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Capacity development country support

ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS Final Draft for Comments August 2019


CAPACITY DEVELOPMENT COUNTRY SUPPORT

ACKNOWLEDGEMENTS This document was developed by the people & policy team, supply chain strengthening centre in UNICEF Supply Division with support from GAVI. Special thanks to the key contributors: Adebayo Adekola, Cheryl Mayo, Dorothy Leab and Musonda Kasonde and review by the People that Deliver (PtD) team – Dominique Zwinkel and Alexis Strader.

For further information: Supply Chain Strengthening Centre, UNICEF Supply Division Sc.strengthening@unicef.org

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CONTENTS

20

2 4

Acronyms

6

Framework for effective organizations from the human capacity lens

7

Country interventions linked to organizational design

8

Assessing programmatic and organizational targets

Introduction and overview

10

Defining HR requirements

11

Organizational design for supply chain and logistics operations: Focus on organizational structure/organogram

12

Key considerations in organizational design

14

Developing an organizational structure at country level

16

Lessons learned in organizational design

19

Gender-friendly organizational design

Sample templates of organograms for supply/logistics systems Country context and organizational structures Specific organogram samples for supply chain organization

34 36 38 39 40 44

Country examples

45

References

48 56 62 63

Annex I Country Organogram Models

Developing and maintaining job descriptions WHO Standard Competencies for Immunization – Vaccine supplies and logistics HR capacity and performance strengthening Managing performance Conclusion

Annex II Sample Job Descriptions Annex III People that Deliver Competency Framework Annex IV APCIS Supply Chain Professional Competency Framework

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CAPACITY DEVELOPMENT COUNTRY SUPPORT

ACRONYMS

3PL

third-party logistics

4PL

fourth-party logistics

CCEOP

Cold Chain Equipment Optimization Project

COE

centre of excellence

DL&HC

Department of Logistics and Health Commodities

EPI

Expanded Programme on Immunization

GAVI

Global Alliance for Vaccine Initiative

GM

general manager

HR

human resources

KPI

key performance indicators

LMIS

logistics management information systems

MCP

medical commodities programme

NSCS

National Strategic Cold Store

OD

organizational design

PESTLE

political-economic-social-technological-legal environment

QA

quality assurance

SCM

supply chain management

SWOT strengths-weaknesses-opportunities-threats USAID

United States Agency for International Development

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ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS


CAPACITY DEVELOPMENT COUNTRY SUPPORT

INTRODUCTION AND OVERVIEW

Countries have dedicated and competent immunization supply chain leaders with adequate numbers of skilled, competent, accountable, motivated, and empowered personnel at all levels of the health system.

All health systems require a reliable supply of high-quality health products for service provision, thereby contributing to improved health outcomes and productivity. As a result, health supply chain strengthening is a major area of focus for governments and development partners, with increasing investment and accountability for procured health products. At the heart of health system strengthening is the need for sustained human resource capacity at all levels for supply chain operations and management. The GAVI supply chain strategy equally promotes five main fundamental building blocks: planning and management, system design, human resources (HR), logistics immunization data and cold chain systems. A critical part of the vision for the GAVI Alliance immunization supply chain strategy is that countries have dedicated and competent immunization supply chain leaders with adequate numbers of skilled, competent, accountable, motivated, and empowered personnel at all levels of the health system. Hence one of the building blocks of the strategy is strengthening HR management with adequate numbers of skilled, competent, accountable, motivated and empowered personnel at all levels of the health system. The expansion of health services with new diseases, growing investment, volume, range and increasing use of technology creates new challenges. The attention to HR is key at a time when countries continue to find ways to address challenges and also plan for future changes. The following challenges, though not exhaustive, call for the need to improve human and organizational capabilities to strengthen the public health supply chain systems to drive system maturity and ownership: • • • • • •

Inadequate HR capacity Limited governance and accountability framework Low data visibility at the last mile Stock-outs Poor planning, financing and resource mobilization Political situation

Need There is an increasing focus on coordination, collaboration and capacities within the supply chain space at country level. The dynamic environment in many contexts calls for a differentiated approach driven by a skilled and competent workforce as a way of improving governance, institutional and individual capacity. Countries continue to take concrete steps to strengthen ownership and sustainability of their supply chains through financing, system improvements and re-engineering, including having dedicated roles and units established within the ministry, programmes and projects. Such mechanisms to improve the supply chain include:

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ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

•  A supply chain and logistics unit within the ministry • • • • • •

of health/EPI Autonomous or semi-autonomous procurement and supply chain agencies New warehouses Partnerships with third-party logistics companies (3PL) Restructuring existing medical/vaccine stores Supply chain project teams National Logistics Working Groups (NLWGs)

Purpose This guidance forms part of the country support packages and responds to a need in the market for proper organizational design that will enhance supply chain efficiency and effectiveness in the public health system. While we do not intend to be prescriptive, this guidance can be contextualized to support decision-making when creating new organizational structures, job descriptions and performance improvement approaches. It is not meant to supersede national regulations regarding organizational capacity development, but serves as an add-on based on recent developments, initiatives and systems. This guidance provides templates and tools to support the immunization programmes in countries to ensure seamless supply chain operations for last-mile delivery and visibility in accordance with recommended standards of practices.

Who will find this guideline useful? This guidance document can be used by all relevant health programmes, HR, and supply and logistics personnel. Depending on the situation in the country, the appropriate authority may be a department, unit, technical working group or committee responsible for health and immunization programmes at all levels.

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CAPACITY DEVELOPMENT COUNTRY SUPPORT

FRAMEWORK FOR EFFECTIVE ORGANIZATIONS FROM THE HUMAN CAPACITY LENS FIGURE 1

Framework for development of individual capacity

Programmatic & Organizational targets

1

HR requirements

2

Job description

3

Training needs analysis

4

Training implementation

5

6

Performance management

Source: Authors

based on clear and appropriate job descriptions (roles, responsibilities and competencies) with well-defined HR performance indicators contributing to the training needs analysis, strategy and planning.

This framework defines a clear approach to developing organizational capacity within the purview of the relevant authority’s programmatic and organizational targets. This framework comprises six process components, as captured in the diagram below. It should be noted, however, that the process is cyclical based a continuous improvement approach. It begins with the need to put in place a vision of an improved organization through clearly defined goals, requirements and needs. The goal of this framework is to drive key actions that will ensure that dedicated and competent immunization supply chain leaders have adequate numbers of skilled competent, accountable, motivated and empowered personnel at all levels of the health supply chain to overcome existing and emerging immunization supply challenges. The sub-goal is to develop organizational and individual capabilities

Key terms Roles refers to competencies, accountabilities and outcomes of a job. Responsibilities are the accountabilities based on key performance indicators for a job. Competencies are observable and measurable knowledge, skills, abilities and personal attributes that contribute to individual performance and achievement of organizational goals.

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ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

COUNTRY INTERVENTIONS LINKED TO ORGANIZATIONAL DESIGN The diagram below provides an overview of country level activities linked to organizational design and performance improvement.

DIAGRAM 1

Country level activities linked to organization design and performance improvement

Performance management Supportive supervision Monitoring & evaluation Performance appraisal National Logistics Working Group

Programmatic & organizational targets Effective Vaccine Management (EVM) Country multi-year plan Supply chain strategy/plans Health system strengthening Continuous improvement planning Country planning process Health policy Maturity scorecards

Job descriptions Development of Terms of Reference Creating new positions

HR Requirements HR for SCM improvement planning Workload analysis Recruitment of SCM workforce Creating supply chain/logistics unit/ departments Developing supply chain process, structure and systems Setting up a new medical/vaccine store/project team

Training needs analysis & implementation Pre- and in-service SCM training (as stand-alone and part of existing curriculum) Mid-Line Manager (MLM) training Strategic Training Executive Programme (STEP) Supply chain & logistic centres of excellence

Source: Authors

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ASSESSING PROGRAMMATIC AND ORGANIZATIONAL TARGETS The purpose of defining clear programmatic and organizational goals based on a well-defined strategy cannot be overemphasized. These goals provide direction for supply chain management in any given

DIAGRAM 2

context. Organizational and programmatic goals should be developed with the following elements and subelements in mind (see Diagram 2).

Key considerations for setting organizational goals

RESOURCES/ INPUTS

ACTIVITIES

LEADERSHIP AND GOVERNANCE

FINANCIAL MANAGEMENT

HUMAN RESOURCES

PROGRAMME MANAGEMENT

PROCESS MANAGEMENT

ORGANIZATION NETWORKS

OUTPUTS

OUTCOMES

IMPACT

Executive leadership Strategic planning Expertise showcase Governance Clear roles and responsibilities Planning Finance rules Recruiting, staffing, orienting Performance, monitoring and evaluation Career development, training Health / gender issues, quality of work environment and atmosphere Clear roles and responsibilities : job descriptions Planning, costing, evaluation Implementing, coordination between activities Monitoring programmes Problem-solving Decision-making Monitoring and evaluation Network within the organization Partnerships Communication and marketing

Resource

Link

United Nations Children’s Fund, A Process Guide and Toolkit for Strengthening Public Health Supply Chains through Capacity Development, UNICEF, New York, 2016.

www.technet-21.org/iscstrengthening/media/attachments/2017/02/07/processguide-and-sc-toolkit-for-public-health-sc-strengthening-through-cd.pdf

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ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS


CAPACITY DEVELOPMENT COUNTRY SUPPORT

DEFINING HR REQUIREMENTS ORGANIZATIONAL OBJECTIVES

HR INVENTORY

HR FORECASTING & DEMAND

HR GAP ESTIMATION

RECRUITMENT ACTION PLAN

the vision and strategy of the organization will enable better achievement of the pre-defined goals, activities and mission of the organization.

During this step, the HR needs are identified to support the strategic vision and goals. A major step is to assess the internal workforce based on the talent supply and actual requirements based on proper workforce planning.

The Human Resources for Supply Chain Management Theory of Change (HR4SCM ToC) developed by People that Deliver (PtD) provides a useful basis for strategic planning by providing a foundation for developing strategies to manage the quantity, type and capacity of human resources required to operate health supply chains. The HR4SCM TOC analyses the conditions needed to ensure that workers at every level are performing optimally, in order to fulfil all the necessary functions of an effective SC system. More information may be found at: <https://peoplethatdeliver.org/ptd/ resources/human-resources-supply-chain-managementtheory-change>.

The HR requirements should be mapped for key leadership, technical and administrative functions. The focus should be on forecasting the HR needs and developing clear strategies to building the talent pipeline in a sustainable manner. This analysis will reveal not only HR gaps but also capacity gaps that can be addressed for existing and new talent/ human resource. The People that Deliver workforce optimization and WHO workload tools are good references to guide in workforce planning. This alignment between human resource requirements and

Resource

Link

Norbert Dreesch et al., ‘An Approach to Estimating Human Resource Requirements to Achieve the Millennium Development Goals,’ Health Policy and Planning, vol. 20, no. 5, 2 August 2005, pp. 267–276.

<https://academic.oup.com/heapol/article-abstract/20/5/267/579129>

United Nations Children’s Fund, Human Resources for the Immunization Supply Chain Rapid Assessment: Training guide & questionnaire, UNICEF, New York, 2016.

<www.technet-21.org/iscstrengthening/media/attachments/2017/05/22/hr-for-iscrapid-assessment-sep-21-2016---english-training-guide.pdf>

People that Deliver, Health Supply Chain Competency Framework for Managers and Leaders, Australian Institute for Sustainable Communities, Canberra, 2015.

<https://peoplethatdeliver.org/ptd/resources/human-resources-supply-chainmanagement-stepped-approach-toolkit>

USAID|Deliver Project, Human Resource Capacity Development in Public Health Supply Chain Management: Assessment guide and tool, USAID, Arlington, Virginia, 2013.

<https://peoplethatdeliver.org/ptd/sites/default/files/resource_contents_ files/HR%20assessment%20guide%20and%20tool_1.pdf#overlaycontext=resources/stepped-approach-documents>

World Health Organization, Workload Indicators of Staffing Need: User’s manual, WHO, Geneva, 2010.

<https://www.who.int/hrh/resources/wisn_user_manual/en>

Pathfinder International, Organisational Structure: Series 1.

<www2.pathfinder.org/site/DocServer/Organisational_Structure.complete. pdf?docID=323>

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ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

ORGANIZATIONAL DESIGN FOR SUPPLY CHAIN AND LOGISTICS OPERATIONS: FOCUS ON ORGANIZATIONAL STRUCTURE/ORGANOGRAM manage the procurement, storage, distribution and monitoring of immunization supplies. An organizational design or redesign should be considered when there is a new strategic direction, significant changes in process, business re-engineering efforts or set-up of new unit/team/department/agencies. It is not necessary to overhaul the entire system, but a redesign can also be a good idea.

Organizational structure provides an overview of business functions in terms of decision-making hierarchy, supervisory authority, flow of communication and human resources with similar functional responsibilities. With the growing needs for ownership and sustainability of procurement and supply chain management, countries seek guidance on how best to create supply and logistics teams and agencies to

DIAGRAM 3

Steps in developing an effective organizational structure

STEP 1

STEP 2

STEP 3

STEP4

Preliminary Analysis Consider

Strategic Design Consider

Operational Design Consider

Implementation Consider

The strenghts, weaknesses, opportunities and threats with existing organisational structure

The objectives of a new organisational design aligned with the organisation's strategic vision

The organisationl structure suited for defined work processes and critical functions including relationships and workflows

The process of change management towards gaining buy-in and support and planning for the new organisational structure

When to consider an organizational design or redesign • Developing a multi-year strategic plan, for example,

• O  rganizational ineffectiveness reflected in persistent

a five-year supply chain strategy for the Public Health Sector. • Change in global or local market and economic dynamics related to drug supplies and procurement. • Major change in laws, policies or procedures that influences business operations, for example, new health policies, update on Essential Medicine List (EML), etc.

performance, leadership and systematic issues, for example, prolonged stock-out situations. • B  usiness process re-engineering (new systems, processes and procedures) may also inform an organizational design/redesign.

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KEY CONSIDERATIONS IN ORGANIZATIONAL DESIGN The following elements should be considered in designing an organizational structure that will ensure product availability to the last mile.

Policy and institutional framework Organizational structures should be within the institutional framework and provision of the law guiding the operation of the country for public/civil service. Supply chain strategy/policies The organizational structure should fit the supply chain strategy and broader policies. Supply chain processes The organizational structure should be determined by the defined supply chain processes. Supply chain pipeline The organizational structure should be aligned to the process by which commodities move from manufacturers to the last mile. Governance The governance structure should elevate the supply chain function. Organizational culture The organization structure should fit the organizational culture (underlying beliefs, assumptions, values and ways of interacting that contribute to the unique social and psychological environment of an organization). Budget The organizational structure should take resource allocation and mobilization into consideration. Talent/human resource pipeline The organizational structure should take into consideration the knowledge, skills and expertise available within and outside the organization. Collaborations/networks/communications The organizational structure should enhance formal and informal mechanisms for collaboration and communication and data visibility. Purpose Its purpose should be well defined based on value for money, efficiency and effectiveness considering core competence.

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DEVELOPING AN ORGANIZATIONAL STRUCTURE AT COUNTRY LEVEL The process of developing an effective organizational structure involves four main steps:

STEP 1: PRELIMINARY ANALYSIS

STEP 2: STRATEGIC DESIGN

STEP 3: OPERATIONAL DESIGN

STEP 4: IMPLEMENTATIION

Preliminary analysis The process starts with understanding the organization in its entirety and why an organizational design or redesign is required. The objectives of the organizational design should be well defined and agreed by stakeholders. KEY ACTIONS: Explore, listen, research and understand the organizational context. APPROACH: Focus group interviews, SWOT analysis, PESTLE analysis, survey and literature review OUTPUTS: Objectives of the organizational design

Strategic design The design process starts with the strategic design and focuses on creating a model that aligns with the organizational strategy and culture. An organizational design without a well-defined and contextualized strategy creates ineffective organizations that may not meet the set vision, goals and objectives. At this phase, you agree on the best model and gain stakeholder consensus on the best-fit organizational design. KEY ACTIONS: Align objectives with strategic priorities. APPROACH: Fishbone, brainstorming, stakeholder engagement OUTPUTS: â&#x20AC;˘ Options for organizational structures based on strategic objectives, competence and functions â&#x20AC;˘ Documented systems, processes and procedures

Operational design The operational design is the phase where the design of the organizational structure occurs in detail with clear insights into the relationship, information flow and key functions. The design must focus not only on the current strategic goals, but also on the future based on the visions and goals defined in the strategy. KEY ACTIONS: Create, develop a prototype, test and iterate. APPROACH: Human-centred design, facilitation, consensus building, VIPP card collection and clustering OUTPUTS: Finalized organogram with key positions

Implementation The implementation phase is focused on buy-in, change management and specific actions required to bring the organizational structure to reality within the organization. This is a process and not a one-time event. KEY ACTIONS: Build, implement, transition and measure. APPROACH: Facilitation, change management OUTPUTS: Implementation plan for the new organizational structure

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CAPACITY DEVELOPMENT COUNTRY SUPPORT

LESSONS LEARNED IN ORGANIZATIONAL DESIGN There are best practices and lessons learned that countries can consider in their design phase.

Reflect and define the purpose of the organizational structure The purpose of designing or reviewing the organizational structure should be well defined from the beginning of the process. This should be aligned with the supply chain strategy and policies. { What is the strategic objective of this organizational structure and how does it help us meet our strategic goals/visions of ensuring quality supplies to the last mile? { What are the critical procurement and supply chain functions within the organization to meet the strategic objectives? { Which activities are value-adding to the organization?

Focus on core competence Every organization should understand its core competence based on its comparative advantage. This should be articulated in the organizational design process. { What is the organizationâ&#x20AC;&#x2122;s core competence in terms of procurement and supply management? { What is the organizationâ&#x20AC;&#x2122;s comparative advantage? { What functions are required to meet the business objectives?

Strategy, systems and process before structure The foundation of any effective and efficient organizational structure lies in well-designed strategy, systems and processes. Without these elements, the organizational structure will fail to meet its objectives. { What are the procurement and supply chain systems and processes in place to meet the organizationâ&#x20AC;&#x2122;s strategic goals and objectives? { What are the latest development and trends in procurement and supply management that will impact on people, processes and technology? { How will they impact on workflow and processes for procurement and supply operations? { Is the organizational culture (values, beliefs, behaviour patterns, and leadership style) aiding or hindering the supply chain performance? How?

Leverage on internal and external talent pipeline The organizational structure shows the strength of any organization in form of its human resources. It is, however, important to leverage on an existing talent pipeline and seek out new talents from the external labour market. { What is the human resource capacity in terms of quantity and quality to perform the procurement and supply operations and management in a manner consistent with the strategy? { What is the quality and availability of talent in the labour market (external view)?

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Drive accountability Performance and results are the focus of all organizations at the end of the day. The organizational structure should be designed to promote accountability at all levels with clear governance structure. { What do results look like and how does this organizational structure help to monitor results and performance?

Focus on improved communications and effective workflows Organizational structures facilitate communication and flow of information including clear understanding of reporting lines. If an organizational structure doesnâ&#x20AC;&#x2122;t enhance communication and flow of information, it negates the characteristics of organizational effectiveness. Communication gets the work done. { What is the generic workflow for functions within the organization? { How does this workflow facilitate communication and flow of information/data?

Do not build in silos Organizations cannot operate in silos. Partnerships and collaborations strengthen organizational effectiveness at all levels. It is important to look at designing an organizational structure that aligns with a broader perspective considering internal and external views. { How do we leverage on available resources and partnership in the organizational design?

Review and update the organizational structure Organizational structures are working documents and should be reviewed where there are changes in laws, strategy, priorities and/or observed weaknesses in the system. It is advised to look into it every 2â&#x20AC;&#x201C;3 years. { What current and future government laws will affect our way of working? { What are the current priorities in efforts to deliver value to the clients? { What are the observed weaknesses in the system and their root causes?

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ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

GENDER-FRIENDLY ORGANIZATIONAL DESIGN in a sector that was once largely dominated by men. The critical step is to ensure that the organizational design process supports the increasing role of gender in supply chain organizations. Given below are tips for ensuring a gender-friendly organization design.

The modern day organization realizes the importance of gender-friendly approaches in its organization design, which ultimately enhances organizational performance and sustainability in the long run. In supply chains, womenâ&#x20AC;&#x2122;s participation has increased over the years

Communication and collaboration allows for timely feedback on matters related to gender representation and organisational culture.

Analyze bottlenecks to gender representaion within the organisational structure and culture.

STATISTICS

GENDER REPRESENTATION

SITUATION ANALYSIS

Understand the labour market and statistics on gender representation in the specific occupation e.g. supply chain. It starts with having data on gender within the organisation.

Maintain gender balance in the governance structure, units and design project team.

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COMMUNICATION


CAPACITY DEVELOPMENT COUNTRY SUPPORT

SAMPLE TEMPLATES OF ORGANOGRAMS FOR SUPPLY/LOGISTICS SYSTEMS Country context and organizational structures The organisational structure is a key element for organizational design and they are designed with the processes, structure and systems in mind. There are

different types of organizational structures and given below are examples and organograms that can support procurement and supply chain management.

Matrix organogram: A matrix structure provides for reporting levels both horizontally as well as vertically. Employees may be part of a functional group but may serve on a team.

EPI Supply Chain/Logistics Department

Finance & Administration

Logistics

Vaccines

Procurement

System Strengthening

Functional units included in the project team

Cold Chain

Warehousing

Maintenance

CCEOP

Distribution

Inventory

Warehouse Upgrade Project

Data

Capacity Building

Information System Improvement

Logistics WorkingGroup

Supply System Strengthening

Business Process Re-engineering

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ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

Product-specific organogram: Another common structure is to be organized by a specific product type.

Warehousing

Vaccines Distribution

Data

Supply System Strengthening

Logistics

Maintenance Cold Chain

Finance & Administration

Inventory

Supply Chain/ Logistics Unit

Other Immunization Commodities

Forecasting Procurement Supply Planning

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CAPACITY DEVELOPMENT COUNTRY SUPPORT

Functional organogram: Functional organizational structures are the most common. A structure of this type groups individuals by specific functions critical to the business.

Warehousing

Distribution

Logistics

Data

Finance & Administration

Supply System Strengthening

MOH/Supply Chain/Logistics Unit

Cold Chain

Forecasting Procurement Supply Planning

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ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

Geographical organograms: For organizations that cover a span of geographic regions, it sometimes makes sense to organize by region. This is done to better support logistical demands and differences in geographic customer needs.

MOH

National Procurement, Supply & Logistics Team EPI

Region 1

Region 2

Supply & Logistics Team

District A

Supply & Logistics Team

Supply & Logistics Team

District B

Supply & Logistics Team

District C

Supply & Logistics Team

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District D

Supply & Logistics Team


CAPACITY DEVELOPMENT COUNTRY SUPPORT

Functional with an outsourced component organogram: Functional organograms are created based on the basic functions in an organization within a well-defined process framework.

Warehousing

Distribution

Outsourced to 3PL/ managed by partners

Logistics

MOH/EPI

Data

Supply System Strengthening

Finance & Administration Forecasting

Cold Chain

Procurement Supply Planning

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ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

Specific organogram samples for supply chain organization This organogram provides an overview of key roles. The type of organizational structure should be selected based on the agencyâ&#x20AC;&#x2122;s strategy, culture and core competence. Central medical store organogram The central medical warehouse/store is responsible for supply chain management of all health commodities including medicines in the public sector. In many contexts, they may also manage and coordinate procurement.

CMS Director

Assistant to the GM

Operations Manager

Inventory

Pharmaceutical Manager

Procurement Manager (dependent on country)

Administration Manager

Quality Assurance

Finance Contracts

Order Fulfilment and Shipment

Pharmaceutical Management

HR

Maintenance

System Strengthening

Legal

Data

Partnerships

IT

Distribution

Transportation

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Forecasting


CAPACITY DEVELOPMENT COUNTRY SUPPORT

Vaccine Store The vaccine store manages all vaccine supplies and immunization commodities.

Vaccine Store Manager

Store Officer

Cold Chain Officer

Shipping Assistant

Maintenance

Inventory Assistant

Store Officer

Quality Assurance Assistant

Biomedical Engineer

Administration Officer

Data Officer

Data Assistant

IT Assistant

LMIS Assistant

Data Analyst Order Fulfilment Assistant

Refrigeration Assistant

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ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

Supply chain agencies A supply chain agency can be an autonomous or semi-autonomous organization created by law to perform procurement and supply chain functions on behalf of the government and sometimes partners.

Board of Directors

MOH

Chief Executive Officer (CEO)

Executive Assistant

Company Secretary

Commercial Services

Operations

Corporate Services

Procurement

Strategy

Medical

Customer Services

Distribution

HR

Contracts

Quality Assurance

Business Planning

Partnerships

Transport

Communications

Buyer

Forecasting

Performance Management

Marketing

Warehousing

Accounts

Supply Planning

Partner Coordination

Inventory

Administration

System Strengthening

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Management Information


CAPACITY DEVELOPMENT COUNTRY SUPPORT

Procurement department The procurement department/unit/team is charged with the sole responsibility of managing all procurement operations, strategy and management for the effective supplies of specific commodities.

Minister of Health

Permanent Secretary

Procurement Director

Sourcing Manager

Procurement Administration Manager

Contracts Manager

Procurement Review Committee

E-Procurement Manager

Strategy, Policies and Processes Manager

Projects & Planning Officer

Buyer Medicines

Procurement Administration Officer

Contracts Officer

Information System Officer

Strategy Officer

Forecast Officer

Buyer Medical Devices and Equipment

Documentation Officer

Supplier Officer

E-Procurement Officer

Process Officer

Project Officer

Buyer Non-Health Commodities

Compliance Officer

Performance Officer

Accounts Officer

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ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

Supply chain/logistics Centres of Excellence (COEs) A centre of excellence is a team or an entity that provides leadership, best practices, research, support and/or training for a focus area, in this case supply chain and/or logistics. COEs in the areas of logistics and supply chain management enhance generation, systematization, dissemination and application of knowledge and research.

COE Programme Director

Collaborating Institutions

Governing Body

Innovation, Projects & Strategic Initiatives Manager

Project Officer

Education & Technical Assistance Manager

Knowledge & Research Manager

Business Development & Partnerships Manager

Administration Manager

Technology Manager

Education Programme Coordinator

Knowledge & Communications Officer

Business Development Officer

Finance Officer

System Analyst

Training Assistant

Research Coordinator

Marketing Officer

HR/Admin Officer

Process Analyst

Institutional Capacity Building Officer

Monitoring & Evaluation Officer

Proposal Writer

Technical Assistance Coordinator

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Solutions Developer


CAPACITY DEVELOPMENT COUNTRY SUPPORT

Third-party logistics companies These private companies provide single or multiple logistics services to organizations. They handle procurement, transportation and distribution functions for client companies.

Board of Directors

Managing Partner/Director

Executive Assistant

Director, Advisory Services

Contracts Officer

Monitoring and Quality Assurance Manager

Contracts Officer Business Development Manager

Supplier Officer

Director, Administration & Corporate Services

Director, Strategy & Business

Logistics Director

Account Manager

Proposal Developer

Corporate Services Officer

Supplier Officer Proposal Lead

Performance Officer

Performance Officer

Accounts Officer

Accounts Officer

Account Officers

Customer Service Officer

Client Relations Officer

Performance Officer

Accounts Officer

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Strategy Lead

Admin manager


ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

Supply chain project team These are teams set up for specific supply chain or logistics projects in the ministry within a timeline. Examples of projects include warehouse construction, implementing a new logistics system, system design or other system-strengthening initiatives.

Project Board

Supply Chain Project Manager

Technical Advisory Committee

Project Assistant

Project Administrator

Supply Chain Consultant(s)

Project Sponsor

Project Technical Lead

Project Officer, Supply Chain

Project Officer, Supply Chain

Project Officer, Supply Chain

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Contractor

Sub-Contractors

Communication & Change Manager


CAPACITY DEVELOPMENT COUNTRY SUPPORT

National PSM/logistics technical working groups These are groups created with an administrative status and clear terms of reference for coordinating national immunization logistics and supply chain activities as well as supply chain investments made by government agencies and development partners. The NLWG provides guidance, expertise and technical assistance on all matters concerning supply chain operations and improvement initiatives. They comprise both technical experts and development partners.

Chair, MOH

Secretary

Government team

Development Partners

NGOs

Sample country organograms are available in Annex II.

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Civil Societies

Private Organizations


ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

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COUNTRY EXAMPLES

DEVELOPING A NEW ORGANIZATIONAL STRUCTURE FOR NATIONAL PRIMARY HEALTHCARE DEVELOPMENT AGENCY (NPHCDA) LOGISTICS DEPARTMENT IN NIGERIA Purpose The National Primary Health Care Development Agency (NPHCDA) is responsible for the planning, management and implementation of primary healthcare including policy formulation, monitoring, evaluation and collaboration in Nigeria. This agency also manages the Expanded Programme on Immunization (EPI). The Department of Logistics and Health was set up in 2014 as one of the institutional transformation initiatives to drive evidence and efficiency for vaccine supply and cold chain procurement, installation and maintenance. With a clear understanding of the system, a consulting firm was engaged to manage the creation of an organizational structure, standard operating procedures and key roles and responsibilities with key performance indicators. This was part of efforts to strengthen the operations of the department through well-defined structures with roles and responsibilities including standard processes.

Preliminary analysis NPHCDAâ&#x20AC;&#x2122;s department of Logistics & Health Commodities undertook a diagnostic of its departmental structure and key processes, which revealed that the departmentâ&#x20AC;&#x2122;s structure was weak in enhancing clarity and documentation of roles & responsibilities, operations based on supply chain systems and implementation of strategic initiatives.

Strategic and operational design The new proposed structure was designed in consideration for the supply chain system and the objective of ensuring efficiency with a focus on: - Incorporating zonal stores into DL&HC - Separation of operations and strategic planning functions - Reorganization of NSCS and zonal stores - Delivery unit to oversee implementation of transformation initiatives - Defined responsibilities, activities and KPIs - Standard operating procedures

Key changes - New positions: Head of Operations & Head of Delivery Unit for Strategic Initiatives - New positions with updated job descriptions: Head of QA & Strategic Planning, Head of Hubs (Lagos, Abuja & Lagos) & Officer, in-bound shipment

Implementation This country case emphasizes the need to define the objectives of creating or revising any organizational structure based on the strategy, system design and processes. This new model is being implemented by the Department of Logistics to improve the efficiency and effectiveness of its operations to meet the goal of reaching the populace with the right vaccines and health commodities.

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ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

ORGANIZATIONAL REDESIGN FOR KENYA MEDICAL SUPPLIES AGENCY (KEMSA) Purpose Kenya Medical Supplies Agency (KEMSA) was established in 2000 as a state corporation through a legal notice according to the laws of Kenya; it was operationalized in 2005 and became an agency in 2013 through an act of Parliament. The agency was charged with procurement, warehousing, distribution, stock management of drugs and medical supplies for public health programmes for health facilities in partnership with county government, facilities and partners based on a defined supply chain system. KEMSA was formed to meet the goal of ensuring high-quality and reliable health supplies in Kenya.

Preliminary analysis The government of Kenya and its development partners started realizing the need for broader, deeper and integrated reform at KEMSA. These reforms started in 2008. The guiding principles of these reforms were that KEMSAâ&#x20AC;&#x2122;s institutional capabilities can be improved by creating appropriate organizational structures, attracting the right talent to leadership and management roles, creating a performance management plan and streamlining operational processes. A workload analysis study was also conducted to inform the optimal staffing levels within each department in KEMSA. Organizational analysis revealed a weak legal framework with little or no autonomy, fragmented supply system, inadequate resources and poor visibility â&#x20AC;&#x201C; all resulting from the lack of leadership and governance structure at KEMSA. The redesign process also became critical with the devolution to counties, that is, the budget for medicines and health commodities will come from county governments who will receive a predetermined allocation from the Federal Government. The devolution of health services led to an identification of strategies to optimize the health supply chain for health product availability.

Strategic and operational design The organization redesign process had specific objectives: - To improve supply chain visibility through real-time information - To enhance supply chain integration and commodity management for stock availability - To improve infrastructure, process and systems at facilities The design phase took into account the strategic initiatives and operational improvements required to ensure stock availability at all levels.

Key changes - A change of status from authority to agency with a robust governance structure to enhance autonomy and allowed for strategic partnerships and integration - Recruiting leadership talent and new positions based on its strategic objectives: Head of USAID/KEMSA MCP & Sales & Marketing and Customer Service Manager - Comprehensive and relevant training programmes institutionalized for existing and new staff at KEMSA - Creating a procurement department for transparency and efficiency - Utilization of outsourcing options to focus on areas of comparative advantage

Implementation The objective of the organizational redesign was instrumental in the design process. As policies and institutions evolve, it is important to address issues of organizational effectiveness through designing the right structures, processes and job descriptions.

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CAPACITY DEVELOPMENT COUNTRY SUPPORT

DEVELOPING AND MAINTAINING JOB DESCRIPTIONS to meet the objective of the job. It defines the importance of the job to the organization and the key requirements to perform well in the role. It is used for recruitment, talent management and development including workload management. Job descriptions will contribute to defining key performance indicators. The job description should be developed by the HR team together with the technical team and should comprise job and task analyses that outline the key tasks.

A major step after the organizational design process and definition of roles is the need to develop clear job descriptions that enhance work performance. This step focuses on creating job descriptions with clear and accurate roles and responsibilities, qualifications and competencies. Job descriptions are key for effective management of human resources within any organization. The job description is a working document that captures the key tasks required

ORGANIZATIONAL FUNCTIONS

JOB ANALYSIS

TASK ANALYSIS

JOB DESCRIPTION

Challenges with job descriptions at country levels DIAGRAM 4

Consequences of poorly written and nonexistent job descriptions

Job misfit & poor hiring Limited performance oversight

The quality of hires is dependent on a clear understanding of job expectations. When the JD is poorly written, it is difficult to attract the right skills and experiences required for the job..

When JDs are not well written, employee performance becomes difficult to plan and monitor.

Poor development plans JDs are useful for employee development; where they are nonexistent or poorly written, it becomes difficult to highlight areas of improvement and key actions to address .them.

Fragmented and unclear responsibilities JDs provide clarity on job requirements and how to achieve the business objectives. Lack of clarity affects performance.

Source: Authors

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ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

Job description templates

The People that Deliver Competency Framework provides a good guide to the supply chain functions based on core competencies: Selection & Quantification, Procurement, Storage & Distribution, Utilization, Resource Management and Professional/ Personal. See Annex III. In addition, the APCIS Supply Chain Management Career Kit provides a good overview of competencies and qualification for supply chain personnel. See Annex IV.

• • • • • • • •

L  ogistics manager D  istribution and transport P  rocurement C  old chain D  ata S  tore/warehousing F  inance and administration S  ystem strengthening

Sample job descriptions for various positions are available in Annex II.

Resource

Link

USAID|Deliver Project, Recruiting Supply Chain Professionals: A ready reference guide for finding and selecting high performers, 2013.

<https://www.k4health.org/sites/default/files/recruitingtoolkit.pdf>

USAID|Deliver Project, Warehouse Staff Job Descriptions—Expanded programme on immunization. Pakistan: Expanded programme on immunization, Ministry of National Health Services regulations and coordination, 2016.

<http://epi.gov.pk/wp-content/uploads/2018/04/3.-EPI_Warehouse-Staf-JobDescriptions_Final_.pdf>

World Health Organization, Functional Job Analysis: Guidelines for task analysis and job design, WHO, Geneva, 1999.

<https://www.who.int/hrh/tools/job_analysis.pdf?ua=1>

People that Deliver and the Federal Ministry of Health National Medical Supplies Fund Sudan, Job Descriptions, Human Resources for Supply Chain Management, 2017.

<https://peoplethatdeliver.org/ptd/sites/default/files/resource_contents_files/ Sudan%20NMSF%20Job%20Descriptions%2C%20April%207%202017.pdf>

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WHO STANDARD COMPETENCIES FOR IMMUNIZATION – VACCINE SUPPLIES AND LOGISTICS outcome of this work gave rise to the outlined generic work functions and competencies, which captured competencies for vaccines supply and logistics role. These work functions and competencies should form the guide for development of job descriptions for the functions.

The Strategic Advisory Group of Experts (SAGE), which is the principal advisory group to WHO for vaccines and immunization, recently agreed with the proposal for publishing the standard competencies as normative guidance for countries’ immunization programmes. The

WHO STANDARD COMPETENCIES FOR IMMUNIZATION – VACCINE SUPPLIES AND LOGISTICS Work functions • D  evelop multi-year strategic and annual work plans for the immunization supply chain • D  evelop, update and disseminate standard operating procedures and guidelines for effective management of • • • • • • • • • •

the supply chain F  orecast and procure appropriate vaccines and immunization-related materials D  efine and implement vaccine arrival procedures (includes customs clearance) Implement and enforce proper vaccine handling, storage and distribution procedures E  xecute end-to-end temperature monitoring M  aintain cold chain inventory, assess and plan for cold chain equipment and spare parts E  stablish and implement a cold chain equipment maintenance system E  stablish, maintain and update stock control/logistics management information system (LMIS) E  nsure the availability of transport for distribution of vaccines, supplies and supervision D  evelop protocols and ensure safe disposal of waste Introduce and maintain performance indicators for monitoring and evaluation of the immunization supply chain and logistics system synergies and partnerships on optimizing immunization supply

Competencies • Analyse outsourcing needs, contract administration and contract management • M  anage and maintain infrastructure (transport, cold chain) • Assess needs and select and implement appropriate product solution (vaccine, cold chain, immunization

supplies etc.) F  orecast vaccine, cold chain, supply and logistical needs C  oordinate with others on procurement D  evelop vaccine arrival, storage, transportation, vaccine management and waste management processes D  evelop and implement effective end-to-end temperature monitoring D  efine policy and processes for repair and maintenance of cold chain equipment, temperature monitoring devices D  esign and implement an LMIS D  evelop and implement a supply chain monitoring plan U  se an LMIS to collect, manage, analyse and interpret supply data C  ollect, analyse and interpret supply chain monitoring data M  ake programmatic decisions based on evidence Write technical reports for supply chain • Write a standard operating procedure for supply chain • Apply knowledge of legal and manufacturing frameworks and constraints to vaccine procurement • • • • • • • • • • •

Credit: World Health Organization, <https://www.who.int/immunization/programmes_systems/workforce/standard_competencies_framework/en>

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ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

HR CAPACITY AND PERFORMANCE STRENGTHENING Conducting a training needs assessment

For organizations to meet their strategic goals, it is important to develop existing HR capacities for optimal performance. It is a continuous process of performance improvement that involves the following:

The training need assessment is a systematic approach for determining the capacity needs of a person performing a specific role based on the job description. This should be defined by core competencies for the job roles.

• D  efinition of training needs • Effective training delivery • Performance management, which includes coaching

The training needs assessment is a strategic action that should guide talent development within any organization and programme. It should be conducted frequently by managers in liaising with the relevant unit responsible for human resource management.

and mentoring

ORGANIZATIONAL FUNCTIONS

CORE COMPETENCIES

JOB & TASK ANALYSIS

TRAINING NEEDS

Resource

Link

Training Needs Analysis, Strategy and Planning Toolkit for Public Health Supply Chains

<www.technet-21.org/iscstrengthening/media/attachments/2018/07/30/ii-toolsfor-iscm-training-needs-analysis.pdf>

Implementing trainings

horse. The training objectives will guide the expected content and outcomes based on the core competencies, that is, the knowledge, skills and attitude required for the job.

The outcomes of a training needs analysis should form the basis for training implementation. A training without a needs assessment is like putting the cart before the

TRAINING NEEDS ASSESSMENT

TRAINING OBJECTIVES

TRAINING IMPLEMENTATION

TRAINING EVALUATION

Resource

Link

Training Needs Analysis, Strategy and Planning Toolkit for Public Health Supply Chains

EVALUATION <www.technet-21.org/iscstrengthening/media/attachments/2018/07/30/iiitemplate-for-iscm-training-strategy.pdf>

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CAPACITY DEVELOPMENT COUNTRY SUPPORT

MANAGING PERFORMANCE This is the process of setting individual goals based on the organizational goals. It begins with defining the critical functions that will help meet the goals. These

ORGANIZATIONAL TARGETS

functions should be translated into the key tasks per individual, which will inform the key performance indicators.

FUNCTIONAL TARGETS

INDIVIDUAL KPIS

PERFORMANCE MONITORING

COACHING & MENTORING FOR PERFORMANCE Coaching Talking to a person, identifying what the person needs, and developing an action plan. The emphasis is on instruction, assessing, and monitoring.

Mentoring Talking with a person who has identified his needs prior to the mentoring relationship. The emphasis is on the following:active listening, instructing, suggesting, establishing connections and realizing potentials.

Differences between coaching & mentoring Coaching

Mentoring

Formal structured activity focused on performance improvement only, for example the development of a skill

Formal structured activity, which can also be informal. It is also aimed at performance improvement with a major component of relationshipbuilding over time.

More specific agenda by the coach

Self-directed by the mentee

Short-term

Long-term

Talking to

Talking with

The fact that the coach is more knowledgeable and experienced is much more obvious in interaction.

The mentor is more knowledgeable and experienced but this fact is less obvious in the interaction.

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ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

Coaching and mentoring

Step 3: Agree The third stage is reaching a consensus on the following: • What is the current performance? • What is the performance gap? • Why do the gaps exist? • What can be done to resolve the challenge i.e. possible solutions? • The best approach to bridging the performance gap? • What will be the mentee’s role in addressing the gap?

Coaching and mentoring should be structured to deliver the expected outcome of facilitating learning within an organization. Coaching or mentoring is all about communication. There are five major steps required in coaching and mentoring. Step 1: Observe The first step in coaching is observation. You need to observe the person carrying out the task, for example completing the LMIS report or review the work products (e.g., LMIS report). This will help to decipher the performance gaps and what can be done.

Step 4: Plan The next step is to plan how the intervention will be carried out in a stepwise manner. Never assume that the individual understands by just talking; allow the person to summarize the action steps agreed upon with specific timelines. Maintain an open-door policy for free communication.

Step 2: Discuss Communication is the cornerstone of coaching and mentoring. The individuals must communicate about the performance issues and how it affects the work output. Note that the impact of the action should be discussed. At this stage, you should focus on the issue and not the person. Don’t just offer solutions; allow the person to think about the challenge and likely solutions to build ownership. Positive change will not occur until you believe that you have a role in solving a problem (ownership).

Step 5: Follow-up Agree on a time to review output(s) on the intervention agreed upon. Be specific about the outputs.

STEPS IN COACHING & MENTORING

AGREE STEP 3

PLAN STEP 4

DISCUSS STEP 2

FOLLOW-UP STEP 5

OBSERVE STEP 1

Source: Authors

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CAPACITY DEVELOPMENT COUNTRY SUPPORT

Giving feedback as part of coaching & mentoring

Elements of high-quality feedback

Feedback is an essential part of coaching and mentoring. Feedback is truthful communication (exchange of information) based on facts between two or more people focusing on specific action(s) and not the person. Feedback should be constructive, with the intention of improvement and positive change. Be it in training, coaching or mentoring, feedback is essential to achieving the objectives.

• B  e truthful. • Always base your feedback on fact and observation,

• •

Feedback is given for the following reasons: • Continuous improvement • Clarification of facts and figures • Accountability • Monitoring • Supervision

not hearsay. Eliminate any preconceived ideas or thoughts. F  ocus on the challenge and not the person. Where personal attitude or behaviour influences the action, be sure to mention. L  isten to the other person. G  ive balanced feedback, that is, both positive and negative where applicable. B  e clear about the challenges, causes, impact, solutions and timelines.

Opportunities for coaching and mentoring in the field • S  upportive supervision • Q  uarterly meetings • P  erformance appraisal • Weekly unit meeting • Training and workshops

Source: TalentAdore

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ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

Sample coaching and mentoring tool using the GROW Model The coach or mentor is to guide the conversation with this tool. GOAL

Establish the goal of the coaching/mentoring sessions What do you see as the main objective/goal of this conversation?

REALITY

Seek to understand the situation Describe the challenge in detail with a focus on what is within your control.

OPTIONS

Facilitate options for solutions to address the situation or challenges. Do not provide any solutions as coach or mentor. What ways can you solve the challenge with a focus on what is within your control?

WAY FORWARD

Guide towards the best solutions without any bias. What solution will work best given the options provided earlier?

Resource

Link

Children’s Vaccine Program at PATH, Guidelines for implementing supportive supervision: A step-by-step guide with tools to support immunization, PATH, Seattle, 2003.

<https://path.azureedge.net/media/documents/Guidelines_for_Supportive_ Supervision.pdf>

World Health Organization, Training for mid-level managers (MLM): 4. Supportive supervision, WHO, Geneva, 2008.

<http://apps.who.int/iris/bitstream/handle/10665/70184/WHO_IVB_08.04_eng. pdf;jsessionid=A0AAF386141E0900541C8EEFED41EF7B?sequence=4>

USAID | Deliver Project, Supervision and On-the-Job Training for Supply Chain Management at the Health Facility, USAID, Arlington, Virginia, 2011.

<https://www.jsi.com/JSIInternet/Inc/Common/_download_pub. cfm?id=15572&lid=3>

USAID|Deliver Project, Supportive Supervision of Supply Chain Personnel (video clip).

<https://www.youtube.com/watch?v=ohrm-PGLydg>

United Nations Children’s Fund, Performance Management Toolkit for Immunization Supply Chain Manager, UNICEF, New York, 2016.

<www.technet-21.org/iscstrengthening/media/attachments/2017/02/07/ performance_management_toolkit_final_14_july_2016.pdf>

United Nations Children’s Fund, Organizational Behaviour and Change Management Toolkit, UNICEF, New York, 2016.

<https://www.unicef.org/supply/files/Organizational_Behaviours_and__ Management_Toolkit_Final_Draft_14_July_2016.pdf>

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CAPACITY DEVELOPMENT COUNTRY SUPPORT

CONCLUSION the organizational design that enhances meeting the objectives. Country transitions and increasing accountability from government and partners continue to drive the need for the dedicated supply chain capacity, hence the creation of units, teams and departments to drive supply chain improvement at all levels with the aim of strengthening health systems.

Organizational design is an iterative process that should be contextualized and collaborative with active participation by all stakeholders. The sustainability of development efforts hinges on country capacity and ownership â&#x20AC;&#x201C; ownership in terms of developing their own systems, processes and procedures within the institutional framework. These institutional frameworks include not just the enabling environment but also

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ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

REFERENCES Committee for Gender Balance and Diversity Research, ‘Using Restructuring to Promote Gender Equality and Diversity: A guide for the research sector’, n.d. Available at <http://kifinfo.no/sites/default/files/restructuring_guide_ eng_web_2.pdf>. Hanover Research, ‘Best Practices and Strategies in Organizational Structure and Design’, 2010. Available at <www. planning.salford.ac.uk/__data/assets/pdf_file/0005/20696/20100908-Best-Practices-and-Strategies-in-OrganizationalStructure-and-Design-Membership.pdf>. National Primary Healthcare Development Agency, Departmental Handbook: Department of Logistics and Health Commodities, NPHCDA, Abuja, 2015. Neilson, Gary L., Jaime Estupiñán and Bhushan Sethi, ‘10 guiding principles of organizational design’, Forbes, 2015. Available at <https://www.forbes.com/sites/strategyand/2015/04/01/10-guiding-principles-of-organizationdesign/#fbffdfb58889>. Sarley, David, Mustafa Mahmud, Jide Idris, Modele Osunkiyesi, Onome Dibosa-Osadolor, Peter Okebukola and Owens Wiwa, ‘Transforming Vaccines Supply Chains in Nigeria’, Vaccine, vol. 35, no. 17, 2017. Available at <https:// www.sciencedirect.com/science/article/pii/S0264410X16311392>. United Nations Children’s Fund, ‘KEMSA after the Devolution: Financial sustainability through the definition of the supply chain strategy and a strong focus on the human resources and leadership components’, UNICEF, New York, 2017. Available at <www.technet-21.org/iscstrengthening/media/attachments/2017/11/06/51497-1---unicef-nationalcapacity-development---kenya---web.pdf>. Yadav, Prashant, ‘KEMSA: A case study of the ongoing transition from an ungainly bureaucracy to a competitive and customer focused medical logistics organization’, 2014. Available at <http://documents.worldbank.org/curated/ en/876311468277741016/pdf/918640WP0P14870e0ongoing0Transition.pdf>

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© UNICEF

ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS


CAPACITY DEVELOPMENT COUNTRY SUPPORT

Annex I: Country Organogram Models

Director, Logistics and Health Comodities department

Administrative unit (documentation & records management)

Head, Hub/NSCS

Head Hub 1

Head Hub 2

Officer, Vaccine Handling Head Warehousing Management

Head, QA & Strategic Planning

Head of Operations

Administrative unit

Head, In-bound shipments management

Officers 1&2 Forecasting and demand planning

Officer in bound shipment

Certification Officer

Officer, Health Commodities Handling

Officer, Warehousing support

Head Transport and deliveries

Regulatory/ collaboration function

Head, Delivery Unit (Drives implementation of transformation initiatives)

National Management capacity Information expansion

3 - hub Management Information model

Logistics management Management information Information systen/ Navision

Small ward Management equipment Information strategy

Capability Management building for Information supply chain leaders Officer, Transport and deliveries Strengthening Management asset Information protection Equipment maintenance officer

Maintenance supervisor

Data management analyst

State roll-out Management of national Information initiatives

Fleet maintenance officer

Officer, wast management

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ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

EPI manager

Deputy EPI Manager

National Logistics Officer

National Cold Logistics Officer

District 1 EPI Focal Point

Central Region CC Officer

District 2 EPI Focal Point

North Region CC Officer

District 3 EPI Focal Point

South Region CC Officer

Data Manager/ M&E

(10 Disticts)

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Surveillance Officer


CAPACITY DEVELOPMENT COUNTRY SUPPORT

Director of Medical Services

Director of Preventive & Promotive Health Services

Inter-Agency Coordinating Committees (ICCs)

Head, Division of Family Health (DHF)

Head, Unit of Vaccines & Immunisation (UVIS)

Secretary Drivers Support Staff

Policy, Advocacy, Training & Performance Monitoring

Comodity Security & Quality Assurance

Data Officers

Logistician

Advocacy Officer

AEFI & Inj. Waste Management

Central Vaccine Store - CVS Staff - DryStore Staff - Cold Chain Staff

Training Officer

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ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

EPI Laboratory UVRI

Asst. Commissioner (Programme Manager)

Senior Health Educator (HP&E) Principal Medical Officer

Senior Medical Officer

Senior Nursing Officer (Public Health)

Senior Nursing Officer (Public Health)

Cold Chain Technician

Support Staff Radio Management operators(2) Information Office Attendants(3)

Officer Supervisor

Pool Management Information Stenographer

Cold Chain Technician

Management Data Clerk Information

Asst. Suppliers Officer

Engineering Asst.

Cold Chain Technician

Cold Chain Technician

Management Accounts Asst. Information

Management Copy Typist Information

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Cold Chain Technician

Security(3), one Management not on payroll Information

Drivers(8) Management Vehicle Information attendants(8)


CAPACITY DEVELOPMENT COUNTRY SUPPORT

Logistician

Dep Director MH

Dep Director CHN

Dep Director NCD

EPI Manager

Deputy EPI Manager

National Management Logistics Information Officer

National Management Cold Chain Information Officer

National Management EPI Information Officer

Management Data Information Manager/M&E

Province 1 EPI Logistician

Province 1 CC Officer

Province 1 EPI Focal Point

Province 2 EPI Logistician

Province 2 CC Officer

Province 2 EPI Focal Point

10 Provinces

10 Provinces

10 Provinces

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Management Surveillance Information Officer


ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

Cabinet Management Secretary for Information Health

Board of Management Information Directors

Cheif Management Executive Information Officer

Commercial Management Services Information Director

Management Operations Information Director

Corporate 3 - hub Services model Director

Management Procurement Information Director

Legal Services Management Director & Information Corporate Secretary

Management Sales & Mkt. Information Manager

Management Distribution Information Manager

Management Finance Information Manger

Procurement Management Manager Information Pharms

Customer Management Service Information Manager

Quality Management Assurance Information Manager

Management ICT Manager Information

Procurement Management Manager Information Non-Pharms

Management Warehouse Information Manager

Management HR & Admin Information Manager

Procurement Management Manager, Information Contract Management

Planning Management & Projects Information Manager

Procurement Management Manager Information Programs

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Head of USAID/ Management Information KEMSA MCP

Chief Management Security Information Officer

PR & Comm. Management Manager Information

Internal Management Audit Information Manager


CAPACITY DEVELOPMENT COUNTRY SUPPORT

Board of Directors

Tender Committee

General Director

Higher Management

Executive Management Information Office

Quality Management Information Assurance

Internal Management Information Audit

Legal Management Information Administration

Public Management Information Relations

Management IT Systems Information

Management Media Information

General Dep Director Directorate Procurement & CHN Contracting

General Dep Director Directorate of CHN Distribution

General Dep Director Directorate of Medical Supply MH State

General Dep Director Directorate of Planning NCD & Resources

General Directorate of Dep Director Biomedical NCD Engineering

Procurement

Pharmacies

Logistics

Finance & Accountitng

Calibration & Measurement

Contracting

Sales

Supervision & Evaluation

Human Resources

Central Workshop

Clearance & Follow-up

Inventory Planning

Shipping & Handling

Support Services

Studies & Projects

Planning & Follow-up

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ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

Operations Division Management Information (EPI Warehouse)

Store and Management Information Logistics

Cold Chain Management Information Maintenance

Store Management Information Officer

Refrigeration Management Information Engineer

Assistant Management Information Store Officer

Assistant Management Information Refigeration Officer

Store Management Information Keeper

Sub-Engineer Management Information (Electrical)

Management Information Helper

Refrigeration Management Information Mechanic

Management Information Laborer

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Annex II: Sample Job Descriptions

Logistics Manager Title: Summary In close collaboration works with the EPI manager, logistics officers and the National Logistics Technical Working group: Coordinate Immunization Supply Chain/logistics management together with the programme team. Support committee in developing a framework of responsibilities of players and their accountability in iSCM. Identify room for improvement for capacity building of stake holders in supply chain management. EVM improvement plan and cold chain inventory. Support EPI and logistics committee in the system to update the cold chain equipment inventory and capacity analysis. Provide technical guidance to the EPI to implement the Effective Vaccine Management Implementation as per schedule and funding availability. Monitor the implementation status of the Effective Vaccine Management Implementation, cold chain equipment procurement and deployment. Support with Cold Chain Equipment (CCE) Optimization Platform to GAVI for accelerated solarization of cold chain. Assist in the development of CCE distribution and installation plan, prioritizing areas most affected by inequities in immunization, respecting national priorities and in line with UNICEF procedures as applicable. Temperature monitoring. Support DPEV in the roll-out of continuous temperature monitoring systems in cold rooms, refrigerators and during distribution process, possibly supported by new technology (GSM, etc). Vaccine and supply management. Review current stock management procedures and suggest steps for improvement, including vaccine wastage monitoring. Review distribution system and suggest steps for improvement, including reception of supplies at entry point (airport/port) and transport to EPI. Strengthen data management, stock monitoring system and suggest improvements to avoid stock-outs and over stocks. Coordinate training, capacity building and supportive supervision for the team. Qualifications

Competencies

University degree in management, public health and/or administration. Minimum two years of work experience of working in immunization and health programmes. Minimum of five years managing supply chain and logistics management. Advanced degree in supply chain management is desirable.

Resource management Selection and quantification Storage and distribution Professional/personal Utilization

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ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

Distribution & Transport Title: Summary The distribution and transport officer will work with the Logistics manager: To prepare feasible realistic distribution plans, which will ensure that vaccines, diluents, injection materials, safety boxes and reporting and stock management tools are distributed adequately and used appropriately. To maintain appropriate storage of vaccines and immunization commodities in the right condition before and during distribution. To coordinate distribution with the team at the sub-national levels while ensuring appropriate stock levels for immunization programmes. To optimize the logistics networks and seek out opportunities to improve last-mile delivery. To participate in system design and optimization efforts for efficient and effective distribution. To support in the supply planning and procurement process with clear oversight on capacity needs for storage and distribution.

Qualifications

Competencies

University degree in management, public health and/or administration. Minimum two years of work experience of working in immunization and health programmes. Minimum of five years managing supply chain and logistics management. Experience with distribution and transport management at large scale. Advanced degree in supply chain management is desirable.

Resource management Selection and quantification Storage and distribution Professional/personal Utilization

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Procurement Manager Title: Summary The Procurement Manager will work with EPI: To manage the procurement of immunization supplies including vaccines liaising with manufacturers and procurement agents based on coordinated forecast in line with procurement laws and guidelines. To establish monthly reporting on national supply levels and procurement plans to identify potential supply gaps early and develop responses to mitigate impact on service delivery. To develop procurement strategies, processes, procedures and plans with partners. To manage all contracts related to procurement, supply and logistics operations. To work with the team to increase the sustainability of procurement, forecasting, quantification and commodity monitoring activities. To support with budgeting and financing for immunization supplies in a timely manner together with the EPI, MOH and MOF. To ensure forecasts and supply plans for all product classes are available and updated to inform procurement. To work with the procurement team to ensure that the procurement plans are appropriate given the demand forecast and resolve any discrepancies. To work collaboratively with partnersâ&#x20AC;&#x2122; in-country quantification core teams to review country supply plans for all commodities; recommend adjustments and reach consensuses with in-country programme management as needed. To collaborate with relevant teams for account reconciliation, audit and inspection. Other duties as required. Qualifications

Competencies

University degree in management, public health and/or administration. Minimum two years of work experience of working in immunization and health programmes. Minimum of five years managing procurement, supply chain and logistics management. Experience in developing procurement strategies, contracts and negotiation.

Procurement Resource management Selection and quantification Storage and distribution Professional/personal Utilization

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ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

Cold Chain Officer Title: Summary The Cold Chain Officer reports to the Immunization Specialist for guidance and general supervision; and is accountable for professional technical contributions to project design, planning, implementation, monitoring, evaluation and administration of immunization Supply Chain Logistics (iSCL), specifically Cold Chain and Vaccine Management (CCVM) management activities, including data analysis, programme planning, programme delivery, progress reporting and commitment for strengthening of cold chain systems coverage, as well as enhancement of teamwork and capacity building, in support of achievement of planned objectives of the immunization work plan, aligned with country programme goals, objectives and strategy. Principal accountabilities Monitor function, procurement and inventory of the cold chain equipment. Record temperature of refrigerators/freezers according to standard protocols. Check if vaccines are properly stored in the cold chain designed equipment. Provide technical guidance to health programmes regarding cold chain protocols. Conduct preventive maintenance. Remove expired vaccines from the cold chain. Prepare and send monthly reports. Replenish vaccine stock. Prepare and send quarterly reports. Carryout preventive maintenance of cold chain equipment. Conduct annual inventory of cold chain. Propose replacement of cold chain equipment. Qualifications

Competencies

University degree in engineering and sciences. Minimum two years of work experience of working in immunization and health programmes. Minimum of five years in managing refrigeration, medical devices and equipment. Experience with cold chain equipment and related devices.

Resource management Selection and quantification Storage and distribution Professional/personal Utilization

Cold Chain Technician Title: Summary The Cold Chain Technician will: Support any new installation of cold chain equipment in country. Support EPI logistic team to develop preventive maintenance plan for all kinds of cold chain equipment across the country and support repair and maintenance. Assist county cold chain technicians on installation, maintenance and repair of cold chain equipment as required. Assist EPI logistics team to keep inventory on cold chain equipment and prepare replacement plan. Assist EPI logistics team to conduct survey on actual life span of different batteries used for solar vaccine fridges across the country and prepare replacement plan. Conduct assessment on means of power supply for county and regional vaccine depots and plan for backup power and replacement. Assist in physical vaccine stock check as required. Provide technical assistance for vaccine storage temperature review. Provide technical assistance as required to develop plan and procedure for fully functional cold chain and logistics unit in country. Perform other duties as required. Qualifications

Competencies

Diploma in health technology Minimum two years of work experience of working in immunization and health-related programmes Minimum of two years in managing refrigeration, medical devices and equipment Experience with cold chain equipment and related devices

Resource management Selection and quantification Storage and distribution Professional/personal Utilization

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CAPACITY DEVELOPMENT COUNTRY SUPPORT

Data and Monitoring Officer Title: Summary The data officer will: Establish, maintain and update databases pertaining to each programmatic area in EPI supply and logistics using relevant information systems. Perform data validation and cleaning on all vaccine logistics data at national and sub-national levels. Provide regular feedback on data quality, timeliness and completeness of reports for action. Track and obtain missing or incomplete logistics data/reports and provide feedback to relevant levels. Provide all-around GIS support including accessibility, Vaccination Tracking System (VTS). Produce weekly, monthly and quarterly analysis feedback from vaccine supply/logistics data to enhance decision-making at state and LGA level. Represent and support at data presentation, analysis and interpretation meetings and workshops. Create and secure backup copies of data in the state. Provide technical data management support to the state government. Conduct data management training to build the capacity of officers. Perform other activities as required by the supervisor. Qualifications

Competencies

University degree in data science, mathematics, computer science, engineering, management science or social science. Minimum two years of work experience of working in immunization and health programmes. Minimum of five years in data management, analysis and triangulation.

Resource management Selection and quantification Storage and distribution Professional/personal Utilization

Warehousing Officer Title: Summary The Warehousing Officer will be responsible to complete all the work connected to the Expanded Programme on Immunization (EPI) Warehouse cold chain and dry store items functions: Set the policy and procedures for the EPI Warehouse for timely receipts and deliveries of vaccines and supplies. Prepare a reliable system/setup for an effective and efficient coordination mechanism with multiple stakeholder donors, nongovernmental organizations, national and international suppliers and freight forwarders, and provincial governments. Take responsibility for all warehouse operations activities including shipping and receiving deliveries, coordinating stock, documenting warehouse transactions, maintaining records and overseeing the storage of surplus inventory. Prepare for all pipeline incoming vaccines and get supply delivery schedules from the various donors and shipments internally procured by the Federal EPI; also, prepare the proper logistics and administrative arrangements in advance. Do a quality check and apply set quality protocols for vaccines and supplies when receiving them at the EPI Warehouse or dispatching them to the provincial governments. Plan and organize the incoming and outgoing flow of vaccines and supplies to avoid overcrowding in the cold room or dry store. Ensure that all vaccines are dispatched according to the priority vaccine distribution list and based on the vaccine vial monitor (VVM) and first-to-expire, first-out (FEFO). Prepare a quarterly/monthly distribution plan for vaccines and supplies for the campaign and routine immunization programme; do this after consulting with the provincial- and district-EPI counterparts. Prepare and provide stock analysis and stock sufficiency reports to the National EPI, as per weekly receipt and issuance. Provide advice/feedback to the EPI about the vaccines and supplies sufficiency level, per the average issuance/consumption provincial and district stakeholders' counterparts to avoid overstock and understock at the Federal EPI Warehouse. Prepare daily/weekly or monthly key performance indicators (KPIs) and action plans for EPI Warehouse staff who are directly or indirectly involved in the various warehouse operations. Qualifications

Competencies

Degree or diploma in any field Minimum two years of work experience of working in a standard warehouse and/or store Proven experience in warehouse operations and management with large commodity volume

Resource management Selection and quantification Storage and distribution Professional/personal Utilization

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ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

Finance & Administration Title: Summary The Finance and Administration Officer will: Manage the implementation of operational strategies and procedures with the team. Coordinate budget preparation and management for operations and programmatic forecast for commodities. Manage cash management, accounts and payment. Coordination administration, human resource and financial management. Support with capacity building, knowledge and team management. Qualifications

Competencies

Degree in finance, accounting or management related field Accounting certification Minimum three years of experience in accounting, finance and budgeting

Resource management Professional/personal competencies

Supply Chain Strengthening Officer Title: Summary The Supply Chain Strengthening Officer will: Coordinate all immunization supply chain strengthening activities towards creating an enabling environment for immunization supply/ logistics management. Manage institutional capacity building efforts with the objective of improving governance, coordination and sustainability. Implement national training plans including rollouts, on-the-job trainings and supportive supervisions for supply chain and logistics within the EPI. Support technical working groups and coordination mechanisms in ensuring supply chain management and visibility at all levels. Strengthen data management with the data team as part of capacity development efforts. Contribute to strategic initiatives, such as warehousing improvements, strategic planning and system design/optimization. Drive effective monitoring and evaluation together with the data team. Build and manage partnership framework with national and international institutions and partners. Qualifications

Competencies

University degree in management, public health and/or administration Minimum two years of work experience of working in immunization and health programmes Minimum of three years of experience in system strengthening and/or capacity building Proven skills in strategic planning, facilitation, developing partnerships and coordination

Resource management Selection and quantification Storage and distribution Professional/personal Utilization

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CAPACITY DEVELOPMENT COUNTRY SUPPORT

Annex III: People that Deliver Competency Framework The link to the full Competency Framework can be found online at <https://tinyurl.com/comptency-compendium>.

Selection and quantification

1.1 Select the appropriate product 1.2 Define the specifications and quality of the product 1.3 Take into account any special considerations for the product 1.4 Forecast and quantify product needs

Procurement

2.1 Manage procurement costs and budget 2.2 Build and maintain supplier relationships 2.3 Manage tendering processes and supplier agreements 2.4 Undertake contract management and risk and quality management 2.5 Assure quality of products 2.6 Manage import and export of products

TECHNICAL

2.7 Manage donations of products 2.8 Prepare for product supply during disasters and emergencies 2.9 Undertake or manage manufacturing or compounding of products 2.10 Undertake or manage re-packing of products Storage and distribution

3.1 Undertake storage, warehousing and inventory management 3.2 Supply commodities to facilities 3.3 Manage transport for commodities 3.4 Manage disposal of products 3.5 Dispense or provide commodities to patients/users

Utilization

4.1 Understand use of medical products including medicines and equipment

Resource management

5.1 Manage, plan and implement projects 5.2 Manage resources and financial activities 5.3 Oversee human resources (e.g., recruitment, training, team management/supervision) 5.4 Implement quality assurance and risk management activities 5.5 Recognize and understand the complementary requirements of a sustainable supply chain management (SCM) system 5.6 Oversee and/or support operation of a Logistic Management Information System (LMIS)

MANAGEMENT

5.7 Manage outsourcing SCM functions Professional and personal

6.1 Demonstrate basic generic skills (e.g., literacy, numeracy, technology) 6.2 Demonstrate strong communication skills 6.3 Utilize problem solving skills 6.4. Exhibit professional and ethical values 6.5 Prove leadership abilities 6.6 Abide by rules/laws/legislation

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ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

Annex IV: APCIS Supply Chain Professional Competency Framework

SUPPLY CHAIN MANAGER DIAGRAM

Occupation-related

Material Manager Specific Requirements includes requirements such as certification, licensure, and specialized educational degrees, or physical and training requirements for supply chain managers. • B  achelors og equivalent degree • Supply chain industry association membership • Supply chain-specific certifications

Profession-related

Supply Chain manager Knowledge Areas andTechnical Competencies represent the knowledge, skills, and abilities needed by supply chain managers. • • • • • • •

Performance trade-offs  arehouse management W Transportation management Supply chain synchronization Risk management Sustainability Local facilities

• • • • • • •

Distribution Warehousing Logistics International regulations Strategic sourcing and supplier relationship Customer relationship management Applying lean and six sigma tools

Operations Management Knowledge Areas and Technical Competencies represent the knowledge, skills, and abilities neede by all occupations within management, including supply chain manageers • • • •

 trategy development and application S Supply chain management Process improvement and six sigma Execution, planning, scheduling control

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• Project management • Lean management • Enabling technology application


CAPACITY DEVELOPMENT COUNTRY SUPPORT

... contiuned

Annex IV: APCIS Supply Chain Professional Competency Framework SUPPLY CHAIN MANAGER DIAGRAM

Foundational

Workplace and Leadership Competencies represent thse skills and abilities that allow individuals to function inan organizational setting. • • • •

Problem solving and decision making  eamwork and collaboration T Accountability and responsibility Customer focus (intenal and external)

• Planning and organizing • Conflict management • Enabling technology

Academic Compentencies are primarily learned in an academic setting, and include cognitive functions and thinking styles. • M  ath, statistics, and analytical thinking • Reading and writing for comprehension • Applied science and technology

• Supply chain fundamentals • Foundations of business management • Operations and enterprise economics

Personal Effectiveness Competencies represents motive and traits as well as interpersonal and self-management styles and generally are applicable to a number of industries at at national level. • Awareness pf the needs of others • Integrity • Continuos learning Source: APCIS

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• Effective communication • Interpersonal skills • Creativity


ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS

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© UNICEF

ORGANIZATIONAL DESIGN FOR PUBLIC HEALTH SUPPLY CHAINS


UNICEF Supply Division Ocenavej 10 -12 2150 Nordhaven Copenhagen Denmark Telephone: +(45)45335515 email:supply@unicef.org www.unicef.org/supply

© United Nations Children’s Fund (UNICEF) April 2019

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Organizational Development for Public Health Supply Chain (Final Draft for Comments)  

With increasing focus on coordination, collaboration and capacities within the public health supply chain space at the country level, there...

Organizational Development for Public Health Supply Chain (Final Draft for Comments)  

With increasing focus on coordination, collaboration and capacities within the public health supply chain space at the country level, there...

Profile for bayus007
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