1 Supply Chain Operations Flow Supply Chain Configurations Supply Chain Strategies.
Human Resources for Health Supply Chain Transformation ......Deliver (PtD) Human Resources for...
Transcript of Human Resources for Health Supply Chain Transformation ......Deliver (PtD) Human Resources for...
Human Resources for Health Supply Chain Transformation:
Exploring Common Best Practices in the African Health Supply Chain
Case Studies from Ethiopia, Kenya, Malawi, Sudan, Tanzania, and Uganda
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Acknowledgements
Theauthorswishtothankeveryonewhohascontributedtothisresearch.Wearegratefultothekeyinformants,whokindlygavetheirtimetobeinterviewedandsharedtheirknowledgeandexpertise. Thank you also to the survey respondents, including the IAPHL and SoSoKEcommunities,whoenriched this research, and to theparticipantsof thePSAwebinarHumanResourcesforHealthSupplyChainTransformation,whoprovidedinvaluablefeedbackonanearlyversionofthisresearch.WewishtoextendourthankstothePSAteamwhoprovidedfeedback,including Sintayehu Beyene Tiruneh, Jean Blackstock, Geleta Beyene Tiruneh, Sophia Iosue,YukabethOtieno,andSolomonTekle.
AUTHORS
PamelaSteele
AndreyLevitskiy
JoannaNayler
DrLakshmySubramanian
SUGGESTEDCITATION
Steele,P.,Levitskiy,A.,Nayler,J.,andSubramanian,L.(2020)HumanResourcesforHealthSupplyChain Transformation: Exploring Common Best Practices in the African Health Supply Chain.PamelaSteeleAssociates.
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Executivesummary
Introduction
Humanresourcemanagement(HRM)isacriticalcomponentofaneffectivehealthsupplychain.Humanresource(HR)andsupplychainpractitionersemphasisetheimportanceofhumancapitalfor successful SupplyChainManagement (SCM)and customer satisfaction, citing thepositiveimpactofstrategicHRMonorganisationalperformance. In low-andmiddle-incomecountries(LMICs),whichexperiencesignificantshortagesofqualifiedandskilledhealthandsupplychainworkers, this impact is particularly relevant.Over thepast several years, the governmentsofmanycountriesinSub-SaharanAfricahavesuccessfullyimplementedvariousHRMstrategiestoimprovetheirpublichealthworkforce.ThepresentstudyaimstoidentifybestpracticesinHRM,andtounderstandifandhowtheseareappliedacrosshealthsupplychainorganisationsinSub-SaharanAfrica.ThegoalistohighlightapproachesthatcaninformandsupporteffectiveSCMandSupplyChainTransformation(SCT)intheregion.
Methodology
ThemethodologyofthisstudyisinformedbytheHRMtheoreticalframeworkandthePeoplethatDeliver (PtD)HumanResources for Supply ChainManagement Theory of Change. The latteridentifiesfourpathwaysofchange(staffing,skill,workconditions,andmotivation)forimprovingsupplychainworkforceperformance.ThestudyusesthesefourpathwaystoorganiseitsfindingsregardingbestpracticesinHRMforthehealthsupplychain,andthepracticescurrentlybeingappliedinSub-SaharanAfrica.
Thestudyinvolvedthreecomponents:
1. A desk review of literature on HR practices and health SCM, which was used to identifyinternationalbestpractices.
2.Anonlinesurveythatcollectedresponsesacrossfivegroupsofstakeholdersinhealthsupplychainonthepracticesappliedintheorganisationsofwhichtheyhaveknowledge.Thisincludedofficials from ministries of health; representatives from parastatal and central procurementagencies and from the district level; representatives from state-level health facilities; andrepresentativesfromthedonorcommunityandprivatecharitableorganisations.
3.Keyinformantinterviews(KIIs)withkeyHRprofessionalsinsixcasestudyparastatalhealthsupply chainorganisations inAfrica,whichhave eachundergonesome formof SCT in recentyears,toprovideasnapshotoftheHRMmechanismsandpracticestheyarecurrentlyapplying.Thecasestudyorganisationsare:theEthiopianPharmaceuticalSupplyAgency(EPSA);theKenyaMedical Supplies Agency (KEMSA); the Central Medical Stores Trust (CMST) of Malawi; theNational Medical Supplies Fund (NMSF) of Sudan; the Medical Stores Department (MSD) ofTanzania;andtheNationalMedicalStores(NMS)ofUganda.
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Keyfindings
Pathway 1. Staffing
Bestpractices
Bestpracticerecruitmentprocessesforsupplychainpersonnelarerigorous,transparent,fair,andcompetitive.Efficientrecruitmentsystemsarecharacterisedbycompetency-basedcandidateassessments that focus on valuable skills, qualifications, trainings, and relevant experiences.Anotherbestpracticeinthisareaisjobdescriptionsthataredevelopedbasedonacompetencyframework.Finally,therearevariousbestpracticemeansofattractingandretainingemployees,including employee compensation which follows clear and competitive pay scales (whichrequiressalarybenchmarkingandcomparisonsbetweenprivateandpublicinstitutions).
Findingsfromthesurveyandthecasestudies
Thesixcasestudyparastatalsupplychainorganisationsconductinternalorexternalrecruitment(or both), in some cases outsourcing the hiring of topmanagementpositions to professionalservices firms. Most of the organisations conduct written or oral technical tests as part ofrecruitment.
Amongthe survey respondents, qualifications and the lengthofprofessional experiencewerefoundtobemoreimportantforthefinalrecruitmentdecisionthanacandidate’sperformanceinaninterview:reportedby42%ofthesurveyrespondents,asagainst35%,respectively.Thiswasmirroredinthesixcasestudyparastatalorganisations:forthemajorityofthese,qualificationsandthelengthofprofessionalexperienceplayapivotalroleintheselectionprocess.
Onlytwooutofthesixcasestudyorganisationsapplyjobdescriptionsbasedonacompetencyframework.
Employee compensationwas found tobe instrumental in attractingand retaining employees.However, despite this importance,most survey respondents (59%) acknowledged that theirorganisationslackbenchmarkedsalaryranges,and69%indicatedthatsalarymarketanalysisisnotconductedintheirorganisations.Thesixcasestudyorganisationsreportedfacinglimitationsin their ability tooffer competitive salaries andbenefitsdue to constraints imposedby stateregulations on salaries and remuneration. To this is added a lack of benchmarking of salaryranges,andsalarymarketanalyses.Together,thishasanegativeimpactonstaffturnoverattheorganisations.
Pathway2.Skills
Bestpractices
Asupplychainworkforce’scontinuouslearning,training,andprofessionalisationarecrucialforenhancing supply chain performance. Best practices in this area can be broken down into avarietyofinitiatives:
Training needs analysis (TNA): TNA aims to identify knowledge and skills gaps, to identifytraininganddevelopmentrequirements.TNAallowsorganisationstodevelopinformeddecisionsonwhatlearningisneededatindividualandorganisationallevels,andtodraftatrainingplanandanorganisationaltrainingstrategytoensuresufficientcapacityforsustainingcurrentandfuturebusinessperformance.
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Professionalappraisals,training,andcontinualprofessionaldevelopment(CPD):CPDofsupplychain specialists occurs through running training and learning courses, tailored to addressspecificskillsneeds;helpingstafftoobtaincertificationsandhigherdegrees;andhelpingstafftoobtainmembershipsinprofessionalassociations.
Professionalisationandcommunitiesofpractice:ProfessionalisationofSCMspecialistsisgainingincreasingattentionfromhealthsupplychainorganisationsinAfrica.ItstaskistoprepareandsupporthighlycompetentmanagersandpractitionersthroughtrainingandcareermanagementbyestablishingglobalstandardsforhealthSCMjobfunctions,skillsneedsanalysis,harmonisedlearningcurricula,andaccreditationofsupplychainworkers.Communitiesofpracticepromoteprofessionalisation by creating a shareddomain for learning, networking, and the sharing ofideas,methods,andexperiences.
Findingsfromthesurveyandthecasestudies
AlthoughTNAiscommonlyperceivedasanintegralpartofHRdevelopmentandtransformation,only50%of survey respondents indicated that their organisations conductTNA, and35%ofrespondentshighlightedthatTNAintheirorganisationsdoesnotleadtothedevelopmentofatrainingstrategyorplan.Allofthesixcasestudyhealthsupplychainorganisationswerefoundto conduct TNA, mostly annually. Of the six case study organisations, five currently providetraining,eitherin-houseorexternally,whilethesixthisdevelopingitstrainingstrategy.NMSFhasadedicatedtrainingcentre,andEPSAisdevelopingone.Twooftheorganisations(NMSandMSD)supportstaffmembershipofprofessionalbodiesbypayingtheirfees.Mentoringalsooccursin theseorganisations, butnot as consistently across theorganisations.The study foundthatsupporting communities of practice is considered an important stimulus for continuousprofessionalandleadershipdevelopmentofemployees.
Pathway3.Workconditions
Bestpractices
Organisationalcultureisanimportantcomponentofcreatingasupportiveworkenvironment,providingawayforemployeestovoicetheirviewsanddevelopconnectionsandpurpose.Therearenumerouswaystostrengthenorganisationalculture,including:(i)implementingpoliciesthatsupport a positive organisational culture (an overarching code of conduct or ethics, anti-harassmentpolicies,anti-discriminationorequalopportunitypolicies,andpoliciesthatcreateagood working environment for women) and reviewing them regularly; (ii) implementingwhistleblowingmechanisms; and (iii) ensuring apositive physical environment, including byestablishinganoccupationalsafetyandhealth(OSH)managementsystem.
Findingsfromthesurveyandthecasestudies
Policiestosupportapositiveorganisationalculture:Havinganoverarchingcodeofconductorethics in place was the most commonly reported policy intervention among the surveyrespondents(63%),andsuchcodeswerealso foundtobe inplaceatallofthesixcasestudyorganisations.Otherpoliciesindicatedbythecasestudyorganisationinformantsasbeinginplaceinclude policies on anti-corruption, anti-fraud, anti-discrimination, HIV and chronic diseases,sexual harassment, and health and safety. Some of the six case study organisations promotewomenorminoritygroupsthroughspecificgroupsordepartments(e.g.aGenderMainstreamingCommittee and a Disability Mainstreaming Committee at KEMSA, and a Gender and YouthDirectorateatEPSA).Otherproceduresincludeusingaffirmativeactionineitherrecruitmentorpromotion, having a clear policy on attracting and maintaining an equal workforce, and
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examining disaggregated data on the gender split at different levels. Key informants alsomentionedhowtheirorganisationssensitiseemployeeson,anddisseminate, theirpoliciesbymeans of consultation, regular reviews, and circulating hard and soft copies across theorganisation.NMSinUgandaisintheprocessofdesigningonlinemodulescoveringitspolicies.
Awhistleblowingmechanism:Suchamechanismwasreportedtobeinplaceby41%ofsurveyrespondents.Fouroutofthesixcasestudyorganisationsalsostatedtheyhaveawhistleblowingpolicymechanism.The survey respondentsand theKIIs reportedbestpractices in creatingawhistleblowingpolicymechanismas includingan independentlymanagedanonymoushotlineandtheuseofspecificemailsystemstoensureanonymity.
EnsuringapositivephysicalenvironmentandOSH:Themostimplementedinterventionreportedbysurveyrespondentswas the improvementof theworkplaceconditionsandprovidingstaffwiththenecessarytoolsandequipmenttoperformtheirjobs(81%).Otherpracticesmentionedby key informants include carrying out tests (e.g. measuring lighting levels and air quality),providing medical cover and free health checks, registering near incidents, and providingpersonalprotectiveequipmenttostaff.Manyofthesixcasestudyorganisationsmentionedthattheycomplywithnational-levelhealthandsafetylegislation.
Pathway4.Motivation
Bestpractices
EmployeemotivationisakeyHRstrategyandplaysacrucialroleinachievinganorganisation’svision. Best practices that can promote good employee motivation include: (i) performancemanagement, including appraisals; (ii) incentives (financial and non-financial, e.g. financialsupport for CPDs, performance-based incentives, recognition, and exposure to stakeholdermeetings);(iii)goodsupervisionandmanagement;(iv)promotions(particularlyifcompetency-based); (v) employee engagement and retention through development opportunities,communication channels, rewards and recognition, and employer’s support (as well asconducting astaff satisfactionsurvey to get employee feedback); and (vi)a cleardisciplinarypolicyandpractice.
Findingsfromthesurveyandthecasestudies
Performance management: 73% of the survey respondents confirmed the presence ofperformancemanagementsystemsintheirhealthsupplychainorganisationsError!Referencesourcenotfound.,while68%ofthesurveyrespondentsalsoindicatedthattheirorganisationshaveaperformancemanagementprocess for identifyinganddocumentingpoorperformance.Some of the best practices identified by the respondents in this area include the use ofperformance indicators, annual appraisals to reinforce performance through a balancedscorecard(BSC),conductingreviewmeetings,andcontinualinvestmentinHRdevelopmentandmanagement.Regardingthecasestudyorganisations,eachidentifieditsuniquecombinationofintrinsicandextrinsicmotivators:performancemanagementissupportedusingkeyperformanceindicators (KPIs) at EPSA, KEMSA, andNMSF;MSD uses its internal appraisal system, calledDRIVE;whileNMSseekstomotivateemployeesthroughchangestotheworkenvironmentandorganisationalculture.Performanceappraisalsarecentraltomotivationacrossallofthesixcasestudyorganisations.
Incentives:ThesurveyrespondentsidentifiedarangeoftoolsthatarecurrentlybeingusedtoincentivisethehealthSupplyChainworkforce, includingfinancialsupportforCPD,paidstudyleave,approvalfortheacquisitionofrelevantcertifications,andperformance-basedincentives.
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Inregardtothesixcasestudyorganisations,incentivesusedtomotivatetheirstaffinclude:toolstoinducerecognition;exposuretostakeholdermeetings;rewardingemployeeperformancewitha recognition letter and a dinner with the CEO (KEMSA); providing hardship allowances,honoraria,andtransportallowances(MSD);andprovidinganentertainmentallowanceforclient-facingjobroles,fuelallowancesformiddleandtopmanagement,andtransportforstaff(NMS).
Goodsupervisionandmanagement:Thesurveyfindingsrevealedthatmonitoringandsupportivevisits,mentoringandcoachingprogrammes,systematicsupervision,andmoderateddiscussionswereconductedintherespondents’organisations.Thesixcasestudyparastatalorganisationshavedifferentapproaches tosupervisorysupport:KEMSAencouragessystematicsupervision,while.NMSaimstoboostinter-departmentalcoachingandmentoring,especiallyforjuniorstaff,andMSDalsoencouragestafftoseekmentoringopportunitiesoutsidetheirorganisationthroughparticipationinworkshopsandseminars.
Promotions: According to the survey results, 59% of the respondents felt that there are notenoughpromotionopportunitiesfortheworkforce.Promotionswerereportedtobebasedonthenumberofyearsinthejobpositionandtofollowachainofsupervisoryandhierarchicalflow.Suchformsofpromotionresultinafragmentedsystemandlowerlevelsofmotivation.Intermsof the six case studyorganisations, promotionsare guidedby theCareerProgressionPlan atKEMSA,theConditionofServicehandbookatCMST,andtheCivilServiceChamberatNMSF.MSDfollowsacompetence-basedpromotionsystem,whileNMSdoesnotexercisepromotionsatall,instead inviting employees to apply for available internalpositionsat various levelsafter theexpirationoftheirfixed-termfour-yearcontract.
Employee engagement and retention: Only 44% of the survey respondents indicated theexistenceofemployeeengagementandretentionpolicies intheirorganisation.59%reportedthat their organisation does not conduct a staff satisfaction survey. At the six case studyorganisationsemployeeengagementandretentionpoliciesareapplied,withtheaimofretaininghighlyskilledstaffandenhancingmotivationatthesixorganisations.A fewof thecasestudyorganisationshavedevelopedstructuredretentionschemesandpolicies(e.g. KEMSA’sTalentManagementManual),whileothersrelyonthevarietyofmonetaryandnon-monetaryincentives,workbenefits,andorganisationalchanges,whichincludeprivatehealthinsuranceandfreehealthchecks,subsidisedmeals,stafftransportation,andtradeunionsupport.
Disciplinaryproceduresandrules:91%ofthesurveyrespondentssaidthattheirorganisationhas a standard disciplinary policy and practice in place. In terms of the six case studyorganisations, disciplinary policies and practices were found to be well documented, andregulatedbyeitherspecificdisciplinarypolicies,codesofconduct,orgovernmentalregulationsand acts. Staff satisfaction surveys are conducted annually or biennially in all the case studyparastatalorganisations,exceptforNMS(whichplanstointroduceonein2020).
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Contents
Acknowledgements .......................................................................................................................... 2
Executive summary .......................................................................................................................... 3
Contents ........................................................................................................................................... 8
Table of acronyms .......................................................................................................................... 10
1. Introduction and rationale ...................................................................................................... 11
2. Methodology .......................................................................................................................... 12
3. Desk review and online survey ............................................................................................... 14
3.1 Pathway 1: Staffing .......................................................................................................... 14
3.2 Pathway 2: Skills .............................................................................................................. 19
3.3 Pathway 3: Working conditions ........................................................................................ 22
3.4 Pathway 4: Motivation ..................................................................................................... 26
4. Organisational case studies .................................................................................................... 30
4.1 ETHIOPIA: Ethiopian Pharmaceutical Supply Agency (EPSA) ............................................. 30
4.1.1 Pathway 1. Staffing .................................................................................................. 30
4.1.2 Pathway 2. Skills ....................................................................................................... 31
4.1.3 Pathway 3. Work environment ................................................................................. 31
4.1.4 Pathway 4. Motivation ............................................................................................. 32
4.2 KENYA: Kenya Medical Supplies Authority (KEMSA) ......................................................... 33
4.2.1 Pathway 1. Staffing .................................................................................................. 33
4.2.2 Pathway 2. Skills ....................................................................................................... 35
4.2.3 Pathway 3. Work environment ................................................................................. 36
4.2.4 Pathway 4. Motivation ............................................................................................. 37
4.3 MALAWI: Central Medical Stores Trust (CMST) ................................................................ 39
4.3.1 Pathway 1. Staffing .................................................................................................. 39
4.3.2 Pathway 2. Skills ....................................................................................................... 40
4.3.3 Pathway 3. Work environment ................................................................................. 41
4.3.4 Pathway 4. Motivation ............................................................................................. 42
4.4 SUDAN: National Medical Supplies Fund (NMSF) .............................................................. 43
4.4.1 Pathway 1. Staffing .................................................................................................. 43
4.4.2 Pathway 2. Skills ....................................................................................................... 44
4.4.3 Pathway 3: Work environment ................................................................................. 44
4.4.4 Pathway 4. Motivation ............................................................................................. 45
4.5 Tanzania: Medical Stores Department (MSD) ................................................................... 46
4.5.1 Pathway 1: Staffing .................................................................................................. 47
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4.5.2 Pathway 2. Skills ....................................................................................................... 48
4.5.3 Pathway 3. Work environment ................................................................................. 49
4.5.4 Pathway 4. Motivation ............................................................................................. 50
4.6 Uganda: National Medical Stores (NMS)........................................................................... 51
4.6.1 Pathway 1. Staffing .................................................................................................. 51
4.6.2 Pathway 2. Skills ....................................................................................................... 53
4.6.3 Pathway 3. Work environment ................................................................................. 54
4.6.4 Pathway 4. Motivation ............................................................................................. 55
5. Conclusion .............................................................................................................................. 57
5.1 Pathway 1. Staffing .......................................................................................................... 57
5.2 Pathway 2. Skills .............................................................................................................. 57
5.3 Pathway 3. Working conditions ........................................................................................ 58
5.4 Pathway 4. Motivation ..................................................................................................... 59
Appendix 1. Comparative tables (case studies) .............................................................................. 60
Appendix 2. Bibliography ............................................................................................................... 72
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Tableofacronyms
BMGF BillandMelindaGatesFoundationBSC BalancedscorecardCEO ChiefexecutiveofficerCMS CentralMedicalStoresCPD ContinuousprofessionaldevelopmentCMST CentralMedicalStoresTrustDRIVE Direction,review,improve,validate,andenjoyEPSA EthiopianPharmaceuticalSupplyAgencyGHSC-PSM GlobalHealthSupplyChain–ProcurementSupplyManagementHR HumanresourcesHRM HumanresourcemanagementIAPHL InternationalAssociationofPublicHealthLogisticiansKEMSA KenyaMedicalSuppliesAuthorityKII KeyinformantinterviewKPIs KeyperformanceindicatorsLMICs Low-andmiddle-incomecountriesMSD MedicalStoresDepartmentNMS NationalMedicalStoresNMSF NationalMedicalSuppliesFundOSH OccupationalsafetyandhealthPtD PeoplethatDeliverPPE PersonalprotectiveequipmentPSA PamelaSteeleAssociatesPSPTB ProcurementandSuppliesProfessionalsandTechniciansBoard
(Tanzania)SCM SupplyChainManagementSOPsSoSoKE
StandardoperatingproceduresSouth–SouthKnowledgeExchange
TNA TrainingneedsanalysisUN UnitedNationsUSAID UnitedStatesAgencyforInternationalDevelopmentWHO WorldHealthOrganization
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1. IntroductionandrationaleManysupplychainorganisationshavebecomeincreasinglyawarethatsuccessfulSupplyChainManagement(SCM)restsontheperformanceofpeople.Thisviewwaspreviouslyovershadowedbyorganisations’focusontechnology,information,andmeasurementsystems.Recognisingtheimportanceofthepeoplewhomanagesupplychains—theirskills,motivations,andcapacitiesfordevelopment—isanessentialstepinanysupplychainimprovementinitiative.Humancapitaliscritical for supply chains’ effective functioning, which has prompted human resource (HR)practitioners and scholars to explore the nexus between HR management (HRM) and SCM.Empirical research has demonstrated the positive impact of HRM on SCM implementation,organisationalperformance,andcustomersatisfactionthroughstrategicmanagementofpeople’sknowledge,skills,andabilities(Gómez-Cedeñoetal.,2015;Hohenstein,2014).
TheimpactofHRMisparticularlyimportantinthecontextoflow-andmiddle-incomecountries(LMICs),whichoftenexperiencesevereshortagesintheirsupplychainworkforces(WHO,2010).WhilsttherehasbeenanincreasingfocusgloballyonHRforhealth,fewerinitiativesexploreHRinhealthsupplychains(mostnotably,thePeoplethatDeliver(PtD)andUnitedStatesAgencyforInternationalDevelopment(USAID)Deliverproject).Moreover,thereareoftengapsindataonsupplychainpersonnel,particularlyattheadministrativelevel, leadingtocapacitygapsgoingunnoticed(Comettoetal.,2014).MultiplegovernmentalinitiativesinSub-SaharanAfricahavesuccessfullyimplementedHRMpracticesandlong-termstrategiestoincreasethequantityandquality of health and supply chain professionals within countries. These approaches, whichcombine interactive and participatory training with the strengthening of health systems,demonstratethepotentialtoimprovetheperformanceofhealthandsupplychainworkforces.
In this context, the present study aims to broaden the HRM perspective and explore howtraditional HRM practices, such as recruitment and employee selection, compensation andbenefits, training and development, performance management, and cultural and diversitymanagement can underpin supply chain transformation. The backdrop for the study is theongoing implementation in Ethiopia of the supply chain transformation programme called‘Admas’(‘Horizon’inAmharic),whichisbeingexecutedbyPamelaSteeleAssociates(PSA)fortheEthiopianPharmaceuticalSuppliesAgency(EPSA).SupportedbytheBillandMelindaGatesFoundation (BMGF), the programme in its current phase aims to ensure clear performancetargetsforalltechnicalandadministrativepersonnelatEPSA,sustainablecapacitydevelopmentinitiatives,andasafeworkenvironment.ThepresentstudyaimstoidentifythebestpracticesinHRMactivitiescurrentlybeingimplementedacrossaselectgroupofsixcasestudyAfricansupplychainorganisations,inordertoidentifyapproachesthatcaninformandsupporteffectiveSCMandtransformation.
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2. MethodologyThe study adopts the traditional HRM framework of practices, such as selection, training,appraisal,andrewards,usedforemployeemanagementinorganisations(WrightandMcMahan,1992).ItalsofollowsthePtDHumanResourcesforSupplyChainManagementTheoryofChange,a framework that enables supply chain practitioners to trace the impact of investments andinterventionsinHRonhealthSupplyChainperformance(PtD,2018).ThisstudylooksatthefourpathwaysofchangeproposedbyTheoryofChangeandadaptssomeofitsindicatorstomonitortheeffectsofHRinterventions.
Themethodologyofthisstudyincludedthreecomponents:
1. Adeskreviewofliterature
ThestudycarriedoutadeskreviewofrelevantliteratureonHRpracticesandhealthSCM,whichincludespeer-reviewedarticles,andglobalprojectreportsandstudies.
2. Anonlinesurvey
Anonlinequestionnairewaspreparedtocollectresponsesacrossawidegroupofstakeholders,particularlylogisticsprovidersatthecentral,district,andstatelevels,aswellasimplementingpartnersandprivatesectorparticipantsinthehealthsupplychain.Invitationstocompletethesurveywerecirculatedthroughmultiplechannels,suchastheInternationalAssociationofPublicHealth Logisticians (IAPHL) platform and the South–South Knowledge Exchange network(SoSoKE).
Intotal,33completeresponseswerereceivedfromfivegroupsofkeystakeholders.Thesampleincluded:
• Officials fromtheministriesofhealth inKenya,Malawi,Nigeria,Somalia,andSouthSudan(19%);
• RepresentativesfromparastatalandcentralprocurementagenciesinEthiopia,Ghana,Liberia,Sudan,Nigeria,andTanzania(35%);
• Representativesfromdistrict-levelagenciesinGhanaandUganda(11%);• Representativesfromstate-levelhealthfacilitiesinNigeria(12%);• Representatives from the donor community andprivate charitable organisations in
Bangladesh,BurkinaFaso,Eswatini,Nigeria,Switzerland,andZambia(23%).
Thesemi-structuredsurveyfollowedtheTheoryofChangeframework,askingamixofclosed-andopen-endedquestionsonthestaffing,skills,workconditions,andmotivationpathways.ThestudycombinesquantitativeandqualitativesurveydatatoillustratethecommonalityofdifferentHRpracticesandmechanismsdiscussedinthedeskreview(Section1).
3. Keyinformantinterviews(KIIs)
Sixinterviewswerecarriedoutonline,viaZoomandMicrosoftTeams,withkeyHRprofessionalsin the six-case study parastatal health supply chain organisations in Africa,which have eachundergonesomeformofsupplychaintransformationinrecentyears.Thekeyinformantswereselected for their extensive knowledge of and experience in the HR processes within theorganisation,eitherinthecapacityofdirectororseniorofficer.TheinterviewswereguidedbythePSApolicyofconfidentialityandanonymity.Thefollowingtableprovidesabreakdownofthecountriesandorganisationsselectedforinterviews.
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Country Nameoftheorganisation
Ethiopia EthiopianPharmaceuticalSupplyAgency(EPSA)
Kenya KenyaMedicalSuppliesAgency(KEMSA)
Malawi CentralMedicalStoresTrust(CMST)
Sudan NationalMedicalSuppliesFund(NMSF)
Tanzania MedicalStoresDepartment(MSD)
Uganda NationalMedicalStores(NMS)
Table1.CountriesandsupplychainorganisationsthatwerethefocusoftheKIIs
The interviews form the central part of the case studies, providing a snapshot of the HRMmechanismsandpracticescurrentlybeingimplementedacrossthecasestudyparastatalsupplychainorganisationsinAfrica(Section2).Thedetailedfindingsfromthecasestudiesareorganisedby the four pathways of change of the PtDHumanResources for Supply ChainManagementTheoryofChange.A comparativesummaryof the findingsof thecasestudies ispresented inAnnex1.
Duetosevererestrictions,imposedbytheglobalpandemicofCOVID-19andtimeconsiderations,thesecasestudiesdonotseek topresentanexhaustivepictureofHRMmechanisms in thesesupplychainorganisations.TheirtaskistohelpaddressthepaucityofdetailedinformationaboutHRpoliciesandpracticesintheseorganisations,aswellasinformandencouragesknowledgesharingandknowledgetransferontrajectoriesforHRinterventionsthatseektoimprovehealthsupplychainsonthecontinent.
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3. Deskreviewandonlinesurvey
3.1 Pathway1:Staffing
Successfulrecruitmentisoftendescribedasfindingtherightpeoplefortherightrolesattherighttime.Achievingthese‘rights’isparamountforensuringeffectivesupplychainperformance.Therecruitment process needs to ensure that selected candidates possess the relevant skills andabilitiesinsupplychainfunctionsthatareessentialfortheorganisationtomanagesupplychainoperationsandtoachieveitscurrentandfuturegoals.RecruitmentisacriticalactivityfortheHRteamandlinemanagersandrequireseveryoneinvolvedtohavesufficientknowledgeandskillstomakeeffectiverecruitmentdecisions.
Theglobalshortageofhealthworkers,revealedbytheWHOin2006,continues(WHO,2006).In2016, the International Labour Office studyanalysed the employment potential of the healthsupplychainworkforce,particularlyinrelationtothedevelopmentofuniversalhealthcoverage.Itdemonstratedthat91%oftheshortfallinsupplychainpersonneloccursinLMICs,andevenmorecriticallyinAfrica(Scheil-Adlung,2016).ThishasputadditionalpressureonrecruitmentsystemsandprocessesinAfricanhealthorganisationstoselectthemostqualifiedhealthworkersandtoensureemployeeretentioninasituationinwhichthereisaninsufficientnumberofskilledcadres, and fierce competitionwith theprivate sector,which ismore successful in attractinghighlytrainedworkforce.
(i)Recruitmentprocess
Recruitment, as an HRM process, includes several stages, beginning with the analysis of HRrequirementsandendingwithanofferofemploymenttoselectedcandidates.TheUSAIDDeliverProjectdevelopedadetailedreferenceguideforrecruitingsupplychainprofessionals,providingtemplatesandsamplestosupportstrategicHRmanagementinhealthsupplychainorganisations(USAIDDeliver,2013).Thestandardsix-stepprocess,demonstratedinFigure1,aimstoprovideaflexibleapproachtorecruitinginordertoattracttherightpeoplewhocanpropelsupplychainperformance.Theoverwhelmingmajorityofouronlinesurveyrespondents(92%)indicatedthattheir respective organisations have put in place similar procedures to secure efficient,transparent,fair,andcompetitiverecruitment.
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Figure1.Standardrecruitingprocess
Source:AdaptedfromUSAIDDeliver,2013.
Step1:Planningrecruitment
Thefirststepoftherecruitmentprocessaimstoidentifythehiringneeds.Keydecisionsshouldbemadeaboutwhatstaffpositionsarerequiredtoeffectivelyrunthesupplychain,where,andatwhatlevel.Thisincludesidentifyingtheexistingvacancies,andanalysingjobspecificationsandrelevantcompetencyrequirements.Theanalysisofsupplychainneedsdependsonthestructure(regional/zonalordistrict/sub-district),design(departments/units),andthemanagementtype(in-houseoroutsourcing)ofthesupplychainorganisation.Settingupastrongrecruitingteamorcommitteeiscrucialforguidingtherecruitmentprocess.Thiscanincludearecruitingmanager,unitdirector,jobsupervisor,andtechnicalspecialistinthevacantjobposition.
Recruitingmanagerscloselymonitorthesourcing,interviewing,andemploymentprocess.Theysupervisetherecruitingcommittee,updatecurrentanddesignnewrecruitingprocedures,andcoordinatethehiringneedswithdepartments.Themanagersapproverecruitmentrequestformsused by department to communicate to the HR team the need to recruit new or additionalmembersoftheworkforce.
Step2:Review/developjobdescriptions
AnimportantstartingpointforaSupplyChainorganisationistodraftalistofcrucialsupplychainpositions and identify staffing requirements for these roles. Most of our survey respondents(94%) indicated thattheirrespectiveorganisationshadpreparedsuch lists.However,21%ofthemhighlightedthattheselistsdidnotspecifythenumberofemployeesrequiredtofillsupplychainroles.
Definingtherequiredjobsinvolvesgatheringinformationfromavarietyofsourcesaboutspecificoutputs of the job, aswell as skills and resources thatwill enable them. This information isdocumentedinajobdescription,whichspecifiesthepurposeoftherole,thescopeofdutiesand
1. PLAN RECRUITMENT
2. DEVELOPRECRUITMENT MATERIALS
3. ADVERTISEPOSITION
4. MANAGE ANDSCREEN CANDIDATES
5. INTERVIEW AND SELECT CANDIDATES
5. EXTEND AND CONFIRM OFFER
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responsibilities, qualifications and skills, working conditions and location, compensation andbenefits, etc. Most of the survey respondents (91%) highlighted that the job descriptionsdevelopedbytheirorganisationsincludedsuchkeyelementsas:
• Clearlydefinedanddetailedjobobjectives(93%);• Essentialprofessionalqualifications(90%);• Arangeofdecision-makingresponsibilities(71%);• Clearreportingrelationships(84%).
Thetaskofreviewingjobdescriptionsfallswithintheremitoftherecruitingcommittee,whichalso
• Decidesonhowtheproposedjobsfitintotheworkforceplanoftheorganisation;• Plansthewholerecruitingprocess;• Developsselectioncriteria(includinginterviewevaluation);• Makesdecisionsonjobadvertising;• Reviewsapplicationsforemployment;• Interviewsselectcandidates;• Extendsandconfirmsoffers.
Animportantfeatureofrecruitmentisacompetency-basedfocus.Thismeansthattheselectionprocessisaimedatidentifyingcandidateswhopossessvaluableknowledge,skills,training,andexperience that underpin their successful performance in supply chain roles. A competencyframeworksetsoutanddefinescompetencyareasandattributesthatserveaskeyperformanceindicators for employees in their expected roles and levels of performance. CompetencyframeworksandcompendiaarenowwidelyusedcomponentsofHRMforSCM:75%oftheonlinesurvey respondents indicated that their organisations followa competency framework in theprocessofdevelopingorreviewingjobdescriptions.
Step3:Preparingrecruitmentmaterials
The recruiting committee is also entrusted with developing materials that will guide therecruitmentprocess.Thesecaninclude:
• Areferenceandemployeebackgroundcheckquestionnaire;• An interview guide, detailing the roles of committeemembers and featuring a list of
questionstobeusedwheninterviewingtheselectgroupofcandidates(includinggeneralHRquestionsandspecialtechnicalinterviewquestions);
• Interviewselectioncriteria–achecklistformforselectingcandidatesforaninterview,whichspecifiesessentialcomponentsfordeterminingthebestqualifyingcandidates(e.g.thelevelofeducation,professionalcertificates,yearsofexperience,relevantskills,etc.,aswellascriteriaspecifictotheposition);
• Interview evaluation criteria – a form for assessing candidates’ performance at aninterviewand ranking candidates for the final employmentoffer (oftenusinga ratingsheetoramorecomplexcandidatecomparisonscorecard).
Step4:Advertising
Itisimportantthatjobadvertsgiveclearandaccurateinformationabouttheorganisationandthevacantposition.Theyshouldnormallycover:
• Ajobsummaryandoutlineofthecorecompetencies(orapersonspecification);• Thejoblocation;
17
• Thetypeofemployment(e.g.fixed-termorpermanentrole);• Theorganisation’sactivitiesandvalues;• Therewardandbenefitspackage,andpossibleflexibleworkingopportunities;• Applicationdeadlinesandinstructionsonhowtoapply.
Many supply chainorganisationssurveyed for thepresentstudy, including the six casestudyparastatalorganisations(Section2),adoptbothinternalandexternalmethodsofadvertising.Forcertain roles, HR departmentsmay decide to advertise positions internally. In this case, jobadvertswillbepostedonnoticeboardsintheorganisation’sheadquartersandhubsorsharedviacorporateemailandotherformsofinternalcommunications(e.g.companynewsletters).Ifthepositionisadvertisedoutsidetheorganisation,theHRdepartmentcanuseseveralchannelstoreachpotentialapplicants,suchas:
• Theorganisationalwebsite;• Commercialonlinejobboards;• NewspapersandlocalTVand/orradiostations;• Recruitmentagencies,careersportals,andprofessionalnetworkingsites;• Publicationsofacademicpartnerinstitutions.
Theonlinesurveyresultsdemonstratethatmany(67%)oftheorganisationsrepresentedbytherespondentsunderstandjobadvertising:theyuseprintedandonlinemedia,aswellaslocalradiostations,asanecessarypreconditionforensuringthetransparencyoftherecruitmentprocess.
Step5:Interviewingandselectingcandidates
Managingjobapplicationsandscreeningcandidatesisamulti-stepprocessthatincludes:
a) Reviewing all candidate applications to ensure they meet minimum requiredqualificationsandsubmittingthemtotherecruitingcommittee;
b) Selectingcandidates tobe interviewedby therecruitingcommitteebasedonrequiredcompetencies,featuredinjobdescriptionsandinterviewselectioncriteria;
c) Schedulingcandidatesforaninterview(whichincludesinformingcandidatesabouttheinterviewprocessandrequestingreferences).
Respondents to our online survey provided examples of recruitment procedures that aim toensurethatthecompetenciesofrecruitedindividualsmatchtherequirementsofcrucialsupplychainpositions.
Toestablishacompetency-basedapproachtorecruitment,therespondentshighlightedthatthefollowingmeasureswereemployedbytheirrespectiveorganisations:
• Assessingcandidates’relevanteducationalbackground,pastworkexperience(especiallyinpreviousSCMprojectsandpublichealthinstitutions),andprofessionalqualificationsandcertifications;
• Conductingspecialisedtests(writtenandoral)toverifytheleveloftechnicalskillsandfield experience of a candidate before the interview, or asking a range of technicalquestionsspecifictothepositionduringtheinterview;
• Includingproblem-solvingsimulationsandleadershipskillstestsaspartoftheinterview.
35%oftheonlinesurveyrespondentspointedtoperformanceduringinterviewsasbeingamongthemostdecisivefactorsforasuccessfuljobapplication.Atthesametime,42%ofrespondentsindicated that the recruitment process in their organisations concentrated more on theassessmentofrelevanteducationandthelengthoffieldexperiencethanontechnicalexpertise.
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Therespondentshighlightedthefollowingmeasurestakenwithintheirorganisationstoensuretransparencyoftherecruitmentprocess:
• Openandextensiveadvertisingofvacantpositions;• Communicatingjobrequirementsandinterviewprocedurestocandidates;• Employingamultidisciplinaryandmulti-stakeholderinterviewpanel;• Carefullyfollowingthroughallthestepsofthestandardrecruitmentprocedurewithout
cuttingcorners.
Therespondentsalsoindicatedthevarietyofstepsundertakenbytheirrespectiveorganisationstosecureafairandcompetitiveprocessofrecruitment,suchas:
• Establishingequalopportunitiesinemployment(especiallyonthegroundsofsex,race,andage);
• Takingallapplicants,bothinternalandexternal,throughthesameselectionprocesstoensurealevelplayingfield;
• Granting all candidates who meet the minimum job requirements a chance to beinterviewed;
• Selecting the best-performing candidate, taking into consideration the results of thewrittentestandperformanceattheinterview,aswellasrelevantqualifications.
Step6:Extendingandconfirminganofferofemployment
After the recruiting committee has selected the top candidate to fill the vacant position andnotifiedtheHRdepartment,aformalletterofemploymentisissued.Itnormallystates:
• Thejobtitle;• Salary;• Employeebenefits;• Startdateandprobationperiod(ifapplicable).
Inourcasesstudiesitwasfoundthatatthisstageorganisationsmayenternegotiationsovertheterms of employment with candidateswhose skills are in high demand, to reach amutuallybeneficialagreement.Ifnegotiationsfailoracandidatedeclinestheofferoutright,thenthenextcandidateontherecruitmentcommittee’sselectionlistismadeanemploymentoffer.Finally,theHRdepartmentprepares for and confirms the employment contractwith the new employee,notifiesothercandidatesthatthejobhasbeenfilled,andcommunicatestothejobmanagerthenewemployee’sstartdate.
(ii)Budgetforsupplychainstaffandpayscale
Clearpayandgrading scalesprovide a framework for administering employee compensationprogrammesthathelpbalanceinternalandexternalequity.Thisisinstrumentalinattractingandretainingemployeeswhocancontributetotheachievementofbetterhealthoutcomesinhealthsupply chains.Awell-designed salary structure also allows supply chainmanagers to rewardperformanceandskillsdevelopment. Inouronlinesurvey59%ofrespondentsacknowledgedthattheirorganisationsdidnothaveclearpayandgradingscaleslinkedtosupplychaincareers.Thisisachallengethatcanhaveanegativeimpactontherecruitmentprocessandlevelofjobsatisfaction. Also, 69% of respondents highlighted that the lack of salary benchmarks oftenbecomesasourceoffrustrationforemployees.Amongthebestpracticeswithintheorganisationsthathelp avoid thissituationandpresent clear and competitivepay scales to employees, thesurveyrespondentsindicated:
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• Governmentsalarybenchmarkingschemes;• Salarycomparisonsbetweenprivateandpublicinstitutions,aswellasmultinationaland
localcompanies;• Salarybenchmarkingforrelatedjobrolesandfunctionswithintheindustry.
3.2 Pathway2:Skills
(i)Trainingneedsanalysis(TNA)
ThepurposeofaTNA isto identify the traininganddevelopmentrequirementsof thesupplychain specialists by assessing their levels of skills and knowledge. A TNA helps to establishcompetencygapsthatimpedeperformanceinthespecialists’respectiverolesandthathindertheoverallefficiencyofthesupplychain.TNAallowsorganisationstodevelopinformeddecisionsonwhatlearningisneededatindividualandorganisationallevels,andtodraftatrainingplanandanorganisationaltrainingstrategytoensuresufficientcapacityforsustainingcurrentandfuturebusinessperformance.ATNAisamulti-stepprocess,whichcanbedividedintothreestages:pre-assessment,TNA,andpost-assessmentstrategyandplanning.
Figure2.StagesofTNA
AlthoughTNAsarebecomingmorecommonacrosssupplychainorganisations,theyarestilllessfar from universal. Only half of our survey respondents indicated that their respectiveorganisations conduct aneedsanalysis. Inmost cases,TNAsareperformedat the endof thefinancialyearandcoincidewithtraditionalemployeeperformanceappraisals.
STAGE 1
PRE-ASSESSMNET
STAGE 2
TRAINING NEEDSASSESSMENT
STAGE 3
POST-ASSESSMENT
§ Mapping out current knowledge and skills
§ Identifying business and staffing needs
§ Applying professional competency framework
§ Skills/knowledge gap analysis
§ Assessing current training provision
§ TNA report, featuring competency gaps and training constraints
§ Developing training strategy
§ Developing training plans (organisationaland individual)
§ Improved training provision
§ Continuous professional support and development
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Figure3.SurveyresultsonconductingaTNA Figure4.Surveyresultsonthefrequency
ofconductingaTNA
ThesurveyresultsindicatethatinmostcasestheTNAisconductedatdepartmentallevel(82%)andorganisation-wide(70%),whileindividualtrainingneedsofemployeesreceivelessattention(65%). The connection between TNA, planning, and training strategy is also becomingmoreevident:65%ofthesurveyrespondentsindicatedthattheirorganisationshaveastrategyorplanthatisinformedbyTNAs.
NumerousHRforhealthdevelopmentandtransformationprogrammes,implementedoverthepastdecade,haveattemptedtocorrect thisskewed focusonorganisationalrequirementsandachieveamoreintegratedandharmonisedapproachtoHRbyaligningorganisationalbusinessobjectiveswiththepersonaltraininganddevelopmentneedsofemployees.Thisisreflectedinindividual development plans, which help supervisors better understand employees’professional goals and development needs, assist organisations in identifying and planningtraining activities, and give employees more control and responsibility over their careerdevelopment.
Individualdevelopmentplansaresometimesusedasperformanceappraisaltools,buttheirrealpower lies in supporting employees’ professionaldevelopment. Individualdevelopmentplansleademployees toreflecton theircompetencies, strengthsandweaknesses,and toundertakelearning and capacitydevelopment activities (Smith and Tillema, 2013). The effectiveness ofindividualdevelopmentplansdependsontheirdesignandhowexplicittheirfocusisonlearninganddevelopmentpurposes.
(ii)Professionalisationframework
In general terms, professionalisationmeans theprocessbywhich anoccupation turns into aprofession.SCMspecialistshavebeenworkinginthepublicandprivatesectorsfordecades,butonly relatively recently has SCM come to be a distinct and complex professional field.Professionalisation has become particularly important in the context of strengthening healthsupplychainsystemsinAfrica,whichrequirestrongerprofessionalexpertiseandnecessitateamore formalisedapproach toactivities, skills,andunderstandingtheeffectivemanagementofsupplychains.Themaintaskofprofessionalisationistopreparehighlycompetentmanagersandpractitioners through training and careermanagement. Thismeans introducing standards ofeducationandcertificationofemployees,andcreatingpartnershipsbetweenkeystakeholders
Yes50%
No50%
DOES YOUR ORGANISATION CONDUCT TNA?
Annually 83%
Quarterly 17%
HOW OFTEN DOES YOUR ORGANISATION CONDUCT
TNA?
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(i.e. government, private sector, academia, business and professional associations, etc.) toestablishSCMasaprofessionaldiscipline.
In2019,USAIDGlobalHealthSupplyChain–ProcurementSupplyManagement(GHSC-PSM),inconjunction with PtD and South African Production and Inventory Control Society (SAPICS),beganpreparingaprofessionalisationframeworkforSCM,combiningmaterialonsupplychaincompetencies with the goal of generating what they described as ‘a paradigm shift’ for HRsystems.Theprojectstipulatesthattheproblemwiththecurrentapproachstemsfromthefactthathealth supply chainorganisationsdonot incorporate supply chain activitieswithin theirstrategicoperatingmodels,andHRdevelopment isnotalignedwiththeirstrategicobjectives.Thiscreatesasituationwheresupplychainactivitiesareperformedbystaffmemberswhodonothavetheessentialskillsorknowledgetoensureoptimalsupplychainperformance.
Professionalisationframeworkseekstoaddressalackof:
• GlobalstandardsforpublicandprivatehealthcareSCM;• Role-baseddefinitionswithcompetency-baseddescriptionsforSCMjobfunctions;• Standardsforskillsneedsanalysis,targetingcompetencygapsinthepublicandprivate
healthcareworkforce;• Afit-for-purposeandharmonisedlearningcurriculumthatpreparesindividualsforwork
withinahealthsupplychainenvironment;• Anindustrybodythatisresponsibleforprofessionalrecognitionofsupplychainworkers;• EthicalandaccountableSCMstandards,whichgobeyondthoseoftheorganisations’own
policies(dosSantosetal.,2019).
The core of the professionalisation framework will consist of an agreed-upon competencyframework,which is expected to align the private and public sectors. Thiswill allow for thedevelopmentofarangeofroles,withassociatedjobdescriptionstocapturetheframeworkandthe potential career progression within SCM, from ‘processor’ to ‘chartered professional’.Qualificationandcertificationwillhelpcementprofessionaleducationpathwaysforsuggestedjobrolesanddescriptions.Finally,acountryimplementationmethodologywillprovidepracticalsteps, with supporting tools on how to engage all relevant stakeholders in various countrycontextsinrelationtotheirprofessionalisationstrategies.
KIIs,conductedbyPtDin2019aspartoftheUSAIDGHSC-PSMproject,confirmedstronginterestof the health SCM community in the professionalisation framework, which has already beenevidentinsomepreviousinitiatives.Forexample,in2017,theSouthAfricanCapacityBuildingChiefDirectorateintheOfficeoftheAccountantGeneralestablishedtheinterimSupplyChainCounciltocoordinatetheinterestsofvariousSCMstakeholdersinthecountry,andtoestablishSCMasaprofessionaldisciplinewithin SouthAfrica. Furthermore, theNationalTreasuryhasdevelopedaSCMMasterLearningCurriculumandSCMQualificationDesignstandardthatdefinetheknowledgeandskillsrequirementforpublicprocurement(CBINews,2017).
Therespondentstoouronlinesurveyalsodemonstratedsignificantinterestintheconceptofaprofessionalisationframework:35%ofrespondentsstatedthattheirorganisationsareplanningtoapplyaformofprofessionalisationframework,andafurther18%indicatedthattheywereexploringtheUSAIDGHSC-PSMprojectandotherprofessionalisationinitiatives.
(iii)Communitiesofpractice
Onewayofpromotingtheprofessionalisationofsupplychainworkersisbycreatingacommunityof practice. This can be best described as a shared domain of interest where committed
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professionalscometogethertohelpandsupporteachother,shareinformationandideas,learn,andimprovetheirskills.‘Community’impliesabroadnetworkofmembersbuildingrelationshipsthatenablethemtointeractandlearnfromeachother.However,thisisnotmerelyaninterestgroup:theengagedmembersarepractitionersandtheirgoalistosharearangeofexperiences,techniques, tools, methods, andways of addressing recurring problems in their professionalroles.Therefore,acommunityofpracticecantakevariousforms,suchasmentoring,on-the-jobtraining, moderated discussions, webinars, publications etc. (Wenger-Trayner, 2015). Thediagram below demonstrates the popularity of various forms of community of practice, asindicatedbyoursurveyrespondents.
Figure5.Formsofcommunityofpractice
Among other forms of community of practice, the respondents highlighted supportivesupervision,workshops,andfieldmeetings.
3.3 Pathway3:Workingconditions
Organisational culture refers to the shared characteristics among people within the sameorganisation, including their values, behaviours, routines, traditions, and perspectives.Organisationalcultureisanimportantcomponentofcreatingasupportiveworkenvironment,providingawayforemployeestovoicetheirviewsanddevelopconnectionsandpurpose.Inasurveyofmorethan2,000peoplein50countries,65%ofrespondentsstatedthatculturewasmore important than strategy or operating model for an organisation’s performance(PricewaterhouseCoopers, 2018).Within the health sector, perceived injustice contributes toworker demotivation and has been shown to negatively impact patient care and the overallorganisationalclimate(Abrese-Akoetal.,2014;Manafaetal,2009).Conversely,apositiveworkclimatepositivelyimpactsorganisationalbehaviour(Jayasuriyaetal.,2014).
Therearenumerouswaystostrengthenorganisationalculture,includingidentifyingthecurrentcultureandhowitcanbeimproved,aswellasimplementingpoliciestocreateafairandsafeworking environment. Key policies to promote a positive organisational culture are outlinedbelow,aswellasbroaderwaysofstrengtheningtheoverallworkingconditionsandculture.Thisis followed by information on whistleblowing policies and establishing a safe physicalenvironment.
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Mentoring , 73%
On-the-job training, 88%
Moderated discussions, 45%
Webinars, 18%
Publications, 36% Other, 36%
Community of practice
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(i)Socialandemotionalenvironment:Implementingpoliciestosupportapositiveorganisational
culture
DrawingonacombinationofaliteraturereviewandguidancefromthePtDHumanResourcesforSupplyChainManagementTheoryofChange, thebelowpolicyareas(anoverarching codeofconduct,anti-harassmentpolicies,anti-discriminationpolicies,andpoliciesthatcreateagoodworkingenvironmentforwomen)wereidentifiedascriticalincreatingastrongorganisationalcultureorsupportiveworkingenvironment.
An overarching code of conduct or ethics. A code of conduct is a tool that can help ensureworkersatanorganisationareworkinginasupportiveandfairenvironmentwiththehighestprofessionalism.61%ofsurveyrespondentsstatedthattheyhadoneinplace.Acodeofconducthelpstoestablishethicalstandards,principles,andaprofessionalworkculture.Severalhealthsupplychainorganisations–includingNMSFinSudan,KEMSAinKenya,andEPSAinEthiopia–have their own specific Code ofConduct,which cover a range of areas, including corruption,harassment,dresscodes,andfairness(KEMSA,2015;NMSF,2015).
Figure 6. Survey results on the implementation of codes of conduct
Anti-harassment policies. The United Nations (UN) defines harassment as ‘any unwelcomeconduct thatmightreasonablybeexpectedorbeperceived tocauseoffenceorhumiliationtoanotherperson,whensuchconductinterfereswithworkorcreatesanintimidating,hostileoroffensiveworkenvironment’,anddefinessexualharassmentsimilarly,butincludesunwelcomecontactofasexualnature(UN,2019).42%ofsurveyrespondentsstatedthattheirorganisationhassuchpoliciesinplace.
Anti-discriminationorequalopportunitypolicies.TheUNdefinesdiscriminationas‘anyunfairtreatmentorarbitrarydistinction’basedonseveralcharacteristics,including(butnotlimitedto)race,sex,gender,ageandethnicorigin(UN,2019).48%ofsurveyrespondentsstatedthattheirorganisationhassuchpolicies inplace. Certain large international organisationshighlight theimportance of reporting any suspicions of misconduct, offering a ‘speak up’ helpline whichprovidesanonymousandconfidentialadvice,aswellasahotlineforreportingmisconduct(UN).Itisnottheresponsibilityofthereportertodecidewhethermisconducthasoccurred(Oxfam).Someorganisations,suchasEPSA,alsoemploydedicatedgenderandyouthequalityofficers.
Policiesthatcreateagoodworkingenvironmentforwomen,includingrecruitment.Policiesthat create a good working environment for women can include: hiring and promotion,challenging everyday discrimination (for example, mistakenly assuming a colleague is more
Yes 61%
No 39%
DOES YOUR ORGANISATION IMPLEMENT A CODE OF CONDUCT?
24
juniorthantheyare),andcreatingazerotoleranceenvironmentandclearproceduresaroundsexual harassment (Krivkovich et al., 2018). 52% of survey respondents stated that theirorganisationhaspoliciesinthisareainplace,thoughdidnotlistmanydetailsofthese.However,onerespondentinBurkinaFasonotedthattheirorganisationpromotedgenderandembracedtheidealsofsexualandreproductivehealth(includingfamilyplanning).
Otherfactorstocreateagoodworkingenvironment.Policiesshouldberegularlyreviewed(theUN reviews its anti-discrimination and harassment policy every two years at a minimum).Further,thereisaneedtodifferentiatebetweenhavingapolicyinplace,andthepolicybeingwellimplementedandwithstaffhavingfullawarenessofit. Inthesurveyresponses,stafffromthesameorganisationwouldoccasionallyprovidedifferentaccountsofthepoliciesinplace,implyingalackoforganisationalclarity.Additionally,onerespondentnotedthat,whilsttheythoughttherewereenvironmentandoccupationalsafetyandhealth(OSH)policiesattheirorganisation,theywerenotsureifthesewereinplace.
Trainingcanalsobeahelpfulwaytocreateawarenessofthedetailsandimportanceoftheabove-mentionedpolicies.52%ofsurveyrespondentssaidtheyworkedatorganisationsthatconducttrainingtocreateanoptimalworkenvironment.Examplesofthistrainingthatweregivenincludeonlinetrainingrelatedtoanti-discriminationandanti-harassment,andtrainingrelatedtohealthsafety,security,andtheenvironment.Onerespondentcommentedthattrainingisdonequarterlyandanothercommentedthatthattheyarerequiredtodotrainingandbecomecertifiedinrelationtotheorganisation’sCodeofEthics.
A2014TNAforNMSFinSudanemphasisedthedifficultyininfluencingstaffattitudesthroughshort trainingcoursesalone(NMSF,2017).Greater impact isobtained fromhavingapositiveorganisational culture, with clear values, principles, attitudes, and beliefs, as well as leaderssettingclearexamplesofhowthisculturecanbeputintopractice(NCIHD,2014).
There are numerous ways, beyond policies, to strengthen organisational culture, and a richliterature is available detailing how organisations have strengthened or changed theirorganisationalculture.EPSAhasrecentlyfocusedontransformingitsorganisationalcultureaspart of its overall transformation programme, working with PSA as part of the AdmasProgramme. This has included conducting a detailed culture assessment to investigate thecurrentorganisationalcultureinEPSA,andthegapbetweentheorganisation’slivedcultureanditsdesiredculture.Thisculturechangeisalsobeingfacilitatedbyinterventionssuchastheuseof cultural ambassadors to cascade the vision and shared values of theAgency and to act ascatalystsandadvocatesforchange.
However, the literaturespecificallyrelating tohealthsupplychain,oreven thegeneralhealthworkforce,andorganisationalculturechangeismorelimited.Morebroadly,companiesthathavesuccessfully changed their organisational culture have done so through taking the time tounderstandemployees'perspectivesandinvolvetheminplanning,emphasisingtheimportanceof employee pride and highlighting exemplary behaviour. The Harvard Business Reviewidentified five principles to facilitate organisational change: matching strategy and culture,focusing on a few critical shifts in behaviour, honouring the strength of the existing culture,integratingformalandinformalinterventions,andmeasuringandmonitoringculturalevolution(Katzenbachetal.,2012).
(ii)Whistleblowingmechanisms
Awhistleblowerisapersonwhoreportsordisclosesinformationofanywrongdoinginaworkcontext,topreventharmortoprotectthepublicinterest(EuropeanCouncildefinition).Several
25
Africancountrieshaverecentlyintroducedlegislationtoprotectwhistleblowers,includingCoted’Ivoire(2009),Ghana(2006),Morocco(2011),Mozambique(2011),andZambia(2010),thoughlawsareonlyonepartofthesolution(Moy,2018).
Most survey respondents reported that their organisation does not have a whistleblowingmechanisminplace(though39%dohaveoneinplace).Forthosewhodo,thisoccursviaanemailorahotline.Othermechanismsmentionedbysurveyrespondentsincludeaspecificemailsystemtoensureanonymity,complaintsboxes,andahotlinewithanonymousIDs,managedbyapartner.Otherrecommendationsforbestpracticesincreatingwhistleblowingchannelsinclude:
• Certain protections should be given towhistleblowers to avoid retribution (includinglegalprotection);
• Thereisaneedtoovercomeculturalbarriers(whistleblowersmaybeseenasdisgruntledemployeesorasmotivatedbyseekingmonetaryrewards);
• Stronginternalreportingsystems(independentand third-party); • Committingtoa‘speak-up’organisationalculture.
(iii) Physical environment: Establishing a safety and health management system, including
developingstandardoperatingprocedures(SOPs)
EffectiveOSHmeasuresarewidelyrecognisedasessentialcomponentsofworkforcehealthandproductivity (International LabourOffice, 2001).Workplace safety includesnot onlyphysicalthreats,butalsopsychosocial(includingstress)andgender-basedviolenceordiscriminationandcanbeveiledunderneathculturalnorms(Deussometal.,2012).
Effective OSH procedures are highly important. Failure by management to maintain safetystandardsisdemotivatingandcanshowalackofappreciationofemployee’swork(Abrese-Akoetal.,2014).Workplacesafetyisalsoakeynon-financialincentive(MinistryofHealthandSocialServices,2015)andapositivepracticeenvironmentcanhelptoincreaseworkermotivationandreduceOSHrisks(Deussometal.,2012;Shumbaetal;2017).
FromacombinationofaliteraturereviewandthePtDframework,thefollowingcriticalfactorswereidentifiedforcreatingastrongOSHenvironment(thefiguresinbracketsarethepercentageofsurveyedrespondentswhoseorganisationimplementsthese):
• Haveasysteminplacetodocumenthealthandsafetyissuesintheworkplace(42%);• Havearegularbudgetavailable toensuremaintenanceandrepairofworkplace items
(58%);• Ensurestaffhavethenecessarytoolsandequipmenttodotheirjobs(84%);• Ensurechecklistsarecompletedtoensurecompliancewithsafetystandardsinthework
area(45%);• Havehealthandsafetypoliciesandproceduresfortheorganisation(58%);• Conducthealthandsafetyriskassessmentsorevaluations(52%).
Staffhaving thenecessary toolsandequipmenttodo their jobswas themostcommonpolicyidentifiedbyrespondentsasbeingimplementedintheirorganisation.Respondentsoutlinedhowtheyimplementtraininginthisarea,includingonsafetyandkeepingtheorganisationclean(oneorganisationtrains125staffineachtopic),andtrainingoninfectionpreventionandcontrol.Onerespondentnotedthatchallengesinthisareaarenumerous,whichcreatesobstaclestohowtheorganisationworks.AnotherhighlightedthatOSHisappliedonlywhenworkersgointothefield(e.g.whendriversassessroads,terrain,andrisk),implyingthatitisnotappliedevenlyacrossthewholecountry/organisation.
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Otherways thataneffectivesafetyandhealthmanagementsystemcanbecreated includebyinitiallycollectingdataonwhatoccupationalinjuriesoccurandfindingoutfromhealthworkerstheirgreatestoccupationalhealthconcerns,andcreatinglegislationorregulatorystandardstoprovide a policy framework which empowers health workers to improve their operationalenvironment.
3.4 Pathway4:Motivation
EmployeemotivationisakeyHRstrategyandplaysacrucialroleinachievinganorganisation’svision. Motivation in health supply chains can be achieved when quality performance issupportedwithinthesystem,theworkforceisadequatelyincentivised,thereisgoodsupervisionandmanagementsupportemployees,competency-basedpromotionisfollowed,theorganisationdesigns a strong employee engagement and retention policy, and there exist disciplinaryguidelines.
EmployeemotivationisakeyHRstrategyandplaysacrucialroleinachievingtheorganisation’svision. Motivation in health supply chains can be achieved when quality performance issupportedwithinthesystem,theworkforceisadequatelyincentivised,thereisgoodsupervisionandmanagementsupportemployees,competency-basedpromotionisfollowed,theorganisationdesigns a strong employee engagement and retention policy, and there exist disciplinaryguidelines.
(i) Performancemanagement
Aneffectiveperformancemanagementsystemisabletoalignindividualemployeegoalswiththeorganisational goals to positively impact supply chain performance and improve healthoutcomes.KeyPerformanceIndicators(KPIs)supportsupplychainmanagerstounderstandtheworkforcesituationandareeffectivewhenappliedconsistentlyandcomprehensively(BeanandGeraghty, 2003). A good KPI is one that is sparse, drillable, actionable, owned, referenced,correlated,balanced,aligned,andvalidated(Eckerson,2009).
The survey revealed that 73% of the respondents confirmed the presence ofperformance management systems in their health supply chain organisations (Figure 7).Some of the best practices in this area indicated by the respondents include the use ofperformance indicators, annual appraisals to reinforce performance through abalancedscorecard (BSC), conducting review meetings, and continual investment in HRdevelopmentandmanagement,therebyimprovingemployeemotivationandperformance.
27
Figure7:Surveyresultsontheimplementationofperformancemanagementsystems
68% of the survey respondents also indicated that their organisations have a performancemanagementprocessforidentifyinganddocumentingpoorperformance.Additionally,KPIsareinplacetostrengthenperformancemanagementandensurealignmentwiththestrategicplan.However,thisisnotastandardpracticeanddifferencesexistsbetweenpracticesinthepublicandintheprivatesector.
(ii)Incentives
Financialandnon-financialincentivescanimprovesupplychainpracticesthroughimprovedstaffmotivation, enhanced collaboration, and increased investment in health supply chaininfrastructure(SpisakandMorgan,2014).ProperuseofincentivescanimproveteamworkandadherencetoSOPs,andcanstrengthenaccountability(Vujicicetal.,2004).Financialincentivesareanimportantmotivatingfactorforhealthworkers,especiallyincountrieswheregovernmentsalariesandwagesareinsufficienttomeetthebasicneedsofhealthworkersandtheirfamilies(Dieleman et al., 2003; Martinez and Lindsay, 2007). Non-financial incentives are needed tocompleteapackagethatwillattracthealthworkers–especiallytoruralandremoteareas–andencouragethemtostayintheworkforce.Thelackofprofessionaldevelopmenthas,likewise,beencitedasareasonforjobdissatisfaction(Bolgeretal.,2005).
The survey identified a range of tools that are currently being used to incentivise the healthsupplychainworkforce.Financialsupportforcontinuingprofessionaldevelopment,partnershipwithlocaluniversities,paidstudyleave,funder-basedcertification,approvalfortheacquisitionofrelevantcertificationsalignedtothePtDtheoryofchange,andperformance-basedincentivesare all used to incentivise the workforce. Donor support for incentives is considered an‘exceptional measure’ that might otherwise be deemed unsustainable (Palmer, 2006). Theutilisation of performance-based contracts to improve workforce participatory spaces forinformationandfeedbacksharinghasbeenencouraged(WHO,2017).Rewardsandincentiveslikepaymentofmembershipfeestosomesupplychainprofessionalbodiesareusedtopromotea culture of performance. However, a robust incentive policy should also be supported byleadershipatalllevels.Withoutthissupportitwillnotbepossibletomotivatethesupplychainworkforce.
Yes73%
No27%
DOES YOUR ORGANISATION HAVE A PERFORMANCE MANAGEMENT SYSTEM?
28
(iii)Goodsupervisionandmanagement
Supervision,includingadequatetechnicalsupportandfeedback,canimprovethemotivationofhealth supply chainprofessionals.The survey revealed thatmonitoringand supportive visits,mentoringandcoachingprogrammes,systematicsupervision,andmoderateddiscussionsareallimplementedby the respondents’ organisations. Similarly, the survey resultshighlighted thatorientation programmes for new recruits have proved effective to maintain supportive linemanagement.
(iv)Promotions
Promotions are an effective tool to identify, develop, and manage work performance(Schippmannetal.,2010;PosthumaandCampion,2008;Campionetal.,2011).McClelland(1973)isoftencreditedwithlaunchingthecompetencymovement,whichisatthecoreofallpersonnelmanagement activities. Designing competency-based promotion systems can foster anenvironment of improved performance and can help an organisation to outperform itscompetitors(Audenaertetal.,2009;Morgesonetal.,2009).
Accordingtothesurveyresults,59%oftherespondentsfeltthattherearenotenoughpromotionopportunitiesfortheworkforce.Promotionsareeitherlinkedtothenumberofyearsinthejobrole,ortiedtothestatecivilservicescheme,orfollowachainoftheorganisationalhierarchy.Thelimitationsimposedbytheover-bureaucratisationofpromotionsresultinafragmentedsystemandlowerlevelsofstaffmotivation.Theliteraturesuggeststhatimprovedperformance-orientedmanagement practices and stronger links between competencies and promotions can helpresolvesomeissuesinthisarea(Chimwazaetal.,2014).
(v)Employeeengagementandretention
Employee engagement is seen as an importantmotivator to improvework efficiency and jobsatisfaction (Schaufeli et al., 2002). Scholarship suggests that development opportunities,communicationchannels,rewardsandrecognition,andemployer’ssupportimproveemployeeengagement(KhalifehandSom,2013;MaceyandSchneider,2008).Autonomy,clarityinroles,decision-makingfreedom,andunityofdirectionarecloselylinkedwithemployeeengagement(Kweninetal.,2013;Richetal.,2010).Traininganddevelopmentopportunities,financialperksandacompetitivepaystructure,anenablingorganisationalculture,positivefeedback,andthestyleofleadershipcaninfluenceemployeeengagementandretention(Guoetal.,2015;PaulandAnantharaman,2003;Zingheimetal.,2009).
Only 44% of the survey respondents indicated the existence of employee engagement andretentionpoliciesintheirorganisation(Figure10).Retentionallowanceslikehousingfacilities,transportation, and health insurance coverage were found to be currently in place to retainemployees. A democratic leadership stylewas found to influence employee performance andsupporttheretentionofhigh-skilledemployees.
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Figure10:Surveyresultsontheimplementationofemployeeengagementandretentionpolicies
It is also important for organisations to conduct a staff satisfaction survey to understandemployeemotivationandretainemployees.59%ofrespondentstoouronlinesurveyreportedthatnosuchsurveyisconductedintheirorganisation.
(vi)Disciplinarypolicyandpractice
91%ofthesurveyrespondentssaidthattheirorganisationhasastandarddisciplinarypolicyandpractice in place (Figure 11). This is guided by disciplinary procedures providing a range ofpossibilities, fromwarnings throughtodismissal,dependingontheseverityand frequencyofresponses.Disciplinarycontrolalsoinvolvespromotingandremovingpersonsfromservicesandprovidingguidelinestoallstaff.
Figure11:Surveyresultsonwhetherastandarddisciplinarypolicyandpracticeisinplace
Yes44%No
56%
DOES YOUR ORGANISATION HAVE AN EMPLOYEE ENGAGEMENT AND RETENTION POLICY?
Yes91%
No9%
DOES YOUR ORGANISATION HAVE A CLEAR DISCIPLINARY POLICY AND PRACTICE?
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4. Organisationalcasestudies
4.1 ETHIOPIA:EthiopianPharmaceuticalSupplyAgency(EPSA)
EPSAwasestablishedin2007(underthenamethePharmaceuticalsFundandSupplyAgency)asa
governmentorganisationundertheEthiopianMinistryofHealthwiththefollowingthreeobjectives:
to enable public health institutions to supply quality assured essential pharmaceuticals as
affordablepricesinasustainablemanner;toplayacomplementaryroleindevelopinghealthservice
expansion;andtocreatetheenablingconditionsfortheaccumulationoffundsinitsrevolvingand
cost-recoverypractice.
4.1.1 Pathway1.Staffing
Jobdescriptionsforsupplychainpositions
JobdescriptionsforpositionsinsupplychainoperationsaredraftedprimarilybyEPSA’stechnicalcommitteeandsubmittedtotheCivilServiceCommissiontoassignandapprovethejobgradeand the salary scale. For supportingpositions, such asHR, finance, and general services, jobdescriptionsandthegradingsystemarepreparedbytheCivilServiceCommissionandalignedwithothercivilserviceorganisationsinthecountry.Indraftingjobdescriptions,theCommissionappliestheformalcriteria,suchasqualification(diploma,bachelor’sdegree,master’sdegree,orPhD), and years of experience. The Commission does not utilise the competency frameworkdevelopedbytheAdmasProgrammein2019,ortheTNAwhichwasconductedatEPSAbyPSAinthesameyear.Instead,thecompetencyframeworkisemployedinthedevelopmentofcapacitydevelopment activities, employee promotion, and transfer. Effectively, this means that thecompetencyframeworkisnotyetfullyintegratedintotheHRmanagementatEPSA,anditcomesintoplayonlywhentheAgencyseekstobridge theskillsgapsof itsemployeesandtodesignsustainablecapacitydevelopmentinterventions.
Recruitmentprocess:advertisingvacanciesandselectingcandidates
JobvacanciesinEPSAareadvertisedinthegovernmentnewspaperandpostedonnoticeboardsinEPSA’sheadquartersandhubs.SalariesforadvertisedpositionsaredecidedonbytheCivilServiceCommissionaccordingtojobgradesandpayscalesestablishedforinstitutionsundertheauspicesoftheMinistryofHealth.NospecialmarketsalaryanalysisisnormallyconductedbeforerecruitmentasEPSAadherestothegovernmentalsalarystructure.
The Civil Service Commission Recruitment and Promotion Guideline stipulates that priorityshouldbe given to filling vacancieswithinEPSA from its existingworkforce. It is only in theabsenceofaninternalcandidatewiththenecessaryqualificationsandexperiencethatthejobcanbe advertisedpublicly. In practice, the decision onwhether EPSA should conduct internal orexternalrecruitingismadeonacase-by-casebasisbythehiringmanager,inconsultationwiththeHRdepartment.However,preferenceisoftengiventointernalrecruiting.
As part of the recruitment process, the HR department usually conducts a written test, aninterview,andanassessmentofspecifictechnicalskills,ifrequiredbythejobdescription.TheCivilServiceCommissionRecruitmentsGuidelinerecommendsthatthetestshouldbetakenatawell-knownhighereducationalinstitutionwithatestingcentre.EPSAnormallysendscandidates
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to sit the test at Addis Ababa University and the results are transferred back to EPSA’s HRdepartment.
Thecrucialphaseofrecruitmentistheinterview,whichisconductedafterthecandidateshavesuccessfully passed the written test and havemet theminimum education and qualificationrequirements.The interviewpanel (orcommittee)comprises thehiringmanager,director,orteamcoordinatorofthedirectoratewherethevacancyhasbeenannounced,andarepresentativefrom the HR directorate. EPSA does not have a standing recruiting committee, and for eachvacancyanewcommitteeisformedonanadhocbasis.Education,professionalqualifications,and the length of experience are themost important criteria in the selection process of therecruitingcommittee.HRspecialistsmeticulouslycountthelengthofexperience,uptomonthsanddays, todistinguishbetween candidateswith a similar level of educationorprofessionalcertification.
4.1.2 Pathway2.Skills
Training,andcapacitybuildinganddevelopment
ThecompetencyframeworkandTNAweredeveloped/conductedbytheAdmasProgrammein2019.FollowingtheTNA,PSAworkedwiththeCapacityBuildingDirectoratetodraftanannualcomprehensivetrainingplan.ThisplanhasnowbeenendorsedbyotherEPSApartners,followinga validation workshop, in which the EPSA Capacity Building Team collected feedback andincorporatedinputfromEPSApartners.TheAgencyiscurrentlyimplementingtrainingactivitiesbasedonthisplan,andPSAhassupportedthedevelopmentofthetrainingstrategyforEPSA,which is now being finalised. This strategy integrates all the deliverables of the AdmasProgramme,beginningwiththecompetencyframework,TNA,individualdevelopmentplans,andatrainingcurriculum.CapacitydevelopmentinEPSAisoftenorganisedintheformoftraditionaloff-the-jobclassroomtraining. Trainers are invited from local academic institutions, although EPSA has not yetestablished formal partnerships with these institutions. The Capacity Building Team hasorganisedresearchforumstoengageandpromoteresearchthroughAddisAbabaUniversityinabidtoimprovetheexposuretoacademiaandresearch.PSAisalsohelpingEPSAtoexpandthestaffcapacitydevelopmentthroughtheTrainingandResourceCentre,adedicatedlearningandtraininghubthathasbeenestablishedinEPSA. Professionalisationframework,mentoring,supervision,andon-the-jobtraining
Aprofessionalisationframeworkandcommunityofpractice,aswellascoachingorsupervision,are not common in EPSA, or in the Ethiopian supply chain sector more widely. The AdmasProgrammeaimstoinstitutionalisementoring,supervision,andcommunitiesofpracticeundertheTrainingandResourceCentre.Currently,PSAsubjectmatterexpertsaretheonlyoneswhoofferstructuredon-the-jobtrainingintheAgency.
4.1.3 Pathway3.Workenvironment
Organisationalcultureandworkenvironment
EPSA has recently focused on changing its organisational culture and has conducted anorganisationalculturediagnosticassessment(concluded inAugust2019).EPSAhascreatedateamfromdifferentdirectoratestofocusonthisarea,aswellasateamofculturalambassadors,tohelpcascadetheorganisation’svaluesandmission.However,theplannedactivitiesforcultural
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change,suchasrollingouttheculturalambassadors’programmetotheregionalhubs,havebeenslowedduetotheCOVID-19pandemicandrelatedrestrictionsinplace.
Useofpolicies
EPSAhasarecentlyupdated itsCodeofConduct.ThisCode isprinted inhardcopiesand theEthicsDirectoratehasaplantorollouttheCodeofConductandtosupportitsimplementation.Additionally, EPSA follows the Ethiopian civil service disciplinary policy.Whilst EPSA has noseparatepoliciesrelatingtoanti-harassment,anti-discrimination,orhealthandsafetyetc.,theCodeofConductdoesincludesomeinformationontheseareas.
Supportingwomenandmembersofminoritygroups
EPSAhasaGenderandYouthDirectorateandfollowsaffirmativeactioninrecruitment,training,andothersimilaractivities.TheAgencyrecentlyconductedajobevaluationandgradingactivity,inwhichwomenweregivenafewmorepercentagepointsasanaffirmativeaction.Thisactionledtomorewomentakingupleadershippositions,includingthedirectoroftheorganisation.Thiswillbefollowedbyfurtheraffirmativeactiontoprovidewomenwithanopportunitytoassumehigher positions in supply chain operational roles and supporting administrative roles.Additionally, as part of the Civil Service Commission regulations, EPSA practises affirmativeactioninrecruitment.
Creatingasafeworkplaceenvironment
EPSAhasanOSHSOP(twotothreepagesinlength),aspartofitsHRManualSOPs.EPSAdoesnot have an overarching systematic approach to health and safety, though it does conductactivities in this area as part of its qualitymanagement activities and different initiatives toimproveoperations.Variouspartnershavealsocreatedinitiativesregardingoperationalhealthandriskassessments.
Whistleblowingmechanism
EPSAdoesnotcurrentlyhaveawhistleblowingpolicybutitplanstocreateone.
4.1.4 Pathway4.Motivation
Performancemanagement
To improve work performance, EPSA has established corporate and directorate-level KPIsgoverned by the Monitoring and Evaluation Framework, a policy document guiding EPSA’sperformance management. The KPIs have supported better understanding of team targets,thereby acting as an important tool to motivate employees.However,cascadingdepartmentalKPIsdowntoindividualKPIshasbeenachallenge.Asaresult,performance appraisalscurrently lack objectivity, comprehensiveness, and linkagestothedirectorateorteamgoals.Incentivepolicy
Atpresent,EPSAhasnoperformance-basedincentivesinplace.,Performanceappraisal
TheBSCwasimposedbytheCivilServiceCommissioninEthiopiaasaperformancemanagementtoolforgovernmentalorganisations.EPSAimplementstheBSCbuthasnotyetstandardiseditsuse across all directorates. EPSA’s Planning, Monitoring and Evaluation teamis currentlysupportingthedirectoratestoachieveuniformityintheapplicationoftheBSC.
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CareerpathsandpromotionopportunitiesStrictly speaking, EPSA does not have a system of career pathways and structured careerprogression linked to vertical and horizontal development of expertise.What does exist is astraightforwardpromotionsystembasedonavailablevacancieswithindirectorates.Anyonewhomeetstheminimumrequirementsforthevacantpositionisconsideredeligibleforpromotion.Asaresultofthissystem,anHRspecialistcanbetransferredtoanewjobintheEthicsDepartment,oraspecialistintheEthicsDepartmentcanbepromotedtoapositioninGeneralServices.
Retentionandengagementpractices
The apparent lack of career progression impacts the motivation and engagement of staff,increasing the staff turnover. At the individual level, employees do not have a career orprofessionaldevelopmentplanandtheemployeeturnoverisparticularlyhighamongtechnicalexpertsandpharmacists.Intheabsenceofemployeeretentionpoliciesattheinstitutionallevel,EPSAisgraduallylosingitshighlyskilledworkforcetopartnerinstitutionsandtheprivatesector.
Supervisorysupport
Currently, there is no formalmentoring, coaching,andstructured supervision at EPSA.In theabsence of SOPs for mentoring across EPSA,PSA subject matter experts havebeen abletointroducementoringsupportthroughasystemofworkshops.Promotingsupervisorysupportis hindered by differences in leadership and management styles across EPSA directorates,resultinginthelackofauniformmentoring,teamsupport,andfeedbackmechanism,whichoftenreliesmainlyonthedirector’sorsupervisor’sinitiative.Disciplinarypolicyandpractice
EPSAfollowstheCivilServiceDisciplinaryCodeofConduct.Staffsatisfactionsurvey
EPSA conducts a staff satisfaction surveyannually.In the 2018/19financial year,the staffsatisfaction levelwasnear58%,asindicatedinEPSA’sannualreport.Similarsurveysarealsoconductedacrossdifferentcorporatelevelsandhubs.
4.2 KENYA:KenyaMedicalSuppliesAuthority(KEMSA)
KEMSAwasestablishedasastatecorporateorganisationin2005.ThroughanactoftheKenyan
Parliament,KEMSAbecamean‘authority’in2013,withthemandatetoprocure,warehouse,and
distributedrugsandmedicalsuppliesforpublichealthprogrammesandtofulfilothertasksrelated
to the public health supply chain. KEMSA employs a not-for-profit, self-sustaining, commercial
businessmodel.,which is alignedwithKenya’s devolvedgovernance system. Its supply system is
demand-driven:thecountry’shealthfacilitiesorderandpayformedicinesandacquiredfundsare
puttowardsreplenishingKEMSA’sstock.
4.2.1 Pathway1.Staffing
Jobdescriptionsforsupplychainpositions
KEMSAhas12 jobgrades, ranging fromthe topmanagementrole inGrade1(chiefexecutiveofficer(CEO)tothelowestpositioninGrade12(shopflooremployees).Everypositionineach
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gradehasajobdescriptionandaclearcareerprogression.Todraft jobdescriptions,establishcareer progression, andproduce theHRManualKEMSA requested assistance from the StateCorporationAdvisoryCommittee.Jobdescriptionsfollowacompetencyframework,whichdetailsspecificcompetencyrequirementsforvariousjobfamiliesinKEMSA,suchaspharmacists,supplychainspecialists,HRspecialists,etc.
Recruitmentprocess
TherecruitmentprocessfortopmanagerialpositionsinLevel1(CEO),Level2(directors),andLevel 3 (managers) is completed by an external recruiter. For this task KEMSA normallyapproachesPricewaterhouseCoopers,Deloitte,orKPMG.Althoughtherecruitmentprocessandrelated arrangements are made by these professional services companies, the candidatesapplyingforpositionsinthesethreelevelsarenormallyinterviewedinKEMSAbytheBoardofMembers,whichincludestheCEO,directors,andmanagers.
RecruitmentforjobrolesbeginningatLevel4anddowntoLevel12isconductedbyKEMSA.Theprocessbeginswithcollectingrecruitmentrequestsfromdepartmentsthatcompleterequisitionforms,whicharethentakentotheHRdepartmentandlatersubmittedtotheCEOforapproval.ForallnewpositionstheHRdepartmentproducesajobdescriptionandrecruitmentschedule.Dependingonthelevel,certainpositionswillonlybeadvertisedonKEMSA’swebsite,orindailynewspapers. Prospective applicants arenormallygivenbetween14and21days to apply forvacancies. Subsequently, the HR department compiles the long list of eligible applicants anddevelopscriteriaforshortlistingcandidates,whoarecalledforaninterview.Theshortlistingisconductedbyaspecialpanel,appointedbytheCEO.
Theinterviewpanelitself isalsoappointedbytheCEO.It isnotastandingcommitteeanditsstructure varies depending on the job vacancy. For example, if the organisation recruits forpositionsinLevel4,whichrequireacandidatetohavearelevantdegreeandupto10yearsofexperienceinasimilarjob,theCEOwilljointheinterviewpanel,togetherwithaspecialistinthesametechnicalareaastheinterviewedcandidate.IfKEMSAisemployingaprocurementofficer,aprocurementspecialistwillbeinvitedtojointhepaneltoaskspecifictechnicalquestionsanddeterminethelevelofprofessionalexpertiseofthecandidate.Thepanelwillalsoinclude:1)anHRspecialist,whowillposespecificHRquestions(e.g.education,certifications,past training,etc.); and 2) a representative of the department where the candidate will eventually work.Dependingontheleveloftheadvertisedposition,thiswillbeeithertheheadofthedepartmentorassistantheadofthedepartment.
Aftertheinterviewandbeforeissuingaformalofferthedetailsofemploymentarefinalisedwiththe selected candidates. If successful candidates have questions or requests, the HR beginsnegotiationstocometoamutualagreementonalltermsofemploymentbeforesigningacontract.After recruitment is completed, new employees undergo a one-week induction programme.DuringorientationsessionsKEMSA’soperationsareexplainedandtheemployeesareintroducedtoeverydepartmentwithintheorganisation,aswellastotheircolleaguesandlinemanagers.Newemployeesareputona90-dayprobationperiod,bytheendofwhichKEMSAconductsaperformancereview.
KEMSAemploysbothinternalandexternaltypesofrecruitment.IftheHRdepartmentidentifiesthattheorganisationmayhavesuitableinternalcandidatesforthevacancies,thesepositionsareadvertisedinternally.Afterreviewingthequalificationsofinternalapplicants,theHRorganisesapanelforasuitabilitytest,lookingspecificallyintoqualificationsandskills,thelengthofworkexperienceinKEMSA,pastperformance,anddisciplinaryrecords.ForcertainpositionsKEMSA
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organisesexternalrecruitment,thoughalsoencouraginginternalcandidatestoapply.Inthiscase,bothinternalandexternalcandidatesgothroughthesamerecruitmentprocess.
Asagovernmentinstitution,KEMSAisguidedbystateregulationsonsalariesandremuneration.Theguidelinesspecifyasalaryrangeforpositionswithintheorganisation.KEMSAhasanine-bandpaystructure.Thismeansthatittakesanemployeenineyearstofinishtheband,iftheybegintheircareerinthecurrentpositionatBand1.Whileconductingasalarystructurereview,KEMSAlooksattherecommendationsprovidedbytheSalariesandRemunerationCommission,andatpaymentsofferedbyotherparastatalorganisations,andconductssalarymarketresearchfordifferentjobfamilies.Astheagencyemploysmanypharmacists, labtechnicians,andothertechnical personnel, it is necessary to research the salary market before advertising newpositions.Atthesametime,KEMSAallowscandidatestonegotiatethesalary,iftheydonotagreewiththetermsbeingoffered.
4.2.2 Pathway2.Skills
TNA
InKEMSAaTNAisconductedannually.Thefinancialyearbeginson1July,andtowardstheendoftheyeareverydepartmentdraftsanannualworkplan.ThisincludesSectionC,whichspecifiestrainingneeds.The information for theTNA isgathered throughperformance appraisalsandemployeerequestsfortraining,whicharefirstreviewedbysupervisorsandthenapprovedbyheadsofdepartments.Performanceappraisalsareconductedtwiceayearandhelpidentifyskillsgaps.Employeesalsocommunicatetheirtrainingneedstosupervisors,whicharereviewedbyheadsofdepartments.
Subsequently, training requests are submitted to the Training Committee in KEMSA, whichsynchronises training for the whole organisation. For example, if the Committee receives arequestfortrainingincustomerserviceforacertainnumberofemployees, itwillconsultthetrainingcalendarfortheyear,andtheavailablebudget,andwilldecideonhowmanyemployeescanbetrainedduringthecurrentyearandhowmanyshouldbescheduledforthefollowingyear.
Capacitybuildinganddevelopment
Employees in all managerial positions must undertake mandatory management training.According to Kenya’s Public Service Commission Standards, employees in top managementpositions (Level 1 –CEO;Level2 –directors)undergo a leadership training course inoneofKenya’sgovernmentschools.EmployeesinLevel3and4canundertakeeitherathree-orfour-monthmanagerialtraining.Thestaffareofferedastudyleaveforthedurationofthetraining.
Asfarastechnicalpersonnelareconcerned,KEMSAhasaprogrammeofcontinuousprofessionaltraining.Technicalprofessionshaverespectiveprofessionalbodies,whichnormallyofferspecifictypesoftrainingandprofessionaldevelopmentprogrammes.Everymemberoftechnicalstaffisexpectedtotakeacertainnumberofcoursestocollectenoughpointstobeawardedapractisingcertificateforthefollowingcalendaryear.Forexample,HRspecialistscantakecoursesattheInstituteofHRManagement,accountantsareofferedprogrammesbytheInstituteofCertifiedPublicAccountantsofKenya,andprocurementspecialistsalsohavetheirownprofessionalbodythatprovidescertification.
Atpresent,KEMSAoutsourcesallthetrainingandtheagencydoesnothaveadedicatedtrainingcentreformembersofstaff.
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Professionalisationframework,mentoring,supervision,andon-the-jobtraining
KEMSAconductscoaching,mentorship,andon-thejobtraining.Theresponsibilityforconductingtheseactivitieslieswithheadsofdepartments.Adecisiononmentorshipandsupervisionistakenjointlybyheadsofdepartments,supervisors,andindividualmembersofstaff.
KEMSAdoesnothaveaprofessionalisationframework.However,KEMSAsupportsprofessionaldevelopmentoftheworkforcebyencouragingthemtoacquirediplomas,Master’sdegreesandPhDs,whichaddpointstotheiroverallscoreinperformanceappraisals.IfKEMSAemployeesareenrolledinacourse,theycanleaveworkearlytoattendeveningclassesandtheyareoffereddaysofleavetositexaminations.However,noadditionalmonetarysupportisprovided.
4.2.3 Pathway3.Workenvironment
Organisationalcultureandworkenvironment
The key informant interviewed about the work environment in KEMSA stated that theorganisation has a very dynamic culture and a sense of belonging, which motivates staff.Additionally,relationshipsbetweenstaffandsupervisors,headsofdepartments,andtherestofthemanagementareveryimportanttotheorganisation.
KEMSAhas anOSHsection andworkplaces are registeredby theDirectorateofOccupationalSafetyandHealth.Theorganisationhasadresscode,includedintheCodeofEthics,whichguidesstaffoncreatingagoodworkenvironment.KEMSAprovidesaconflictofinterestformforstafftosigninsituationsofpotentialconflictsofinterest.
Atpresent,KEMSAdoesnothaveastaffcanteenonitspremises,butthereareplanstoconstructoneby2021.Theorganisationalsoplanstobuildadedicatedstaffrecreationarea,withsportsfacilities.Thereareothernon-financialincentivesinplace,suchasguestdinnerswiththeCEO.
Useofpolicies
KEMSAimplementsthefollowingpolicies:
• An OSH policy implemented with the Directorate of Occupational Safety and Health(withinKenyantheMinistryofLabour).
• ACodeofEthicscreated jointlywith theElectronic IndustryCitizenshipCoalition, theCommissioninchargeofissuesrelatingtoethicsandintegrity.NewstaffmustsignthistocommitthemselvestoupholdingintegrityandapplyingethicsatKEMSA.SuppliersthatareawardedatendermustalsosignanagreementstatingthattheycommittolegalandethicalpracticewhilstworkingwithKEMSA.
Onceapolicyhasbeenauthorised(includingbeingsanctionedbytheBoardandtheCEO),itisthencommunicatedtomembersofstaffandlaunchedonastartdate.ThenewpolicyisputinasharedfolderinKEMSA’sintranetforstaffmemberstoaccess,print,andshare.MostpoliciesinKEMSAarereviewedeverytwoyears.
Supportingwomenandmembersofminoritygroups
KEMSAhasaGenderMainstreamingCommittee(alongsideothermainstreamingcommittees)whichinvestigateshowKEMSAcanensurethatbothwomen’sandmen’sinterestsandconcernsarenotcompromisedinanyway.KEMSAfollowsthe70:30male/femalecompositionprincipleandconsidersgenderwhenrecruiting,aswellaslookingattheratioofwomentomeninKEMSAandthegendersplitatdifferentlevels.Thisincludesquestioningandusingdisaggregateddata
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on, forexample,howmanywomenoccupydirectorialandmanagerialpositionsorhowmanymenareemployedinthelowerposts.
KEMSAsupportsminoritygroups inprocurement(includingyouth,women,andpeople livingwithdisability).KEMSAalsohasaDisabilityMainstreamingCommittee,whichexamineshowtheorganisation can support employees with disabilities in their workplace, making KEMSA adisabledpersons-compliantorganisation.According toanationalactofparliament,KEMSA isadvisedtorecruit5%ofpeoplelivingwithdisability.
Creatingasafeworkplaceenvironment
The Directorate of Occupational Safety andHealth carries out tests, includingmeasuring airqualityandlightingquality,andcheckingventilationsystems,andprovidesrecommendationsforKEMSAtoimplement.
KEMSAsupportsstaffwelfarethroughprovidingmedicalcovertoitsemployees,includingfreeannualhealthchecks.KEMSAalsoorganisesafree ‘HealthDay’,afamilyfundayduringwhichstaffareencouragedtoattendwiththeirfamiliesandaretestedforlifestylesdiseases,suchashighbloodpressure,diabeticbloodsugarlevels,eyehealth,etc.
KEMSAalsosupportsOSHinthefollowingways:
• Carryingoutannualauditstomitigaterisks;• Registering‘nearincidents’,whereanincidentmayhavecausedaninjury;• Insuringstaffagainstworkplaceinjuries;• Ensuring that staff wear personal protective equipment (PPE) in the workplace and
checkingtherecommendedilluminationlevelsforhealthandsafety;• Assessingwhether theoverallworkplaceenvironmentmeetsrequiredconditions(e.g.
workroomsarewellventilatedandclean,haveenoughfloorarea,asuitableseat,etc.);• Providingannualhealthcheckstoemployeesworkinginareasofhigheroccupationalrisk
(e.g. in loading/unloading ordistribution) to identify ailments acquired as a result ofoccupationalactivity.KEMSAinvestigatespotentialsourcesofoccupationalhazardsandmitigatesagainstthem.
Whistleblowingmechanism
KEMSAhasawhistleblowingpolicymechanismthatallowsemployeestoraiseconcernsaboutmalpractice or impropriety. Employees who raise such concerns are protected by a specialcommissionthatensureswhistleblowers’anonymity.
4.2.4 Pathway4.Motivation
Performancemanagement
The key informant for KEMSA highlighted that the organisation seeks to foster a sense ofbelonging,toestablishstrongrelationshipsbetweenstaffandsupervisors,toprovideasafeandsecureworkenvironment,andtoinstilasenseofcareersecuritytomotivate KEMSApersonnel.The organisation employs KPIs to strengthening the performance management process andimprovingstaffmotivation.
Incentivepolicy
EmployeeperformanceatKEMSAisappreciatedinseveralways,includingthrougharecognitionlettersignedbytheCEO,beinggivenanopportunitytodinewiththeCEO,etc.Theseformsofrecognitionandawardsarepresentedatannualstaffpartiesandcanactassourcesofmotivation
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forotheremployees.KEMSAisamongthebest-payingparastatal agencies inKenyaandstaffaregivenannualsalary increments astheymovethroughdifferentpaybands.
Performanceappraisal
KEMSAconductstwomajorperformanceappraisals throughouttheyear:themid-yearreview(December–January)andend-of-yearappraisals(June–July).Currently,theorganisationemploystwomethodsofappraisal:
• A 90-degree performance appraisal,where themanager gives their evaluation to theemployeeonone-to-onebasis;
• A 180-degree appraisal process, which involves a self-assessment by an employee(assigningmarksorascoretotheirindividualperformance),whichisthendiscussedwiththeirsupervisorandfinallyratifiedbytheheadofthedepartment.
KEMSAplanstorollout360-degreeappraisals inthefuture.
Careerpathsandpromotionopportunities
KEMSAhasaCareerProgressionPlan.TheHRdepartmentinformsemployeesthatafteracertainperiodtheirjobsneedtobereviewedinrelationtoapotentialpromotionbasedonthefollowingcriteria:
• Skills;• Experience;• Performance;• Discipline;• Competencies;and• Jobvacancies(forpromotionstothenextlevel).
Suitability tests are conducted to informpromotiondecisions. In theCareerProgressionPlanthereisalsoaspecialclausethatguaranteesemployeestherighttomoveupthecareerladderafterthreeyears,subjecttoreceivinggoodperformanceappraisalsandevidenceofhavingtherequiredcompetencies.
Supervisorysupportandretentionpolicy
KEMSAprovidessupervisorysupportthroughcoachingandmentoring.TheheadofdepartmentandemployeesjointlyidentifyanddecideontheprofessionalsupporttobeprovidedtoKEMSAstaff.TheorganisationalretentionpolicyisguidedbytheTalentManagementManual.
Disciplinarypolicyandpractice
DisciplinarypoliciesaremonitoredbyaspecialcommitteeatKEMSA,whichintervenesinthecaseofseriousgrievances.Inothercircumstances,disciplinaryissuescan besolved bythemanagementstaffandheadofthedepartment.
Staffsatisfactionsurvey
AstaffsatisfactionsurveyisconductedeverytwoyearstoallowKEMSAsufficienttimetoactonthefeedbackfromthesurvey. Theresultsaresummarisedinareport,whichisthensharedwithallKEMSAstaff.
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4.3 MALAWI:CentralMedicalStoresTrust(CMST)
CMSTwasestablishedin2010bytheGovernmentofMalawiandwasregisteredasapublictrustin
2011,becomingfullyfunctionalin2012.CMST’svisionistoimprovehealthinMalawibyensuringa
reliable and continuous access to high qualitymedicines andmedical supplies through efficient
procurement,warehousinganddistributionservicesataffordablecost.
4.3.1 Pathway1.Staffing
Jobdescriptions
CMST has a list of crucial supply chain positions and has developed job descriptions for itsorganisationalroles.Thedevelopmentofjobdescriptionsdidnotfollowaspecificcompetencyframework: they were drafted according to CMST’s assessment of skills and responsibilitiesrequiredforjobpositions.Jobdescriptionsarenormallyreviewedeveryfourtofiveyearsaspartoforganisationalfunctionalreviews,whichareoutsourcedtoaconsultancyfirm.Themostrecentfunctionalreviewwascompletedin2014andchangeswereimplementedin2015.Asatthetimeofwritingin2020,anotherfunctionalreviewiscurrentlybeingconducted.
Recruitmentprocess
AtCMST,therecruitmentprocessdependsonthegradeofthevacantposition.Interviewpanelsareopentoexternalexpertsdependingonthenatureof the jobrole.Forexample, ifCMST isrecruitinganaccountant,representativesoftheInstituteofCharteredAccountantsinMalawi,andalsooftheAccountantGeneral’sDepartment,willbeapartoftheinterviewboard.TheinternalCMSTcommitteewillincludetheheadoftherelevantdepartment.Foralljobinterviews,fromofficer to director level, CMST invites external panellists to take part. In general terms, therecruitment approach remains the same for both technical and managerial positions. Forexample,anHRmanagerwouldundergothesamerecruitmentprocessasapharmacist.Theonlydifferenceisinthetechnicalexpertiseofinterviewpanellists,whichdependsonthenatureofthejobvacancy.
CMST’sjobgradingsystemconsistsof11grades,fromthetop-levelmanager(Grade1)tothelowestjobgrade(Grade11).TheleadingmanagerialpositionsincludeCEO(Grade1),director(Grade2),linemanager(Grade3),andmiddlemanager(Grade4).
InmakingarecruitmentdecisionCMSTpaysspecialattentiontothecandidate’squalificationsandyearsofexperience.Theminimumrequirementsarehighlightedinthejobadvertisementandfollowedthroughintheprocessofshortlistingcandidates.Beforeinvitingcandidatestoaninterview,CMSTnormallypreparesasetofquestionsand,dependingonthegradeofthevacantposition,alsocreatesacasestudytask,whichissentatleastaweekinadvancetothecandidates,requiringthemtoprepareapresentationaspartoftheirassessment.
According toCMST’sTermsandConditionsof Servicehandbook, vacancies for certain juniorpositions are first advertised internally. Other professional positions, from officer level andabove,areadvertisedbothinternallyandexternally.Ifaninternalcandidateisrecommendedbytheinterviewpanel,CMSTwillselectaninternalcandidate,particularlybecausetheconditionsofservicestipulateaguaranteeofcareerprogressionwithintheorganisation.
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Careerprogression
TheTermsandConditionsofServicehandbook,receivedbyeverynewemployeeuponjoiningtheorganisation,hasasectionthatspecifiesthemechanismandcriteriaforpromotion.Aftertheannual performance appraisal, a director of the department can issue recommendations forpromotion.ThesearesubmittedtotheseniormanagementandreviewedbytheHRDirector,whocansupporttherecommendations.
4.3.2 Pathway2.Skills
TNA
Atthebeginningofthefinancialyear,CMSTfinalisestheannualplanningandrequestsheadsofdepartmentstosubmittheirtrainingneeds.TheHRdepartmentconsolidatestheserequestsintoa training plan, which is cost assessed and matched to the training budget. As a youngorganisation,CMSThasfounditdifficulttomatchthedepartmentaltrainingneedstoavailableresources.ThetrainingbudgetislimitedandCMSTattemptstoprioritiseasmuchaspossiblethose training needs that can help address gaps in employee performance identified duringannualappraisal.
Capacitybuildinganddevelopment
CMSTconductsacertainamountofon-the-jobtrainingandtheHRteamhandlestheinductiontrainingfornewemployees,includingdepartmentalmanagers.Technicaltrainingisoutsourcedtoexternalserviceproviders.Forexample, forpurposesof trainingin financeandaccountingCMSTsendsemployeestotheInstituteofCharteredAccountantsinMalawi,whichhasanannualcalendar of training programmes. Similarly, pharmacists will be referred to the Pharmacist,Medicines,andPoisonsBoard,whichcoordinatesthetrainingofpharmacists.Therearealsotwomanagement institutes in the country: the Malawi Institute of Management and the StaffDevelopment Institute. Both organisations are governmental institutions that publish annualtrainingcalendars,whichCMSTfollowsinstructuringitstrainingplan.TheTrustalsoliaiseswiththeInstituteofProcurementandSupplytoplantrainingforpersonnelworkinginprocurementandsupplychain.
CMSTnormallydevelopsannualtrainingplans.Atthecorporatelevel,theTrustcreatesafive-yearstrategicplan.Themostrecentplanfinishedon30June2020.Oneoftheobjectivesofthenew strategicplan for financial year2020–2025 ishuman capitaldevelopment.TheplanstillneedstobeapprovedbytheBoard.Afterapproval,CMSTwilldevelopthestaffdevelopmentandtrainingstrategyforthenextfiveyears.
CMST has benefited from support from the Global Fund and is currently implementing theNational Supply Chain Integration Project, which also focuses on HR and organisationaldevelopment. This project is being managed by organisational development consultants atChemonicsInternational,whoarehelpingCMSTtodevelopthefive-yearHRstrategy.CMST’staskistoensurethattheorganisationhastherightskillsandtherighthumancapacitytoimplementthe new strategic plan, as well as the supply chain integration strategy that CMST has beendeveloping.
Communityofpractice
CMSThasnot createda communityof practice. Instead, it relies onmore formal training: forexample,theGovernmentofMalawipartnershipwithIndiaintrainingpublicservants.TheTrusthasparticipatedinthistrainingwiththeassistanceoftheHRdepartmentoftheGovernmentofMalawi.ThekeyinformantforCMSThighlightedthatthisisanareainwhichtheTrustshould
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undertakemorecollaborationwithotherinstitutions,andthatinthefutureitwillparticipateinadoptingaprofessionalisationframework.
4.3.3 Pathway3.Workenvironment
Organisationalcultureandworkenvironment
CMST’sTermsandConditionsofServicearetheorganisation’sprimaryframeworkrelatingtocreatingagoodworkenvironment.Thedocumenthasbeenreviewedandthefinalconsultationforthenewserviceswascompletedinthesummerof2020.ThefinaldraftwillbepresentedatthenextBoardmeeting,tobeapprovedandadopted,andwillthenreplacethepreviousversionoftheTermsandConditionsofServicedatingfrom2015.TheTermsandConditionsofServiceincludeaCodeofConduct,whichoutlines thenorms,rules,andresponsibilitiesof staff intheworkplace.
Internally, CMST intends to enhance corporate communication to better inform staff of theorganisation’sobjectivesandmission.Externally, theTrust is reviewing itsbrandandaims torepositiontheinstitutionthroughthenewstrategicplantoimproveitspublicimage.
Useofpolicies
CMSThasthe followingpoliciesinplace(includedasannexes totheTermsandConditionsofService):
• HIVandAIDSworkplacepolicy;• FraudandCorruptionPreventionPolicy;activitiesarecoordinatedbytheInstitutional
IntegrityCommittee.WhenareportisreceivedfromDeloitte(whichmanagesthisarea),theCommitteeinvestigatesandthensubmitsitsownreporttotheCEO.Dependingonthenatureofthereport,theCEOwillinstitutedisciplinarymeasuresand,ifapplicable,referthecasetotherelevantlawenforcementagencies;
• CodeofConduct(outlinescorevalues,mission,rules,andpracticesofstaffconductintheworkplace);
• StaffTrainingandDevelopmentManual(andtherelevantcommittee).
ThedevelopmentofpoliciesatCMSTfollowsaconsultativeprocess.Thisbeginswithchoosingrepresentatives from different departments and sections. If consultants are engaged, theconsultantswillworkwiththeinternalandexternalteamtodevelopthepolicy.Aspartofthedevelopment,variousstakeholdersareconsulted.Oncethedraftisready,itissenttotheBoardforapproval.
Once a policy is approved, printed copies are disseminated to staff for engagement andexplanation.Thishelpstomakestaffawareofthecontentsofthefinaldocumentandtogivethemtheopportunitytoraiseanyquestionswiththeimplementingdepartment.
Supportingwomenormembersofminoritygroups
CMSTaimstodevelopspecificpoliciesintheseareasinthefuture.
Creatingasafeworkplaceenvironment
CMSTfollowstheLabourActforHealthandSafetyandconductsregulartrainingsandfiredrills.Theorganisationensuresthereisacleanenvironmentand,ifrequired,staffareprovidedwithPPE(thisisnotlimitedtostaffworkinginwarehouses,italsoincludesthoseworkingincleaning,thesecurityteam,deliveryservicesetc.)
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Whistleblowingmechanism
CMSThasawhistleblowingpolicy,whichispartofitsFraudandCorruptionPreventionpolicyandisoutsourcedtoDeloitte.Thisinvolvesanonymousreporting.Deloittegeneratesreports,whicharethensubmittedtotherelevantauthority.
4.3.4 Pathway4.Motivation
Performancemanagement
CMST uses the BSC for managing the performance of Board members, while employeeperformanceismanagedbyaspecialtooldevelopedbyconsultants.Infinancialyear2020/21,CMSTwillbegintousetheBSCuniformlyacrossallorganisationallevels.
Incentivepolicy
Non-financialincentivesincluderecognitionforgoodperformanceduringannualappraisals.Staffexchangeprogrammeshelpmotivateemployeestoexploreskillsandworkenvironments.Staffalsotakepartinmeetingswithstakeholders,whichhelpthembetterunderstandthestakeholderperspectiveandincreasestheirsenseofbelonging.Annualassessmentsfocusonperformanceand includeasystemofrewardsandsanctionsbasedon theoverall jobprogress.RewardsatCMST include salary increments, promotions, grade changes, training opportunities, etc.Sanctionscanincludeoralandwrittenreprimands,andrecommendationsformoreon-the-jobtraining.
Performanceappraisals
AppraisalsatCMSTareguidedbyclearjobdescriptionsandstaffobjectives.Thesysteminvolvesan open appraisal, whereby an employee fills the BSC and indicates their level of individualperformance. This is followed by the supervisor's input and assessment. Following this, anemployeeandsupervisorcometogethertodiscusstheappraisalbasedonKPIs.
Promotions
AtCMST,nouniversalcompetency-basedpromotionframeworkisfollowed.PromotionsarealsogovernedbytheTermsandConditionsofServicehandbook.Thereisacriterionforpromotionsbased on annual staff performance assessments. Performance over the years is key topromotions.OtherkeyfactorsforpromotionsatCMSTincludequalifications,experience,etc.
Supervisorysupport
CMSTencouragesopendiscussionsamongststaffandlinemanagerstomotivateemployeesandimproveperformance.
Retentionandengagementpractices
ThekeyinformantforCMSThighlightedthatatransparentcommunicationandfeedbackpolicyencouragesmoreengagementbystaffintheorganisation.Everytwoyearsastaffteam-buildingexercise is conducted,which actsasa forumwherein staff share individual experiences.ThisinitiativeiswellappreciatedbythestaffatCMST.
Intermsofstaffretention,theTermsandConditionsofServiceindicatetheneedtorecruitwell-qualified staff. To achieve this, CMST offers a competitive remuneration package, which hasresultedinlowstaffturnover.
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Staffsatisfactionsurvey
AstaffsatisfactionsurveyisconductedannuallyatCMSTtounderstandstaffsatisfaction,identifygaps,anddesignpoliciestoimprovestaffsatisfaction.
4.4 SUDAN:NationalMedicalSuppliesFund(NMSF)
NMSF isthesuccessorof theCentralMedicalSuppliespubliccorporation(establishedasa semi-
autonomous organisation in Sudan in 1991). The organisation implemented a comprehensive
reformprogrammein2011andin2015wastransformedintoNMSFaftertheapprovalofanewact
bytheSudaneseNationalAssembly.In2015,NMSFwasgivenmoreflexibilityregardingcommercial
operationsandinthepurchaseandsaleofmedicalproducts.NMSF’skeyobjectiveistoensurethat
essentialmedicinesandmedicalsuppliesofprovensafety,efficacy,andqualityareavailabletothe
populationatreasonableprices.Sincethe1990sithasemployedacost-recoverysystem.
4.4.1 Pathway1.Staffing
Jobdescriptions
Until2017NMSFdidnothavewell-definedandstructuredjobdescriptionsandapproachedPtDtohelpdevelopthemfortheentireorganisation.Thestructureofjobdescriptionsincludes:
• Jobtitle;• Superior-subordinate relationships and the management level (Director General, or
departmentaldirector,etc.);• Jobpurpose;• Keyresponsibilities;• Qualificationsandexperiencerequirements;• Skillsandknowledgerequirements.
Recruitmentprocess
HR recruitment at NMSF is guided by the Civil Service Act 2007. The requirements andproceduresofrecruitmentfollowtherecommendationsoftheNationalCivilServiceCommission–theSudannationalcommissionforrecruitmentinthecivilservice.
IntheSudancivilservice,therearetwocategoriesofworkforce:skilledemployees(generallyuniversitygraduates, suchasaccountants,doctors,engineers,pharmacists,etc.)andunskilledlabour(workerswithhighschooldiplomaorless,suchasdrivers,cleaners,messengers,etc.).SkilledemployeesbegintheircivilservicecareeratScale9(alsocalledentryscale)andmoveuptothehighestpositioninScale1.ThescaleforunskilledlabourbeginsatScale16andgoesuptoScale10(thehighestscaleforthisgroupofstaff).
ItisthesoleresponsibilityofNMSFtorecruitlow-levellabourers(uptoScale10).Themid-levelemployees(Scale9toScale6)arerecruitedbytheNationalCivilServiceCommission.Inordertorecruit for these positions, NMSF submits a request to the Commission, which assembles arecruitingcommitteethatincludesanNMSFrepresentativeandthatcarriesouttheadvertisingandrecruitmentprocess.Afterrecruitmentiscompleted,theCommissionsendsaformalrequesttoNMSFtoappointtheselectedcandidate.
Aseparaterecruitingcommitteeisassembledtoselectcandidatesforleadershippositions(Scale5 to Scale 1). After the selection is completed, the Director General requests the Board of
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Administration,chairedbytheMinisterofHealth,toapprovecandidates.Afterthat,theMinisterof Health submits a formal request of appointment to the Council of Ministers, through theMinistryofLabour.
The key informant for NMSF highlighted that during recruitment, the recruiting committeeensuresthatcandidatesmeetthejobdescriptionrequirementsandcheckstheirreferences,butspecial attention is paid to experience, including supply chain experience and postgraduatestudies.
4.4.2 Pathway2.Skills
Training,andcapacitybuildinganddevelopment
TrainingprogrammesatNMSFareinformedbyTNAatthedepartmental,ratherthanindividual,level. TNA ismore group-based, and is carriedout forprocurement, distribution, andqualityassurance.NMSFfindsitdifficulttotailortrainingtotheindividualneedsofitsmorethan400membersofstaffandtotrainthemonanindividualbasis.
NMSFbegandevelopingtrainingprogrammesin2011butuntil2014itdidnothaveanytraininggovernanceinplace.Originally,theprogrammesofferedmostlytraditionalclassroomtraininginpublichealthsupplychainandsupportingservices,suchasfinanceandIT.NMSFalsoencouragedself-learning among its employees, providing access to e-journals, e-books, and setting up alibrary.Additionally, NMSF began sending staff to conferences relevant to theirwork, and toregionalworkshops.
NMSFhasitsownworkshopforchecking,calibrating,andrepairingmedicalequipment,whichprovideson-the-jobtrainingandapprenticeshipstobiomedicalengineers.However,mentoring,coaching,andtrainingforpharmacistswasintroducedonlyin2018.
TNA informs the training curriculum at NMSF and theHR department has a well-developedenterprise resource planning (ERP) module that holds comprehensive information on everymemberofstaff,includingtheirtrainingandprofessionaldevelopment,whichcanbeaccessedviaamobileapp.
Aspartofthecapacitydevelopmentinitiative,theDirectorGeneralofNMSFmadeonlinetrainingcourses on good governance in the management of medicine, hosted by the Global HealtheLearningCentre,mandatoryforallNMSFpharmacistsandpartoftheirperformanceevaluation.NMSFalsohostedcontinuousprofessionaldevelopment(CPD)programmesincollaborationwiththe Sudanese Pharmacists Professional Union to ensure that pharmacists improve theirknowledge,skills,andcompetencies,andenhancetheircareerprogression.NMSFhasbecomethe national centre for continuing education and the CPD of pharmacists in Sudan. TheorganisationcoverstheannualsubscriptionfeesforaccessingspecialisedsoftwaredevelopedbyCoAcSLtd,for1,000pharmacists.Similarinitiativeshavebeenimplementedforprocurementandsupplychainspecialists. In2019,24employees inthesepositionscompleted theCIPSLevel4(DiplomainProcurementandSupply)modules.
4.4.3 Pathway3:Workenvironment
Organisationalcultureandworkenvironment
NMSF initiated changes to its organisational culture, first by completely changing itsphysicalenvironment.Thisincludedrefurbishingstaffoffices,providingnewdesksandcomputers,andinstallingemailsystems.Second,NMSFthenmovedtochangethecultureitself,focusingonhowtoadoptaCodeofConductandhowtomaintain thephysicalenvironment. NMSFstaffcame
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togethertofinaliseandagreeupontheCodeofConduct,whichwasthensignedandplacedineveryemployee’sfile.Third,NMSFmovedontoapplyingtheCodeofConduct,whichincludedthefollowingactivities:
• Maintainingthecleanlinessoftheenvironment(includingcontractingaspecialisttoteachhygienepractices).
• Changingtheculturebyencouragingstafftofocusontheirworkandteachingeffectivetimemanagementtechniques.
• Establishedasmallfootballpitchforstafftoplayon.• Createdacafeteriawithsubsidisedmeals,andaminisupermarket.• Installedacashmachine.• PutinplaceinfrastructureprovidingthehighestinternetspeedinSudan.
Changingtheworkenvironmenthadapositiveimpactontheoverallculture,creatingastrongsenseofloyaltyandbelonging.ThekeyinformantforNMSFemphasisedthatduringaneight-monthperiodafterthetransformation,only8%ofstaffresigned(largelyduetopersonalreasons,suchasmovingabroad).
Useofpolicies
NMSFhasanextensivesetofpolicies,includinganti-corruptionandanti-fraudpolicies,andemailpolicy,andapolicyongoodgovernanceformedicine.NMSFalsofollowsthedisciplinarycodeforcivilservicestaff.However,thereisnopolicyonharassment.
Supportingwomenandmembersofminoritygroups
Therearenoformalpoliciestosupportwomen,thoughtheNMSFrespondentstatedthat38%ofstaff at NMSFarewomen. They also stated that ifmanual labourer staff (ofwhomnone arewomen)arediscounted,womenformmostoftheworkforce.ThecurrentDirectorGeneralisawoman.
Creatingasafeworkplaceenvironment
NMSFprovidesemergencykitsforminorinjuries.
Whistleblowingmechanism
NMSF has a whistleblowing policy which is included in its anti-corruption policy. Thewhistleblowingmechanismtakesthe formofananonymousemailaddress,towhichstaffcanprovideinformationconcerninganywrongdoing.
4.4.4 Pathway4.Motivation
Performancemanagement
AtNMSF,KPIsare inplace tosupportstaff tounderstandtheir individualrolesbetterandtocontribute towardsNMSF’s goals. TheHR department has supported and led theway in thetransformationofNMSFbyclearlyaligningtheKPIstotheoverallorganisationalgoals.
Incentivepolicy
In2012,NMSFstartedgivingincentiveslinkedtoperformance.Simplecriteriaweresettosendasignalforimprovedperformance.Bytheendof2018,theincentiveswerefourtimesthegrosssalary,i.e.anemployeeearnedfivetimesthebasesalaryeverymonth.Everymonthalldirectorssubmittedevaluationsofsubordinateswhichwerethoroughlyreviewedbytheseniorleadership.Ascoreofgreater than70wasneededmonthlytobeentitledtoreceive incentives.Since the
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NMSFActwasapprovedstaffnowreceiveanadditionalbenefitpackage(beyondthanthecivilservantpackage).Accordingtothebenefitpackage,pharmacistsareentitledtoreceive50%oftheirbasicsalaryontopofthemonthlysalary;forbiomedicalengineerstheyreceive40%oftheirbasicsalaryontopofthemonthlysalary;andforotherstaffa20%top-upisprovided.Therearealsocashallowances:marriedstaffwithchildrenreceiveeveryyearfourmonthsoftheirgrosssalaryasacashallowance,andmarriedstaffwithoutchildrenreceivethreemonthsoftheirgrosssalary.
Performanceappraisals
The Civil Service Chamber guides performance appraisals at NMSF. The supervisors aremandated to complete assessments anonymously and submit them to theHR department. Aspecialcommitteethenassessestheinputstorecommendcandidatesforahigherjobscale.Thecommittee meets on an ad hoc basis coincided with the cycles of employee performanceappraisals(e.g.forpharmaciststheappraisalisconductedeverytwoyears).
Promotions
AtNMSFtheCivilServiceChamberalsoguidesthepromotionofeligiblecandidates.However,promotionsarenotlinkedtoacompetenceframework.
Supervisorysupport
MentoringandcoachingsupportarestilllackingatNMSF.Theywerestartedlatein2018,basedonthePtDframework.
Retentionandengagementpractices
Engagement policies include changing the physical ambience of NMSF offices, installing newequipment,andprovidingaccesstohigh-speedinternet.NMSFhasalsoundertakenotherstepsto offer a range of benefits to staff, including providing transport for employees, providinguniformstoall staff,andofferingprivatemedical insurance forstaffandtheir families(NMSFpaysthefullinsurancepremium).Otherincentivesincludesubsidisedmeals,andamini-marketandcashmachineinthepremises.Thesestrategieshavehelpedtomaintainastrongsenseofloyalty and belongingness within the organisation and to keep staff turnover at 8% (2018).Overall,trainingopportunities,theworkenvironment,incentives,andsupportfromtradeunionshavecontributedtowardsarobustretentionpolicy.
Disciplinarypolicyandpractice
NMSFfollowstheDisciplinaryActforthecivilservice.
Staffsatisfactionsurvey
NMSFconductsastaffsatisfactionsurveyeveryyear,andtheresultsarediscussedwiththeemployees.
4.5 Tanzania:MedicalStoresDepartment(MSD)
MSDwas establishedbyaTanzanianAct of Parliament in 1993as anautonomousdepartment
withintheMinistryofHealth,CommunityDevelopment,Gender,ElderlyandChildren.MSD’smission
is to ensure medicines, medical supplies, and laboratory reagents of acceptable quality and
affordablepricearealwaysavailabletoTanzanians.MSDcollaborateswiththeprivatesectorto
create localmanufacturing facilities (as per thePublicPrivatePartnershipAct, 2010)and from
2017,MSDstartedtoprocureitsmedicalsuppliesdirectlyfrommanufacturers,ratherthanfrom
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suppliers.MSD’svisionistobecomeacentreofexcellenceforhealthcommoditiessupplychainin
Africa.
4.5.1 Pathway1:Staffing
Jobdescriptions
MSDwassupportedby the consulting firmAccenture andBMGF indevelopinga competencyframeworkforsupplychain.Theorganisationlookedatthesupplychainsystemfromendtoendto understandwhat level of skills and competencieswas required for chain professionals. Itconductedinterviews,reviewedsetsofqualifications,andcameupwithalistofcompetenciesforsupplychainroles.Afewnewpositionswereaddedtotheexistinglistofcrucialsupplychainjobs, such as Demand and Supply PlanningOfficer for Quantification to quantify themedicalcommodities needs before submitting a request to the procurement team. MSD has alsorecognised the need for stock verifiers and some other positions, such as procurement andwarehousingspecialists.Previously,thesewarehousingpositionswerequitegenericandhadtobe adjusted to reflect specific warehousing functions and processes, such as dispatching,receiving,orcustodianship.
Recruitmentprocess
RequestsforhiringnewemployeesaresubmittedbyMSDdepartmentstotheHRdepartmentviajobrequisitionforms.Atpresent,thesystemofreviewingjobrequisitionsismanual,withtheprospect of its automation soon. The HR specialists check the requisition against theorganisationallistofjobrolesandthenumberofemployeesrequiredforaspecificdepartmentorarea.TheHRdepartmentcanrejecttherequisitionifitdoesnotcomplywithorganisationalcapacity.Uponreceivingtherequisition,HRspecialistsalsolookthroughthelistofemployeeslinedupforrecategorisationtonewpositions,asthesebecomevacant.Recategorisationofstaffreflects the factthatemployeesacquirenewskills,qualifications,andeducation(e.g.Master’sdegreeoradiploma).TheHRdepartmentattemptstomatchtheseemployeestothepositionsfeatured in jobrequisitions. If theorganisationdoesnothave therightpersonnel thatcanberecategorised,thesevacanciesareadvertisedexternally.
MSDisapublicorganisationandaccordingtotheamendmentsmadetothePublicServiceActinNovember2016allpublic organisations inTanzaniamust conduct their external recruitmentcampaignthroughthegovernmentagencythePublicServiceRecruitmentSecretariat.MSDsendsjobadvertstotheagencyforpublicationontheSecretariatportal(www.ajira.gov.tz),aswellasontheMSDwebsiteandothermediaplatforms.TheadvertisementwillsaythattheSecretariatisrecruitingonbehalfofMSD.Incertaincases,thestaterecruitmentagencycanbringstafffromotherorganisationswhohaverequestedatransfertoMSD,iftheymatchtherequiredskills.
TheMSDHRdepartmentdealswithallof thepracticalitiesof therecruitmentprocess,whichincludeperformingvariouschecks,shortlisting,conductinginterviews,andissuingjobofferstoselectedcandidates.Thedepartmentalso followsthesecurityvettingprocedure,as theentireworkforceemployedinthepublicserviceisrequiredtoreceivegovernmentsecurityclearance.
Thedepartmenthasaninterviewmatrix,andaquestionnairethatincludesthetechnicalside,aswellasasectiononrequiredcompetencies, job fitness,andqualifications.Forexample, if theorganisation is seeking to employ a Quality Assurance Officer, the HR will ask the QualityAssurance Manager to draft a set of technical questions based on a specific job description(especially if thedepartmentseeks a trainedbiomedical engineeror apharmacist towork inquality assurance). To this list of technical questions, the HR department adds a number oftraditionalHRquestions to ensure that the candidatesare fit for the roles.According to staff
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regulations,theDirectorofHumanResourcesservesasChairandtheHRManagerasSecretaryoftheinterviewpanelforalljobpositionsatofficerlevelandabove.Thepanelalsoincludesakeytechnicalspecialistfromtherelevantdepartment.
Ifthereisalargepoolofqualifiedcandidates,theyarefirstaskedtositanassessmenttest.Thisis conducted for all technical and supporting positions, except from managerial roles anddirectors.Forthesejobroles,theassessmentisusuallyoutsourcedtoarecruitmentcompany.(Previously, theassessmentofcandidatesapplying fordirectorialpositionswasconductedbyDeloitte).Thekeyinformanthighlightedthatwhenpositionsofactingdirectorsbecomevacantin the future, MSD will not engage a consulting firm again, but rather search for suitablecandidatesinternally.
Oncetheselectionprocessiscompleted,theHRdepartmenttakesnewemployeesthroughthemandatory induction process. They are assigned to supervisors and enter a six-monthprobationary period. From the very beginning, new employees are communicated clear jobtargetsandexpectations,aswellastheavailablesupporttheymightrequireinperformingtheirjobs,especiallyiftheycamestraightfromuniversityorschool,orhaveonlyundertakenashort-terminternship.
Careerprogression
Toprovideclearcareerstructuresforemployees,MSDhasdevelopedaSchemeofService.Theoutlook of the Government of Tanzania is decidedly pro-qualification, which means that ifemployeesattainacertainqualification,theycanmoveuptoadifferentlevel,accordingtotheirexperience,joboutput,andperformanceevaluation.TheSchemeofServicehasfourtosixstepsineveryjobrolebeforeanemployeecangettoamanagerialposition,providedthatitisvacant,offering a straight career path for all employees. For example, one can start as WarehouseAssistant and then grow to Principal Warehouse Assistant. The road to promotion involvesacquiringsufficientexperience,scoringatleast‘B’oraboveintheperformanceevaluation,andobtaining certain qualifications after sitting an examination and undergoing professionalevaluation regulated by the Procurement and Supplies Professionals and Technicians Board(PSPTB).
4.5.2 Pathway2.Skills
TNA
TNA atMSD is conducted annually. Government institutions are required to follow theOpenPerformanceAppraisalSystem(OPRAS),butMSDhasrequestedpermission to follow itsowninternal performance management system. This is called DRIVE and consists of five majorcomponents:knowyourdirection,reviewwhereyouare,improveonyourperformance,validatethe results, and enjoy your rewards. A special section on the appraisal form is dedicated toprofessionaldevelopment.Thishastobecompletedandmarkedbyboththesupervisorandtheemployee,andtheymustagreeonareasofdevelopment.Thedepartmentwillalsoaddcertaintrainingneedsandbothassessmentswillbetakenintoconsiderationinthedevelopmentofatrainingplan.TheHRdepartmentcriticallyreviewsperformanceappraisalandtrainingneedsforms to ensure that they comply with real performance objectives and the needs of theorganisation.Forexample,employeesmayrequestmoretraininginprojectmanagement,whiletheHRdepartmentmaydecidethatduetochangestheirwork,theseemployeesactuallyrequiremoreexposure.Togiveoneexample:MSDhiresalotofpharmacistsandplacesthemincustomerservice, sales, andprocurement.Theorganisationrecognises that these employees, originallytrainedaspharmacists,requiredadditionaltrainingtoperforminnewroles.
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MSDlooksatTNAfromtheperspectiveofemployeeperformanceandfromthebusinesspointofview.Forexample,theorganisationisembarkingonmanufacturingitsownpersonalprotectivepacks,whichrequirestheProduction/ManufacturingTeamtoundergospecialisedtraining.TheHRdepartmentisalsoengagedindevelopingastrategicplanforthenewfinancialyear(whichbeginson1July)thatdefinesthebusinessfocusoftheorganisation.
Trainingandlearning
Thetrainingprocessitselfisamixtureofin-houseandoutsourcedtraining.MSDdoesnothaveaselected group of institutions to outsource training to, but it often collaborates with PSPTBbecauseofitsspecialfocusonthesupplychain.In2020,theCOVID-19pandemichaschangedthewaytrainingisconductedatMSD:thebudgetfortraininghasbeensignificantlyreducedandmostofthetrainingisconductedin-houseusingdigitaltechnology.
Continuingprofessionaldevelopment
TheStaffRegulationsManualstipulatesthatMSDwillsupportthemembershipofallitsstaffinrelevantprofessionalassociations,andwillcovertheassociatedmembershipcosts,subscriptiontoacademicjournals,etc.Forexample,theorganisationencouragespharmaciststoregisterandparticipate in seminars run by the Commonwealth Pharmacist Association. MSD pays themembershipfeesandthecostsofparticipatinginseminars,whichprovideemployeeswithnewknowledge, mentoring, and coaching. MSD lawyers are registered with the Tanganyika LawSociety. Warehousing and procurement staff, pharmacists, doctors, and finance and auditpersonnelaremembersoftheirrespectiveprofessionalassociations.
ThekeyinformantforMSDhasindicatedthatthementorshipsystemwithintheorganisationisnotyetrobust.Currently,ithasonlyasmallpoolofon-the-jobmentorsandtheHRdepartmentattempts tosupport some formofmentoringbyorganisingaseries of talks, deliveredby theDirectorGeneral,andmeetingsbetweenMSDmanagersandCEOsofotherorganisationstoshareexpertise.
4.5.3 Pathway3.Workenvironment
Creatingastrongorganisationalculture
Thekey informant forMSDstated thattheorganisationaims toensureemployees’voicesareheardandencouragesanorganisationalculturewhichvaluesdiversityandprovidesaconducivework environment. The organisation’s values are respect, passion, integrity, courtesy, andinnovation.
Useofpolicies
MSDhasthefollowingpoliciesinplace:
• Ananti-harassmentpolicy;• ACodeofConduct(signedbystaffwhentheyjoin).
Additionally, its disciplinary process is governed by the Public Service Act 2002 and PublicServiceRegulations2003.Newstaffregulationshavebeeninplacesince1July2020,whichdetailthedisciplinaryprocesses, includingthelegalprocess,addressinginternalgrievances,andtheCodeofConduct.
Supportingwomenormembersofminoritygroups
Asmentionedabove,MSDhasananti-harassmentpolicy.WhilstMSDonlyemploysTanzanians,itemploysstaffofdifferentethnicitiesanddoesnotdiscriminatebasedonreligionorgender.
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MSD also encourages people with disabilities to work for it and has conducted purposefulrecruitmentinthisarea.MSDhasalsorecruitedstaffwithtotaldisabilitiesandhassupportedthembyprovidingthemwithwheelchairs.
Creatingasafeworkenvironment
MSDensurescompliancewithOSHstandards(asgovernedbytheOccupationalSafetyandHealthAuthority,OSHA),andensuresthatallemployeesareworkinginasafemannerandhavesafetygear.MSDuseshealthinspectorswhocheckconditionsandensurethattheorganisationoperatesinasafeenvironmentthatwillnotharmworkersortheirsurroundings.
SpecificmeasuresMSDhasinplaceinclude:
• Conductingquarterlymedicaltests(priortoCOVID-19);• Providingahepatitisvaccinetoworkers;• Conductingcampaigns,suchasencouragingemployeestohaveHIVtests;• Providingtherightgownsandshoesforstaffworkingincoldvaccinestores;• Providingtransporttothoseworkingatnight;• Providingotherstaffbenefits,suchasmobileairtimecredit,transportallowance,andfuel.
4.5.4 Pathway4.Motivation
Performancemanagement
Forperformancemanagement,MSDusesitsowninternalsystem,DRIVE.It isasystemthatisbasedonobjectivesbeingagreedinMay–JuneeveryyearandonthefilingoftheobjectivestotheHRdepartment,whichcommencestheperformanceyear.ManagersreviewtheBSCobjectiveswhich have been assigned to their directorates.Managers choose relevant objectives for theemployeesanddiscussthesewiththem.TheobjectivesmustfollowtheSMARTprinciples:i.e.bespecific,measurable, achievable, realistic, and timely. Employees and themanagermustbothdiscuss and understand all the objectives as themanager will review progress against themthroughout the year. Employees should know their own individual responsibilities regardinghelpingMSD to achieve its goals.This aims to enhance personal accountability and enablesemployeestowritedownactionstobetakentomeettheobjectives.TheHRwillfinallyreviewtheobjectivesandcheckthequality.Incentivepolicy
Thereisaninternalincentiveschemewhichincludeshardshipallowancesforemployeeswholiveinhard-to-reachareas,honorariatorewarddesiredresults,providingphones,airfans,andtransportallowances,etc.Performanceappraisal
AtMSD,performancereviewsarecarriedouttwiceayear,inDecemberandMay.Managersarerequiredtoclearlycommunicateanexplanationforallratingstotheemployeeandtobeclearinsuggestingwaysinwhichtheycanimprove.Thisreviewisusuallycarriedoutinaprivateplace,whereboththepartiesfeelcomfortableandarenotinterrupted.Managerandemployeeagreeonatimeandplacethatgivesenoughtimeforthediscussion.Whenthemid-yearreviewisheld,the‘what’objectiveisdiscussed,toidentifyanysupportthattheemployeemightneed,andthe‘how’objectiveisdiscussedtoimprovetheachievementofdeliverables.Themanagerselectsanagreedratingandwritescommentsonstrengthsandthescopeofimprovement.TheannualappraisalisguidedbytheoverallDRIVEscore.
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Promotion
MSDfollowscompetence-basedpromotions:competenciesforsupplychainhavebeendevelopedand supported by BMGF and Accenture. Like any public sector organisation in Tanzania,afterhavingspentfouryearsinservice,employeesareeligibleforpromotionsasmandatedbythe Public Services Act. However, MSD ensures that such promotions always aligned to thecompetence.PromotionsarealsoguidedbytheDRIVEscore.Ifanemployee’sperformanceisnotasdesired,thentheyareputonaPerformanceImprovementPlananditisclearlycommunicatedthatemployeesarenotentitledtobepromoteddespitebeingeligibleforthesame.Retentionandengagementpractices
TheStaffRegulationManualstatesthattwoprofessionalmembershipswillbesupportedbyMSDandthemembershipfeesarecoveredbytheemployer.Themembershipsalsoprovideaccesstospecialisedacademicjournalsandotherresourcesthathelpemployeestoengageinself-studyandenhancetheirprofessionalknowledge.MSDallowsstaffenrolledinhigherdegreecoursestotake long-term study leaves. The key informant for MSD emphasised that the organisationpromotesaninclusiveworkenvironmentandintroducedarangeoffinancialincentives.Theseincludeagratuityscheme,whichoffersapay-outtoallstaffeverytwoyears,aswellasawardsandcashincentivesforinnovationandcreativity,initiatedbytheICTdirectorate.AlthoughMSDdoes not have a specific retention scheme, these engagement policies have resulted in lowattritionrates.Disciplinarypolicyandpractice
DisciplinarypoliciesandpracticesaregovernedbythePublicServiceAct2002anditsregulationsof2003.TheyarealsoincorporatedintotheMSDStaffRegulation2020.Staffsatisfactionsurvey
MSDconductsastaffsatisfactionsurveyonceeveryyearthroughtheHRdepartment.ThistakesplaceinthePublicServiceWeek.ThefeedbackofemployeesiscollectedthroughSurveyMonkeyandguidesaplanofactions.
4.6 Uganda:NationalMedicalStores(NMS)
NMS was established as a statutory corporation in Uganda in 1993. In 2009, NMS underwent
significantchanges,includingreceivingpre-financingandthecentralisationofalargepartofthe
drugsandmedicinessuppliesbudget.NMS’smandateistoprocure,store,anddistributeessential
medicines and medical supplies to all public health facilities in Uganda, as well as serving
governmenthealthfacilitiesanddistributingvaccinesacrossthecountry.
4.6.1 Pathway1.Staffing
Jobdescriptions
Job descriptions for positionswithinNMS are featured in the JobDescriptionManual,whichdefinesthejobholder’skeyroles,requiredqualifications,competenciesandresponsibilities,andwhichspecifiesthepurposeofeachjob.Theinitiativetodraftjobdescriptionscamefromheadsofdepartments,andinitiallyaconsultanthelpedNMStocreatejobdescriptionsforthemanual(incollaborationwithheadsofdepartmentsandinconsultationwithvariousstakeholders).JobholderaccountabilitieswerediscussedwiththeNMSmanagementandapprovedbytheBoardoftheorganisation.Jobdescriptionsarecontinuallyupdated,totakeaccountofneworganisationalneeds.
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The JobDescriptionManual isnotspeakingacompetency framework, thoughtherearesomesimilaritiesbetweenthem.
Recruitment
NMS has an established organisational structure, which specifies all positions within eachdepartment.Everyjobrolemusthaveaminimumoffivekeyaccountabilities,keyresearchareas,andqualificationsrequiredtoperformeachjob.
When a position becomes vacant, the head of the respective department notifies the HRdepartmentbysubmittinga jobrequisition form.TheHRdepartment thenplacesan internaladvert to first try and find a suitable candidate internally. If theHRdepartment can identifypotential candidates, it will initiate the application and shortlisting process. The shortlist isapproved by the topmanagement of the organisation and the candidates are invited for aninterview. If the HR department is unable to establish qualifying internal candidates, topmanagement recommends that thepositionbe advertised externally.The adverts areusuallyplacedontheNMSwebsiteandsocialmedia,aswellasinnationalprintmedia,andareexpectedtorunforaminimumofsevendays.
ApplicationsaresenttoNMSbycourieroronline.TheHRdepartmentcollatestheseandsubmitsarequesttothetopmanagementtoappointashortlistingcommittee.Thetaskofthecommitteeis to go through all the applications and check themagainst the specific requirementsof thevacant job, i.e. qualifications, experiences, and desired competencies. Once the shortlisting iscompleted,thelistispresentedtothetopmanagementagainforapproval.
Thenextstepdependsontheoverallnumberofapplicantsandvacancies.NMSeitherconductsoralinterviewswithshortlistedcandidatesorrequirescandidatestotakeanaptitudetestoratechnicaltest.TestsareoftenconductedwhenNMSreceivesmanyapplications.Ifthenumberofcandidatesislow,thenNMSproceedsstraighttointerviews.However,certaintechnicalpositionsrequire amandatoryprofessional test to establish the competence level of the candidate. Forexample,whenselectingacoldchaintechnician,NMSchecksthecandidate’sknowledgeofthecoldchainandessentialtechnicalskills.
Toconduct interviews, the topmanagementappointsaninterviewcommittee thatselects thebestcandidateforthejob,whoislaterapprovedandappointedbythetopmanagement.
Interviewsandappointmentsaredifferentdependingonthelevelofthejobvacancy.CandidatesforthepositionsofCEOandBoardSecretary(whoalsodoublesasDeputyCEO)areappointedbytheMinisterofHealth.NMS’seightheadsofdepartmentsareinterviewedandappointedbythefullBoardofDirectors.Themiddlemanagement(e.g.theheadoftransportandlogisticsoranHRofficer)andoperationalteamsareinterviewedbyacommitteeconsistingoftopmanagement,whichincludesheadsofrelevantdepartments(suchasStoresandOperations,HR,Procurement,Quality Control, Internal Audit, ICT, etc.). All other technical personnel (e.g. engineers,pharmacists,etc.)areinterviewedbyheadsofdepartments.
Thekey informant forNMSstatedthat intheprocessofselectingcandidatestheorganisationplacesmostemphasisontheirbehaviouralassessmentandabilitytofitwellwiththerestoftheteam.Experience is an importantpart of the assessment, butNMS currentlydoesnothave aspecialscoreforexperienceoreducation.NMStakesallaspectsintoaccountduringselection,though it identifies theperson’scharacteras themost important. Incertaincases,to increasegenderparity,thecommitteeconsidersgivingpreferencetoafemalecandidate.
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Careerprogression
Everyemployeesignsafour-yearfixed-termcontract,whichisrenewableafterthetermperiod.Once a vacancyopens, individuals can apply for it and, if qualified, be appointed to that role.Beforetakingupanewrole,theemployeemustresignfromtheirpreviouspost.
Previously,NMS’sorganisationalstructurewasnarrow,anditwasnotpossibleforemployeestoconsidercareerprogressionwithinthissystem.NMShassincetriedtoexpanditsstructureandnowoffersvariouslevelsthroughwhichemployeescannavigatevariouscareerpathsandfindinternal opportunities. Whilst NMS does not have a traditional career ladder approach, theorganisationdoesnotimposerestrictionsonstaff.Ifanopportunityarisesandanemployeefeelsthattheyhavethenecessaryexperienceandqualifications,theycanapply.
The respondent from NMS noted that conventional career ladders lock people in, forcingemployees togo throughseveral intermediarysteps toprogress to thenext levelorposition.However,atNMSanassistantwarehouseofficerwiththenecessaryskillsandqualificationscanapplyforaseniorwarehouseofficerpositionwithoutneedingtoserveinintermediarypositionsforseveralyears.Therespondentnotedthatthisapproachisflexibleandlessrestrictive,asitdoesnottieindividualstoapath.Ifacareeropportunityarises,andthecandidatedemonstratesallthenecessaryqualificationsandskills,theycanapply,evenifthevacancyisnotwithinthecandidate’spathway.NMSthereforehasmanyemployeeswhocrossdepartments:forexample,moving from stores and operations,where theywere performing stock control, to becomingsenior procurement officers. This approach also supports skills transfer: that same personmovingfromstockcontroltoprocurementwillbeawareoftheentirevaluechainintermsofprocurementandlogisticsmanagement,astheyhavebeenatthereceivingendofthestockandnowcanbringthisexperiencetocontractinitiationandprocurementmanagement.Inthisway,thisapproachhelpsstafftobenefitfromawiderangeofexperiences.
4.6.2 Pathway2.Skills
TNA
NMS conducts TNA annually at the individual, departmental, and organisational level. Thetrainingneeds of employees are identified from performance appraisals reports, and the topmanagementprioritisestrainingneedsfortheentireorganisation.Eachperformanceappraisalformcontainsadevelopmentneeds section,where an employee is expected to indicate theirindividualdevelopmentneeds.Oncethosetraininganddevelopmentneedsareestablished,theHRdepartmentconsolidatesthemintoonegeneralannualneedsassessment.
Trainingandlearning/capacitybuildinganddevelopment
Incertaincases,NMSreliesonitsownresourcestoconducttraining.Forexample, ifgapsareidentifiedintheITcompetenciesofitsemployees,theICTdepartmentwillcomeupwithaplanto help rectify those issues. However, NMS’s training programmes are mostly facilitated byexternalorganisations.
ThetrainingcoursesthemselvesmaytakeplaceatNMSfacilities,runbyexternaltrainers,thoughNMS also selects employees to attend trainings, seminars, and conferences outside theorganisation and abroad. NMS does not have contracted partnerships with these externalorganisationsbutinvitesemployeestoattendwhentheyfindasuitabletrainingprogramme.
NMSencourages the long-termprofessionaldevelopmentof itsemployees.Forexample, ifanemployeeisamemberofaprofessionalbody,NMSwillcoverthecostoftheannualsubscription.Every employee is entitled to join two professional bodies and NMSwill pay for up to twomembershipsubscriptionseveryyear,ifthemembershipisrelevanttotheemployee’srole.NMS
54
encourages staff to attend training programmes and courses, andpays for CPD, such as CPDworkshops,whichitfacilitatesandsponsors.
In certain circumstances, NMS also covers the cost of acquiring a new qualification, if it isnecessary for theemployee’sperformance inthecurrentrole. Itspreference,however, is thatemployeestakelong-distanceorpart-timecoursesthatdonotaffecttheirdailyworkanddonotrequire taking a long leave to complete the course. NMS can grant leave if the employee isscheduledtositanexambutcannotofferlongleavesofabsence.
4.6.3 Pathway3.Workenvironment
Creatingastrongorganisationalculture
ThekeyinformantforNMSemphasisedthattheorganisationseekstocommunicateandinstiltheorganisationalcultureinemployeesrightfromtheinductionperiod.NMSaimstocreateanon-discriminatoryandsafeenvironmentthatisconducivetowork,forallstaff.
NMS has its own specific HRmanual – theNationalMedical StoresHumanResourceManual,which explains theduties and responsibilities of every employee, andorganisational rulesofconduct.OtherstepsNMStakestocreateagoodoverallworkenvironmentincludethefollowing:
• Providingeveryemployeewith thenecessaryrequirements for themtodotheirwork(e.g. mobile airtime credit, internet access). Staff in client-facing roles have a smallentertainmentallowanceformeetingwithkeyclients.NMSalsoprovidesafuelallowancetomembersofthemiddlemanagement.
• Providingmealsintheworkplace.NMSoffersbreakfastandlunch,andprovidesdinnerfor staffworking anight shift (this is not a common practice among organisations inUganda).
• Providingtransportationforstaff(e.g.staffbus).
Useofpolicies
PoliciesNMSemploysincludethefollowing:
• Policiestostopdiscriminationbasedongenderandotherfactors;• Adisciplinarycodeandprocedure,availableintheorganisation’sHRmanual;• An HIV and other chronic diseases workplace policy. This protectsindividualswith
medicalconditions;• Healthandsafetypolicies–toprotectindividualsfrominjuryandharm;• Sexualharassmentpolicy–toprotectcolleaguesfromsexualharassment;• ACodeofConduct,asanannextotheHRmanual,whicheveryemployeemustreadand
sign;• NMSfollowsthenationalpolicyof theAnti-CorruptionAct.Corruptionisalsocovered
undertheDisciplinaryCode;• Afraudpolicyandriskmanagement;• Legaland regulatory compliance to ensurebehaviours andpracticesare conducted in
accordancewithnationalandlocallaws.
Tohelpraiseawarenessofthepolicies,employees’inductionincludesacomprehensivereviewof HR policies. NMS also regularly conducts staff sensitisation and continuously reviewsorganisationalpolicies.
NMScreateditsowntrainingdivisioninJuly2020andiscurrentlydesigningaprogrammeofmodulesrelatingtoitsdifferentpolicies,involvingstaffstudyingorreadingthepoliciesandthen
55
answeringquestionsonthepoliciestoearnpoints.Staffcanthenaccessrewardsviathesepoints(e.g.toreceiveapromotionorbeassignedaseniorrole,staffmustfirstearnacertainnumberofpoints,whichcanonlybeachievedbyattemptingspecificmodules).Modulescanfocusontopicssuchasleadership,NMS’spolicies(e.g.fraudpolicy,financialmanagementetc.),innovationetc.
Supportingwomenormembersofminoritygroups
NMS’s recruitment policy and HR policy emphasise non-discrimination based on anycharacteristic. The organisation has a very clear policy regarding attracting,maintaining,andmotivatinganequalworkforcethatalwaysmeetsthecorporategoalsofbusinessneeds.
Creatingasafeworkenvironment
NMShasfocusedoncreatingasafeworkenvironmentbyintroducingthefollowingmeasuresandpolicies.NMShasaspecificsectionwhoseroleistoensurethatemployeesareprovidedwiththenecessaryprotectiveequipment(includingsafetyshoes,overalls,andhelmets)andworkinasafeenvironment(e.g.preventingexposuretohighlevelsofnoise).
NMSprovidesnecessary and relevant insurance cover to staffat theworkplace andprovideshealthandsafetytraining.Relatingtofiresafety,NMSinstalledfirealarms,markedfireassemblypoints,andorganisedfiresafetytraining.
NMSalsoprovideswelfarepackagesthroughmedicalinsurancecoverforstaff,theirspouses,anduptofouroftheirchildren.
Whistleblowingmechanism
NMShasariskmanagementpolicy,whichcomesunderitsriskmanagementprocedures.Thispolicyemphasisesthatanymeansofwhistleblowingisacceptable,andthepolicyhighlightsthatthe anonymity and identity of whistleblowers should be protected. The policy outlines howinformationreceivedshouldbeinvestigatedandtreatedwithconfidentiality.Ifaculpritisfound,itdetailshowtheyaremanaged.
4.6.4 Pathway4.Motivation
Performancemanagementandengagementpractices
Employee motivation is primarily achieved by highlighting KPIs and maintaining clarityregarding roles at NMS. This is reviewed every six months to ensure the staff have a clearunderstandingofindividualtargets.Motivationisalsolinkedtoopportunitiestoinnovateandtostaffparticipationinthedecision-makingprocess.Othermeasurestoenhancemotivationincludea robust reward systemand competitive salarypackages (NMS’s salaries are consistentwithmarket rates), safe work environment, policies against discrimination, welfare packages(including insurance, familymedical benefits),meals at theworkplace (e.g. lunch and dinnerdependingontheworkshifts),andastrongcompanybranding.Incentivepolicy
AllNMSstaffarepaidanattractivesalarythatisconsistentwiththemarketrate.Incentivesalsoincludeentertainmentallowancesforclient-facingjobroles,fuelallowancesforstaffatmid-levelandfortop-levelmanagement,transportfacilitiesforemployees(staffbus),etc.Anannualleaveallowanceanda25%gratuityisofferedtoNMSstaff.
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Performanceappraisal
NMSconductsannualperformanceappraisalsforthetopandmiddlemanagementandbi-annualappraisals for the lower-level staff (officersandassistants)during July(review for January toJune)andJanuary(reviewforJulytoDecember).Promotion
NMSdoesnotconductpromotions.Everyemployeereceivesa four-yearcontract. Initially,allvacantpositionsareadvertisedinternally,andNMStriestofillthemthroughexistingcandidates.If the internalcandidatesfulfilalltheperformance-basedeligibilitycriteria, theyareofferedafreshcontract,whichisregardedasnewrecruitmentandnotapromotion.Supervisorysupport
NMSencouragesinter-departmentcoachingandmentoringofemployees,especiallyforjunior-levelstaffwhoaresupportedthroughageneralinductionandattachedtoaseniorstaffmemberresponsibleforconductingmentoringactivities.Disciplinarypolicyandpractice
Thedisciplinarycodeguidesalldisciplinarycasesandadisciplinaryprocedureisalsofollowed,asstipulatedintheHRmanual.Staffsatisfactionsurvey
NMShasnotconductedastaffsatisfactionsurveyinthepastbutthereareplanstoconductsuchasurveythisyear,withtheinvolvementofinternalandexternalstakeholders.
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5. Conclusion
5.1 Pathway1.Staffing
Successful recruitment of the health supply chain workforce depends on how closely thecompetencies of the recruited individuals match the requirements of crucial supply chainpositions. Job descriptions, developed based on a competency framework, have become acommonbestpractice,asdemonstratedby75%ofthesurveyrespondentsandtwooutofthesixcasestudyparastatalhealthsupplychainorganisationsinSub-SaharanAfrica.Bestrecruitmentpracticesapplya flexiblestep-by-stepapproach toensurea fair, transparent,andcompetitiveselectionprocess.Thestudyexaminedvariousmechanismsemployedbyorganisations in thefocus countries to conduct planning, advertise supply chain positions, and manage jobapplications,aswell assessing candidates’ competencies andpastperformance throughpanelinterviewsandtechnicaltests.Thesix-casestudyparastatalsupplychainorganisationsconductinternal or external recruitment (or both), in some cases outsourcing the hiring of topmanagementpositionstoprofessionalservicesfirms.Assessmentofrelevanteducationandthelengthoffieldexperience,ratherthantechnicalexpertise,wasreportedasthecrucialcomponentofrecruitmentprocessby42%oftherespondents,whileperformanceduringinterviewwasseenasadecisivefactorinhiringacandidateby35%ofsurveyrespondents.Similarly,inmostofthesixcasestudyparastatalorganisationsqualificationandthe lengthofprofessionalexperienceplayapivotalroleintheselectionprocess,andmostoftheorganisationsconductwrittenororaltechnicaltestsaspartofrecruitment.
Effective employee compensation is instrumental for attracting and retaining employees;therefore,awell-designedsalarystructureisconsideredimperativeforeffectivelymanagingandrewarding the performance of supply chain personnel. Most survey respondents (59%)acknowledgedthattheirorganisationslackbenchmarkedsalaryrangesand69%ofrespondentsindicatedthatsalarymarketanalysisisnotconductedintheirorganisations.Someofthehealthsupplychainorganisationsexaminedinthecasestudiesreferredtolimitationsintheirabilitytooffer competitive salaries and benefits, due to constraints imposed by state regulations onsalariesandremuneration.
5.2 Pathway2.Skills
Adequate technical, managerial, and leadership skills are essential for effective employeeperformance. TNA aims to identify knowledge and skills gaps depending on requiredcompetenciesandthetrainingobjectives,bothorganisationalandindividual.Ithelpsemployeestobridgethosegapsandensurethattheirperformancecomplieswiththebusinessneedsoftheorganisation.AlthoughTNAiscommonlyperceivedasanintegralpartofHRdevelopmentandtransformation,50%of survey respondents indicated that their organisationsdonot conducttrainingassessment,and35%ofrespondentshighlightedthatTNAintheirorganisationsdoesnot lead to the development of a training strategy or plan. The study emphasised that bestpracticesinthesurveyedorganisationsaimedatsupportingCPDofsupplychainspecialistsaretailoredtoaddressspecificskillsneedsthroughtrainingandleaning,providecertificationsandencourageobtaininghigherdegrees,andsupportmembershipsinprofessionalassociations.
Professionalisation of SCM specialists, although a new area of HR development, is gainingincreasingattentionfromhealthsupplychainorganisationsinAfrica.Itstaskistoprepareand
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supporthighlycompetentmanagersandpractitionersthroughtrainingandcareermanagementbyestablishingglobalstandardsforhealthSCMjobfunctions,skillsneedsanalysis,harmonisedlearningcurricula,andaccreditationofsupplychainworkers.
Communitiesofpracticepromote theprofessionalisationofsupplychainworkers indifferentareas,creatingashareddomainforlearning,networking,andthesharingofideas,methodsandexperiences.Thesurveyrespondents indicated thatacommunityofpracticecan takevariousforms, such as on-the-job training,moderateddiscussions,webinars andworkshops, etc.Thestudyfoundthatsupportingcommunitiesofpracticeisconsideredasanimportantstimulusforcontinuousprofessionalandleadershipdevelopmentofemployees.
5.3 Pathway3.Workingconditions
Organisational culture is a key part of creating a supportive work environment. The studyidentifiedseveralkeypolicyareastosupportorganisationalculture,encompassinghealthandsafety policies, anti-harassment policies, creating a good environment for women, codes ofconduct,andequalopportunities.Allsixcasestudyparastatalorganisationsstatedthattheyhavea code of conduct in place. Regarding overall organisational culture, one KII respondentemphasised the importanceof changing the cultureby first ensuring there is agoodphysicalenvironment.Ways of creating a good physical environment for staff include creating sportsteams,ensuringacleanenvironment,andprovidingsubsidisedmealsataworkplacecanteen.
Some of the six-case study parastatal health supply chain organisations promote women orminority groups through specific groups or departments (e.g. a Gender MainstreamingCommittee and a Disability Mainstreaming Committee at KEMSA, and a Gender and YouthDirectorate atEPSA).OtherproceduresmentionedbyKIIs includeusing affirmative action ineitherrecruitmentorpromotion,havingaclearpolicyonattractingandmaintaininganequalworkforce,andexaminingdisaggregateddataonthegendersplitatdifferentlevels.
Having an overarching code of conduct or ethics in place was the most common policyinterventionlistedbysurveyrespondents(63%haveoneinplace),andthesewerealsofoundtobeinplaceatallofthesixcasestudyparastatalorganisations.OtherpoliciesmentionedinKIIscovered a range of areas: anti-corruption, anti-fraud, anti-discrimination, HIV and chronicdiseases,sexualharassment,andhealthandsafety.Policiesalonearenotsufficienttoimproveworking conditions: policies should be regularly reviewed, and steps taken to ensureimplementation. KIIs mentioned how their organisations sensitise employees on, anddisseminate,theirpoliciesbymeansofconsultation,regularreviews,printingouthardcopies,anduploadingsoftcopiestotheintranet.NMSinUgandaisalsointheprocessofdesigningonlinemodulescoveringitspolicies.
The study also examined theuseofwhistleblowers to create a goodworking environment, amechanismthatwasreportedtobeinplaceby41%ofsurveyrespondents.FouroutofthesixKIIsalsostatedtheyhaveawhistleblowingpolicymechanism.Keypracticesidentifiedfromthesurvey respondents and the KIIs in creating a whistleblowing policy mechanism include anindependentlymanaged anonymous hotline and the use of specific email systems to ensureanonymity.
EffectiveOSH,encompassingpsychosocialthreatsandgender-basedviolence,aswellasphysicalharm, isan importantpartof increasingworkermotivationand theoverallenvironment.Thestudy identified six key policy areas or interventions that support OSH, including budgeting,checkliststoensurecompliance,riskassessments,andoverallpoliciesandproceduresinplace.Themostimplementedinterventionreportedbysurveyrespondentswastheimprovementofthe
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workplace conditionsandproviding staffwith thenecessary toolsandequipment toperformtheirjobs(81%).Otherimportantareasmentionedbykeyinformantsincludedcarryingouttests(e.g.lightingconditions,airquality),providingmedicalcoverandfreehealthchecks,registeringnear incidents,andprovidingprotectiveequipment tostaff.Multipleorganisationsmentionedthattheycomplywithnational-levelhealthandsafetylegislation.
5.4 Pathway4.Motivation
MotivatingthehealthSupplyChainworkforceiskeytoimprovingperformanceandcommitment.Thestudyconcludedthateverycountryhas identified itsuniquecombinationof intrinsicandextrinsicmotivators.Forexample,performancemanagementissupportedusingKPIsatEPSA,KEMSA,andNMSF.MSDuses its internalappraisalsystem,calledDRIVE,whileNMSseeks tomotivateemployeesthroughchangestotheworkenvironmentandorganisationalculture.
A range of performance incentives andwork benefits are utilised across the six case studyparastatalorganisationstoenhancethemotivationofstaff.ThisincludesrewardingemployeeperformancewitharecognitionletterandadinnerwiththeCEOatKEMSA;providinghardshipallowances, honoraria, and transport allowances at MSD; and providing an entertainmentallowance for client-facing job roles, fuel allowances for middle and top management, andtransportforstaffatNMS.
Performance appraisals are central to motivation across the six case study parastatalorganisations. These are conducted annually or bi-annually, using either the BSC tool or 90-degreeor180-degreeappraisalmethods.
Promotionsalsoemergeasanimportantmechanismofemployeemotivation.TheyareguidedbytheCareerProgressionPlanatKEMSA,theConditionofServicehandbookatCMST,andtheCivilServiceChamberatNMSF.MSDfollowsacompetence-basedpromotionsystem,whereasNMSdoesnotexercisepromotionsatall, instead invitingemployees toapply foravailable internalpositionsatvariouslevelsaftertheexpirationoftheirfixed-termfour-yearcontract.Thestudyrevealed thatmentoring, coaching, andsupervision activitiesareoften limited at the six casestudyorganisations. Someof theorganisations are lacking SOPs formentoring and coaching,others encourage staff to seek mentoring opportunities outside their organisation throughparticipationinworkshopsandseminars.
Thestudyidentifiedavarietyoftoolsthatareusedtoimproveemployeeengagementandstaffretention.Afewofthesixcasestudyorganisationshavedevelopedstructuredretentionschemesandpolicies(e.g.KEMSA’sTalentManagementManual),whileothersresorttovariousmonetaryand non-monetary incentives, work benefits, and organisational changes. These range fromprivatehealth insuranceand freehealthchecks, tovariousallowances, subsidisedmeals, stafftransportation,andtradeunionsupport.
Disciplinaryproceduresandrulesarewelldocumentedacrossthesix-casestudyorganisationsandareregulatedbyeitherdisciplinarypolicies,codesofconduct,orgovernmentalregulationsand acts. Staff satisfaction surveys are conducted annually or biennially in all the case studyparastatalorganisations,exceptforNMS.Thelatterhasnotconductedsuchasurveyinthepastbut plans to introduce one in 2020, and to extend participation to internal and externalstakeholders.
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Appendix1.Comparativetables(casestudies)
ThefollowingfourcomparativetablessummariseHRMpracticesatthesixcasesstudyparastatalorganisations.
A.1Pathway1.Staffing
Sub-themeKEMSA,
Kenya
NMSF,
Sudan
NMS,
Uganda
EPSA,
Ethiopia
MSD,
Tanzania
CMST,
Malawi
Recruitmentprocess
Has12jobgrades.
Recruitmentfortop
managerial
positions(Grades1–
3)isoutsourced,but
candidatesare
interviewedbythe
KEMSABoardof
Members.
Recruitmentfor
Grades4–12is
conductedin-house.
Advertisingisboth
internaland
external(depending
ontheposition).
Interviewpanelis
appointedbyCEO.
Dependingonthe
levelofthejob,the
panelmayinclude
CEO;HRmanager;a
technicalspecialist
intherelevantarea;
Has16jobscales:
Skilledemployees
(Scales1–9)and
unskilledlabour
(Scales10–16).
Candidatesfor
positionsinScales
1–5selectedbythe
specialRecruiting
Committee,
approvedbythe
Boardof
Administrationand
appointedbythe
CouncilofMinisters.
Candidatesfor
positionsinScales
6–9arerecruitedby
theNationalCivil
ServiceCommission.
Candidatesforjobs
inScales10–16are
recruitedbyNMSF.
Vacanciesarefirst
advertised
internally,according
todepartmentaljob
requisitionforms.
TheHRdepartment
conductsthe
applicationand
shortlistingprocess.
Shortlistsapproved
bythetop
managementbefore
candidatesare
invitedfor
interview.
Ifpositionscannot
befilledinternally,
HRdepartment
initiatesexternal
recruitment.
Advertsareplaced
ontheNMSwebsite,
socialmedia,andin
thenationalprint
mediafora
Vacancies
advertisedin
government
newspaperand
postedonEPSA
noticeboards.
Accordingtothe
CivilService
Commission
guideline,priorityin
fillingvacanciesis
giventotheexisting
workforce.Onlyin
theabsenceofa
suitableinternal
candidateisthejob
advertised
externally.
Writtentest(taken
atAddisAbaba
University)
precedesthe
interview,whichis
Employment
requestsare
submittedbyMSD
departmentstothe
HRviajob
requisitionforms.
Beforeinitiating
recruitment,theHR
explores
opportunitiesfor
staffre-
categorisation.If
not,allvacancies
canbefilledby
recategorisedstaff,
theHRadvertises
positionsexternally.
Accordingtothe
PublicServiceAct
(2016),theMSD
recruitment
campaignis
conductedthrough
thePublicService
11jobgrades,
rangingfrom
leadingmanagerial
positions(Grades1–
4)tomiddleand
lower-leveljobs
(Grade11).
Recruitmentis
regulatedbythe
Termsand
Conditionsof
Servicehandbook.
Certainjunior
positionsadvertised
internally.Other
positions,from
officerleveland
above,are
advertisedboth
internallyand
externally.
Recruiting
committeedrafts
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headorassistant
headofthe
department.
minimumofseven
days.
Shortlisting
committeeis
organisedbytheHR
departmentand
approvedbythetop
management.
NMSconducts
aptitudetestsor
technicaltests
dependingonthe
natureofthejoband
thevolumeof
applications.
Separateinterview
committeesare
organisedfor
differentlevelsof
jobposition.
thecrucialphaseof
recruitment.
Recruitment
Secretariat.
TheMSDHR
department
performschecks
andshortlisting,
conductsinterviews
andmakesjob
offers.
Aninterviewmatrix
isemployed
(includingtechnical
questionnaire,
sectionsonrequired
competencies,
qualifications,and
jobfitness).
Assessmenttests
areconductedfor
technicaland
supporting
positions.
Professional
assessmentof
candidatesfortop
managerialrolesis
outsourcedtoa
recruitment
company.
interviewquestions
andpreparesacase
studytasktobe
completedby
candidatesin
advanceand
presentedaspartof
theirassessment.
Job descriptions Basedona
competency
framework;include
clearlydefinedand
Basedon
competency
frameworkand
developedbyPtD.
Developed
accordingtotheJob
DescriptionManual.
DevelopedbyCivil
ServiceCommission,
notbasedona
competency
Basedonthe
competency
framework
developedby
Jobdescriptionsdo
notfollowa
competency
framework,but
62
detailedobjectives,
essential
professional
qualificationsand
competency
requirements.
Developedin
assistancewiththe
StateCorporation
Advisory
Committee.
Includeclear
objectives,
responsibilities,
qualifications,skills,
andexperience
requirements.
Noseparate
competency
framework
available.
Draftedwiththe
assistanceofa
consultantandin
collaborationwith
headsof
departments.
Containclearjob
objectives,
responsibilities,and
essential
professional
qualifications.
Approvedbythe
Boardofthe
organisationand
regularlyupdated.
framework,and
alignedwithother
civilservice
organisationsinthe
country.
Accenturewith
supportfromBMGF.
Thecrucialsupply
chainpositionswere
reviewed,andjob
descriptionsrevised
andexpanded
followingthe
framework.
includejob
objectives,essential
skills,qualifications,
andresponsibilities.
Payscaleandsalaries
Guidedbystate
regulationson
salariesand
remuneration.Nine-
bandpaystructure
foreachjobfamily.
KEMSAconducts
salarymarket
analysisandcan
negotiatesalaries
withspecialistsin
highdemand.
Clearpay
benchmarking
linkedtosupply
chaincareersat
NMSFandthejob
gradingsystem.
Payandgrading
scalesareclearand
tendtobealigned
withsupplychain
careersand
consistentwith
marketrates.
Salariesaredefined
bytheCivilService
Commission
accordingtojob
gradesandfollow
thepayscales
establishedfor
institutionsunder
theauspicesofthe
MinistryofHealth.
Salarymarket
analysisisnot
conducted.
Clearsalary
benchmarking
linkedtosupply
chaincareers.Salary
marketanalysisis
alsoconducted.
Structured
accordingtojob
grades,includes
salaryincrements.
63
A.2Pathway2.Skills
Sub-themeKEMSA,
Kenya
NMSF,
Sudan
NMS,
Uganda
EPSA,
Ethiopia
MSD,
Tanzania
CMST,
Malawi
TNA,andtrainingstrategyandplanning
TNAisconducted
annually,informed
byperformance
appraisals.
Trainingrequests
aresubmittedto
theTraining
Committee,which
plansthetraining
calendar.
Mandatory
leadershiptraining
ingovernment
school(forGrades
1and2roles).
Special
professional
trainingfor
technical
personnelto
obtainpractising
certificateata
relevant
professional
body/institute.
Alltrainingis
outsourced.
TNAisconducted
annually.Training
followsa
comprehensive
trainingstrategy
andplan.Training
usuallyconductedat
departmentallevel.
Varioustraining
coursesandCPD
programmes
providedatNMSF
andthededicated
trainingcentre(esp.
forpharmacists).
TNAisconducted
annuallyand
informedby
performance
appraisalreports.
Trainingismostly
outsourcedto
external
organisationsor
conductedin-house
byexternaltrainers.
TNAhasbeen
conductedatthe
organisational,
departmental,and
individuallevel
(supportedbyPSA).
Trainingstrategy
andplanningare
beingdeveloped.
TNAisconducted
annually,informed
byperformance
appraisals.
MSDhasdeveloped
itsownappraisal
system(DRIVE).
TheHRdepartment
reviewstraining
needsrequestsand
draftsatraining
plan,dependingon
employee
performanceand
organisational
needs.
MSDconductsa
mixtureofin-house
andoutsourced
training,and
partnerswith
variousinstitutions
(e.g.PSPTB).
TNAisconductedas
partofperformance
appraisalsystem.
TheHRdepartment
consolidates
trainingrequests,
draftstheannual
trainingplan,
definesthebudget
(currentlyquite
limited).CMSTis
currentlyplanning
thestaff
developmentand
trainingstrategyfor
financialyear
2020/25(aspartof
theNationalSupply
ChainIntegration
Project).
64
Professionalisation,mentoring,supervision,on-the-jobtraining
Coaching,
mentoring,andon-
the-jobtraining.
Mentorshipand
supervision
decisionsaremade
jointlybetween
headsof
department,
supervisors,and
employees.
NMSFencourages
networkingwith
professionals(incl.
SudanPharmacist
Union),performing
researchrelatedto
medicalsupply
chain,trainingand
educating
individualsatother
organisations,and
developinganethic
ofcontinuous
professional
improvement.
NMSencourages
stafftojoinrelevant
professional
associations,covers
incurred
membershipand
subscriptionfees.
NMSFsupportsstaff
intakingpart-time
qualificationcourses
bycoveringthefees.
MeasuresforCPD,
workshops,on-the-
jobtraining,self-
sponsoring,and
countysponsorship
fortraining.
PSAissupporting
EPSAinestablishing
thededicated
Trainingand
ResourceCentreto
conductalltraining
andCPDactivities
in-house.
Supportsstaff
membershipof
professionalbodies
andcovers
associatedcosts.
Mentorshipisnot
yetrobust:thereisa
smallpoolofon-the-
jobmentorsandthe
HRorganises
variousmentoring
activities.
Conductssomeon-
the-jobtraining.
Technicaltrainingis
outsourcedto
externalinstitutions
andprofessional
bodies.CMST
followstraining
calendarofthese
institutionstodraft
itstrainingplan.
A.3Pathway3.Workenvironment
Sub-themeKEMSA,
Kenya
NMSF,
Sudan
NMS,
Uganda
EPSA,
Ethiopia
MSD,
Tanzania
CMST,
Malawi
Overallorganisationalculture
Astrong
organisational
culturethat
promotesexcellence
andchange.
Staffsignaconflict
ofinterestformand
supplierssignan
agreement thattheycommittolegaland
ethicalpractice.
NMSFhaschanged
organisational
culturebyfirst
upgradingphysical
workenvironment
(e.g.installingnew
desks,computers,
emailsystems,high-
speedinternet,etc.).
NMSFhastaken
stepstoimprove
employeewelfare
(e.g.transportation
towork,private
medicalinsurance).
Organisational
cultureis
communicatedto
employeesduring
theinduction
process.
NMShasaHR
manualexplaining
employeeconduct.
Providesworkplace
meals,staff
transport,fuel
allowancefor
middle
EPSAhas
establishedaSupply
AgencyEthicsUnit
inaccordancewith
theRegulationsof
theCouncilof
MinistersRegulation
144/2000.
EPSAisintroducing
apoolofcultural
ambassadors
(followingthe
AdmasProgramme
organisational
culturediagnostic).
MSDusesaKPIto
ensurework
environmentis
conduciveto
improvedHR
planningand
management.
Termsand
Conditionsof
Servicearethe
primaryframework
increatingagood
workenvironment
(currentlyatfinal
stageofbeing
updated).
65
Othermeasures
includedeveloping
staffrecreational
area,buildinga
cafeteria,mini-
market,cashpoint,
AdoptedaCodeof
Conductand
providestrainingon
howtomaintaina
cleanandsafe
working
environment.
management,
mobileairtime
credit,smallclient
entertainment
budget(if
applicable).
Policiestopromotewomenormembersofminoritygroups
Gender
Mainstreaming
Committeeensures
thatinterestsand
concernsofboth
womenandmenare
notcompromised.
Examinesgender
ratiointhe
workplaceat
differentlevels.
Disability
Mainstreaming
Committeefocuses
onsupportingstaff
livingwith
disabilities.
Supportsminority
groupsin
procurement.
RecruitmentandHR
policiesemphasise
non-discrimination
basedonany
characteristic.
Clearpolicyon
attracting,
maintaining,and
motivatingequal
opportunities
workforce.
EPSAhasaGender
andYouth
Directorateand
followsaffirmative
actionin
recruitment,
training,andother
similaractivities.
Hasananti-
harassmentpolicy.
Encourages
recruitmentof
peoplewith
disabilitiesandhas
practised
affirmativeactionin
recruitment.
66
Policiesthatpromoteorganisationalculture
KEMSAhasaCode
ofEthics,signedby
newstaff.
Newpoliciesare
sharedatameeting,
onKEMSA’s
intranet,andinhard
copies.Mostpolicies
arereviewedevery
twoyears.
CodeofConduct
(appliedfollowinga
jointdiscussion
involvingall
employees).
Extensivecorpusof
policiesincluding:
• Anti-corruptionpolicies;
• Anti-fraudpolicies;
• Emailpolicy;
• Goodgovernanceformedicines.
NationalMedical
StoresHuman
ResourceManual.
Policiestostop
discrimination
basedongenderand
otherfactors.
HIVandother
chronicdiseases
workplacepolicy.
CodeofConduct
(everyemployee
mustreadandsign).
Fraudpolicyand
riskmanagement.
Sexualharassment
policy.
Healthandsafety
policies.
Followsnational
Anti-CorruptionAct.
Continuously
reviewspolicies,
conductsregular
staffsensitisation.
NMSinprocessof
creatingonline
modulesdedicated
toorganisational
EPSAhasarecently
updatedCodeof
Conduct,which
includes
informationon
healthandsafety,
anti-harassment,
andanti-
discrimination.
Anti-harassment
policy.
CodeofConduct.
HIVworkplace
policy.
Fraudand
Corruption
PreventionPolicy.
CodeofConduct
(outlinescore
values,vision,and
mission).
Policiesdeveloped
byaconsultative
process,andonce
finalisedstaffhave
opportunitiesto
raisequestions.
Copyofeachpolicy
isgiventostaff.
67
policies(andother
topics).
OSH(includingpoliciesandprocedures)
DirectorateofOSH
helpstoimplement
policies.Directorate
ofOSHcarriesout
tests(e.g.air
sampling.assessing
lightingquality,
sufficientminimum
workspace)and
provides
recommendations.
Providesmedical
covertostaff,
annualfreemedical
examinations,anda
familyfunday,
whichincludes
healthtesting.
Carriesoutannual
auditsandregisters
nearincidents,
ensurestheuseof
PPE.
Insuresstaffagainst
workplaceinjuries.
OSHregulations.
First-aidkits.
Healthandsafety
policy.
Specificsectionto
ensureemployees
areprovidedwith
necessaryPPEand
haveasafework
environment.
NMSprovidessafety
weartostaff,
includingshoes,
overalls,and
helmets.
Healthandsafety
training,firesafety
proceduresforthe
workplace.
Medicalinsurance
coverforstaff,their
spouses,andupto
fourchildren.
OSHSOPs.
Ensurescompliance
withstandards,
governedbythe
OccupationalSafety
andHealth
Authority.
ThisincludesPPE
forstaffworkingin
coldvaccinestores,
transportationfor
staffworkingnight
shifts,mobile
airtimecredit,etc.
Conductsquarterly
medicaltests(prior
toCOVID-19),
hepatitisvaccine,
andawareness
campaigns(e.g.
encourages
employeestotake
HIVtests).
FollowsLabourAct
forHealthand
Safety.
Conductshealthand
safetytrainingsand
firesafetydrills.
Ensuresthereisa
cleanenvironment
andstaffuse
protective
equipment(e.g.
warehouseworkers,
cleaningteam,
securityteam,etc.).
Detailsofwhistleblowingmechanism(ifapplicable)
Specialcommission
protects
whistleblowers’
identity.
Themechanism
ensures
whistleblower
anonymity.
Themechanism
emphasisesthatany
formof
whistleblowingis
acceptableand
anonymityof
whistleblowers
shouldbeprotected.
Thereisno
mechanism
currentlyinplace,
butplanstocreate
one.
Themechanism
ensuresanonymity
andisoutsourcedto
Deloitte.
68
A.4Pathway4.Motivation
Sub-theme KEMSA,
Kenya
NMSF,
Sudan
NMS,
Uganda
CMST,
Malawi
MSD,
Tanzania
EPSA,
Ethiopia
Performancemanagementpolices
KPIsstrengthenthe
performance
management
processand
improvestaff
motivation.KEMSA
staffareencouraged
byfosteringasense
ofbelonging.
KPIstosupportstaff
performance
managementand
theunderstanding
ofindividualtasks
andorganisational
goals.
KPIsreviewedevery
sixmonthsto
ensurestaffhave
clearunderstanding
ofindividualtargets.
CMSTuses
theBSCtomanage
performanceof
Boardmembers.
Therestofthestaff
areassessedby
different
performance
managementtools,
developedby
consultants.
MSDusesitsown
internalappraisal
systemcalled
DRIVE,basedon
agreedperformance
objectives
submittedtotheHR
annuallyinMay–
June.
Corporateand
directorate-level
KPIsinplace,which
aregovernedbythe
monitoringand
evaluation
framework.
Incentivesandbenefits
Employeerewards
andrecognition
systeminclude
annual
salary increments, a
recognitionletter
signedbytheCEO,a
dinnerwiththeCEO,
etc.
NMSFintroduced
performance-based
rewardsand
incentivesin2012.
Thesystemapplies
ifanemployee
scoresabove70
pointsin
performance
appraisal.NMSF
offersstaffan
additionalbenefits
package.
NMSstaffarepaid
attractivesalary
consistentwiththe
marketrate.
Incentivesand
benefitsalsoinclude
entertainment
allowanceforclient-
facingjobroles,fuel
allowancesforstaff
atmid-andtop-level
management,
transportforstaff
(staffbus),etc.
Non-financial
incentives,suchas
recognitionforgood
performanceduring
annualappraisals,
staffexchange
programmes,staff
engagementin
stakeholder
meetings,etc.
Anorganisational
incentivescheme
includeshardship
allowancesfor
employeeswho
resideinhard-to-
reachareas,an
honorariumin
recognitionfor
contributionto
work,mobile
airtimecreditand
transport
allowances,etc.
Noperformance-
basedincentivesare
inplace.
Appraisal KEMSAconductsbi-
annualperformance
appraisals;utilises
90-degreeand180
degree-
performance
appraisalmethods.
TheCivilService
Chamberguides
performance
appraisal.
Supervisorsare
mandatedtofillthe
assessment
NMSconducts
performance
appraisalbythetop
managementtwicea
year:inJuly(review
forJanuaryto
June)andin
Anopenappraisal
systemwherebyan
employeefillsthe
BSCand
indicatesthelevelof
individual
performance.
Performancereview
conductedtwicea
year(inDecember
andMay).
EPSAhasbeenusing
theBSCas
performance
managementtool,
butnotuniformly
throughoutthe
organisation.
69
anonymouslyand
submitittotheHR
department.
January(reviewfor
JulytoDecember).
Promotion Promotionsdepend
onskills,experience,
performance,
competence,
disciplinaryissues,
availabilityof
vacancy,etc.
Civil
ServiceChambergui
despromotionof
eligiblecandidates.
However,
promotionsarenot
linkedto
competence
framework.
NMSdoes
notconductpromoti
ons.Everyemployee
receivesafour-year
contract.Initially,all
vacantpositionsare
advertised
internallyandtried
tobefilledthrough
existingcandidates.
Promotionsaregove
rnedbythe
ConditionofService
handbookandbased
onannualstaff
performance
assessments.There
isnocompetency-
basedpromotion
framework.
MSDfollows
competence-based
promotionslinked
tothecompetency
framework.
Promotionsarealso
guidedbytheDRIVE
appraisalsystem
score.Tohelp
underperforming
employees,MSDhas
introduceda
Performance
ImprovementPlan.
Promotionsarenot
linkedto
competencies.
Educational
qualificationsand
yearsofexperience
areusedasthemain
criteriafor
promotion.
Capacitybuildinganddevelopment
PublicService
Rulestandards
requireCEOsand
directorstoundergo
leadershiptraining
atgovernment
school.Managersin
Grades3and4
undergospecial
management
training.Members
oftechnicalstaff
needtocompletea
numberof
professional
traininghoursto
collectpointsfor
apractising
certificateattheend
ofeverycalendar
year.
Capacity
developmentcan
includeself-learning
(usinglearning
facilitiesand
resourcesofthe
NMSFTraining
Centre).Staffare
encouragedto
participatein
conferencesand
workshopsinthe
region,andother
relevanttraining
offeredtothestaff.
TNAidentifiesthe
trainingneeds
whichsupportthe
developmentofan
annualtraining
program.The
performance
appraisalalso
guidestraining
opportunitiesasthe
developmentofstaff
iscentraltoNMS.
Trainingismostly
outsourcedbasedon
theareaofworklike
accounting,
management,
pharmacy,etc.On-
thejobtrainingand
stafforientationare
conductedin-house.
AtMSDTNAis
conductedannually
aspartofthe
performance
managementsystem
calledDRIVE.
Trainingisaligned
withthechanging
businessneeds,
SupplyChain
landscape,
andMSD’sneed.A
mixofin-houseand
externaltraining
opportunitiesare
providedtothe
staff.
Atpresent,thereisa
TNAandatraining
plan,whichhas
beenendorsedby
otherpartnersof
EPSA.Atraining
strategyisbeing
developedandwill
beendorsedsoon.
70
Supervision KEMSAprovides
supervisorysupport
throughcoaching
andmentoring.
Mentoringand
coachingactivities
beganin2018but
arestillscarceat
NMSF.
NMSencourages
inter-departmental
coachingand
mentoringof
employees,
(especiallyfor
junior-levelstaffas
partofgeneral
induction).
CMSTencourages
mentorshipasopen
interactionbetween
staffmembersand
linemanagersto
forgesenseof
guidanceand
support.
MSDprovides
mentorshipsupport
foremployees.Staff
areencouragedto
participatein
seminarsand
workshops,which
includeanelement
ofmentoringand
coaching.
Participationfees
arecoveredbyMSD.
Nomentoring,
coaching,and
structured
supervisionscheme
availableatan
organisationallevel.
PSAcurrently
supportsEPSAin
theimplementation
ofthisscheme.
Engagementandretentionstrategies
KEMSA’sretention
policyisbasedona
TalentManagement
Manual.KEMSA
providesaone-week
induction
programme,study
leaveforcompleting
trainingordegree
courses,etc.Asa
resultofitsretention
strategies,KEMSA
hasbeenabletokeep
staffturnoverata
lowlevel.
Engagementpolicies
includedchanging
theambienceofthe
office,
providingbetteracc
esstocomputers,
ERPsystem,
providing
transportationfor
employees(inair-
conditionedmini-
vans),
introducinguniform
s,providingprivate
medicalhealth
insuranceforstaff
andfamily
members,
subsidisedmeals,
mini-market,cash
pointsontheNMSF
premises,etc.
NMSisfocusedon
retainingthebest-
performing
employees,
conducting
employee
motivation
programmesand
prioritisinginternal
recruitmenttohelp
retainthequalified
workforce.
CMSToffers
competitive
remuneration
package,conducts
team-building
exercises(everytwo
years),andcommits
totransparent
communicationand
feedbackpolicy.
Theseeffortshelp
keepstaffturnover
atlowlevel.
MSDdoesnothavea
specialretention
schemebutoffersa
rangeofbenefits
andactivitiesto
sustainemployee
engagement.These
includeofferinga
clearcareer
progression,paying
formembershipin
uptotwo
professional
associations,
offeringagratuity
schemewithapay-
outtoallstaffevery
twoyears,etc.These
benefitshave
contributedtovery
lowattritionrates.
Thelackofcareer
pathsand
organisational
retentionpolicies
hascontributedtoa
declineinemployee
engagementand
increasedemployee
turnover.
Disciplinarypolicyandpractice
Thedisciplinary
policiesare
monitoredbya
NMSFadherestothe
DisciplinaryActfor
theCivilService.
Thedisciplinarycod
eguidesAll
disciplinarycases
followadisciplinary
Disciplinarypolicies
areapartofthe
Termsand
Disciplinarypolicies
andpractices
aregovernedbythe
PublicServiceAct,
EPSA followsthe
civil
service disciplinary
codeofconduct.
71
specialcommitteein
KEMSA.
codeand
disciplinary
procedures
explainedintheHR
Manual.
Conditionsof
Service.
2002andits
regulationsof2003.
Staffsatisfactionsurvey
Thesurveyis
conductedevery
twoyears.
Thesurveyis
conductedevery
yearandtheresults
arediscussedwith
employees.
Thesurveywasnot
conductedinthe
past.Thereare
planstoconductthe
staffsatisfaction
surveyin2020and
extendittointernal
andexternal
stakeholders.
Thesurveyis
conductedannually.
Thesurveyis
conductedannually
bytheHR
department.
Thesurveyis
conductedannually
attheorganisational
andhub/location
level.
72
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