Kurt Lewin (1951) developed the thought of force-field analysis by looking behaviour
within organization as a dynamic and not as a static balance of forces working
in opposite directions within the organization. Lewins believes that, any
change brought by current situation or condition of the organisation and this
cause force to change or resist to change. These forces may originate in the
internal or external environment in the Health Facilities or in the behaviour
of the Facilities in-charge.


Health Facilities in-charge supposed to make extra
effort in initiating change in the organisation while making sure of reducing resistance
to change. Health Facilities in-charge supposed to look condition in the
hospital as an equilibrium that is the result of driving forces and resisting
forces working against each other. Assessment of potential changes and
resistance and attempt to change must be done in order to balance the forces so
that there will be movement toward a desired condition.

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There are three ways Health Facilities in-charge can
do this: increasing the driving forces, reducing the resisting forces, or
considering new driving forces.


Lewin points out that increasing one set of forces without decreasing
the other set of forces will increase tension and conflict in the organization.
Reducing the other set of forces may reduce the amount of tension. Although
increasing driving forces is sometimes effective, it is usually better to
reduce the resisting forces because increasing driving forces often tends to be
offset by increased resistance. Put another way, when we push people, they are
likely to push back. Forces for change and resistance to change; these are the
types of situations that Health Facilities in-charge face and must work with on
a daily basis when attempting to effect change.


Moreover, change involves a sequence
of organizational processes that occurs over time. Lewin suggests this process
typically requires three steps: unfreezing, moving, and refreezing. which can be apply by managers to
implement changes; Unfreezing
implies breaking down the existing ways of doing things so as the people are
ready to accept new alternatives. Moving
is the step whereby people become receptive to change, the proposed change is
introduced in a systematic manner and learning takes place during this phase. Refreezing is where by change is made a
permanent part of organizations life. At this stage new practice are accepted
and change is stabilized. However, RBF initiative was applied in order to break
down existing ways of doing things in health facilities whereby now quality and
quantity indicators supposed to be attained in order for the facilities receive
incentive funds for day-to-day running cost.