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[DATE] [SPEAKERS NAMES]
GLOBAL HEALTH SUPPLY CHAINS. DAR ES SALAAM TANZANIA 2016
Thanks to our generous sponsors
GLOBAL HEALTH SUPPLY CHAINS - DAR ES SALAAM TANZANIA – 2016
Assessing HR for the Immunization Supply Chain A Holistic Approach
Ms Musonda Kasonde, UNICEF Supply Division Dr Bastiaan Remmelzwaal, UNICEF ESA Region
GLOBAL HEALTH SUPPLY CHAINS - DAR ES SALAAM TANZANIA – 2016
This Presentation
Case for Holistic HR Assessment
Methodology
Findings from multi-country study
Critical success factors for country uptake
Conclusion
GLOBAL HEALTH SUPPLY CHAINS - DAR ES SALAAM TANZANIA – 2016
Background
System design
Supply chain leadership
Better cold chain equipment
Data for management Continuous
improvement plans
If we help countries put in place the supply chain fundamentals…
…then EPI will begin to reach the objectives of vaccine that is…
…helping to achieve the desired results:
Available • In the right place
at the right time
Potent • Providing a high
level of immunity
Efficient • Resources used for
best purpose
Vaccine coverage & equity
Under-5 mortality
In 2014, Gavi Alliance partners approved an Immunisation Supply Chain Strategy
GLOBAL HEALTH SUPPLY CHAINS - DAR ES SALAAM TANZANIA – 2016
The ISC strategy fundamentals
Supply chain management and improvement plans
• Support development and implementation of continuous and comprehensive supply chain management plans.
Supply chain data for management
• Track and use supply chain performance metrics to make strategic and operational decisions.
System design (select countries only)
• Support priority countries in improving system design.
Supply chain cold chain equipment
• Enable countries to get the right equipment in place.
Plans Data Cold chain equipment
System design
Supply chain leadership
• Ensure dedicated supply chain leaders are in place at all levels of the health system with the right capabilities, authority and accountability .
Leaders
GLOBAL HEALTH SUPPLY CHAINS - DAR ES SALAAM TANZANIA – 2016
Alignment with the EVM approach
20% 24%38%
28%16% 19% 17%
30% 37%
80% 77%62%
73%85% 81% 83%
70% 63%
Distribution Information systems
Buildings and
equipment
Storage capacity
Temperature monitoring
Stock management
Maintenance Pre-shipment &
vaccine arrival
Vaccine management
Average scores for 57 countries (WHO)
EVMA: Limited focus on HR !
GLOBAL HEALTH SUPPLY CHAINS - DAR ES SALAAM TANZANIA – 2016
Existing HR Assessment Tools
HRM Assessment Approach (CapacityPlus, 2013)
HR Capacity Development in Public Health SCM (USAID, 2013)
Competency Compendium for Health SCM (PtD, 2014)
Discrete Choice Experiment for the Health Workforce (WHO, 2012)
Workload Indicators of Staffing Needs – WISN (WHO, 2010)
Health Workforce for Universal Health Coverage (WHO, 2016)
4-Step Approach to HR Development (PtD, 2014)
GLOBAL HEALTH SUPPLY CHAINS - DAR ES SALAAM TANZANIA – 2016
Holistic Approach
Why the need for an additional tool?
Look at HR for ISCM holistically
Rapid, Lightweight
Integrated with the Comprehensive EVMA and Improvement Plan
GLOBAL HEALTH SUPPLY CHAINS - DAR ES SALAAM TANZANIA – 2016
Holistic Approach
GLOBAL HEALTH SUPPLY CHAINS - DAR ES SALAAM TANZANIA – 2016
HR Indicator Framework
HR Policy Posts filled Recruitment Working conditions Job descriptions Supportive supervision Performance monitoring Competency levels Training Career paths
HR Planning
HR Management
HR Development
GLOBAL HEALTH SUPPLY CHAINS - DAR ES SALAAM TANZANIA – 2016
Methodology
Collaborative effort: UNICEF Supply Division UNICEF ESA Regional Office
Gavi Alliance P&P Working Group
GLOBAL HEALTH SUPPLY CHAINS - DAR ES SALAAM TANZANIA – 2016
Methodology
Desk Review HR Rapid Assessment
Findings & Recommen-
dations
Agree Action Plan
• HR Action Plan • National ownership
• Scan the literature • Analyse data
• Engage with MoH • Interviews, Site visits
• Draft report • Seek consensus
1 2 3 4
GLOBAL HEALTH SUPPLY CHAINS - DAR ES SALAAM TANZANIA – 2016
Methodology
2016: HR Assessment carried out in 7 countries (ESA Region)
Country Population DTP3 Coverage Ethiopia 102m 72 Kenya 46.8m 87 South Sudan 12.5m 46 Malawi 18.6m 96 Lesotho 1.95m 69 Uganda 38.3m 99 Zambia 15.5m 90
GLOBAL HEALTH SUPPLY CHAINS - DAR ES SALAAM TANZANIA – 2016
Findings
Level HR P
olic
y
Post
s Fill
ed
Recr
uitm
ent
Wor
king
Co
nditi
ons
Job
Desc
riptio
ns
Supp
ortiv
e Su
perv
isio
n
Perf
orm
ance
M
onito
ring
Com
pete
ncy
Leve
ls
Trai
ning
Care
er P
aths
PrimarySub-NationalLowest DistrictService Level
Key to Scores≥ 80%
65-80%≤ 65%
HR Planning HR Management HR Development
Example of a GOOD Performing Country
GLOBAL HEALTH SUPPLY CHAINS - DAR ES SALAAM TANZANIA – 2016
Level HR P
olic
y
Post
s Fill
ed
Recr
uitm
ent
Wor
king
Co
nditi
ons
Job
Desc
riptio
ns
Supp
ortiv
e Su
perv
isio
n
Perf
orm
ance
M
onito
ring
Com
pete
ncy
Leve
ls
Trai
ning
Care
er P
aths
PrimarySub-NationalLowest DistrictService Level
Key to Scores≥ 80%
65-80%≤ 65%
HR Planning HR Management HR Development
Findings
Example of a POOR Performing Country
GLOBAL HEALTH SUPPLY CHAINS - DAR ES SALAAM TANZANIA – 2016
Findings
Example of a GOOD
Performing Country
85
85
74
HR Planning
HR Management
HR Development
HR Capacity by Category (%)
GLOBAL HEALTH SUPPLY CHAINS - DAR ES SALAAM TANZANIA – 2016
Findings
Example of a POOR
Performing Country
66
20
32
HR Planning
HR Management
HR Development
HR Capacity by Category (%)
GLOBAL HEALTH SUPPLY CHAINS - DAR ES SALAAM TANZANIA – 2016
Findings
85%
77%
95%
79%
72%
66%
59%
76%
85%
63%60%
41%
25%
20%22%
45%
74%
58% 59%
29%
49%
32%
26%
47%
0%
100%
C1 C2 C3 C4 C5 C6 C7 AVG
HR Planning HR Management HR Development
80%
65%
GLOBAL HEALTH SUPPLY CHAINS - DAR ES SALAAM TANZANIA – 2016
Characteristics of GOOD Performers
National ownership, vision and leadership
Continuous improvement in immunization coverage
Sustained good performance
Key supply chain positions filled with qualified staff
Timely replacement of retiring staff
Inclusive partnerships
GLOBAL HEALTH SUPPLY CHAINS - DAR ES SALAAM TANZANIA – 2016
Common Characteristics (All Countries)
No Training Plan in place; training is haphazard
No periodic Training Needs Assessment (TNA)
Poor routine supportive supervision
No job descriptions, or not Supply Chain specific
Poor collaboration with local training institutions
Lack of operational research
GLOBAL HEALTH SUPPLY CHAINS - DAR ES SALAAM TANZANIA – 2016
Conclusion
Study provides insight into HR strengths/weaknesses
Variation in HR performance between countries
Practical HR Action Plans developed for each country
Success factors for HR Action Plan implementation: Buy-in by MoH Senior Management Integrate HR Assessment into EVMA (mandatory)
Focussed TA Support to countries, as per HR Action Plan
Partner Collaboration, Government-led
GLOBAL HEALTH SUPPLY CHAINS - DAR ES SALAAM TANZANIA – 2016
Conclusion
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