1307528088181-MIDDLE LEVEL MANAGERS Action Research Final Paper

7/27/2019 1307528088181-MIDDLE LEVEL MANAGERS Action Research Final Paper

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MIDDLE LEVEL MANAGERS, INFLUENCE AND STRATEGY PROCESS:

Abstract:

Strategy is centrally concerned with the process of how firms respond to and exploit

environmental signals( Mintzberg 1979).Although the filed of business policy was built on the

classical process studies of Chandler (1962); looked at strategic initiatives as a multi level

process ,but his emphasis on the role of top management (Burgelman 1983) laid the foundation

for dominance of research on issues faced by top management (Floyd and Woolridge 2000).This

has led the discipline to look at strategy as distinct formulation and implementation with

emphasis on content and implementation as assured. The result is that even today there is no

convincing explanation as how some firms are able to achieve superior performance over time

(Joyce2005).

Of late there is an attempt to look at the role of middle level managers in the strategy process

(Balogun 2003; Howell et al 2006) but they are sporadic and fragmented. There is still lacking, a

comprehensive look at the role of middle level managers and its linkage to firm performance.

Competitive advantage is built thorough generation and deployment of capabilities over time and

generation of capabilities is crucially dependent upon the role of middle level managers. The

middle management is defined as managers in the second and third level of hierarchy and those

who are not reporting directly to the CEO (Floyd and Woolridge 1992).

Traditionally middle level managers were given the role of executors of a calculated formalstrategy that was articulated in detailed plans. This required the use of authority and influence to

some extent. The realities of todays business requires a reorientation of the roles of middle level

managers towards management of relationships, finding innovation, creating a mind set and

facilitating learning(Floyd and Woolridge 1997, 2000). This change in orientation accentuates

the importance of use of influence as a mechanism to motivate and obtain commitment from

operating staff while simultaneously reducing the role of authority.

This paper articulates the central proposition that differences in performance of middle level

managers is contingent upon their effective use of influence to maintain staff commitment.

The paper first builds the conceptual basis for this proposition, and then describes the context in

which the proposition is to be tested. After the methodology and results; the paper discusses the

role of influence and its linkage to the results. Finally it outlines limitations of the study and

identifies some options for future research.

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INTRODUCTION:

Strategy as a field of enquirydeveloped from a practical need to understand reasons for success

and failure among organizations. This led to a focus on overall performance and on the top

management. The works of Chandler (1962) and Andrews (1971) created a view that strategy is

made at the top and executed at the bottom, further reinforcing the fields focus on the top

management while implementation was seen as secondary (Floyd and Woolridge 1996)

The emergence of corporate planning in the 1970s further heightened the disconnect between

formulation and implementation, as operating decisions were made as if plans did not exist. Key

insight was that plans were ineffective and line managers needed to be involved in the process

(Floyd and Woolridge 2000).The development of analytical tools like BCG, PIMS further

reinforced the notion that strategy was an exclusive top management function. The development

of the strategic management paradigm delineated the formulation and implementation

components of strategy, identified roles for all mangers except the lowest operating level in the

formulation process. Implementation was design of standards, measures, incentives, rewards,

penalties, and controls (Floyd and Woolridge 1996). Managers were thought to be more as

obstacles. It was Mintzberg and Waters (1985) whose view that strategy is a pattern in a stream

of decisions, that expanded the role of other than the top management in strategy making since

strategies could be emergent. Burgelman (1983c) integrated both the top down and bottom up

view of strategy by introducing the concept of autonomous development of strategy in addition

to the normal intended strategy, reinforcing the observations of Bower(1970) who stated that the

top management had little control on what projects get pushed for approval. These put the role

of middle level managers in the correct perspective.

The middle level managers are located between the strategic apex and the operating core.

Irrespective of their location, their distinguishing function is to align the organisational goals and

strategies with its operating levels (Floyd and Woolridge 1996).

Traditionally middle level managers were given the role of executors of a calculated formal

strategy that was articulated in detailed plans. This role was appropriate for a period up to the

1970s, where the emphasis was on meeting an expanding demand for goods. With the growth of

middle level managers in the post world war 2 eras, there was also the rise of the management

schools which was an attempt to professionalize the burgeoning cadre of middle level managers

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and thus creating a distinction from the rest of the members of the organisation. They personified

commitment and were the core of corporate strength (Floyd and Woolridge 1996).

With increasing pace of change in todays business environment due to globalization of

competition, demanding customers and rapidly changing technologies, the role of middle level

managers has shifted to supporting the top managements vision by developing and promoting

initiatives that respond to changing conditions (Floyd and Woolridge 2000).

The changing orientation of middle management work (adapted from Floyd and Woolridge

1996) can be represented as follows:

Traditional orientation Present orientation

Developing coordination within

functional boundaries

Boundary spanning( relationships across

boundaries)

Controlling growth Finding innovation( championing)

Executing plans Synthesizing informationApplying new technologies to production Facilitating learning (transferring technology).

This reorientation is as a result of trends to outsource due to emphasis on doing only core

activities, increase in the services components of business, increased emphasis on relationships

in business as a means to achieve competitive advantage, changing customer characteristics, and

increased competition resulting in an emphasis on strategic understanding instead of planning.

The increased use of technology at all levels of the organisation increases the work role of

middle level managers as they have to identify methods of taking advantage of technology

(Floyd and Woolridge 2000).

Thus the realities of todays business requires a reorientation of the roles of middle level

managers towards management of relationships, finding innovation, creating a mind set and

facilitating learning(Floyd and Woolridge 1997, 2000).

THE ROLE OF THE MIDDLE LEVEL MANAGER

The four crucial roles of the middle manager (Floyd and Woolridge 1992, 1996) have been

identified as;

1. Synthesizing information (sense making)the position of centrality in theorganisational information network facilitates his ability to synthesize (attend, frame and

diagnose issues) information and influence both the operational level and top

management perceptions.

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2. Facilitating adaptability(sense making and sense giving): Middle level managers

facilitate generation of variant behavior, cooperation and help in stimulating

experimentation leading to innovation, which can then lead to new strategic initiatives

3. Championing strategic alternatives (issue selling) -- this arises form their unique

position in the middle of the organisation and as a linking pin to bring entrepreneurial and

innovative proposals to the notice of the top management. This is after they have

screened the information, got informal cooperation, provided resources for

experimentation and established feasibility of the proposal.

4. Implementing deliberate strategy (sense giving): They also translate strategic

plans into operational plans and facilitate implementation of change.

The middle level managers are at the nexus of social interactions, act as a node in a network of

communications, connect flow of information from top to operating level and vice versa, and

integrate these communications. Thus they are in a position to appreciate the firms strategic

requirement. The middle level managers are in a position to know the availability and depth of

capabilities in an organisation and thus can help in synchronizing strategic plans with reality.

Their interaction with the customers gives them an idea of the market requirements enabling

them to adapt capabilities to service these needs. This is enabled by their ability to translate

customer needs to requirement of product characteristics, in the process creating knowledge. By

their very position as a linking pin between top management and operational level, they act to

supply feed back to the top management which facilitates adjustments in the strategic plans.

Capability based competition forces managerial knowledge to be placed at the centre of strategic

planning which brings to fore the role of middle level managers by virtue of their centrality in

the organisational information network and their ability to promote organisational learning. The

effective execution and integration of all these roles is what results in superior firm performance

(Floyd and Woolridge 1992, 1997)(see figure 1).

The most crucial activities thus are sense making, sense giving and issue selling (Dutton and

Ashford 1993). Sense making is comprehension and issue diagnosis and facilitates issue selling

as upward influence tactics and sense giving as downward influence tactics (Dutton et al 2001).

Strategic sense making and sense giving are defined (Gioia and Chittipeddi 1991; Gioia and

Thomas 1996; Thomas et al 1993, 1994) as two complimentary and reciprocal processes. Sense

making is the way managers understand, interpret and make sense out of information

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surrounding strategic change. Sense giving is the attempts to influence the outcomes through

communication of thoughts and thus gain support. Sense making involves noticing, framing and

diagnosis of an issue.

Through the processes of sense making, sense giving and issue selling the middle level managers

are able to determine their involvement in organisational strategic issues and exert influence to

facilitate acceptance of their supported initiatives. The combination of involvement and influence

(both upward and downward) results in the four roles they are credited withsynthesizing

(sense making and sense giving); facilitating (sense making and sense giving); championing

(sense giving and issue selling) and implementing ( sense giving).

THE FACTORS INFLUENCING THE PERFORMANCE OF MIDDLE

MANAGERS

Organisations can be seen as interpretation systems (Weick 1979) or as complex adaptive

systems with dispersed controls, multiple integrated levels of building blocks and members

acting consistent with their expectations (Floyd and Woolridge 2000) or as social systems

consisting of patterned recurring relationships among individuals whose roles are linked by

networks transmitting information, affect and influence. In these views; people organize

themselves to make sense of the inputs and enact them back to make order out of the world

Deliberatestrategies

Emergentstrategies

Implementation

Facilitating

Synthesizing

Accumulation ofnew capabilities

Deployment ofcapabilities

Shared strategic

understanding

Performance

Championing

Incorpora

tion Incorporation

in capability

set of firm

Envir

onment

FIGURE 1

5

Adapted from Floyd and Woolridge 1992, 1996


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(Weick and Sutcliffe 2005). Organisational sense making can be seen as organizing through

communication in a social community where know how and information combine into

knowledge and adaptability depends upon the speed and efficiency of creation and transfer of

knowledge (Kogut and Zander 1996).The recombination of this knowledge allows evolution of

capabilities (Kogut and Zander 1992) which organisations make use to exploit opportunities

present in the environment. Organisation attention, sense making and knowledge generation

through involvement and influence of members determines organisational performance.

In an organisation; top management mediates between the organisation and capital markets to

maintain economic discipline and take care of stakeholders interests; core transforms inputs into

outputs and the middle management, who have the largest connections, hold the organisation

together transferring knowledge and influence (Floyd and Woolridge 2000). It highlights the

criticality of the role of middle management which is influenced very much by the context in

which they operate.

Factors which influence their performance can be categorized into individual and organisational

factors.

INDIVIDUAL FACTORS

These are the factors which determine the ability of the middle level manager to show

involvement and use influence in the performance of his work related activities.

The ability to influence is influenced by an individuals educational background, his functional

experience and the diversity of his experience (hambrick 2005). Personality traits like N-ACH

(need for achievement), internal locus of control, personal initiative and persistence influence the

ability of a manger to exercise and use influence (miller and droge 1986; frese and Fay 2001).

These individual characteristics increase the cognitive ability of the manager, improve his

communication skills and give him a greater understanding and awareness of the organisational

context which facilitates the successful use of influence.

ORGANISATIONAL FACTORS:

Organisation al factors such as organisational strategy, absorptive capacity (Cohen and levinthal

1990), communication and information processing systems (Dollinger 1984), knowledge systems

(Nonaka 1994) create the context in which the influence is exercised. They give meaning and

substance to the influence tactics of managers. The influence tactics are part of the activities of

the middle level managers.

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THE OUTPUT OF MIDDLE MANAGERS:

Floyd and Woolridge (1992) identified the four main activities of the middle level managers as

synthesizing, facilitating, championing and implementation. Success in these activities leads to

effective development and deployment of organisational capabilities leading to superior firm

performance (Floyd and Woolridge 2000).

Middle level mangers when synthesizing create strategic meaning out of operating and strategic

information; share this information thereby facilitating integration of new knowledge and thus

development of knowledge base. When facilitating they nurture and develop experimental

programs and organisational elements that increase organisational flexibility; encourage

organisational learning and expand the range of firms strategic response (Floyd and Woolridge

1996). When championing they attempt to provide the firm with new capabilities or allow firm to

use existing capabilities differently. When implementing they align organisational action with

strategic intent. In these activities they are facilitated by their individual capabilities which

facilitate their involvement and influence subject to the moderation of the organisational factors.

INFLUENCE AND INFLUENCE TACTICS:

Power, influence and political behavior are constantly encountered in organisations.

Traditionally influence has been linked to role of hierarchical authority and bureaucratic

rationality (Mowday 1978). The ability to influence decisions is both a function of formal

position and non formal attempts. Therefore the role of power and influence assume importance.

Authority refers to legitimate power based on formal position. Power and influence refer to a

generalized ability to change the actions of others in some intended fashion (Mowday 1978).

Influence tactics are mechanisms used to influence people. They have been categorized as soft

which does not entail use of formal authority and as hard where formal authority and coercion

is used. Soft tactics are ingratiation, consultation, inspirational and personal appeals and rational

persuasion while hard tactics are pressure, legitimizing or coercion (Falbe and Yukl 1992).

Managerial performance is significantly influenced by his success in influencing people.

Influence can lead to continued commitment and extra effort from subordinates; successful

implementation of policies and strategies (Nutt 1987); obtaining cooperation and support from

colleagues and adoption of innovations (Falbe and Yukl 1992). Use of soft tactics and in

combination has been found to result in greater successful outcomes than hard tactics

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Influence attempts can result in commitment, compliance and resistance. Commitment is

indicated by exercise of initiative and persistent effort to do the task. Compliance is an effort to

carry out the task but makes only average effort while resistance is seen when there is avoidance

of effort to carry out the task (Falbe and Yukl 1992).

Thus Managerial performance is a result of interaction of individual abilities utilized in an

organisational context to generate activities which are in line with the organisational

expectations. The whole model can be depicted as in figure 2

THE CONTEXT:

Literature states that number of contextual and individual factors determine the choice of

influence tactics and its effectiveness. Some of them are relative power of the parties; direction

and objective of the influence attempt, political skill of individual and the choice of tactic itself

(Higgins et al 2003). The choice of the context should facilitate the observation of these factors

and give scope to the managers to exercise them. The health care service context offers such an

opportunity.

Health care is defined as the activities and means used to prevent or cure morbidity arising out of

different processes. Health services can be delivered as close to the client system which covers

population based preventive services, primary health care services and first level referral care.

Primary health services constitute of essential health care made universally accessible to all

through their participation. They can also be delivered through specific disease centric

programmes delivered in project mode through specifically constituted agency.

Health care as a service is one of the factors which influence the health of an individual. Risk

and uncertainty are special features of health care service and are responsible for all of the

special characteristics of the service. The special characteristics include an irregular and

unpredictable demand; provide satisfaction only in cases of illness which are associated with

impairment of physical capacity or even death. (Arrow 1963). In view of these characteristics,

influence becomes a crucial factor which impacts the outcomes of the delivery mechanisms.

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THE INDIAN PUBLIC HEALTH SERVICE DELIVERY SYSTEM:

The Indian health care system in the public sector is designed to implement disease specific

programmes through a widespread and elaborate network of health care professionals. At the

district; which is the basic unit of administration in the country; the health care service delivery

set up consists of a networked set of facilities. Starting with the sub centers (one sub centre for

every 5000 population), the network hierarchically builds up to the level of the district hospital.

The primary health centre (PHC) is the first line of referral cum service delivery centre where a

qualified physician is posted as in charge of all activities being undertaken by them. The PHC

controls a network of sub centers manned by supervisory and front line paramedical staff. The

service delivery is done both through the front line paramedical staff and the medical officer of

the PHC (NCMH 2005).

The medical officer, by virtue of being the first line of qualified personnel for referral services

and as in charge of the service delivery organisation, has the dual job of influencing the

performance of the staff under him and the customers with whom he directly deals with as

referrals. Thus influence is directed towards both the service deliverer and the recipient.

One of the important programmes run by the government of India is the Reproductive and the

child health (RCH) programme which has been recently revamped. The RCH aims to improve

the health of the mother, child and the adolescent female.

THE REPRODUCTIVE AND THE CHILD HEALTH PROGRAMME:

It consists of four sub programmes. They are:

1. Population stabilization through family planning activities

2. Improve health of the mother through maternal care program

3. Improve the health of the child through child health program

4. Improve female adolescent health

India accounts for 25% of the global maternal mortality and infant mortality rate. The infant

mortality rate (no of deaths of infants/1000 live births) has stagnated at 65 for the last 10 years

after it witnessed a sharp drop from 91 in 1990 to 65 in 1996. The maternal mortality rate (no of

maternal deaths per 100000 pregnancies) has been stagnating around 540 for the last ten years.

The major reasons for the stagnation in these two critical indices have been poor access to

antenatal, delivery and post partum care. A very low percentage of deliveries were conducted by

trained health personnel and a resultant high rate of infant deaths in the first 28 days of child

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birth. The quality of antenatal delivery, and post partum care have a significant impact on neo

natal death rates which are contributing maximum to the infant mortality rate.

In view of these factors, the emphasis in the RCH program has been shifted from population

stabilization to providing access to mothers and neonates to institutional facilities for deliveries

and associated care including emergencies and complications.

Two specific programmes have been started in the state of Gujarat namely the Chiranjeevi and

the janani suraksha yojana (JSY). Both the programmes are aimed at the population which is

below the poverty line (below BPL families). The aim is to facilitate access to those poor

families who are not in a position to afford access to institutional facilities for obstetric and

gynecological care (Bhat et al 2006).

The aim of this paper is to look at the role of the medical officer at the PHC in the

implementation of the RCH program and test the central proposition that differences in

performance of middle level managers is contingent upon their effective use of influence to

maintain staff commitment.

METHODOLOGY:

The choice of the context for the hypothesis testing is based on the fact that influence plays a

significant part in achievement of the performance targets in the health care service delivery and

that differences in performances are largely dependent on the effective use of influence by the

medical officers. The medical officer in this case can be considered as the middle level manager

as he is at least three levels away from the top management and is two levels above the front line

staff that render majority of the services (Floyd and Woolridge 1992). Although he is involved in

direct delivery of referral service; this can be viewed as a necessity for him to establish his

technical competence which is crucial for him to establish trust among his staff and customers.

This is an antecedent which influences his ability to effectively use influence tactics to foster

commitment among his frontline staff.

Sample and design:

The study consisted of comparing the performance of two medical officers of two PHCs. The

performance with respect to the Reproductive and child health program and the two schemes

under it was chosen. At the PHC level this is the flagship program under implementation and

caters to a significant section of the population. Considering the importance of the programme in

the overall scheme of health services; it is presumed that significant portion of the effort and

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resources go into the implementation of the programme and achievement of the targets under this

programme would be of importance to the medical officer of the PHCs.

Literature states that effectiveness of influence depends upon individual and contextual factors.

Since the aim is to study the effectiveness of use of influence; control of contextual factors is

established by the choice of the PHCs. The district Sabarkantha was chosen for convenience and

for the fact that this was one of the districts where the Chiranjeevi scheme was implemented. To

control for contextual factors; the block Prantij and the PHCs poglu and moyad were chosen.

Both the taluks covered by the PHCs have more or less same socio economic indicators as

indicated by the district officials. Both the taluks have roughly 7% of the population below

poverty line; same population levels (approximately 51000); equal ease of access by road to

district head quarters and the national highway to Udaipur. Both the PHCs have been rated as

A in the ratings for 2005-06(see transcript of interview with District officer RCH). Both the

PHCs had had the same MO for more than one year.

Effectiveness of influence tactics has been studied using the critical incidents method (Fable and

yukl 1992). Commitment on behalf of the user of influence tactics leads to persistence and

greater chances of success (Kikul and Neuman 2000). Commitment has also been studied using

the survey instrument in form of questionnaires (Meyer and Allen 1997).

Effectiveness of use of influence leading to commitment in the lower staff is built over time. The

medical officer needs to maintain his influence over time to enable achievement of targets by the

lower staff. There fore resorting to cross sectional study would not have established this fact.

Hence it was necessary to study the process over time.

In view of paucity of time and resources, it was decided to go for retrospective histories; which is

considered appropriate for processual studies (Pettigrew 1997). The aim is to identify some

critical incidents and look at the behavioral response of the two medical officers which would

give an indication of their commitment. This is appropriate since affective commitment has been

defined as strong emotional attachment and involvement with the organisation which is reflected

behaviorally as initiative and persistence (Meyer and Allen 1997). Semi structured interviews

were used. Interviews were conducted with the Additional director/ medical services; the district

officer (RCH) of Sabarkantha; Block health officer (BDHO); the medical officers of the PHCs

Poglu and Moyad.

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Variables:

The dependent variable is the performance achieved against targets under the various sub

programmes of the Reproductive and the child health programme (RCH). The performance for

the current period was considered as appropriate as the effort put in is with respect to the targets

of the current period and there fore current performance reflects the outcomes of the effort being

put in. Data on performance against targets given in the programme were collected from the

Block health officers office at Prantij. The Block health officer is the immediate supervisor of

the PHCs in the block and is directly concerned with their performance.

The independent variable is identified as affective commitment on behalf of the medical

officer/PHC. Affective Commitment has been defined as employees identification, or strong

emotional attachment and involvement in the organisation (Meyer and Allen 1997). It is

reflected in the behavior as initiative and persistence (Kikul and Neuman 2000). While initiative

represents a work behavior defined as self starting and proactive that overcomes the barriers to

achieve a goal (Frese et al 2001); persistence is to see that setbacks occurring as part of change

or inertia from implementers is overcome. Persistence is a dimension of initiative (Frese et al

2001).

FINDINGS AND DISCUSSION:

The comparative figures for performance against the sub programmes under the RCH and the

schemes of Chiranjeevi and JSY are placed as annexure A. Also indicated in the same annexure

is the staffing status of the PHCs under study. The figures are for the period April to October of

the current financial year although the work load is for the entire financial year.

From the tables the following findings stand out:

1. Both the PHCs have equivalent levels of work load as targets under various sub

programmes even though both cater to the same level of population. In the case of

Moyad, the smaller number of staff is compensated by the reduced work load in line with

number of sub centers under its control.

2. The performance of PHC Poglu is superior to that of PHC Moyad in all the sub

programmes and the two schemes. In the maternal health sub programme, Poglu PHC has

a higher percentage of deliveries in its own sub centers; in government institutions

including its own referral units. Its institutional deliveries are lesser as compared to

Moyad PHC.

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3. In the family planning activities, Poglu has performed better than Moyad in distribution

of oral pills and condoms while both are equal in the category of sterilization operations

and insertion of IUDS.

4. In the immunization programme the significant finding is that Poglu PHC has not only

done better in all types of vaccination but significantly it has achieved far higher figures

in immunization of the girl child.

5. In the implementation of Chiranjeevi and JSY, Poglu PHC has done better in coverage,

(achieved 92.3 %), done more numbers in both schemes. The significant finding is the

still large numbers of deliveries conducted under the JSY scheme.

From the interviews of the Additional director and the Block health officer, it is apparent that

commitment on behalf of the Medical officer is the key factor which significantly influences the

commitment of staff and subsequent performance.

Three incidents highlight the difference in the commitment of the Medical officers.

1. First is the utilization and implementation of the facilitating factor of untied funds for

contingencies both at PHC level and sub center level.

2. Second is the non availability of the self generated targets as part of the action plan

creation process and its comparison with the actual targets.

3. Third is the significant difference in the focus on special groups; greater number of

deliveries conducted in their own sub centers and at their own referral centers. Associated

with it is the focus of the identification of the below poverty line families and generating

institutional access to them

Utilization of untied funds:

. A scheme of untied funds has been started under the RCH and the NHRM. Under NRHM,

contingency funds up to 10000 rs for sub centers; 25000 rs at PHC level and 50000rs AT CHC

level have been sanctioned and disbursed for use for tackling contingencies.

The state has been asking the medical officers of PHCs to take advantage of the contingency

funds being made available to them at sub center and PHC level.

Problems are encountered in motivating Medical officers to promote the use of these funds both

at PHC and sub center levels B.K. Patel additional director/ medical services

The problem of petty repairs to sub centre and supply of consumables is now easily addressed.

Recently we have been given untied funds for use in contingencies under the NRHM; which I

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have distributed to the sub centers. Those funds help in sorting out most of these problems. Dr

D.K. Mehta / Medical officer / Poglu

No; we do not have any contingency funds Dr. Rajesh Patel/ medical officer/ Moyad

The first instance indicates the differences in the personal initiative on behalf of the two medical

officers (Frese et al 1997); the differences in the approach to problem solving and also

involvement with the organisation. At the information level it shows the greater awareness of the

organisational context by the Medical officer Poglu and his ability to see an opportunity to

facilitate organisational task execution. It also corroborates the problem of motivation to use

these funds.

Non availability of self generated targets:

Generally the variation between the filed proposed targets and the communicated targets does

not exceed 10%. In our case this year the variation has been larger. A comparison of the figures

sent by us in form 1 and those communicated to us reveals this.

The targets given by the district authorities are accepted and we try to do our best. I try to

convince the staff to accept the revised targets. Dr D.K. Mehta / Medical officer / Poglu

In the case of Moyad; the said document could not be produced.

The second incident reveals the lack of importance attached to documents indicating decreased

attachment to organisation.

Greater focus on special groups

Poglu has also managed a greater focus on the two special programmes meant for the

underprivileged and special focus groups which reflects in the greater coverage of the girl child

in the immunization programme and better performance in both JSY and Chiranjeevi schemes.

They have also conducted greater number of deliveries in their own sub centers and referral

units. This incident clearly highlights the differences in capabilities of the staff; the self

confidence to deploy them and the customer trust in the staff.

These three incidents clearly highlight the difference in the commitment levels of the Medical

officers based on the differences in the innate abilities, greater awareness of organisational

context, greater personal initiative and resultant greater customer trust (Floyd and Woolridge

1996, 2000; Frese et al 2001).

From the above one can tentatively conclude that the differences in the performance outcomes of

the two PHCs was due to the difference in the individual abilities of the medical officers to

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effectively use influence as indicated by their commitment to the organisation. The assumption

in the case is that the ability of the staff working under the two medical officers is the result in

their ability to sustain commitment of the lower staff. This assumption can be safely made as the

staff working in both the PHCs would have the same innate ability, based on their screening and

selection for these posts.

This leads us to the fact that the central proposition expounded that differences in

performance of middle level managers is contingent upon their effective use of influence to

maintain staff commitment stands supported.

CONTRIBUTIONS, LIMITATIONS AND DIRECTIONS FOR FUTURE RESEARCH

The study attempted was an exploratory one and was restricted to a single instance or case study

using retrospective histories. There is a need to extend the study to a larger sample of case

studies and to different contexts. However, the study opens up new avenues for future research.

The role of the middle manager needs to be looked at from the perspective of development and

deployment of capabilities which play a significant role in the success of influence tactics and

thereby the commitment of the lower staff.

CONCLUSION

This paper attempted an exploratory study to link the effectiveness of use of influence tactics by

middle level managers and its impact on unit performance. The proposition stands tentatively

supported which opens up new research opportunities in the study of the role of middle level

managers. It is argued that further research in this stream would facilitate the linkage between

strategic renewal and organisational adaptation.

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ANNEXURE A: PERFORMANCE INDICES FOR PHCS POGLU, MOYAD AND

CHAMARA.

TABLE 1:

Comparison of indicators of maternal health (Prantij block; Sabarkantha district)

Indicators Maternal healthPOGLU MOYAD MAJARA

Ante natal registration( load) 1552 854 1549

Registered 861 418 763

% early registration 66.32 69.38 56.36

3 medical check up 935 326 555

Institutional deliveries(load) 1410 777 1409

Sub centre 102 46 3

Own referral units 27 34 1

Other government hospitals 166 18 107

Private hospitals 417 431 462

Domiciliary deliveries(total) 163 33 40Doctors 17 0 18

Nurse/ANM 98 30 17

Trained attendant 48 3 3

Untrained 0 0 2

Total deliveries 875 595 653

% Delivery in government institutions 33.7 16.4 17

% Delivery at home 18.6 4.2 16.38

% Attended by skilled person 100 100 99.6

% Delivered in institutions 62 76.6 46.3

TABLE 2:

Comparison of indicators of family planning activities (prantij block; sabarkantha district)

Indicators Family planning activities

Actuals achieved/targets Poglu Moyad Majara

Operations 154/ 495(31.1%) 85/272(31.1%) 117

IUD 538/889(42.7%) 219/498(43%) 378

Oral pills 209/222(94.1%) 105/125(84%) 206

Emergency contraceptives 0 0 0

Condoms 778/1237(62.9%) 400/680(58.8%) 791

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TABLE 3:

Comparison of immunization activities (prantij block; sabarkantha district)

Indicators Immunization activities

Actuals achieved Poglu Moyad Majara

Work load 1322 728 1321

Male childrenBCG 425 245 363DPT 408 248 372

Polio 442 219 372

Measles 538 247 379

Fully immunized 439 219 379

Female childrenBCG 406 193 306

DPT 394 206 301

Polio 405 198 301

Measles 356 202 282

Fully immunized 402 171 279

Total childrenBCG 831(62.8%) 438(60.1%) 669

DPT 802 454 673Polio 847 417 673

Measles 894 449 661

Fully immunized 841(63.6%) 390(53.57) 658

TABLE 4:

Comparison of deliveries under Chiranjeevi and JSY (prantij block; sabarkantha district)

all figure for year 2006-07(except as indicated)Indicators Poglu Moyad Majara

Population 52298 51629 50442

No of BPL families 732 718 1108

Percentage of population of BPL 7% 7.1% 11%

Birth rate( 2005) 22.36 % 21.79% 22.67%

Deliveries under Chiranjeevi (up to oct.) 58 49 64

Beneficiaries/Deliveries under JSY 64/27 27/7 33/7

Work load (for 6 months) 92 90 139

% BPL families covered 92.3 62.2 51

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TABLE 5:

Salient socio-economic and health situation features of sabarkantha district (2004)

Indicator Value

Population in thousand 2189

Density per square kilometer 282Sex ratio 797

Literacy rate 67.32

% Urban population 10.89

% BPL population 54

Road length per square kilometer 60

Total fertility rate 2.25

Girls married below age 18(as %) 29.7

% Delivery in government institutions 8.6

% Delivery at home 36.9

% Attended by skilled person 72.3

% Delivered in institutions 62%% Total workers 45.15

% full ANC ( 3 medical check up) 23

% institutional deliveries( 2006 up to November)/state 73/(60)

IMR(2006)/ state IMR 52/(62)

MMR( 2006)/state MMR 162/( 389)

TABLE 6: Indicators of performance for family planning and immunization activities

Indicators Poglu Moyad

Self

generated

Final

targets

Self

generated

Final

targets

sterilization operations 488 495 269 272

IUD 936 889 na 495

condoms 1309 1237 na 680

oral contraceptives 259 227 na 125

ANC 1473 1551 na 855

deliveries 1288 1322 na 777

BCG;VIT A; DT 1272 1322 na 728

TT Ist dose 1465 1257 na 855

TT 3rd dose 589 562 na na

TABLE 7:

STAFFING STATUS:Poglu: PHC MO+ pharmacist+ lab technician+ staff nurse+ 10FHW+ 5 MHW+ 2

supervisors +driver2 vacancies; 12 sub centers

Moyad : PHC MO+ pharmacist+ lab technician+ staff nurse+ 5FHW+ 2MHW+ 3

supervisors+ driver2 vacancies; 7 sub centers

Majara : PHC MO+ pharmacist+ lab technician+ staff nurse+ 7FHW+ 4MHW+ 2

supervisors +driver2 vacancies; 9 sub centers

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MIDLLE LEVEL MANAGERS,

INFLUENCE

AND STRATEGY PROCESS

A

PAPER

SUBMITTED

TO

PROFESSOR AJEET MATHUR

BY

BNV LAKSHMIFPM III

BUSINESS PLOICY

1307528088181-MIDDLE LEVEL MANAGERS Action Research Final Paper

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