of the company. They will not hesitate to let it be known. According to a survey conducted by Parlons RH, 33% of them talk about their company on social networks. Assessments of management, of the strategy adopted or of their work colleagues, these positive and negative opinions will have an impact on the image of the company, and strongly influence new job candidates [17]. The Human Resources Management manager must then adapt his policy to motivate and retain his employees. To achieve this, several levers can be activated from recruitment through management to compensation. Specifically, it is a question of trusting one’s employees; of making teams responsible; of contributing to the growth of one’s employees; of showing respect and recognition; of offering a pleasant working environment as well as decent compensation to employees. It should be noted that happy and engaged employees can only positively boost the activity of the organization, hence the need to take care of them.

Control

Once the strategy is in place and the organization’s activity is planned, top management is called upon to establish a work control system through which the activity of each employee is monitored. Work teams are required to regularly report their performance to the hierarchy, which intervenes in the event of malfunctions [26]. The achievement of objectives remains the central goal of the structure, with the role of the hierarchy being limited to the analysis of possible gaps between the objectives previously set and the results obtained by the work team, as well as their readjustment for the purpose of achieving the objectives.

Assessment

Evaluation is an essential element of the system approach, as it allows the management team to verify whether the objectives set are met in accordance with the organization’s missions, issues, needs and expectations of stakeholders [3]. It is a verification review that identifies errors, but also successes, allowing capitalization of experience and learning lessons to improve the strategy and competitiveness of the organization [4].

In short, Top Management has, among other things, the mission of setting up adequate structures; distributing tasks; providing resources and information necessary to achieve strategic objectives. To do this, the quality of leadership, exemplarity, ethical sense, human and professional values of the manager positively encourage worker commitment, and therefore, organizational performance [4]. Also, a management system is effective to the extent that each actor in the chain knows what to do, how to do it, where to do it, when to do it, and with what to do it. The manager can thus use the QQOQCCP method to structure the organization in such a way as to respond effectively to strategic issues as follows [5]:

a) What: object, action, phase, operation…

b) Who: staff, customers, suppliers…

c) Where: location, service, distances…

d) When: day, night, moment, duration, frequency…

e) How: methods, procedures, supplies, transport…

f) How much: cost, means, resources…

g) Why: define the goal, the purpose…

The QQOQCCP (What, Who, Where, When, How, How Much, Why), also called the questioning method, is a problem-solving tool comprising an almost exhaustive list of information on the organizational situation [5].

Human Resources Management in Health

Roussel defines Human Resources Management (HRM) as “the set of activities that aim to develop the collective efficiency of the people who work for the company. Since efficiency is the extent to which the objectives are achieved, HRM will have the mission of leading the development of Human Resources (HR) with a view to achieving the company’s objectives. HRM defines HR strategies and means, organizational operating methods and support logistics in order to develop the skills necessary to achieve the company’s objectives.” [7]. It therefore consists of the Management of People at work in Organizations and involves providing said organizations with personnel who are qualitatively and quantitatively capable of enabling them to produce goods and services.

People at Work

HRM has the dual specificity of concerning people (a particular production factor) at work (performing a particular activity). It is therefore a question of how social relations in the company and the quality of life at work can influence the production factor that is human being.

Social Relations in the Company

In terms of social relations, the company must walk on both feet: institutional dialogue and daily work relations. It is essential, in this dialogue, to promote the integration of all social differences within the company, for a better social climate, free from any discrimination. In their roles and mission, staff representatives are to be considered here as partners in dialogue with managers, in terms of information, consultation, negotiation and recourse to experts for conflict resolution.

Quality of Life at Work

According to the WHO, QVT is defined as “ An individual’s perception of his or her place in life, in the context of the culture and value system in which he or she lives, in relation to his or her goals, expectations, standards and concerns. It is a broad conceptual field, encompassing in a complex way the person’s physical health, psychological state, level of independence, social relationships, personal beliefs and relationship with the specificities of his or her environment “ [31]. The quality of life at work policy calls upon, among other things:

i. a local contract for improving working conditions (analysis of schedules, organization of services, staff numbers, professional burnout, ergonomics (the science of adapting work to the worker and the product to the user), premises, etc.) and not the other way around.

ii. work-life balance, etc.

More than a code of conduct, it is a shared commitment to provide the best means to promote a good quality of life at work. Quality of life at work advocates a global and positive approach to health issues in organizations [28]. From an approach to vulnerability, which was at the center of actions in terms of psychosocial risks, we have moved to a more dynamic and participatory approach centered on the individual in their work environment.

Human Resources Management in Hospital Environments

The world of patients and caregivers; of men who care for men; of men who confide in other men, cannot be a simple and binary world, which can be reduced to the universe of a company like any other [27]. In recent years, the notion of “ client “ has surfaced, seeming to make the terms “ sick “ or “ patient “, or even “ user “, obsolete and old-fashioned. Well-intentioned caregivers have introduced “ the sick person “ to show all the human dimensions of this qualification which is so decisive when it comes to building a policy. What is designated already exists by the words which are used to qualify it. However, all these names are accurate, in turn, according to the moments of hospital time, and the same person can be a “ patient “ and a few hours later a “ client “ and become a “ user “ again in their overall understanding of the public service.

This hospital world must integrate many complementary approaches to adapt well but also to be understood. And if, in the pyramid scheme of an organization, it is a brain (manager) that functions and speaks on behalf of everyone, in general-the others tend to go on standby and are generally considered intelligent only if they obey the boss-a hospital manager should absolutely avoid this kind of operation. It will be in his interest to make the three main professional components (medical, nursing and administrative) work and converge towards their reason for being within this institution, in the service of life. Everyone has a share of initiative, everyone has a part in the collective momentum of the hospital, in its understanding of the expectations of its population, in its perception of the possibilities of its professionals.

The alchemy of federating, of giving a demanding and exciting movement, of gradually introducing a true quality culture can hardly be put into an equation or result from recipe books, even less from articles on management. The entry points are multiple. They result as much from a lucid idealism as from pedagogical pragmatism and above all from a great humility in the face of the complexity of the phenomena to be mastered. Professional bureaucracy type organization Mintzberg, et al., (1989) with multiple and heterogeneous components, with a diversity of profiles of the different actors who rub shoulders daily: doctors, surgeons, pharmacists, nurses, laboratory technicians, maintenance workers, administrators and others. A good hospital manager, who wants to succeed in a competitive environment, must consider this hetero complexity, in this particular institution “ where neither error nor delay are tolerated, due to a vital prognosis that can be engaged at any time “ N EBOLO, et al., (2019).

In their service relationships, in fact, health is from the outset a question of efficiency, because it arises in terms of resources available for action. First, the health of the agent is a condition of his “understanding” with the client-user-patient. The most accomplished form of this assertion certainly concerns the care relationship: the “caregiving body” is not only a status of professional and social belonging, it is also a psychophysiological resource on which the effectiveness of care depends. From this angle, the health of the caregiving body is a health issue for the bodies being cared for, and therefore for the effectiveness of the care system.

Conclusion

It should be noted that, since the hospital organization is part of complex organizational structures, the management of its Human Resources is just as complex, given the particularities that mark its system. In addition, any manager who wants to succeed in a competitive environment must consider the fact that Human Resources are a key factor of competitiveness. Because, what differentiates the successful company from the non-performing company, are and above all the People: their enthusiasm, their creativity, everything else can be bought, learned or copied. Hence the importance of giving to the management of human capital in any company in general and, more particularly in a hospital organization where we are dealing with humans called to watch day and night, to save human lives. And to be able to save a life, you must first be alive yourself. An invitation to ensure the well-being, both physical, social and psycho- spiritual, of the key element, essential to the management of any organization, which wants to perform in a competitive environment: the Man. Because, as implied by this Latin expression from the New Testament, also present in the commentaries of the Old Testament “ Medice, cura ipsum “, translated into French as “ doctor, heal yourself “ [16], our health facilities can become sick from their sick staff, and it is up to the manager (Top as well as local, ...) to ensure this.

Beyond the action of the ministry and the various health administrations, a large part of what we have to invent is up to the actors in the field. In this scheme, managers (directors, medical advisors, general supervisors, service majors, etc.) play a leading role in supporting change and adapting organizations to new challenges. It is they, through their ability to understand the needs of populations, through their proximity to professionals exercising the various professions and through their in-depth knowledge of the realities of communities, who are and will have the capacity to define and implement the most effective organizational methods to meet the challenges of the health system.

Acknowledgements

None.

Conflict of Interest

None.

References

• Alia Conseil (2013) Human resources management guide for information technology companies.
• Arnould L (2020) Steps and examples of nonviolent communication.
• Benchehida S (2020) Quality management in health: The ISO 9001 standard for health establishments: alignment with the requirements of the High Authority for Health. AFNOR editions.
• Benoit C (2019) Managing a healthcare facility: Organizational methods, management practices, new management tools. Gereso edition.
• Bentalab S (2015) The QQOQCCP method, a simple and efficient analysis tool – QUALIBLOG | The QSE manager's blog.
• Cometto G, Nartey E, Zapata T, Kanda M, Md Y, et al. (2019) Analyzing public sector institutional capacity for health workforce governance in the South-East Asia region of WHO. Hum Resour Health 17 (1): 43.
• Study (2020) Human Resources Management-22925 Words | Study.
• Godfroid M, Labie M, Ludovic URGEGHE (2016) Theories of Organizations.
• Johnson G, Scholes K, Whittington R, Fréry F (2008) Strategic (8^th) Pearson education.
• Louazel M, Mourier A, Ollivier E, Ollivier R (2018) Health management: Management and conduct of health organizations. Press of the School of Advanced Studies in Public Health.
• Louazel M, Mourier A, Ollivier E, Ollivier R, Courrèges C (2018) Management in health: Management and conduct of health organizations.
• Louazel M, Mourier A, Ollivier R (2020) Management in health. Presses de l’EHESP.
• Mantione F (2016) Is management a science or an art? Florian Mantione Institute.
• Married P (2021) Boosting the attractiveness of the company in all areas. Online Chartered Accountant.
• Martins J (2024) Efficiency and Effectiveness at Work• Asana.
• Martorano P (2024) Doctor, Heal Yourself! By Patrice Martorano-Thought for the Day-Thought for the Day-TopChré
• Milan Tania, Louise (2021) Methods to implement to retain your employees.
• Minvielle É, Gallopel Morvan K, Januel JM (2018) Managing a healthcare organization: The contribution of management sciences.
• Noisette T (2024) Nonviolent Communication (NVC). Tiphaine Noisette.
• Nxumalo N, Goudge J, Gilson L, Eyles J (2018) Performance management in times of change: Experiences of implementing a performance assessment system in a district in South Africa. Int J Equity Health 17 (1): 141.
• WHO (2007) Everyone's business - Strengthening health systems for better health outcomes. WHO framework for action.
• WHO (2008) Leadership and governance of health systems in the WHO European Region.
• WHO (2009) WHO | About health systems. WHO; World Health Organization.
• WHO (2010) Essential elements of a well-functioning health system.
• WHO (2016) Human resources for health: A global strategy to 2030. 58.
• Plane JM (2019) Management of organizations-5^th Theories, concepts, performances - FNEGE label: Theories, concepts, performances (5^th edition). Dunod.
• Romatet JJ (2007) The role of the manager in complex organizations the example of the French hospital. Rech Soins Infirm 91: 8‑
• Rouat S, Sarnin P (2013) Prevention of psychosocial risks at work and maturation dynamics: The intervention process as an operator of transformation and development of cooperation. Activities, 10 (1): Article 1.
• Staff Writer (2024) Effectiveness vs. Efficiency: What You Need to Achieve Both | Smartsheet.
• Vainieri M, Noto G, Ferre F, Rosella, LC (2020) A Performance Management System in Healthcare for All Seasons? Int J Environ Res Public Health 17 (15): 5590.
• WHO E, Nakajima H, Health, WHOD of F (1994) Health, population and development: WHO progress report, International Conference on Population and Development, Cairo, 1994, abstract guidance (WHO/FHE/94.2. Unpublished). World Health Organization.