concern s and i nnucnc. :c the executive branch of go11ern111c11t (Department of Budget and Management and the Ofllcc of the President). :ind Congres. '-(particularly the,·ery powerful Approprialions Co1111 nillcc or L11e !·louse of Representatives). Al the local level, RH U supervisors should be able to influence the mayor, Sanggunia n, budget officer and other personnel wbu prep. ire the municip al/city hudgct. Good ma nagcmcn l ''starts with a coorcli natc<l purposeful organization of people who, collectively on :1 runctionnl responsibility hnsis, :-ire responsible for: selling objectives, plannin g str:-1 tcg_r, sel:ti ng goals-short-term objectiv e, developing company philosophy, setting policies-I he pl. 111, planning the organization, prc,vi<ling personnel, establishing procedures, p1·oviding facilities, pr·1>vicling capit:-il, selling. pcrform~n ce stan<l;mts, initiati-ng management program s, develnpin)!, management informallon systems and :iclivaling people" (Meier, in Swansb11rg, 1993:19). These are responsib ilities of the different levels (Jf management. The aext section will focus on public heallh care organizations-the local hcal U1 departments and health centers. MANAGEMENT IN PUBLIC HEALTH Management processes arc the same evety\"'here but in public health, the context makes monagcment in public health in a way different. Management in public health, particular ly in the Philippine setting is a unique undertaking given Lhe different macro and micro contexts of lhe local public health organization--government. policies, programs of the nationa l governm ent, national and local health budgets, geography, political dynan,ics, and local culture. The local pub J;c health organization The health department is one of the departments or offices in the local governmen t unit. Its si7:e, which is reflected in the number of its human resources and budget, depends on a number of factors such as populat ion size, financial capability oflhe LGU and the local leaders' commitment to public health. Sometimes, a number of personnel are added for political consideration s, that is, fulfilling a promise made to political allies. And sometimes, casual employees have a short-term appointments becnuse there are just many people also waiting: for their turn to work. Big cities, particularly first class cities have bigger health department s, that is, more hca 1th personnel (not necessar ily more nurses) and health centers. Nursing is reflected as a distinct unit in the organizational structure. A nursing service has a chief nurse (Nul'Se V to VII), an assistant chief nurse, a number of superviso rs (some are assigned to different he;ilth progran1s such as materna J and child health) and PHNs and midwives who are assigned to the different health centers. These health centers :ire generally headed by physicians. In the other end of the continuum, there are poor or small municipalities that )lave only less than ten public health workers (including one or two nurses). There are also doctor-less municipalities and ·the R. HU may be headed by a public health nurse. The standard health services provided in health centers are immunization, prenatal, natal and postnatal care, consultations, laboratory and diagnostic examinations, emergency medical care, treatment of common illnesses and referral to hospital~. The scope and coverage of services are primarily determined by the availability of financial resources. 421 