People that Deliver Strategic Plan Human resources (HR) for Supply chain management (SCM) in health, (ALTER TALK TITLE AS REQUIRED)

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Overview 1. The health supply chain workforce WHAT is it? WHY does it matter? 2. The People that Deliver Initiative WHAT is PtD and HOW does it work? 3. The HR building blocks for SCM Explaining a systematic approach? 4. Results from PtD focus countries 5. HOW can you get engaged with PtD?

1. The health supply chain workforce Key messages: HRH is part of health systems strengthening where there is currently a global shortage of healthcare workers. With an increase in global investments in health commodities there is an increased strain on national supply chain systems and staff who run them. Public health supply chains are complex with multiple functions that require, tools, infrastructure, procedures, personnel and management to run them properly. In many countries the personnel who are asked to run the supply chain are under-qualified and not well supported resulting in poor medicine availability. Countries need to change their approach, paying more attention to the human resources that run supply chains, making them more professional.

HRH within health system strengthening WHO building blocks

Global Shortage of Health Workers  Shortage of 4.3 million health workers globally  2.4 million doctors, nurses and midwives  1.9 million management and support staff, including health administrators, managers, and logisticians  57 countries with critical shortages ‘Imagine’ health worker video:

Global investments in health commodities  Every year billions of US dollars are spent by development partners and national governments procuring health commodities for low- and middle-income countries  Source : WHO, 2012 Huge increases in the quantity, value and complexity of medicines and commodities flowing through public health supply chains. Yet more than one-third of the world’s population still lacks regular access to essential medicines (WHO, 2011)

Strain on national supply chain systems and workers  Source: : WHO/IVB, Apr (based on Chad data)  24-fold increase in the value of new vaccines introduced into a country…  … resulted in a 5-fold increase in the workload for supply chain management

Health supply chain functions  Source: USAID | DELIVER Project 2010

The complex nature of supply chains – Potter and Brough model  leadership.org/sites/default/files/capacity%20pyramid%20blog.jpg leadership.org/sites/default/files/capacity%20pyramid%20blog.jpg

A change in approach is needed Underper- forming health programs and unachieved health goals Poor availability of health commodities at facilities, wasted resources Underqualified & disempowered staff managing public health supply chains Supply chains poorly managed and insufficiently resourced "When you use a nurse or a physician as a logistician, you lose the nurse or physician and you don't get a good logistician!" Prof. Saracino, former Minister of Health, Côte d'Ivoire

SC workforce positions do not require relevant SC qualifications Clinical staff fill SC position Short- term training provided Limited available resources & incentives Staff rotation/ migration Characteristics  Short-term focus  Significant expenditure  Requires extensive external assistance  Limited long-term progress in human capacity  Limited sustainability or institutionalization Lack of professional status and performance HR for SCM current paradigm

Qualified staff hired/ contracted for SCM positions Appropriate career incentives provided High staff satisfaction and retention SCM jobs desirable; qualifications sought National institutions provide relevant qualifications Characteristics  Long term focus  Requires reform of perceptions, policies and practices  Converts existing expenditures into investment  Capacity benefits accumulate over time  Inherently sustainable and country-driven Elevated status for SCM and SCM workforce HR for SCM desired paradigm

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2. The People that Deliver Initiative Key messages: The People that Deliver (PtD) Initiative was founded in 2011 to focus on promoting sustainable workforce excellence in health supply chain management. PtD has a clear vision, mission and strategy to meet its goals with the aid of PtD members. A focused working group structure lead by an Executive Manager and directed by a Board, provides the basis for activity in PtD focus countries and broader global engagement

Improving health outcomes by promoting sustainable workforce excellence in health supply chain management 70+ member organizations  country governments  international agencies  academic institutions  implementing partners  Non-governmental organizations  private companies

Significant PtD Milestones  June 2011, PtD Global Harmonization and Positioning Conference, WHO Geneva  July 2011 – Dec 12, PtD Board established with TOR, admin, focus countries, & working groups established. (Advocacy & Knowledge Management, Technical, & Research)  June 2012, UNICEF offers to host the PtD Secretariat  June 2013, Appointment of Executive Manager for PtD  June 2013, Approval of PtD Strategic Plan  Aug 2013, PtD Operational Plan approved

Vision  The People that Deliver Initiative envisions a world where national supply chain workforces are planned, financed, developed and supported in a way that ensures equitable and sustainable access to the medicines and other commodities needed for optimal health outcomes.

Mission  People that Deliver is a global partnership whose mission is to build global and national capacity to implement evidence- based approaches to plan, finance, develop, support and retain the national workforces needed for the effective, efficient and sustainable management of health supply chains.

Strategic goals I. Global recognition that strong supply chains are essential for positive health outcomes and require a competent, recognized and supported supply chain workforce with significant technical and managerial capacity. II. Government and national health institutions demand, recruit and retain appropriately qualified personnel for positions with supply chain responsibilities.

Strategic goals III. Adequate personnel from relevant cadres with appropriate supply chain competencies and qualifications are available. IV. A repository of evidence-based resources for HR for SCM is established, accessible, used and disseminated.

Principles  Country lead activity  Globally influenced but locally applied  Systematic approach to HR for SCM  Professionalization of SCM workforce (logisticians or health based, local context)  Inclusive of private sector  Selection, quantification, procurement, storage, distribution, use  All levels of the supply chain  Consider the “know do” gap

Structure of PtD Board AKMWGTWGRWG Secretariat  Focus countries  Members

Current Board  country governments  international agencies  academic institutions  implementing partners  nongovernmental organizations  private companies

PtD Operational Plan Expected main customers PtD core servicesHow to access PtD services PtD Members Regional networks and organizations Country governments International organizations & initiatives  Provision of advocacy materials, and strategies in response to requests on issues relating to HR for SCM  Direct engagement with the secretariat  Direct engagement with working group leads See  Use of procurement and Supply Management (PSM) Tool box  Laptop SCM education repository tools/laptop.html  PtD Website  Development and/or application of country specific best practice approaches, tools and evidence for specific HR for SCM country based interventions  Facilitation of linkages where an identified need exists (e.g. technical expertise, resource mobilisation, etc.)  Encourage exchange of country – experiences (south-to-south learning).

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3. The HR Building Blocks for SCM Key messages: A systematic approach to HR for SCM requires attention to be given to five different HR building blocks in any given context. A HR for SCM assessment tool has been published by the USAID/DELIVER Project in conjunction with PtD and is available for use. The results of any assessment need to inform the development of a strategic and operational plan with engagement from SCM stakeholders as a basis for sustainable change.

A Systematic Approach to HR for SCM Block 1 Engaged Stakeholders Block 2 Optimise Policies & Plans Block 3 Workforce Development Block 4 Increase Performance Block 5 Professionalisation of SCM

Block 1- Engaged Stakeholders  Stakeholders, who provide technical leadership and advocacy in the field of supply chain management (SCM), as well as human resource management.

Block 2 – Optimise Policies and Plans  Policies, plans, and associated standard operating procedures (SOPs) that support human resource capacity development and management, including finance and human resource information systems (HRIS).

Block 3 – Workforce Development  Initiatives that focus on identifying and building a robust workforce, including recruiting, competency modelling and development, and pre-service education and continued professional development.

Block 4 – Increase Performance  Management initiatives that identify and enhance workforce performance, including retention, supervision, mentoring and coaching, and task shifting.

Block 5 – Professionalisation of SCM  Processes designed to establish supply chain roles or a set of professional responsibilities/competencies.  Including minimum pre-service education, professional networks and registration.

How to Assess HR for SCM  USAID DELIVER Project with PtD  Human Resource Capacity Development in Public Health Supply Chain Management: Assessment Guide and ToolResource Capacity Development in Public Health Supply Chain Management: Assessment Guide and Tool  Dashboard of the five building blocks

How to Assess HR for SCM Step 1: Conduct AssessmentStep 2: Develop Strategic PlanStep 3: Develop Operational Plan

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4. Results from PtD focus countries Dominican Republic EthiopiaIndonesia Burkina FasoLiberia MozambiqueNamibia Key messages: Activity is most sustainable when HR for SCM assessments are used to develop strategic and operational plans. A more sustainable approach occurs when key SCM stakeholders work together to implement activities.

Following a HR for SCM assessment in 2011, the MOH recently approved a new pharmaceutical logistics strategic plan which foresees significant reform of the HR structures and systems for public health supply chain managers. The plan has three main components:  Build up a logistics cadre in Mozambique with private sector partnerships  Working with ministry on HR for SCM cadres aiming to free up clinical cadres for more clinical work. Retention strategies will also be considered.  Within the Central Medical Stores they are investigating how to incentivise, motivate and coach staff. PtD members involved in this project include: JSI, Village Reach, Deloite, Accenture Mozambique

Namibia Following a HR for SCM assessment the following areas of specific focus have been identified:  To provide technical assistance to the Namibian MOHSS for enhanced planning, deployment, training and retention of the SCM workforce.  To document the implementation process, identify lessons learned, and draft a case study/guidance document on strengthening the SCM workforce that can be shared for additional testing and replication in other countries. Specific projects include SCM competency mapping, workload analysis and SCM education. PtD members involved in this project include: Capacity Plus, SCMS, SIAPS,

Dominican Republic & LAC Following an initial HR for SCM management assessment in the Dominican Republic plans are moving forward to:  Developed job descriptions and a supervision manual for supply chain staff  Develop a diploma course that is being institutionalized through the National Institute of Public Administration and in collaboration with a local university  Engaged with other LAC partners in a regional workshop on HR for SCM More broadly in the LAC region:  El Salvador has, and Guatemala is due to, undertake HR for SCM assessment  El Salvador has requested the development and delivery of a workshop to strengthen the motivation and supportive supervision of supply chain workers. PtD members involved in this project include: CapacityPlus, SIAPS,

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5. How can you get engaged with PtD?  Become a PtD member (go to  Join a PtD working group (  Become a PtD Twitter follower  Update LAPTOP with SCM courses offered by your own institution (visit  Tell us your HR for SCM stories or projects  Advocate for HR for SCM within your organization  For more information, contact  the Secretariat:  the Executive Manager:

A brief summary 1. The health supply chain workforce What is it? Why does it matter? 2. The People that Deliver Initiative What is PtD and how does it work? 3. The HR building blocks for SCM Explaining a systematic approach? 4. Results from PtD focus countries 5. How can you get engaged with PtD?

Questions