Leadership and Management Theories in Public Health

Among the negative developments in Malaysian society today is the increase in the number of mental patients. In 2007, the number of patients seeking psychiatric outpatients at government hospitals was 324,344. The 3rd National Health and Morbidity Survey (2015) found that those with mental disorders were 11.2 percent for adults and 20.3 percent for children and adolescents. The statistics clearly showed improvement over the year 1996 where the number was 10.3 per cent adult and 13 per cent of children and adolescents. The Health and Mobility Survey made in 2011 shows 12 per cent (about 2.6 million) Malaysians aged between 18 and 60 years facing various mental illnesses.

According to the President of the Malaysian Psychiatric Association (MPA), Dr. Abdul Kadir Abu Bakar, the statistic is a high figure as it shows one in six (1: 6) people of this country suffering from mental illness. According to him, mental illness is also more common among women at 12.1 percent compared to men (10.4 percent). For women the cause is more due to problems with spouses and problems with children, while for men it is more to brain injury due to road accidents and drug abuse. Deputy Health Minister Datuk Seri Dr Hilmi Yahaya stated that 2014 (2014) that the Ministry of Health statistics showed that one in 100 Malaysians were diagnosed with schizophrenia. According to him, schizophrenic patients can act injuring themselves and others. We have been surprised by various tragedies involving life due to psychological disorders or mental illness.

Leadership and Management Theories in Public Health

There are five major theories and models of leadership and management in public health. The keys to these leadership traits are: providing a model, inspire a shared vision, being ready to carry out the process, animate others to act, and inspire them (Daumerie et al. 2012)

1. The rational - economic model that is based on the assumption that people are mainly motivated by an economic interest that is a resource managed by companies to obtain organizational compliance by different members.

2. The Social Model: this model emerges from the limitations of the "rational - economic model" and from the different pieces of evidence that have shown the importance of other variables beyond the physical components in work. It is learned that production standards no longer come from the top of the company, or a leader, or manager or supervisor; rather, productivity standards are established by the same working groups.

3. The Model of self-realization that finds its sustenance in that the activities developed in the company are increasingly less far-reaching and deep when tasks are divided into sub-tasks and processes into sub-processes. The organization in its effort to maximize profits "routinizes everything that is possible to routinize." People have to find meaning in what they do by seeking self-realization to reach their highest potential.

Theories of Leadership and Leadership Qualities They consider that the leader is born with some characteristics, or innate qualities. They maintain that they are born with qualities such as intelligence, charisma, optimism, fighting spirit, security, etc., or they cannot be developed by much training that is received. Examples of innate leaders would be Martin Luther King, Ernesto Che Guevara, Mother Teresa of Calcutta, Margaret Thatcher, Eva Peron, etc (Bifftu & Dachew, 2014). Theories of the behavior of the person: They are based on observing the behavior of different leaders (Bifftu & Dachew, 2014).

A. Theory X and Theory Y:

Douglas McGregor states that there are two radically different models of people in relation to their attitude towards work, which will lead to two different views in the direction of people. On the one hand are people who do not like work, do not want to take responsibility, prefer to be sent, and work only to earn money (Theory X). On the other hand, there are those who love work, are active, like to take responsibility, are creative, independent, etc. (Theory Y). Depending on the conception that the leader of the individuals has (X or Y), he will exercise a style of authoritarian or participative leadership.

B. Theory of Managerial Mesh:

Robert Blake and Jane Mouton, based on previous studies, developed a grid or management mesh in which up to 81 different leadership styles can be identified depending on the behavior of the leader: If you are more concerned about people and if the primary interest is production.

Theory of Situational Leadership:

According to this theory, there is no one style of leadership better than another. What is relevant are the specific characteristics of each work situation (employees, activity, place, etc.) to adapt to it. Paul Hersey and Ken Blanchard are the creators of this model of situational leadership. According to them, the style of leadership must be chosen based on the interaction between the public health leaders and their subordinates.

Application of Theories in Public HealthIn the last 10 years there have been significant changes in the health sector all around the world, from a time of great investments, when countries had a large inflow of foreign currency, to a time of economic recession, where both internal and external debts, the Public spending and the devaluation of the currency have led to an economic deterioration that affects the provision of a public health service, so the quality of the service rendered has deteriorated, which leads to a managerial approach to health services in different health institutions. Participation and decentralization in health management should encourage initiatives to increase the financial sustainability of the system to increase the quality of obtaining health, improve health worker care and raise their self-esteem. In this new context, the managerial capacity of the leaders is evaluated and most of the time they are held accountable for the successes and failures of the provision of services, where, however, the managerial efficiency of a leader is not the exclusive product of his or her capacity or their collective, but the context in which it operates.

In the scenario of public health institutions, there are hospitals and clinics, which present a crisis framed in individualistic features with excessive organizational bureaucratic structures, located behind social, economic, and cultural problems, with a lack of leadership, a deficient quality in the services and high deficit in the performance of managerial functions, this being one of the aspects that should be considered, not envisioning a short-term exit to these problems (Altintas et al. 2016). To these must be added the political problems such as the case of the Zulia State, where there are disconnected policies between the central governing body of health policies such as the Ministry of Health and Social Development and the policies implemented in the region.

Skills to Manage and Lead in Public Health Leadership has a huge impact on the welfare and mental health of workers. Their commitment and team climate are reinforced thanks to the leadership that promotes health, which prevents the loss of talent due to the losses caused by...