1. Task Shifting and Vendor Managed Inventory October 6, 2010 Tinei Chitsike Logistics Advisor USAID | DELIVER PROJECT Zimbabwe Field Office

2. Public Health Challenges Lack of financial & human resources Attracting, recruiting and retaining skilled health workers Poor working conditions, low motivation & brain drain Economic challenges, wage bill restrictions & salary freezes

3. Task Shifting Move work from non-specialized to specialized health workers Establish a core group of professionals who use formal procedures Train, certify, mentor/coach, and routinely assess quality Sustain motivation and performance levels.

4. Opportunities To a certain extent, relieves dependence on certain scarce qualified staff Improves workforce skills mix and health- related system efficiency. Risks Professional responsibility vs. legal liability Potential institutional and professional resistance.

5. Lessons Learned Do not use task shifting in isolation but as part of the overall strategy Establish clear protocols to reduce workload and simplify tasks Progressively increase and diversify workload and implement easy-to-use technologies Provide adequate training, support, and supervision to manage stress and burnout.

6. Vendor managed inventory VMI is a form of task shifting Is a means of optimising supply chain performance in which the vendor is responsible for maintaining the client’s inventory. Vendor has visibility of the client’s inventory and is responsible for generating orders and replenishing stocks Commercial sector–soft drinks, public sector–DTTU

7. Benefits of VMI: DTTU in Zimbabwe

8. Recommendations (Task Shifting) As part of the broad strategy, mobilize resources to address conditions of service Understand country context before beginning Assess impact on outcomes, efficiency, and effectiveness of health care delivery Encourage stakeholder participation.

9. Recommendations (VMI) Use VMI program to yield positive results by increasing availability of commodities Use VMI to potentially achieve cost efficiencies by minimizing supply chain cost drivers, e.g., training Ensure management capacity is in place for VMI—use third party logistics provider.

10. Thank You Questions?