Principles of organization Di Lisiori of work. Tbisis nlso called specialization ordepartmentation. Howv~i11 the work (11ealth sen;ces) be cli,ided? ls the cli,ision of work according to client groups (children, women, elderly). or pi-ugr,un (maternal aud child. commtrnicable diseases, non-communicable cliseases )? In big organizations, senices can be organized into clusters or teams. This means that a g Toup or team of sen ice providers (physician. nttrse, midwife and others) are assigned to a specific program, sen. ice or unit. HCl\,·ever. in small health centers. prob:. ibly the only di\ision of work that could be done is the one based on position (or profession). 'What are the duties and responsibilities of the physician. nurse and mid,dfe? Sometimes the d Lcrnnction of tllese pt·ofe. ssiooal responsibililies is not very clear all110ugh tile clifferent professional practice acts cottld sen'e us a guide. If there are no physicians. particularly in cases of emergency, nurses anu u1-idwives sometimes perform what are legally considered as medical function s. Coord-inatio11. Coordinati on is the "conscious activity of assembling and synchronizing differentiated work efforts so tl1at they function harmoniously in the attainm ent of orgnnization objecth·es~ (Rakich. Longest and o·oonovan. p. 143). Proper coordination results in harmonious relationship among the different groups within the organization. Man~· nurses are designated as coordinators of health programs like EPI, Naliona] TB Program. Healthy Lifestyle, Leprosy Control Program, Reproductive Health and Family Planning Program and n,,JCI; and other acthities such as medical missions, health campaigns, training programs, and information, education and communicatio n (TEC). Unfh J of command. This prindple means that an employee should be responsible to, and receive orders from, only one superior. lo some health organizations, this may not be easy to follow. For example, PHNs who ru·e assigned to health centers may be accountable to, and receh·e orders from two people-the chief nurse (who is usually in a different location) and the head of the health center. To prevent confusion and ill feelings among the staff, tl1e areas of concern and responsibilities of tl1e two beads should be adequately delineated and clarified. Allthority and 1·espo11sib ility.. Authorit y means a superior's right to command and exact obedience from his/her subordinates. If a PHN, for example, is given Tesponsibility as an EPT Coordinator she should also be grnoted corresponding authority to ensure that the program requirements are available and program activities are done by those assigned to do them. She, then will be accountable to her superior for the program's performance. Span of control. Span of control means "the number of subordinates reporting directly to a superior" (Rakich, Longest, and O'Donovan, p. 149). In the public llea Jth setting, the span of control for a J'HN who is the direct supervisor of midwives, is determined by a number of factors, such as: level of training or competence of the subordinates; degree of geograpl1ical dispersion or how far ·the subordinat es are from each other and how · accessible they are to the supervisor; and the level of difficulty or complexity of the supervisees' work. There are no fixe. d rules in determining t. he subordinate-s uperviso r ratio. What is important is tlia. t the span of control allows improved com. munication, efficiency and coordination (Douglass, D· 37).. Too many midwives reporting to a PHN can delay decision-making and responding the supervisees' problems, issues and concerns; too few, on the other hand is inefficient. If nurse supervisors nre adequate]y 424 