human resources for health supply chain transformation ......deliver (ptd) human resources for...

Human Resources for Health Supply Chain Transformation:

Exploring Common Best Practices in the African Health Supply Chain

Case Studies from Ethiopia, Kenya, Malawi, Sudan, Tanzania, and Uganda

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Acknowledgements

Theauthorswishtothankeveryonewhohascontributedtothisresearch.Wearegratefultothekeyinformants,whokindlygavetheirtimetobeinterviewedandsharedtheirknowledgeandexpertise. Thank you also to the survey respondents, including the IAPHL and SoSoKEcommunities,whoenriched this research, and to theparticipantsof thePSAwebinarHumanResourcesforHealthSupplyChainTransformation,whoprovidedinvaluablefeedbackonanearlyversionofthisresearch.WewishtoextendourthankstothePSAteamwhoprovidedfeedback,including Sintayehu Beyene Tiruneh, Jean Blackstock, Geleta Beyene Tiruneh, Sophia Iosue,YukabethOtieno,andSolomonTekle.

AUTHORS

PamelaSteele

AndreyLevitskiy

JoannaNayler

DrLakshmySubramanian

SUGGESTEDCITATION

Steele,P.,Levitskiy,A.,Nayler,J.,andSubramanian,L.(2020)HumanResourcesforHealthSupplyChain Transformation: Exploring Common Best Practices in the African Health Supply Chain.PamelaSteeleAssociates.

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Executivesummary

Introduction

Humanresourcemanagement(HRM)isacriticalcomponentofaneffectivehealthsupplychain.Humanresource(HR)andsupplychainpractitionersemphasisetheimportanceofhumancapitalfor successful SupplyChainManagement (SCM)and customer satisfaction, citing thepositiveimpactofstrategicHRMonorganisationalperformance. In low-andmiddle-incomecountries(LMICs),whichexperiencesignificantshortagesofqualifiedandskilledhealthandsupplychainworkers, this impact is particularly relevant.Over thepast several years, the governmentsofmanycountriesinSub-SaharanAfricahavesuccessfullyimplementedvariousHRMstrategiestoimprovetheirpublichealthworkforce.ThepresentstudyaimstoidentifybestpracticesinHRM,andtounderstandifandhowtheseareappliedacrosshealthsupplychainorganisationsinSub-SaharanAfrica.ThegoalistohighlightapproachesthatcaninformandsupporteffectiveSCMandSupplyChainTransformation(SCT)intheregion.

Methodology

ThemethodologyofthisstudyisinformedbytheHRMtheoreticalframeworkandthePeoplethatDeliver (PtD)HumanResources for Supply ChainManagement Theory of Change. The latteridentifiesfourpathwaysofchange(staffing,skill,workconditions,andmotivation)forimprovingsupplychainworkforceperformance.ThestudyusesthesefourpathwaystoorganiseitsfindingsregardingbestpracticesinHRMforthehealthsupplychain,andthepracticescurrentlybeingappliedinSub-SaharanAfrica.

Thestudyinvolvedthreecomponents:

1. A desk review of literature on HR practices and health SCM, which was used to identifyinternationalbestpractices.

2.Anonlinesurveythatcollectedresponsesacrossfivegroupsofstakeholdersinhealthsupplychainonthepracticesappliedintheorganisationsofwhichtheyhaveknowledge.Thisincludedofficials from ministries of health; representatives from parastatal and central procurementagencies and from the district level; representatives from state-level health facilities; andrepresentativesfromthedonorcommunityandprivatecharitableorganisations.

3.Keyinformantinterviews(KIIs)withkeyHRprofessionalsinsixcasestudyparastatalhealthsupply chainorganisations inAfrica,whichhave eachundergonesome formof SCT in recentyears,toprovideasnapshotoftheHRMmechanismsandpracticestheyarecurrentlyapplying.Thecasestudyorganisationsare:theEthiopianPharmaceuticalSupplyAgency(EPSA);theKenyaMedical Supplies Agency (KEMSA); the Central Medical Stores Trust (CMST) of Malawi; theNational Medical Supplies Fund (NMSF) of Sudan; the Medical Stores Department (MSD) ofTanzania;andtheNationalMedicalStores(NMS)ofUganda.

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Keyfindings

Pathway 1. Staffing

Bestpractices

Bestpracticerecruitmentprocessesforsupplychainpersonnelarerigorous,transparent,fair,andcompetitive.Efficientrecruitmentsystemsarecharacterisedbycompetency-basedcandidateassessments that focus on valuable skills, qualifications, trainings, and relevant experiences.Anotherbestpracticeinthisareaisjobdescriptionsthataredevelopedbasedonacompetencyframework.Finally,therearevariousbestpracticemeansofattractingandretainingemployees,including employee compensation which follows clear and competitive pay scales (whichrequiressalarybenchmarkingandcomparisonsbetweenprivateandpublicinstitutions).

Findingsfromthesurveyandthecasestudies

Thesixcasestudyparastatalsupplychainorganisationsconductinternalorexternalrecruitment(or both), in some cases outsourcing the hiring of topmanagementpositions to professionalservices firms. Most of the organisations conduct written or oral technical tests as part ofrecruitment.

Amongthe survey respondents, qualifications and the lengthofprofessional experiencewerefoundtobemoreimportantforthefinalrecruitmentdecisionthanacandidate’sperformanceinaninterview:reportedby42%ofthesurveyrespondents,asagainst35%,respectively.Thiswasmirroredinthesixcasestudyparastatalorganisations:forthemajorityofthese,qualificationsandthelengthofprofessionalexperienceplayapivotalroleintheselectionprocess.

Onlytwooutofthesixcasestudyorganisationsapplyjobdescriptionsbasedonacompetencyframework.

Employee compensationwas found tobe instrumental in attractingand retaining employees.However, despite this importance,most survey respondents (59%) acknowledged that theirorganisationslackbenchmarkedsalaryranges,and69%indicatedthatsalarymarketanalysisisnotconductedintheirorganisations.Thesixcasestudyorganisationsreportedfacinglimitationsin their ability tooffer competitive salaries andbenefitsdue to constraints imposedby stateregulations on salaries and remuneration. To this is added a lack of benchmarking of salaryranges,andsalarymarketanalyses.Together,thishasanegativeimpactonstaffturnoverattheorganisations.

Pathway2.Skills

Bestpractices

Asupplychainworkforce’scontinuouslearning,training,andprofessionalisationarecrucialforenhancing supply chain performance. Best practices in this area can be broken down into avarietyofinitiatives:

Training needs analysis (TNA): TNA aims to identify knowledge and skills gaps, to identifytraininganddevelopmentrequirements.TNAallowsorganisationstodevelopinformeddecisionsonwhatlearningisneededatindividualandorganisationallevels,andtodraftatrainingplanandanorganisationaltrainingstrategytoensuresufficientcapacityforsustainingcurrentandfuturebusinessperformance.

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Professionalappraisals,training,andcontinualprofessionaldevelopment(CPD):CPDofsupplychain specialists occurs through running training and learning courses, tailored to addressspecificskillsneeds;helpingstafftoobtaincertificationsandhigherdegrees;andhelpingstafftoobtainmembershipsinprofessionalassociations.

Professionalisationandcommunitiesofpractice:ProfessionalisationofSCMspecialistsisgainingincreasingattentionfromhealthsupplychainorganisationsinAfrica.ItstaskistoprepareandsupporthighlycompetentmanagersandpractitionersthroughtrainingandcareermanagementbyestablishingglobalstandardsforhealthSCMjobfunctions,skillsneedsanalysis,harmonisedlearningcurricula,andaccreditationofsupplychainworkers.Communitiesofpracticepromoteprofessionalisation by creating a shareddomain for learning, networking, and the sharing ofideas,methods,andexperiences.


AlthoughTNAiscommonlyperceivedasanintegralpartofHRdevelopmentandtransformation,only50%of survey respondents indicated that their organisations conductTNA, and35%ofrespondentshighlightedthatTNAintheirorganisationsdoesnotleadtothedevelopmentofatrainingstrategyorplan.Allofthesixcasestudyhealthsupplychainorganisationswerefoundto conduct TNA, mostly annually. Of the six case study organisations, five currently providetraining,eitherin-houseorexternally,whilethesixthisdevelopingitstrainingstrategy.NMSFhasadedicatedtrainingcentre,andEPSAisdevelopingone.Twooftheorganisations(NMSandMSD)supportstaffmembershipofprofessionalbodiesbypayingtheirfees.Mentoringalsooccursin theseorganisations, butnot as consistently across theorganisations.The study foundthatsupporting communities of practice is considered an important stimulus for continuousprofessionalandleadershipdevelopmentofemployees.

Pathway3.Workconditions

Bestpractices

Organisationalcultureisanimportantcomponentofcreatingasupportiveworkenvironment,providingawayforemployeestovoicetheirviewsanddevelopconnectionsandpurpose.Therearenumerouswaystostrengthenorganisationalculture,including:(i)implementingpoliciesthatsupport a positive organisational culture (an overarching code of conduct or ethics, anti-harassmentpolicies,anti-discriminationorequalopportunitypolicies,andpoliciesthatcreateagood working environment for women) and reviewing them regularly; (ii) implementingwhistleblowingmechanisms; and (iii) ensuring apositive physical environment, including byestablishinganoccupationalsafetyandhealth(OSH)managementsystem.


Policiestosupportapositiveorganisationalculture:Havinganoverarchingcodeofconductorethics in place was the most commonly reported policy intervention among the surveyrespondents(63%),andsuchcodeswerealso foundtobe inplaceatallofthesixcasestudyorganisations.Otherpoliciesindicatedbythecasestudyorganisationinformantsasbeinginplaceinclude policies on anti-corruption, anti-fraud, anti-discrimination, HIV and chronic diseases,sexual harassment, and health and safety. Some of the six case study organisations promotewomenorminoritygroupsthroughspecificgroupsordepartments(e.g.aGenderMainstreamingCommittee and a Disability Mainstreaming Committee at KEMSA, and a Gender and YouthDirectorateatEPSA).Otherproceduresincludeusingaffirmativeactionineitherrecruitmentorpromotion, having a clear policy on attracting and maintaining an equal workforce, and

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examining disaggregated data on the gender split at different levels. Key informants alsomentionedhowtheirorganisationssensitiseemployeeson,anddisseminate, theirpoliciesbymeans of consultation, regular reviews, and circulating hard and soft copies across theorganisation.NMSinUgandaisintheprocessofdesigningonlinemodulescoveringitspolicies.

Awhistleblowingmechanism:Suchamechanismwasreportedtobeinplaceby41%ofsurveyrespondents.Fouroutofthesixcasestudyorganisationsalsostatedtheyhaveawhistleblowingpolicymechanism.The survey respondentsand theKIIs reportedbestpractices in creatingawhistleblowingpolicymechanismas includingan independentlymanagedanonymoushotlineandtheuseofspecificemailsystemstoensureanonymity.

EnsuringapositivephysicalenvironmentandOSH:Themostimplementedinterventionreportedbysurveyrespondentswas the improvementof theworkplaceconditionsandprovidingstaffwiththenecessarytoolsandequipmenttoperformtheirjobs(81%).Otherpracticesmentionedby key informants include carrying out tests (e.g. measuring lighting levels and air quality),providing medical cover and free health checks, registering near incidents, and providingpersonalprotectiveequipmenttostaff.Manyofthesixcasestudyorganisationsmentionedthattheycomplywithnational-levelhealthandsafetylegislation.

Pathway4.Motivation

Bestpractices

EmployeemotivationisakeyHRstrategyandplaysacrucialroleinachievinganorganisation’svision. Best practices that can promote good employee motivation include: (i) performancemanagement, including appraisals; (ii) incentives (financial and non-financial, e.g. financialsupport for CPDs, performance-based incentives, recognition, and exposure to stakeholdermeetings);(iii)goodsupervisionandmanagement;(iv)promotions(particularlyifcompetency-based); (v) employee engagement and retention through development opportunities,communication channels, rewards and recognition, and employer’s support (as well asconducting astaff satisfactionsurvey to get employee feedback); and (vi)a cleardisciplinarypolicyandpractice.


Performance management: 73% of the survey respondents confirmed the presence ofperformancemanagementsystemsintheirhealthsupplychainorganisationsError!Referencesourcenotfound.,while68%ofthesurveyrespondentsalsoindicatedthattheirorganisationshaveaperformancemanagementprocess for identifyinganddocumentingpoorperformance.Some of the best practices identified by the respondents in this area include the use ofperformance indicators, annual appraisals to reinforce performance through a balancedscorecard(BSC),conductingreviewmeetings,andcontinualinvestmentinHRdevelopmentandmanagement.Regardingthecasestudyorganisations,eachidentifieditsuniquecombinationofintrinsicandextrinsicmotivators:performancemanagementissupportedusingkeyperformanceindicators (KPIs) at EPSA, KEMSA, andNMSF;MSD uses its internal appraisal system, calledDRIVE;whileNMSseekstomotivateemployeesthroughchangestotheworkenvironmentandorganisationalculture.Performanceappraisalsarecentraltomotivationacrossallofthesixcasestudyorganisations.

Incentives:ThesurveyrespondentsidentifiedarangeoftoolsthatarecurrentlybeingusedtoincentivisethehealthSupplyChainworkforce, includingfinancialsupportforCPD,paidstudyleave,approvalfortheacquisitionofrelevantcertifications,andperformance-basedincentives.

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Inregardtothesixcasestudyorganisations,incentivesusedtomotivatetheirstaffinclude:toolstoinducerecognition;exposuretostakeholdermeetings;rewardingemployeeperformancewitha recognition letter and a dinner with the CEO (KEMSA); providing hardship allowances,honoraria,andtransportallowances(MSD);andprovidinganentertainmentallowanceforclient-facingjobroles,fuelallowancesformiddleandtopmanagement,andtransportforstaff(NMS).

Goodsupervisionandmanagement:Thesurveyfindingsrevealedthatmonitoringandsupportivevisits,mentoringandcoachingprogrammes,systematicsupervision,andmoderateddiscussionswereconductedintherespondents’organisations.Thesixcasestudyparastatalorganisationshavedifferentapproaches tosupervisorysupport:KEMSAencouragessystematicsupervision,while.NMSaimstoboostinter-departmentalcoachingandmentoring,especiallyforjuniorstaff,andMSDalsoencouragestafftoseekmentoringopportunitiesoutsidetheirorganisationthroughparticipationinworkshopsandseminars.

Promotions: According to the survey results, 59% of the respondents felt that there are notenoughpromotionopportunitiesfortheworkforce.Promotionswerereportedtobebasedonthenumberofyearsinthejobpositionandtofollowachainofsupervisoryandhierarchicalflow.Suchformsofpromotionresultinafragmentedsystemandlowerlevelsofmotivation.Intermsof the six case studyorganisations, promotionsare guidedby theCareerProgressionPlan atKEMSA,theConditionofServicehandbookatCMST,andtheCivilServiceChamberatNMSF.MSDfollowsacompetence-basedpromotionsystem,whileNMSdoesnotexercisepromotionsatall,instead inviting employees to apply for available internalpositionsat various levelsafter theexpirationoftheirfixed-termfour-yearcontract.

Employee engagement and retention: Only 44% of the survey respondents indicated theexistenceofemployeeengagementandretentionpolicies intheirorganisation.59%reportedthat their organisation does not conduct a staff satisfaction survey. At the six case studyorganisationsemployeeengagementandretentionpoliciesareapplied,withtheaimofretaininghighlyskilledstaffandenhancingmotivationatthesixorganisations.A fewof thecasestudyorganisationshavedevelopedstructuredretentionschemesandpolicies(e.g. KEMSA’sTalentManagementManual),whileothersrelyonthevarietyofmonetaryandnon-monetaryincentives,workbenefits,andorganisationalchanges,whichincludeprivatehealthinsuranceandfreehealthchecks,subsidisedmeals,stafftransportation,andtradeunionsupport.

Disciplinaryproceduresandrules:91%ofthesurveyrespondentssaidthattheirorganisationhas a standard disciplinary policy and practice in place. In terms of the six case studyorganisations, disciplinary policies and practices were found to be well documented, andregulatedbyeitherspecificdisciplinarypolicies,codesofconduct,orgovernmentalregulationsand acts. Staff satisfaction surveys are conducted annually or biennially in all the case studyparastatalorganisations,exceptforNMS(whichplanstointroduceonein2020).

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Contents

Acknowledgements .......................................................................................................................... 2

Executive summary .......................................................................................................................... 3

Contents ........................................................................................................................................... 8

Table of acronyms .......................................................................................................................... 10

1. Introduction and rationale ...................................................................................................... 11

2. Methodology .......................................................................................................................... 12

3. Desk review and online survey ............................................................................................... 14

3.1 Pathway 1: Staffing .......................................................................................................... 14

3.2 Pathway 2: Skills .............................................................................................................. 19

3.3 Pathway 3: Working conditions ........................................................................................ 22

3.4 Pathway 4: Motivation ..................................................................................................... 26

4. Organisational case studies .................................................................................................... 30

4.1 ETHIOPIA: Ethiopian Pharmaceutical Supply Agency (EPSA) ............................................. 30

4.1.1 Pathway 1. Staffing .................................................................................................. 30

4.1.2 Pathway 2. Skills ....................................................................................................... 31

4.1.3 Pathway 3. Work environment ................................................................................. 31

4.1.4 Pathway 4. Motivation ............................................................................................. 32

4.2 KENYA: Kenya Medical Supplies Authority (KEMSA) ......................................................... 33


4.2.2 Pathway 2. Skills ....................................................................................................... 35



4.3 MALAWI: Central Medical Stores Trust (CMST) ................................................................ 39


4.3.2 Pathway 2. Skills ....................................................................................................... 40



4.4 SUDAN: National Medical Supplies Fund (NMSF) .............................................................. 43


4.4.2 Pathway 2. Skills ....................................................................................................... 44

4.4.3 Pathway 3: Work environment ................................................................................. 44


4.5 Tanzania: Medical Stores Department (MSD) ................................................................... 46

4.5.1 Pathway 1: Staffing .................................................................................................. 47

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4.5.2 Pathway 2. Skills ....................................................................................................... 48



4.6 Uganda: National Medical Stores (NMS)........................................................................... 51


4.6.2 Pathway 2. Skills ....................................................................................................... 53



5. Conclusion .............................................................................................................................. 57

5.1 Pathway 1. Staffing .......................................................................................................... 57

5.2 Pathway 2. Skills .............................................................................................................. 57

5.3 Pathway 3. Working conditions ........................................................................................ 58

5.4 Pathway 4. Motivation ..................................................................................................... 59

Appendix 1. Comparative tables (case studies) .............................................................................. 60

Appendix 2. Bibliography ............................................................................................................... 72

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Tableofacronyms

BMGF BillandMelindaGatesFoundationBSC BalancedscorecardCEO ChiefexecutiveofficerCMS CentralMedicalStoresCPD ContinuousprofessionaldevelopmentCMST CentralMedicalStoresTrustDRIVE Direction,review,improve,validate,andenjoyEPSA EthiopianPharmaceuticalSupplyAgencyGHSC-PSM GlobalHealthSupplyChain–ProcurementSupplyManagementHR HumanresourcesHRM HumanresourcemanagementIAPHL InternationalAssociationofPublicHealthLogisticiansKEMSA KenyaMedicalSuppliesAuthorityKII KeyinformantinterviewKPIs KeyperformanceindicatorsLMICs Low-andmiddle-incomecountriesMSD MedicalStoresDepartmentNMS NationalMedicalStoresNMSF NationalMedicalSuppliesFundOSH OccupationalsafetyandhealthPtD PeoplethatDeliverPPE PersonalprotectiveequipmentPSA PamelaSteeleAssociatesPSPTB ProcurementandSuppliesProfessionalsandTechniciansBoard

(Tanzania)SCM SupplyChainManagementSOPsSoSoKE

StandardoperatingproceduresSouth–SouthKnowledgeExchange

TNA TrainingneedsanalysisUN UnitedNationsUSAID UnitedStatesAgencyforInternationalDevelopmentWHO WorldHealthOrganization

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1. IntroductionandrationaleManysupplychainorganisationshavebecomeincreasinglyawarethatsuccessfulSupplyChainManagement(SCM)restsontheperformanceofpeople.Thisviewwaspreviouslyovershadowedbyorganisations’focusontechnology,information,andmeasurementsystems.Recognisingtheimportanceofthepeoplewhomanagesupplychains—theirskills,motivations,andcapacitiesfordevelopment—isanessentialstepinanysupplychainimprovementinitiative.Humancapitaliscritical for supply chains’ effective functioning, which has prompted human resource (HR)practitioners and scholars to explore the nexus between HR management (HRM) and SCM.Empirical research has demonstrated the positive impact of HRM on SCM implementation,organisationalperformance,andcustomersatisfactionthroughstrategicmanagementofpeople’sknowledge,skills,andabilities(Gómez-Cedeñoetal.,2015;Hohenstein,2014).

TheimpactofHRMisparticularlyimportantinthecontextoflow-andmiddle-incomecountries(LMICs),whichoftenexperiencesevereshortagesintheirsupplychainworkforces(WHO,2010).WhilsttherehasbeenanincreasingfocusgloballyonHRforhealth,fewerinitiativesexploreHRinhealthsupplychains(mostnotably,thePeoplethatDeliver(PtD)andUnitedStatesAgencyforInternationalDevelopment(USAID)Deliverproject).Moreover,thereareoftengapsindataonsupplychainpersonnel,particularlyattheadministrativelevel, leadingtocapacitygapsgoingunnoticed(Comettoetal.,2014).MultiplegovernmentalinitiativesinSub-SaharanAfricahavesuccessfullyimplementedHRMpracticesandlong-termstrategiestoincreasethequantityandquality of health and supply chain professionals within countries. These approaches, whichcombine interactive and participatory training with the strengthening of health systems,demonstratethepotentialtoimprovetheperformanceofhealthandsupplychainworkforces.

In this context, the present study aims to broaden the HRM perspective and explore howtraditional HRM practices, such as recruitment and employee selection, compensation andbenefits, training and development, performance management, and cultural and diversitymanagement can underpin supply chain transformation. The backdrop for the study is theongoing implementation in Ethiopia of the supply chain transformation programme called‘Admas’(‘Horizon’inAmharic),whichisbeingexecutedbyPamelaSteeleAssociates(PSA)fortheEthiopianPharmaceuticalSuppliesAgency(EPSA).SupportedbytheBillandMelindaGatesFoundation (BMGF), the programme in its current phase aims to ensure clear performancetargetsforalltechnicalandadministrativepersonnelatEPSA,sustainablecapacitydevelopmentinitiatives,andasafeworkenvironment.ThepresentstudyaimstoidentifythebestpracticesinHRMactivitiescurrentlybeingimplementedacrossaselectgroupofsixcasestudyAfricansupplychainorganisations,inordertoidentifyapproachesthatcaninformandsupporteffectiveSCMandtransformation.

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2. MethodologyThe study adopts the traditional HRM framework of practices, such as selection, training,appraisal,andrewards,usedforemployeemanagementinorganisations(WrightandMcMahan,1992).ItalsofollowsthePtDHumanResourcesforSupplyChainManagementTheoryofChange,a framework that enables supply chain practitioners to trace the impact of investments andinterventionsinHRonhealthSupplyChainperformance(PtD,2018).ThisstudylooksatthefourpathwaysofchangeproposedbyTheoryofChangeandadaptssomeofitsindicatorstomonitortheeffectsofHRinterventions.

Themethodologyofthisstudyincludedthreecomponents:

1. Adeskreviewofliterature

ThestudycarriedoutadeskreviewofrelevantliteratureonHRpracticesandhealthSCM,whichincludespeer-reviewedarticles,andglobalprojectreportsandstudies.

2. Anonlinesurvey

Anonlinequestionnairewaspreparedtocollectresponsesacrossawidegroupofstakeholders,particularlylogisticsprovidersatthecentral,district,andstatelevels,aswellasimplementingpartnersandprivatesectorparticipantsinthehealthsupplychain.Invitationstocompletethesurveywerecirculatedthroughmultiplechannels,suchastheInternationalAssociationofPublicHealth Logisticians (IAPHL) platform and the South–South Knowledge Exchange network(SoSoKE).

Intotal,33completeresponseswerereceivedfromfivegroupsofkeystakeholders.Thesampleincluded:

• Officials fromtheministriesofhealth inKenya,Malawi,Nigeria,Somalia,andSouthSudan(19%);

• RepresentativesfromparastatalandcentralprocurementagenciesinEthiopia,Ghana,Liberia,Sudan,Nigeria,andTanzania(35%);

• Representativesfromdistrict-levelagenciesinGhanaandUganda(11%);• Representativesfromstate-levelhealthfacilitiesinNigeria(12%);• Representatives from the donor community andprivate charitable organisations in

Bangladesh,BurkinaFaso,Eswatini,Nigeria,Switzerland,andZambia(23%).

Thesemi-structuredsurveyfollowedtheTheoryofChangeframework,askingamixofclosed-andopen-endedquestionsonthestaffing,skills,workconditions,andmotivationpathways.ThestudycombinesquantitativeandqualitativesurveydatatoillustratethecommonalityofdifferentHRpracticesandmechanismsdiscussedinthedeskreview(Section1).

3. Keyinformantinterviews(KIIs)

Sixinterviewswerecarriedoutonline,viaZoomandMicrosoftTeams,withkeyHRprofessionalsin the six-case study parastatal health supply chain organisations in Africa,which have eachundergonesomeformofsupplychaintransformationinrecentyears.Thekeyinformantswereselected for their extensive knowledge of and experience in the HR processes within theorganisation,eitherinthecapacityofdirectororseniorofficer.TheinterviewswereguidedbythePSApolicyofconfidentialityandanonymity.Thefollowingtableprovidesabreakdownofthecountriesandorganisationsselectedforinterviews.

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Country Nameoftheorganisation

Ethiopia EthiopianPharmaceuticalSupplyAgency(EPSA)

Kenya KenyaMedicalSuppliesAgency(KEMSA)

Malawi CentralMedicalStoresTrust(CMST)

Sudan NationalMedicalSuppliesFund(NMSF)

Tanzania MedicalStoresDepartment(MSD)

Uganda NationalMedicalStores(NMS)

Table1.CountriesandsupplychainorganisationsthatwerethefocusoftheKIIs

The interviews form the central part of the case studies, providing a snapshot of the HRMmechanismsandpracticescurrentlybeingimplementedacrossthecasestudyparastatalsupplychainorganisationsinAfrica(Section2).Thedetailedfindingsfromthecasestudiesareorganisedby the four pathways of change of the PtDHumanResources for Supply ChainManagementTheoryofChange.A comparativesummaryof the findingsof thecasestudies ispresented inAnnex1.

Duetosevererestrictions,imposedbytheglobalpandemicofCOVID-19andtimeconsiderations,thesecasestudiesdonotseek topresentanexhaustivepictureofHRMmechanisms in thesesupplychainorganisations.TheirtaskistohelpaddressthepaucityofdetailedinformationaboutHRpoliciesandpracticesintheseorganisations,aswellasinformandencouragesknowledgesharingandknowledgetransferontrajectoriesforHRinterventionsthatseektoimprovehealthsupplychainsonthecontinent.

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3. Deskreviewandonlinesurvey

3.1 Pathway1:Staffing

Successfulrecruitmentisoftendescribedasfindingtherightpeoplefortherightrolesattherighttime.Achievingthese‘rights’isparamountforensuringeffectivesupplychainperformance.Therecruitment process needs to ensure that selected candidates possess the relevant skills andabilitiesinsupplychainfunctionsthatareessentialfortheorganisationtomanagesupplychainoperationsandtoachieveitscurrentandfuturegoals.RecruitmentisacriticalactivityfortheHRteamandlinemanagersandrequireseveryoneinvolvedtohavesufficientknowledgeandskillstomakeeffectiverecruitmentdecisions.

Theglobalshortageofhealthworkers,revealedbytheWHOin2006,continues(WHO,2006).In2016, the International Labour Office studyanalysed the employment potential of the healthsupplychainworkforce,particularlyinrelationtothedevelopmentofuniversalhealthcoverage.Itdemonstratedthat91%oftheshortfallinsupplychainpersonneloccursinLMICs,andevenmorecriticallyinAfrica(Scheil-Adlung,2016).ThishasputadditionalpressureonrecruitmentsystemsandprocessesinAfricanhealthorganisationstoselectthemostqualifiedhealthworkersandtoensureemployeeretentioninasituationinwhichthereisaninsufficientnumberofskilledcadres, and fierce competitionwith theprivate sector,which ismore successful in attractinghighlytrainedworkforce.

(i)Recruitmentprocess

Recruitment, as an HRM process, includes several stages, beginning with the analysis of HRrequirementsandendingwithanofferofemploymenttoselectedcandidates.TheUSAIDDeliverProjectdevelopedadetailedreferenceguideforrecruitingsupplychainprofessionals,providingtemplatesandsamplestosupportstrategicHRmanagementinhealthsupplychainorganisations(USAIDDeliver,2013).Thestandardsix-stepprocess,demonstratedinFigure1,aimstoprovideaflexibleapproachtorecruitinginordertoattracttherightpeoplewhocanpropelsupplychainperformance.Theoverwhelmingmajorityofouronlinesurveyrespondents(92%)indicatedthattheir respective organisations have put in place similar procedures to secure efficient,transparent,fair,andcompetitiverecruitment.

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Figure1.Standardrecruitingprocess

Source:AdaptedfromUSAIDDeliver,2013.

Step1:Planningrecruitment

Thefirststepoftherecruitmentprocessaimstoidentifythehiringneeds.Keydecisionsshouldbemadeaboutwhatstaffpositionsarerequiredtoeffectivelyrunthesupplychain,where,andatwhatlevel.Thisincludesidentifyingtheexistingvacancies,andanalysingjobspecificationsandrelevantcompetencyrequirements.Theanalysisofsupplychainneedsdependsonthestructure(regional/zonalordistrict/sub-district),design(departments/units),andthemanagementtype(in-houseoroutsourcing)ofthesupplychainorganisation.Settingupastrongrecruitingteamorcommitteeiscrucialforguidingtherecruitmentprocess.Thiscanincludearecruitingmanager,unitdirector,jobsupervisor,andtechnicalspecialistinthevacantjobposition.

Recruitingmanagerscloselymonitorthesourcing,interviewing,andemploymentprocess.Theysupervisetherecruitingcommittee,updatecurrentanddesignnewrecruitingprocedures,andcoordinatethehiringneedswithdepartments.Themanagersapproverecruitmentrequestformsused by department to communicate to the HR team the need to recruit new or additionalmembersoftheworkforce.

Step2:Review/developjobdescriptions

AnimportantstartingpointforaSupplyChainorganisationistodraftalistofcrucialsupplychainpositions and identify staffing requirements for these roles. Most of our survey respondents(94%) indicated thattheirrespectiveorganisationshadpreparedsuch lists.However,21%ofthemhighlightedthattheselistsdidnotspecifythenumberofemployeesrequiredtofillsupplychainroles.

Definingtherequiredjobsinvolvesgatheringinformationfromavarietyofsourcesaboutspecificoutputs of the job, aswell as skills and resources thatwill enable them. This information isdocumentedinajobdescription,whichspecifiesthepurposeoftherole,thescopeofdutiesand

1. PLAN RECRUITMENT

2. DEVELOPRECRUITMENT MATERIALS

3. ADVERTISEPOSITION

4. MANAGE ANDSCREEN CANDIDATES

5. INTERVIEW AND SELECT CANDIDATES

5. EXTEND AND CONFIRM OFFER

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responsibilities, qualifications and skills, working conditions and location, compensation andbenefits, etc. Most of the survey respondents (91%) highlighted that the job descriptionsdevelopedbytheirorganisationsincludedsuchkeyelementsas:

• Clearlydefinedanddetailedjobobjectives(93%);• Essentialprofessionalqualifications(90%);• Arangeofdecision-makingresponsibilities(71%);• Clearreportingrelationships(84%).

Thetaskofreviewingjobdescriptionsfallswithintheremitoftherecruitingcommittee,whichalso

• Decidesonhowtheproposedjobsfitintotheworkforceplanoftheorganisation;• Plansthewholerecruitingprocess;• Developsselectioncriteria(includinginterviewevaluation);• Makesdecisionsonjobadvertising;• Reviewsapplicationsforemployment;• Interviewsselectcandidates;• Extendsandconfirmsoffers.

Animportantfeatureofrecruitmentisacompetency-basedfocus.Thismeansthattheselectionprocessisaimedatidentifyingcandidateswhopossessvaluableknowledge,skills,training,andexperience that underpin their successful performance in supply chain roles. A competencyframeworksetsoutanddefinescompetencyareasandattributesthatserveaskeyperformanceindicators for employees in their expected roles and levels of performance. CompetencyframeworksandcompendiaarenowwidelyusedcomponentsofHRMforSCM:75%oftheonlinesurvey respondents indicated that their organisations followa competency framework in theprocessofdevelopingorreviewingjobdescriptions.

Step3:Preparingrecruitmentmaterials

The recruiting committee is also entrusted with developing materials that will guide therecruitmentprocess.Thesecaninclude:

• Areferenceandemployeebackgroundcheckquestionnaire;• An interview guide, detailing the roles of committeemembers and featuring a list of

questionstobeusedwheninterviewingtheselectgroupofcandidates(includinggeneralHRquestionsandspecialtechnicalinterviewquestions);

• Interviewselectioncriteria–achecklistformforselectingcandidatesforaninterview,whichspecifiesessentialcomponentsfordeterminingthebestqualifyingcandidates(e.g.thelevelofeducation,professionalcertificates,yearsofexperience,relevantskills,etc.,aswellascriteriaspecifictotheposition);

• Interview evaluation criteria – a form for assessing candidates’ performance at aninterviewand ranking candidates for the final employmentoffer (oftenusinga ratingsheetoramorecomplexcandidatecomparisonscorecard).

Step4:Advertising

Itisimportantthatjobadvertsgiveclearandaccurateinformationabouttheorganisationandthevacantposition.Theyshouldnormallycover:

• Ajobsummaryandoutlineofthecorecompetencies(orapersonspecification);• Thejoblocation;

17

• Thetypeofemployment(e.g.fixed-termorpermanentrole);• Theorganisation’sactivitiesandvalues;• Therewardandbenefitspackage,andpossibleflexibleworkingopportunities;• Applicationdeadlinesandinstructionsonhowtoapply.

Many supply chainorganisationssurveyed for thepresentstudy, including the six casestudyparastatalorganisations(Section2),adoptbothinternalandexternalmethodsofadvertising.Forcertain roles, HR departmentsmay decide to advertise positions internally. In this case, jobadvertswillbepostedonnoticeboardsintheorganisation’sheadquartersandhubsorsharedviacorporateemailandotherformsofinternalcommunications(e.g.companynewsletters).Ifthepositionisadvertisedoutsidetheorganisation,theHRdepartmentcanuseseveralchannelstoreachpotentialapplicants,suchas:

• Theorganisationalwebsite;• Commercialonlinejobboards;• NewspapersandlocalTVand/orradiostations;• Recruitmentagencies,careersportals,andprofessionalnetworkingsites;• Publicationsofacademicpartnerinstitutions.

Theonlinesurveyresultsdemonstratethatmany(67%)oftheorganisationsrepresentedbytherespondentsunderstandjobadvertising:theyuseprintedandonlinemedia,aswellaslocalradiostations,asanecessarypreconditionforensuringthetransparencyoftherecruitmentprocess.

Step5:Interviewingandselectingcandidates

Managingjobapplicationsandscreeningcandidatesisamulti-stepprocessthatincludes:

a) Reviewing all candidate applications to ensure they meet minimum requiredqualificationsandsubmittingthemtotherecruitingcommittee;

b) Selectingcandidates tobe interviewedby therecruitingcommitteebasedonrequiredcompetencies,featuredinjobdescriptionsandinterviewselectioncriteria;

c) Schedulingcandidatesforaninterview(whichincludesinformingcandidatesabouttheinterviewprocessandrequestingreferences).

Respondents to our online survey provided examples of recruitment procedures that aim toensurethatthecompetenciesofrecruitedindividualsmatchtherequirementsofcrucialsupplychainpositions.

Toestablishacompetency-basedapproachtorecruitment,therespondentshighlightedthatthefollowingmeasureswereemployedbytheirrespectiveorganisations:

• Assessingcandidates’relevanteducationalbackground,pastworkexperience(especiallyinpreviousSCMprojectsandpublichealthinstitutions),andprofessionalqualificationsandcertifications;

• Conductingspecialisedtests(writtenandoral)toverifytheleveloftechnicalskillsandfield experience of a candidate before the interview, or asking a range of technicalquestionsspecifictothepositionduringtheinterview;

• Includingproblem-solvingsimulationsandleadershipskillstestsaspartoftheinterview.

35%oftheonlinesurveyrespondentspointedtoperformanceduringinterviewsasbeingamongthemostdecisivefactorsforasuccessfuljobapplication.Atthesametime,42%ofrespondentsindicated that the recruitment process in their organisations concentrated more on theassessmentofrelevanteducationandthelengthoffieldexperiencethanontechnicalexpertise.

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Therespondentshighlightedthefollowingmeasurestakenwithintheirorganisationstoensuretransparencyoftherecruitmentprocess:

• Openandextensiveadvertisingofvacantpositions;• Communicatingjobrequirementsandinterviewprocedurestocandidates;• Employingamultidisciplinaryandmulti-stakeholderinterviewpanel;• Carefullyfollowingthroughallthestepsofthestandardrecruitmentprocedurewithout

cuttingcorners.

Therespondentsalsoindicatedthevarietyofstepsundertakenbytheirrespectiveorganisationstosecureafairandcompetitiveprocessofrecruitment,suchas:

• Establishingequalopportunitiesinemployment(especiallyonthegroundsofsex,race,andage);

• Takingallapplicants,bothinternalandexternal,throughthesameselectionprocesstoensurealevelplayingfield;

• Granting all candidates who meet the minimum job requirements a chance to beinterviewed;

• Selecting the best-performing candidate, taking into consideration the results of thewrittentestandperformanceattheinterview,aswellasrelevantqualifications.

Step6:Extendingandconfirminganofferofemployment

After the recruiting committee has selected the top candidate to fill the vacant position andnotifiedtheHRdepartment,aformalletterofemploymentisissued.Itnormallystates:

• Thejobtitle;• Salary;• Employeebenefits;• Startdateandprobationperiod(ifapplicable).

Inourcasesstudiesitwasfoundthatatthisstageorganisationsmayenternegotiationsovertheterms of employment with candidateswhose skills are in high demand, to reach amutuallybeneficialagreement.Ifnegotiationsfailoracandidatedeclinestheofferoutright,thenthenextcandidateontherecruitmentcommittee’sselectionlistismadeanemploymentoffer.Finally,theHRdepartmentprepares for and confirms the employment contractwith the new employee,notifiesothercandidatesthatthejobhasbeenfilled,andcommunicatestothejobmanagerthenewemployee’sstartdate.

(ii)Budgetforsupplychainstaffandpayscale

Clearpayandgrading scalesprovide a framework for administering employee compensationprogrammesthathelpbalanceinternalandexternalequity.Thisisinstrumentalinattractingandretainingemployeeswhocancontributetotheachievementofbetterhealthoutcomesinhealthsupply chains.Awell-designed salary structure also allows supply chainmanagers to rewardperformanceandskillsdevelopment. Inouronlinesurvey59%ofrespondentsacknowledgedthattheirorganisationsdidnothaveclearpayandgradingscaleslinkedtosupplychaincareers.Thisisachallengethatcanhaveanegativeimpactontherecruitmentprocessandlevelofjobsatisfaction. Also, 69% of respondents highlighted that the lack of salary benchmarks oftenbecomesasourceoffrustrationforemployees.Amongthebestpracticeswithintheorganisationsthathelp avoid thissituationandpresent clear and competitivepay scales to employees, thesurveyrespondentsindicated:

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• Governmentsalarybenchmarkingschemes;• Salarycomparisonsbetweenprivateandpublicinstitutions,aswellasmultinationaland

localcompanies;• Salarybenchmarkingforrelatedjobrolesandfunctionswithintheindustry.

3.2 Pathway2:Skills

(i)Trainingneedsanalysis(TNA)

ThepurposeofaTNA isto identify the traininganddevelopmentrequirementsof thesupplychain specialists by assessing their levels of skills and knowledge. A TNA helps to establishcompetencygapsthatimpedeperformanceinthespecialists’respectiverolesandthathindertheoverallefficiencyofthesupplychain.TNAallowsorganisationstodevelopinformeddecisionsonwhatlearningisneededatindividualandorganisationallevels,andtodraftatrainingplanandanorganisationaltrainingstrategytoensuresufficientcapacityforsustainingcurrentandfuturebusinessperformance.ATNAisamulti-stepprocess,whichcanbedividedintothreestages:pre-assessment,TNA,andpost-assessmentstrategyandplanning.

Figure2.StagesofTNA

AlthoughTNAsarebecomingmorecommonacrosssupplychainorganisations,theyarestilllessfar from universal. Only half of our survey respondents indicated that their respectiveorganisations conduct aneedsanalysis. Inmost cases,TNAsareperformedat the endof thefinancialyearandcoincidewithtraditionalemployeeperformanceappraisals.

STAGE 1

PRE-ASSESSMNET

STAGE 2

TRAINING NEEDSASSESSMENT

STAGE 3

POST-ASSESSMENT

§ Mapping out current knowledge and skills

§ Identifying business and staffing needs

§ Applying professional competency framework

§ Skills/knowledge gap analysis

§ Assessing current training provision

§ TNA report, featuring competency gaps and training constraints

§ Developing training strategy

§ Developing training plans (organisationaland individual)

§ Improved training provision

§ Continuous professional support and development

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Figure3.SurveyresultsonconductingaTNA Figure4.Surveyresultsonthefrequency

ofconductingaTNA

ThesurveyresultsindicatethatinmostcasestheTNAisconductedatdepartmentallevel(82%)andorganisation-wide(70%),whileindividualtrainingneedsofemployeesreceivelessattention(65%). The connection between TNA, planning, and training strategy is also becomingmoreevident:65%ofthesurveyrespondentsindicatedthattheirorganisationshaveastrategyorplanthatisinformedbyTNAs.

NumerousHRforhealthdevelopmentandtransformationprogrammes,implementedoverthepastdecade,haveattemptedtocorrect thisskewed focusonorganisationalrequirementsandachieveamoreintegratedandharmonisedapproachtoHRbyaligningorganisationalbusinessobjectiveswiththepersonaltraininganddevelopmentneedsofemployees.Thisisreflectedinindividual development plans, which help supervisors better understand employees’professional goals and development needs, assist organisations in identifying and planningtraining activities, and give employees more control and responsibility over their careerdevelopment.

Individualdevelopmentplansaresometimesusedasperformanceappraisaltools,buttheirrealpower lies in supporting employees’ professionaldevelopment. Individualdevelopmentplansleademployees toreflecton theircompetencies, strengthsandweaknesses,and toundertakelearning and capacitydevelopment activities (Smith and Tillema, 2013). The effectiveness ofindividualdevelopmentplansdependsontheirdesignandhowexplicittheirfocusisonlearninganddevelopmentpurposes.

(ii)Professionalisationframework

In general terms, professionalisationmeans theprocessbywhich anoccupation turns into aprofession.SCMspecialistshavebeenworkinginthepublicandprivatesectorsfordecades,butonly relatively recently has SCM come to be a distinct and complex professional field.Professionalisation has become particularly important in the context of strengthening healthsupplychainsystemsinAfrica,whichrequirestrongerprofessionalexpertiseandnecessitateamore formalisedapproach toactivities, skills,andunderstandingtheeffectivemanagementofsupplychains.Themaintaskofprofessionalisationistopreparehighlycompetentmanagersandpractitioners through training and careermanagement. Thismeans introducing standards ofeducationandcertificationofemployees,andcreatingpartnershipsbetweenkeystakeholders

Yes50%

No50%

DOES YOUR ORGANISATION CONDUCT TNA?

Annually 83%

Quarterly 17%

HOW OFTEN DOES YOUR ORGANISATION CONDUCT

TNA?

21

(i.e. government, private sector, academia, business and professional associations, etc.) toestablishSCMasaprofessionaldiscipline.

In2019,USAIDGlobalHealthSupplyChain–ProcurementSupplyManagement(GHSC-PSM),inconjunction with PtD and South African Production and Inventory Control Society (SAPICS),beganpreparingaprofessionalisationframeworkforSCM,combiningmaterialonsupplychaincompetencies with the goal of generating what they described as ‘a paradigm shift’ for HRsystems.Theprojectstipulatesthattheproblemwiththecurrentapproachstemsfromthefactthathealth supply chainorganisationsdonot incorporate supply chain activitieswithin theirstrategicoperatingmodels,andHRdevelopment isnotalignedwiththeirstrategicobjectives.Thiscreatesasituationwheresupplychainactivitiesareperformedbystaffmemberswhodonothavetheessentialskillsorknowledgetoensureoptimalsupplychainperformance.

Professionalisationframeworkseekstoaddressalackof:

• GlobalstandardsforpublicandprivatehealthcareSCM;• Role-baseddefinitionswithcompetency-baseddescriptionsforSCMjobfunctions;• Standardsforskillsneedsanalysis,targetingcompetencygapsinthepublicandprivate

healthcareworkforce;• Afit-for-purposeandharmonisedlearningcurriculumthatpreparesindividualsforwork

withinahealthsupplychainenvironment;• Anindustrybodythatisresponsibleforprofessionalrecognitionofsupplychainworkers;• EthicalandaccountableSCMstandards,whichgobeyondthoseoftheorganisations’own

policies(dosSantosetal.,2019).

The core of the professionalisation framework will consist of an agreed-upon competencyframework,which is expected to align the private and public sectors. Thiswill allow for thedevelopmentofarangeofroles,withassociatedjobdescriptionstocapturetheframeworkandthe potential career progression within SCM, from ‘processor’ to ‘chartered professional’.Qualificationandcertificationwillhelpcementprofessionaleducationpathwaysforsuggestedjobrolesanddescriptions.Finally,acountryimplementationmethodologywillprovidepracticalsteps, with supporting tools on how to engage all relevant stakeholders in various countrycontextsinrelationtotheirprofessionalisationstrategies.

KIIs,conductedbyPtDin2019aspartoftheUSAIDGHSC-PSMproject,confirmedstronginterestof the health SCM community in the professionalisation framework, which has already beenevidentinsomepreviousinitiatives.Forexample,in2017,theSouthAfricanCapacityBuildingChiefDirectorateintheOfficeoftheAccountantGeneralestablishedtheinterimSupplyChainCounciltocoordinatetheinterestsofvariousSCMstakeholdersinthecountry,andtoestablishSCMasaprofessionaldisciplinewithin SouthAfrica. Furthermore, theNationalTreasuryhasdevelopedaSCMMasterLearningCurriculumandSCMQualificationDesignstandardthatdefinetheknowledgeandskillsrequirementforpublicprocurement(CBINews,2017).

Therespondentstoouronlinesurveyalsodemonstratedsignificantinterestintheconceptofaprofessionalisationframework:35%ofrespondentsstatedthattheirorganisationsareplanningtoapplyaformofprofessionalisationframework,andafurther18%indicatedthattheywereexploringtheUSAIDGHSC-PSMprojectandotherprofessionalisationinitiatives.

(iii)Communitiesofpractice

Onewayofpromotingtheprofessionalisationofsupplychainworkersisbycreatingacommunityof practice. This can be best described as a shared domain of interest where committed

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professionalscometogethertohelpandsupporteachother,shareinformationandideas,learn,andimprovetheirskills.‘Community’impliesabroadnetworkofmembersbuildingrelationshipsthatenablethemtointeractandlearnfromeachother.However,thisisnotmerelyaninterestgroup:theengagedmembersarepractitionersandtheirgoalistosharearangeofexperiences,techniques, tools, methods, andways of addressing recurring problems in their professionalroles.Therefore,acommunityofpracticecantakevariousforms,suchasmentoring,on-the-jobtraining, moderated discussions, webinars, publications etc. (Wenger-Trayner, 2015). Thediagram below demonstrates the popularity of various forms of community of practice, asindicatedbyoursurveyrespondents.

Figure5.Formsofcommunityofpractice

Among other forms of community of practice, the respondents highlighted supportivesupervision,workshops,andfieldmeetings.

3.3 Pathway3:Workingconditions

Organisational culture refers to the shared characteristics among people within the sameorganisation, including their values, behaviours, routines, traditions, and perspectives.Organisationalcultureisanimportantcomponentofcreatingasupportiveworkenvironment,providingawayforemployeestovoicetheirviewsanddevelopconnectionsandpurpose.Inasurveyofmorethan2,000peoplein50countries,65%ofrespondentsstatedthatculturewasmore important than strategy or operating model for an organisation’s performance(PricewaterhouseCoopers, 2018).Within the health sector, perceived injustice contributes toworker demotivation and has been shown to negatively impact patient care and the overallorganisationalclimate(Abrese-Akoetal.,2014;Manafaetal,2009).Conversely,apositiveworkclimatepositivelyimpactsorganisationalbehaviour(Jayasuriyaetal.,2014).

Therearenumerouswaystostrengthenorganisationalculture,includingidentifyingthecurrentcultureandhowitcanbeimproved,aswellasimplementingpoliciestocreateafairandsafeworking environment. Key policies to promote a positive organisational culture are outlinedbelow,aswellasbroaderwaysofstrengtheningtheoverallworkingconditionsandculture.Thisis followed by information on whistleblowing policies and establishing a safe physicalenvironment.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Mentoring , 73%

On-the-job training, 88%

Moderated discussions, 45%

Webinars, 18%

Publications, 36% Other, 36%

Community of practice

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(i)Socialandemotionalenvironment:Implementingpoliciestosupportapositiveorganisational

culture

DrawingonacombinationofaliteraturereviewandguidancefromthePtDHumanResourcesforSupplyChainManagementTheoryofChange, thebelowpolicyareas(anoverarching codeofconduct,anti-harassmentpolicies,anti-discriminationpolicies,andpoliciesthatcreateagoodworkingenvironmentforwomen)wereidentifiedascriticalincreatingastrongorganisationalcultureorsupportiveworkingenvironment.

An overarching code of conduct or ethics. A code of conduct is a tool that can help ensureworkersatanorganisationareworkinginasupportiveandfairenvironmentwiththehighestprofessionalism.61%ofsurveyrespondentsstatedthattheyhadoneinplace.Acodeofconducthelpstoestablishethicalstandards,principles,andaprofessionalworkculture.Severalhealthsupplychainorganisations–includingNMSFinSudan,KEMSAinKenya,andEPSAinEthiopia–have their own specific Code ofConduct,which cover a range of areas, including corruption,harassment,dresscodes,andfairness(KEMSA,2015;NMSF,2015).

Figure 6. Survey results on the implementation of codes of conduct

Anti-harassment policies. The United Nations (UN) defines harassment as ‘any unwelcomeconduct thatmightreasonablybeexpectedorbeperceived tocauseoffenceorhumiliationtoanotherperson,whensuchconductinterfereswithworkorcreatesanintimidating,hostileoroffensiveworkenvironment’,anddefinessexualharassmentsimilarly,butincludesunwelcomecontactofasexualnature(UN,2019).42%ofsurveyrespondentsstatedthattheirorganisationhassuchpoliciesinplace.

Anti-discriminationorequalopportunitypolicies.TheUNdefinesdiscriminationas‘anyunfairtreatmentorarbitrarydistinction’basedonseveralcharacteristics,including(butnotlimitedto)race,sex,gender,ageandethnicorigin(UN,2019).48%ofsurveyrespondentsstatedthattheirorganisationhassuchpolicies inplace. Certain large international organisationshighlight theimportance of reporting any suspicions of misconduct, offering a ‘speak up’ helpline whichprovidesanonymousandconfidentialadvice,aswellasahotlineforreportingmisconduct(UN).Itisnottheresponsibilityofthereportertodecidewhethermisconducthasoccurred(Oxfam).Someorganisations,suchasEPSA,alsoemploydedicatedgenderandyouthequalityofficers.

Policiesthatcreateagoodworkingenvironmentforwomen,includingrecruitment.Policiesthat create a good working environment for women can include: hiring and promotion,challenging everyday discrimination (for example, mistakenly assuming a colleague is more

Yes 61%

No 39%

DOES YOUR ORGANISATION IMPLEMENT A CODE OF CONDUCT?

24

juniorthantheyare),andcreatingazerotoleranceenvironmentandclearproceduresaroundsexual harassment (Krivkovich et al., 2018). 52% of survey respondents stated that theirorganisationhaspoliciesinthisareainplace,thoughdidnotlistmanydetailsofthese.However,onerespondentinBurkinaFasonotedthattheirorganisationpromotedgenderandembracedtheidealsofsexualandreproductivehealth(includingfamilyplanning).

Otherfactorstocreateagoodworkingenvironment.Policiesshouldberegularlyreviewed(theUN reviews its anti-discrimination and harassment policy every two years at a minimum).Further,thereisaneedtodifferentiatebetweenhavingapolicyinplace,andthepolicybeingwellimplementedandwithstaffhavingfullawarenessofit. Inthesurveyresponses,stafffromthesameorganisationwouldoccasionallyprovidedifferentaccountsofthepoliciesinplace,implyingalackoforganisationalclarity.Additionally,onerespondentnotedthat,whilsttheythoughttherewereenvironmentandoccupationalsafetyandhealth(OSH)policiesattheirorganisation,theywerenotsureifthesewereinplace.

Trainingcanalsobeahelpfulwaytocreateawarenessofthedetailsandimportanceoftheabove-mentionedpolicies.52%ofsurveyrespondentssaidtheyworkedatorganisationsthatconducttrainingtocreateanoptimalworkenvironment.Examplesofthistrainingthatweregivenincludeonlinetrainingrelatedtoanti-discriminationandanti-harassment,andtrainingrelatedtohealthsafety,security,andtheenvironment.Onerespondentcommentedthattrainingisdonequarterlyandanothercommentedthatthattheyarerequiredtodotrainingandbecomecertifiedinrelationtotheorganisation’sCodeofEthics.

A2014TNAforNMSFinSudanemphasisedthedifficultyininfluencingstaffattitudesthroughshort trainingcoursesalone(NMSF,2017).Greater impact isobtained fromhavingapositiveorganisational culture, with clear values, principles, attitudes, and beliefs, as well as leaderssettingclearexamplesofhowthisculturecanbeputintopractice(NCIHD,2014).

There are numerous ways, beyond policies, to strengthen organisational culture, and a richliterature is available detailing how organisations have strengthened or changed theirorganisationalculture.EPSAhasrecentlyfocusedontransformingitsorganisationalcultureaspart of its overall transformation programme, working with PSA as part of the AdmasProgramme. This has included conducting a detailed culture assessment to investigate thecurrentorganisationalcultureinEPSA,andthegapbetweentheorganisation’slivedcultureanditsdesiredculture.Thisculturechangeisalsobeingfacilitatedbyinterventionssuchastheuseof cultural ambassadors to cascade the vision and shared values of theAgency and to act ascatalystsandadvocatesforchange.

However, the literaturespecificallyrelating tohealthsupplychain,oreven thegeneralhealthworkforce,andorganisationalculturechangeismorelimited.Morebroadly,companiesthathavesuccessfully changed their organisational culture have done so through taking the time tounderstandemployees'perspectivesandinvolvetheminplanning,emphasisingtheimportanceof employee pride and highlighting exemplary behaviour. The Harvard Business Reviewidentified five principles to facilitate organisational change: matching strategy and culture,focusing on a few critical shifts in behaviour, honouring the strength of the existing culture,integratingformalandinformalinterventions,andmeasuringandmonitoringculturalevolution(Katzenbachetal.,2012).

(ii)Whistleblowingmechanisms

Awhistleblowerisapersonwhoreportsordisclosesinformationofanywrongdoinginaworkcontext,topreventharmortoprotectthepublicinterest(EuropeanCouncildefinition).Several

25

Africancountrieshaverecentlyintroducedlegislationtoprotectwhistleblowers,includingCoted’Ivoire(2009),Ghana(2006),Morocco(2011),Mozambique(2011),andZambia(2010),thoughlawsareonlyonepartofthesolution(Moy,2018).

Most survey respondents reported that their organisation does not have a whistleblowingmechanisminplace(though39%dohaveoneinplace).Forthosewhodo,thisoccursviaanemailorahotline.Othermechanismsmentionedbysurveyrespondentsincludeaspecificemailsystemtoensureanonymity,complaintsboxes,andahotlinewithanonymousIDs,managedbyapartner.Otherrecommendationsforbestpracticesincreatingwhistleblowingchannelsinclude:

• Certain protections should be given towhistleblowers to avoid retribution (includinglegalprotection);

• Thereisaneedtoovercomeculturalbarriers(whistleblowersmaybeseenasdisgruntledemployeesorasmotivatedbyseekingmonetaryrewards);

• Stronginternalreportingsystems(independentand third-party); • Committingtoa‘speak-up’organisationalculture.

(iii) Physical environment: Establishing a safety and health management system, including

developingstandardoperatingprocedures(SOPs)

EffectiveOSHmeasuresarewidelyrecognisedasessentialcomponentsofworkforcehealthandproductivity (International LabourOffice, 2001).Workplace safety includesnot onlyphysicalthreats,butalsopsychosocial(includingstress)andgender-basedviolenceordiscriminationandcanbeveiledunderneathculturalnorms(Deussometal.,2012).

Effective OSH procedures are highly important. Failure by management to maintain safetystandardsisdemotivatingandcanshowalackofappreciationofemployee’swork(Abrese-Akoetal.,2014).Workplacesafetyisalsoakeynon-financialincentive(MinistryofHealthandSocialServices,2015)andapositivepracticeenvironmentcanhelptoincreaseworkermotivationandreduceOSHrisks(Deussometal.,2012;Shumbaetal;2017).

FromacombinationofaliteraturereviewandthePtDframework,thefollowingcriticalfactorswereidentifiedforcreatingastrongOSHenvironment(thefiguresinbracketsarethepercentageofsurveyedrespondentswhoseorganisationimplementsthese):

• Haveasysteminplacetodocumenthealthandsafetyissuesintheworkplace(42%);• Havearegularbudgetavailable toensuremaintenanceandrepairofworkplace items

(58%);• Ensurestaffhavethenecessarytoolsandequipmenttodotheirjobs(84%);• Ensurechecklistsarecompletedtoensurecompliancewithsafetystandardsinthework

area(45%);• Havehealthandsafetypoliciesandproceduresfortheorganisation(58%);• Conducthealthandsafetyriskassessmentsorevaluations(52%).

Staffhaving thenecessary toolsandequipmenttodo their jobswas themostcommonpolicyidentifiedbyrespondentsasbeingimplementedintheirorganisation.Respondentsoutlinedhowtheyimplementtraininginthisarea,includingonsafetyandkeepingtheorganisationclean(oneorganisationtrains125staffineachtopic),andtrainingoninfectionpreventionandcontrol.Onerespondentnotedthatchallengesinthisareaarenumerous,whichcreatesobstaclestohowtheorganisationworks.AnotherhighlightedthatOSHisappliedonlywhenworkersgointothefield(e.g.whendriversassessroads,terrain,andrisk),implyingthatitisnotappliedevenlyacrossthewholecountry/organisation.

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Otherways thataneffectivesafetyandhealthmanagementsystemcanbecreated includebyinitiallycollectingdataonwhatoccupationalinjuriesoccurandfindingoutfromhealthworkerstheirgreatestoccupationalhealthconcerns,andcreatinglegislationorregulatorystandardstoprovide a policy framework which empowers health workers to improve their operationalenvironment.

3.4 Pathway4:Motivation

EmployeemotivationisakeyHRstrategyandplaysacrucialroleinachievinganorganisation’svision. Motivation in health supply chains can be achieved when quality performance issupportedwithinthesystem,theworkforceisadequatelyincentivised,thereisgoodsupervisionandmanagementsupportemployees,competency-basedpromotionisfollowed,theorganisationdesigns a strong employee engagement and retention policy, and there exist disciplinaryguidelines.

EmployeemotivationisakeyHRstrategyandplaysacrucialroleinachievingtheorganisation’svision. Motivation in health supply chains can be achieved when quality performance issupportedwithinthesystem,theworkforceisadequatelyincentivised,thereisgoodsupervisionandmanagementsupportemployees,competency-basedpromotionisfollowed,theorganisationdesigns a strong employee engagement and retention policy, and there exist disciplinaryguidelines.

(i) Performancemanagement

Aneffectiveperformancemanagementsystemisabletoalignindividualemployeegoalswiththeorganisational goals to positively impact supply chain performance and improve healthoutcomes.KeyPerformanceIndicators(KPIs)supportsupplychainmanagerstounderstandtheworkforcesituationandareeffectivewhenappliedconsistentlyandcomprehensively(BeanandGeraghty, 2003). A good KPI is one that is sparse, drillable, actionable, owned, referenced,correlated,balanced,aligned,andvalidated(Eckerson,2009).

The survey revealed that 73% of the respondents confirmed the presence ofperformance management systems in their health supply chain organisations (Figure 7).Some of the best practices in this area indicated by the respondents include the use ofperformance indicators, annual appraisals to reinforce performance through abalancedscorecard (BSC), conducting review meetings, and continual investment in HRdevelopmentandmanagement,therebyimprovingemployeemotivationandperformance.

27

Figure7:Surveyresultsontheimplementationofperformancemanagementsystems

68% of the survey respondents also indicated that their organisations have a performancemanagementprocessforidentifyinganddocumentingpoorperformance.Additionally,KPIsareinplacetostrengthenperformancemanagementandensurealignmentwiththestrategicplan.However,thisisnotastandardpracticeanddifferencesexistsbetweenpracticesinthepublicandintheprivatesector.

(ii)Incentives

Financialandnon-financialincentivescanimprovesupplychainpracticesthroughimprovedstaffmotivation, enhanced collaboration, and increased investment in health supply chaininfrastructure(SpisakandMorgan,2014).ProperuseofincentivescanimproveteamworkandadherencetoSOPs,andcanstrengthenaccountability(Vujicicetal.,2004).Financialincentivesareanimportantmotivatingfactorforhealthworkers,especiallyincountrieswheregovernmentsalariesandwagesareinsufficienttomeetthebasicneedsofhealthworkersandtheirfamilies(Dieleman et al., 2003; Martinez and Lindsay, 2007). Non-financial incentives are needed tocompleteapackagethatwillattracthealthworkers–especiallytoruralandremoteareas–andencouragethemtostayintheworkforce.Thelackofprofessionaldevelopmenthas,likewise,beencitedasareasonforjobdissatisfaction(Bolgeretal.,2005).

The survey identified a range of tools that are currently being used to incentivise the healthsupplychainworkforce.Financialsupportforcontinuingprofessionaldevelopment,partnershipwithlocaluniversities,paidstudyleave,funder-basedcertification,approvalfortheacquisitionofrelevantcertificationsalignedtothePtDtheoryofchange,andperformance-basedincentivesare all used to incentivise the workforce. Donor support for incentives is considered an‘exceptional measure’ that might otherwise be deemed unsustainable (Palmer, 2006). Theutilisation of performance-based contracts to improve workforce participatory spaces forinformationandfeedbacksharinghasbeenencouraged(WHO,2017).Rewardsandincentiveslikepaymentofmembershipfeestosomesupplychainprofessionalbodiesareusedtopromotea culture of performance. However, a robust incentive policy should also be supported byleadershipatalllevels.Withoutthissupportitwillnotbepossibletomotivatethesupplychainworkforce.

Yes73%

No27%

DOES YOUR ORGANISATION HAVE A PERFORMANCE MANAGEMENT SYSTEM?

28

(iii)Goodsupervisionandmanagement

Supervision,includingadequatetechnicalsupportandfeedback,canimprovethemotivationofhealth supply chainprofessionals.The survey revealed thatmonitoringand supportive visits,mentoringandcoachingprogrammes,systematicsupervision,andmoderateddiscussionsareallimplementedby the respondents’ organisations. Similarly, the survey resultshighlighted thatorientation programmes for new recruits have proved effective to maintain supportive linemanagement.

(iv)Promotions

Promotions are an effective tool to identify, develop, and manage work performance(Schippmannetal.,2010;PosthumaandCampion,2008;Campionetal.,2011).McClelland(1973)isoftencreditedwithlaunchingthecompetencymovement,whichisatthecoreofallpersonnelmanagement activities. Designing competency-based promotion systems can foster anenvironment of improved performance and can help an organisation to outperform itscompetitors(Audenaertetal.,2009;Morgesonetal.,2009).

Accordingtothesurveyresults,59%oftherespondentsfeltthattherearenotenoughpromotionopportunitiesfortheworkforce.Promotionsareeitherlinkedtothenumberofyearsinthejobrole,ortiedtothestatecivilservicescheme,orfollowachainoftheorganisationalhierarchy.Thelimitationsimposedbytheover-bureaucratisationofpromotionsresultinafragmentedsystemandlowerlevelsofstaffmotivation.Theliteraturesuggeststhatimprovedperformance-orientedmanagement practices and stronger links between competencies and promotions can helpresolvesomeissuesinthisarea(Chimwazaetal.,2014).

(v)Employeeengagementandretention

Employee engagement is seen as an importantmotivator to improvework efficiency and jobsatisfaction (Schaufeli et al., 2002). Scholarship suggests that development opportunities,communicationchannels,rewardsandrecognition,andemployer’ssupportimproveemployeeengagement(KhalifehandSom,2013;MaceyandSchneider,2008).Autonomy,clarityinroles,decision-makingfreedom,andunityofdirectionarecloselylinkedwithemployeeengagement(Kweninetal.,2013;Richetal.,2010).Traininganddevelopmentopportunities,financialperksandacompetitivepaystructure,anenablingorganisationalculture,positivefeedback,andthestyleofleadershipcaninfluenceemployeeengagementandretention(Guoetal.,2015;PaulandAnantharaman,2003;Zingheimetal.,2009).

Only 44% of the survey respondents indicated the existence of employee engagement andretentionpoliciesintheirorganisation(Figure10).Retentionallowanceslikehousingfacilities,transportation, and health insurance coverage were found to be currently in place to retainemployees. A democratic leadership stylewas found to influence employee performance andsupporttheretentionofhigh-skilledemployees.

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Figure10:Surveyresultsontheimplementationofemployeeengagementandretentionpolicies

It is also important for organisations to conduct a staff satisfaction survey to understandemployeemotivationandretainemployees.59%ofrespondentstoouronlinesurveyreportedthatnosuchsurveyisconductedintheirorganisation.

(vi)Disciplinarypolicyandpractice

91%ofthesurveyrespondentssaidthattheirorganisationhasastandarddisciplinarypolicyandpractice in place (Figure 11). This is guided by disciplinary procedures providing a range ofpossibilities, fromwarnings throughtodismissal,dependingontheseverityand frequencyofresponses.Disciplinarycontrolalsoinvolvespromotingandremovingpersonsfromservicesandprovidingguidelinestoallstaff.

Figure11:Surveyresultsonwhetherastandarddisciplinarypolicyandpracticeisinplace

Yes44%No

56%

DOES YOUR ORGANISATION HAVE AN EMPLOYEE ENGAGEMENT AND RETENTION POLICY?

Yes91%

No9%

DOES YOUR ORGANISATION HAVE A CLEAR DISCIPLINARY POLICY AND PRACTICE?

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4. Organisationalcasestudies

4.1 ETHIOPIA:EthiopianPharmaceuticalSupplyAgency(EPSA)

EPSAwasestablishedin2007(underthenamethePharmaceuticalsFundandSupplyAgency)asa

governmentorganisationundertheEthiopianMinistryofHealthwiththefollowingthreeobjectives:

to enable public health institutions to supply quality assured essential pharmaceuticals as

affordablepricesinasustainablemanner;toplayacomplementaryroleindevelopinghealthservice

expansion;andtocreatetheenablingconditionsfortheaccumulationoffundsinitsrevolvingand

cost-recoverypractice.

4.1.1 Pathway1.Staffing

Jobdescriptionsforsupplychainpositions

JobdescriptionsforpositionsinsupplychainoperationsaredraftedprimarilybyEPSA’stechnicalcommitteeandsubmittedtotheCivilServiceCommissiontoassignandapprovethejobgradeand the salary scale. For supportingpositions, such asHR, finance, and general services, jobdescriptionsandthegradingsystemarepreparedbytheCivilServiceCommissionandalignedwithothercivilserviceorganisationsinthecountry.Indraftingjobdescriptions,theCommissionappliestheformalcriteria,suchasqualification(diploma,bachelor’sdegree,master’sdegree,orPhD), and years of experience. The Commission does not utilise the competency frameworkdevelopedbytheAdmasProgrammein2019,ortheTNAwhichwasconductedatEPSAbyPSAinthesameyear.Instead,thecompetencyframeworkisemployedinthedevelopmentofcapacitydevelopment activities, employee promotion, and transfer. Effectively, this means that thecompetencyframeworkisnotyetfullyintegratedintotheHRmanagementatEPSA,anditcomesintoplayonlywhentheAgencyseekstobridge theskillsgapsof itsemployeesandtodesignsustainablecapacitydevelopmentinterventions.

Recruitmentprocess:advertisingvacanciesandselectingcandidates

JobvacanciesinEPSAareadvertisedinthegovernmentnewspaperandpostedonnoticeboardsinEPSA’sheadquartersandhubs.SalariesforadvertisedpositionsaredecidedonbytheCivilServiceCommissionaccordingtojobgradesandpayscalesestablishedforinstitutionsundertheauspicesoftheMinistryofHealth.NospecialmarketsalaryanalysisisnormallyconductedbeforerecruitmentasEPSAadherestothegovernmentalsalarystructure.

The Civil Service Commission Recruitment and Promotion Guideline stipulates that priorityshouldbe given to filling vacancieswithinEPSA from its existingworkforce. It is only in theabsenceofaninternalcandidatewiththenecessaryqualificationsandexperiencethatthejobcanbe advertisedpublicly. In practice, the decision onwhether EPSA should conduct internal orexternalrecruitingismadeonacase-by-casebasisbythehiringmanager,inconsultationwiththeHRdepartment.However,preferenceisoftengiventointernalrecruiting.

As part of the recruitment process, the HR department usually conducts a written test, aninterview,andanassessmentofspecifictechnicalskills,ifrequiredbythejobdescription.TheCivilServiceCommissionRecruitmentsGuidelinerecommendsthatthetestshouldbetakenatawell-knownhighereducationalinstitutionwithatestingcentre.EPSAnormallysendscandidates

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to sit the test at Addis Ababa University and the results are transferred back to EPSA’s HRdepartment.

Thecrucialphaseofrecruitmentistheinterview,whichisconductedafterthecandidateshavesuccessfully passed the written test and havemet theminimum education and qualificationrequirements.The interviewpanel (orcommittee)comprises thehiringmanager,director,orteamcoordinatorofthedirectoratewherethevacancyhasbeenannounced,andarepresentativefrom the HR directorate. EPSA does not have a standing recruiting committee, and for eachvacancyanewcommitteeisformedonanadhocbasis.Education,professionalqualifications,and the length of experience are themost important criteria in the selection process of therecruitingcommittee.HRspecialistsmeticulouslycountthelengthofexperience,uptomonthsanddays, todistinguishbetween candidateswith a similar level of educationorprofessionalcertification.

4.1.2 Pathway2.Skills

Training,andcapacitybuildinganddevelopment

ThecompetencyframeworkandTNAweredeveloped/conductedbytheAdmasProgrammein2019.FollowingtheTNA,PSAworkedwiththeCapacityBuildingDirectoratetodraftanannualcomprehensivetrainingplan.ThisplanhasnowbeenendorsedbyotherEPSApartners,followinga validation workshop, in which the EPSA Capacity Building Team collected feedback andincorporatedinputfromEPSApartners.TheAgencyiscurrentlyimplementingtrainingactivitiesbasedonthisplan,andPSAhassupportedthedevelopmentofthetrainingstrategyforEPSA,which is now being finalised. This strategy integrates all the deliverables of the AdmasProgramme,beginningwiththecompetencyframework,TNA,individualdevelopmentplans,andatrainingcurriculum.CapacitydevelopmentinEPSAisoftenorganisedintheformoftraditionaloff-the-jobclassroomtraining. Trainers are invited from local academic institutions, although EPSA has not yetestablished formal partnerships with these institutions. The Capacity Building Team hasorganisedresearchforumstoengageandpromoteresearchthroughAddisAbabaUniversityinabidtoimprovetheexposuretoacademiaandresearch.PSAisalsohelpingEPSAtoexpandthestaffcapacitydevelopmentthroughtheTrainingandResourceCentre,adedicatedlearningandtraininghubthathasbeenestablishedinEPSA. Professionalisationframework,mentoring,supervision,andon-the-jobtraining

Aprofessionalisationframeworkandcommunityofpractice,aswellascoachingorsupervision,are not common in EPSA, or in the Ethiopian supply chain sector more widely. The AdmasProgrammeaimstoinstitutionalisementoring,supervision,andcommunitiesofpracticeundertheTrainingandResourceCentre.Currently,PSAsubjectmatterexpertsaretheonlyoneswhoofferstructuredon-the-jobtrainingintheAgency.

4.1.3 Pathway3.Workenvironment

Organisationalcultureandworkenvironment

EPSA has recently focused on changing its organisational culture and has conducted anorganisationalculturediagnosticassessment(concluded inAugust2019).EPSAhascreatedateamfromdifferentdirectoratestofocusonthisarea,aswellasateamofculturalambassadors,tohelpcascadetheorganisation’svaluesandmission.However,theplannedactivitiesforcultural

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change,suchasrollingouttheculturalambassadors’programmetotheregionalhubs,havebeenslowedduetotheCOVID-19pandemicandrelatedrestrictionsinplace.

Useofpolicies

EPSAhasarecentlyupdated itsCodeofConduct.ThisCode isprinted inhardcopiesand theEthicsDirectoratehasaplantorollouttheCodeofConductandtosupportitsimplementation.Additionally, EPSA follows the Ethiopian civil service disciplinary policy.Whilst EPSA has noseparatepoliciesrelatingtoanti-harassment,anti-discrimination,orhealthandsafetyetc.,theCodeofConductdoesincludesomeinformationontheseareas.

Supportingwomenandmembersofminoritygroups

EPSAhasaGenderandYouthDirectorateandfollowsaffirmativeactioninrecruitment,training,andothersimilaractivities.TheAgencyrecentlyconductedajobevaluationandgradingactivity,inwhichwomenweregivenafewmorepercentagepointsasanaffirmativeaction.Thisactionledtomorewomentakingupleadershippositions,includingthedirectoroftheorganisation.Thiswillbefollowedbyfurtheraffirmativeactiontoprovidewomenwithanopportunitytoassumehigher positions in supply chain operational roles and supporting administrative roles.Additionally, as part of the Civil Service Commission regulations, EPSA practises affirmativeactioninrecruitment.

Creatingasafeworkplaceenvironment

EPSAhasanOSHSOP(twotothreepagesinlength),aspartofitsHRManualSOPs.EPSAdoesnot have an overarching systematic approach to health and safety, though it does conductactivities in this area as part of its qualitymanagement activities and different initiatives toimproveoperations.Variouspartnershavealsocreatedinitiativesregardingoperationalhealthandriskassessments.

Whistleblowingmechanism

EPSAdoesnotcurrentlyhaveawhistleblowingpolicybutitplanstocreateone.

4.1.4 Pathway4.Motivation

Performancemanagement

To improve work performance, EPSA has established corporate and directorate-level KPIsgoverned by the Monitoring and Evaluation Framework, a policy document guiding EPSA’sperformance management. The KPIs have supported better understanding of team targets,thereby acting as an important tool to motivate employees.However,cascadingdepartmentalKPIsdowntoindividualKPIshasbeenachallenge.Asaresult,performance appraisalscurrently lack objectivity, comprehensiveness, and linkagestothedirectorateorteamgoals.Incentivepolicy

Atpresent,EPSAhasnoperformance-basedincentivesinplace.,Performanceappraisal

TheBSCwasimposedbytheCivilServiceCommissioninEthiopiaasaperformancemanagementtoolforgovernmentalorganisations.EPSAimplementstheBSCbuthasnotyetstandardiseditsuse across all directorates. EPSA’s Planning, Monitoring and Evaluation teamis currentlysupportingthedirectoratestoachieveuniformityintheapplicationoftheBSC.

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CareerpathsandpromotionopportunitiesStrictly speaking, EPSA does not have a system of career pathways and structured careerprogression linked to vertical and horizontal development of expertise.What does exist is astraightforwardpromotionsystembasedonavailablevacancieswithindirectorates.Anyonewhomeetstheminimumrequirementsforthevacantpositionisconsideredeligibleforpromotion.Asaresultofthissystem,anHRspecialistcanbetransferredtoanewjobintheEthicsDepartment,oraspecialistintheEthicsDepartmentcanbepromotedtoapositioninGeneralServices.

Retentionandengagementpractices

The apparent lack of career progression impacts the motivation and engagement of staff,increasing the staff turnover. At the individual level, employees do not have a career orprofessionaldevelopmentplanandtheemployeeturnoverisparticularlyhighamongtechnicalexpertsandpharmacists.Intheabsenceofemployeeretentionpoliciesattheinstitutionallevel,EPSAisgraduallylosingitshighlyskilledworkforcetopartnerinstitutionsandtheprivatesector.

Supervisorysupport

Currently, there is no formalmentoring, coaching,andstructured supervision at EPSA.In theabsence of SOPs for mentoring across EPSA,PSA subject matter experts havebeen abletointroducementoringsupportthroughasystemofworkshops.Promotingsupervisorysupportis hindered by differences in leadership and management styles across EPSA directorates,resultinginthelackofauniformmentoring,teamsupport,andfeedbackmechanism,whichoftenreliesmainlyonthedirector’sorsupervisor’sinitiative.Disciplinarypolicyandpractice

EPSAfollowstheCivilServiceDisciplinaryCodeofConduct.Staffsatisfactionsurvey

EPSA conducts a staff satisfaction surveyannually.In the 2018/19financial year,the staffsatisfaction levelwasnear58%,asindicatedinEPSA’sannualreport.Similarsurveysarealsoconductedacrossdifferentcorporatelevelsandhubs.

4.2 KENYA:KenyaMedicalSuppliesAuthority(KEMSA)

KEMSAwasestablishedasastatecorporateorganisationin2005.ThroughanactoftheKenyan

Parliament,KEMSAbecamean‘authority’in2013,withthemandatetoprocure,warehouse,and

distributedrugsandmedicalsuppliesforpublichealthprogrammesandtofulfilothertasksrelated

to the public health supply chain. KEMSA employs a not-for-profit, self-sustaining, commercial

businessmodel.,which is alignedwithKenya’s devolvedgovernance system. Its supply system is

demand-driven:thecountry’shealthfacilitiesorderandpayformedicinesandacquiredfundsare

puttowardsreplenishingKEMSA’sstock.


Jobdescriptionsforsupplychainpositions

KEMSAhas12 jobgrades, ranging fromthe topmanagementrole inGrade1(chiefexecutiveofficer(CEO)tothelowestpositioninGrade12(shopflooremployees).Everypositionineach

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gradehasajobdescriptionandaclearcareerprogression.Todraft jobdescriptions,establishcareer progression, andproduce theHRManualKEMSA requested assistance from the StateCorporationAdvisoryCommittee.Jobdescriptionsfollowacompetencyframework,whichdetailsspecificcompetencyrequirementsforvariousjobfamiliesinKEMSA,suchaspharmacists,supplychainspecialists,HRspecialists,etc.

Recruitmentprocess

TherecruitmentprocessfortopmanagerialpositionsinLevel1(CEO),Level2(directors),andLevel 3 (managers) is completed by an external recruiter. For this task KEMSA normallyapproachesPricewaterhouseCoopers,Deloitte,orKPMG.Althoughtherecruitmentprocessandrelated arrangements are made by these professional services companies, the candidatesapplyingforpositionsinthesethreelevelsarenormallyinterviewedinKEMSAbytheBoardofMembers,whichincludestheCEO,directors,andmanagers.

RecruitmentforjobrolesbeginningatLevel4anddowntoLevel12isconductedbyKEMSA.Theprocessbeginswithcollectingrecruitmentrequestsfromdepartmentsthatcompleterequisitionforms,whicharethentakentotheHRdepartmentandlatersubmittedtotheCEOforapproval.ForallnewpositionstheHRdepartmentproducesajobdescriptionandrecruitmentschedule.Dependingonthelevel,certainpositionswillonlybeadvertisedonKEMSA’swebsite,orindailynewspapers. Prospective applicants arenormallygivenbetween14and21days to apply forvacancies. Subsequently, the HR department compiles the long list of eligible applicants anddevelopscriteriaforshortlistingcandidates,whoarecalledforaninterview.Theshortlistingisconductedbyaspecialpanel,appointedbytheCEO.

Theinterviewpanelitself isalsoappointedbytheCEO.It isnotastandingcommitteeanditsstructure varies depending on the job vacancy. For example, if the organisation recruits forpositionsinLevel4,whichrequireacandidatetohavearelevantdegreeandupto10yearsofexperienceinasimilarjob,theCEOwilljointheinterviewpanel,togetherwithaspecialistinthesametechnicalareaastheinterviewedcandidate.IfKEMSAisemployingaprocurementofficer,aprocurementspecialistwillbeinvitedtojointhepaneltoaskspecifictechnicalquestionsanddeterminethelevelofprofessionalexpertiseofthecandidate.Thepanelwillalsoinclude:1)anHRspecialist,whowillposespecificHRquestions(e.g.education,certifications,past training,etc.); and 2) a representative of the department where the candidate will eventually work.Dependingontheleveloftheadvertisedposition,thiswillbeeithertheheadofthedepartmentorassistantheadofthedepartment.

Aftertheinterviewandbeforeissuingaformalofferthedetailsofemploymentarefinalisedwiththe selected candidates. If successful candidates have questions or requests, the HR beginsnegotiationstocometoamutualagreementonalltermsofemploymentbeforesigningacontract.After recruitment is completed, new employees undergo a one-week induction programme.DuringorientationsessionsKEMSA’soperationsareexplainedandtheemployeesareintroducedtoeverydepartmentwithintheorganisation,aswellastotheircolleaguesandlinemanagers.Newemployeesareputona90-dayprobationperiod,bytheendofwhichKEMSAconductsaperformancereview.

KEMSAemploysbothinternalandexternaltypesofrecruitment.IftheHRdepartmentidentifiesthattheorganisationmayhavesuitableinternalcandidatesforthevacancies,thesepositionsareadvertisedinternally.Afterreviewingthequalificationsofinternalapplicants,theHRorganisesapanelforasuitabilitytest,lookingspecificallyintoqualificationsandskills,thelengthofworkexperienceinKEMSA,pastperformance,anddisciplinaryrecords.ForcertainpositionsKEMSA

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organisesexternalrecruitment,thoughalsoencouraginginternalcandidatestoapply.Inthiscase,bothinternalandexternalcandidatesgothroughthesamerecruitmentprocess.

Asagovernmentinstitution,KEMSAisguidedbystateregulationsonsalariesandremuneration.Theguidelinesspecifyasalaryrangeforpositionswithintheorganisation.KEMSAhasanine-bandpaystructure.Thismeansthatittakesanemployeenineyearstofinishtheband,iftheybegintheircareerinthecurrentpositionatBand1.Whileconductingasalarystructurereview,KEMSAlooksattherecommendationsprovidedbytheSalariesandRemunerationCommission,andatpaymentsofferedbyotherparastatalorganisations,andconductssalarymarketresearchfordifferentjobfamilies.Astheagencyemploysmanypharmacists, labtechnicians,andothertechnical personnel, it is necessary to research the salary market before advertising newpositions.Atthesametime,KEMSAallowscandidatestonegotiatethesalary,iftheydonotagreewiththetermsbeingoffered.


TNA

InKEMSAaTNAisconductedannually.Thefinancialyearbeginson1July,andtowardstheendoftheyeareverydepartmentdraftsanannualworkplan.ThisincludesSectionC,whichspecifiestrainingneeds.The information for theTNA isgathered throughperformance appraisalsandemployeerequestsfortraining,whicharefirstreviewedbysupervisorsandthenapprovedbyheadsofdepartments.Performanceappraisalsareconductedtwiceayearandhelpidentifyskillsgaps.Employeesalsocommunicatetheirtrainingneedstosupervisors,whicharereviewedbyheadsofdepartments.

Subsequently, training requests are submitted to the Training Committee in KEMSA, whichsynchronises training for the whole organisation. For example, if the Committee receives arequestfortrainingincustomerserviceforacertainnumberofemployees, itwillconsultthetrainingcalendarfortheyear,andtheavailablebudget,andwilldecideonhowmanyemployeescanbetrainedduringthecurrentyearandhowmanyshouldbescheduledforthefollowingyear.

Capacitybuildinganddevelopment

Employees in all managerial positions must undertake mandatory management training.According to Kenya’s Public Service Commission Standards, employees in top managementpositions (Level 1 –CEO;Level2 –directors)undergo a leadership training course inoneofKenya’sgovernmentschools.EmployeesinLevel3and4canundertakeeitherathree-orfour-monthmanagerialtraining.Thestaffareofferedastudyleaveforthedurationofthetraining.

Asfarastechnicalpersonnelareconcerned,KEMSAhasaprogrammeofcontinuousprofessionaltraining.Technicalprofessionshaverespectiveprofessionalbodies,whichnormallyofferspecifictypesoftrainingandprofessionaldevelopmentprogrammes.Everymemberoftechnicalstaffisexpectedtotakeacertainnumberofcoursestocollectenoughpointstobeawardedapractisingcertificateforthefollowingcalendaryear.Forexample,HRspecialistscantakecoursesattheInstituteofHRManagement,accountantsareofferedprogrammesbytheInstituteofCertifiedPublicAccountantsofKenya,andprocurementspecialistsalsohavetheirownprofessionalbodythatprovidescertification.

Atpresent,KEMSAoutsourcesallthetrainingandtheagencydoesnothaveadedicatedtrainingcentreformembersofstaff.

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Professionalisationframework,mentoring,supervision,andon-the-jobtraining

KEMSAconductscoaching,mentorship,andon-thejobtraining.Theresponsibilityforconductingtheseactivitieslieswithheadsofdepartments.Adecisiononmentorshipandsupervisionistakenjointlybyheadsofdepartments,supervisors,andindividualmembersofstaff.

KEMSAdoesnothaveaprofessionalisationframework.However,KEMSAsupportsprofessionaldevelopmentoftheworkforcebyencouragingthemtoacquirediplomas,Master’sdegreesandPhDs,whichaddpointstotheiroverallscoreinperformanceappraisals.IfKEMSAemployeesareenrolledinacourse,theycanleaveworkearlytoattendeveningclassesandtheyareoffereddaysofleavetositexaminations.However,noadditionalmonetarysupportisprovided.



The key informant interviewed about the work environment in KEMSA stated that theorganisation has a very dynamic culture and a sense of belonging, which motivates staff.Additionally,relationshipsbetweenstaffandsupervisors,headsofdepartments,andtherestofthemanagementareveryimportanttotheorganisation.

KEMSAhas anOSHsection andworkplaces are registeredby theDirectorateofOccupationalSafetyandHealth.Theorganisationhasadresscode,includedintheCodeofEthics,whichguidesstaffoncreatingagoodworkenvironment.KEMSAprovidesaconflictofinterestformforstafftosigninsituationsofpotentialconflictsofinterest.

Atpresent,KEMSAdoesnothaveastaffcanteenonitspremises,butthereareplanstoconstructoneby2021.Theorganisationalsoplanstobuildadedicatedstaffrecreationarea,withsportsfacilities.Thereareothernon-financialincentivesinplace,suchasguestdinnerswiththeCEO.

Useofpolicies

KEMSAimplementsthefollowingpolicies:

• An OSH policy implemented with the Directorate of Occupational Safety and Health(withinKenyantheMinistryofLabour).

• ACodeofEthicscreated jointlywith theElectronic IndustryCitizenshipCoalition, theCommissioninchargeofissuesrelatingtoethicsandintegrity.NewstaffmustsignthistocommitthemselvestoupholdingintegrityandapplyingethicsatKEMSA.SuppliersthatareawardedatendermustalsosignanagreementstatingthattheycommittolegalandethicalpracticewhilstworkingwithKEMSA.

Onceapolicyhasbeenauthorised(includingbeingsanctionedbytheBoardandtheCEO),itisthencommunicatedtomembersofstaffandlaunchedonastartdate.ThenewpolicyisputinasharedfolderinKEMSA’sintranetforstaffmemberstoaccess,print,andshare.MostpoliciesinKEMSAarereviewedeverytwoyears.


KEMSAhasaGenderMainstreamingCommittee(alongsideothermainstreamingcommittees)whichinvestigateshowKEMSAcanensurethatbothwomen’sandmen’sinterestsandconcernsarenotcompromisedinanyway.KEMSAfollowsthe70:30male/femalecompositionprincipleandconsidersgenderwhenrecruiting,aswellaslookingattheratioofwomentomeninKEMSAandthegendersplitatdifferentlevels.Thisincludesquestioningandusingdisaggregateddata

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on, forexample,howmanywomenoccupydirectorialandmanagerialpositionsorhowmanymenareemployedinthelowerposts.

KEMSAsupportsminoritygroups inprocurement(includingyouth,women,andpeople livingwithdisability).KEMSAalsohasaDisabilityMainstreamingCommittee,whichexamineshowtheorganisation can support employees with disabilities in their workplace, making KEMSA adisabledpersons-compliantorganisation.According toanationalactofparliament,KEMSA isadvisedtorecruit5%ofpeoplelivingwithdisability.


The Directorate of Occupational Safety andHealth carries out tests, includingmeasuring airqualityandlightingquality,andcheckingventilationsystems,andprovidesrecommendationsforKEMSAtoimplement.

KEMSAsupportsstaffwelfarethroughprovidingmedicalcovertoitsemployees,includingfreeannualhealthchecks.KEMSAalsoorganisesafree ‘HealthDay’,afamilyfundayduringwhichstaffareencouragedtoattendwiththeirfamiliesandaretestedforlifestylesdiseases,suchashighbloodpressure,diabeticbloodsugarlevels,eyehealth,etc.

KEMSAalsosupportsOSHinthefollowingways:

• Carryingoutannualauditstomitigaterisks;• Registering‘nearincidents’,whereanincidentmayhavecausedaninjury;• Insuringstaffagainstworkplaceinjuries;• Ensuring that staff wear personal protective equipment (PPE) in the workplace and

checkingtherecommendedilluminationlevelsforhealthandsafety;• Assessingwhether theoverallworkplaceenvironmentmeetsrequiredconditions(e.g.

workroomsarewellventilatedandclean,haveenoughfloorarea,asuitableseat,etc.);• Providingannualhealthcheckstoemployeesworkinginareasofhigheroccupationalrisk

(e.g. in loading/unloading ordistribution) to identify ailments acquired as a result ofoccupationalactivity.KEMSAinvestigatespotentialsourcesofoccupationalhazardsandmitigatesagainstthem.


KEMSAhasawhistleblowingpolicymechanismthatallowsemployeestoraiseconcernsaboutmalpractice or impropriety. Employees who raise such concerns are protected by a specialcommissionthatensureswhistleblowers’anonymity.



The key informant for KEMSA highlighted that the organisation seeks to foster a sense ofbelonging,toestablishstrongrelationshipsbetweenstaffandsupervisors,toprovideasafeandsecureworkenvironment,andtoinstilasenseofcareersecuritytomotivate KEMSApersonnel.The organisation employs KPIs to strengthening the performance management process andimprovingstaffmotivation.

Incentivepolicy

EmployeeperformanceatKEMSAisappreciatedinseveralways,includingthrougharecognitionlettersignedbytheCEO,beinggivenanopportunitytodinewiththeCEO,etc.Theseformsofrecognitionandawardsarepresentedatannualstaffpartiesandcanactassourcesofmotivation

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forotheremployees.KEMSAisamongthebest-payingparastatal agencies inKenyaandstaffaregivenannualsalary increments astheymovethroughdifferentpaybands.

Performanceappraisal

KEMSAconductstwomajorperformanceappraisals throughouttheyear:themid-yearreview(December–January)andend-of-yearappraisals(June–July).Currently,theorganisationemploystwomethodsofappraisal:

• A 90-degree performance appraisal,where themanager gives their evaluation to theemployeeonone-to-onebasis;

• A 180-degree appraisal process, which involves a self-assessment by an employee(assigningmarksorascoretotheirindividualperformance),whichisthendiscussedwiththeirsupervisorandfinallyratifiedbytheheadofthedepartment.

KEMSAplanstorollout360-degreeappraisals inthefuture. 

Careerpathsandpromotionopportunities

KEMSAhasaCareerProgressionPlan.TheHRdepartmentinformsemployeesthatafteracertainperiodtheirjobsneedtobereviewedinrelationtoapotentialpromotionbasedonthefollowingcriteria:

• Skills;• Experience;• Performance;• Discipline;• Competencies;and• Jobvacancies(forpromotionstothenextlevel).

Suitability tests are conducted to informpromotiondecisions. In theCareerProgressionPlanthereisalsoaspecialclausethatguaranteesemployeestherighttomoveupthecareerladderafterthreeyears,subjecttoreceivinggoodperformanceappraisalsandevidenceofhavingtherequiredcompetencies.

Supervisorysupportandretentionpolicy

KEMSAprovidessupervisorysupportthroughcoachingandmentoring.TheheadofdepartmentandemployeesjointlyidentifyanddecideontheprofessionalsupporttobeprovidedtoKEMSAstaff.TheorganisationalretentionpolicyisguidedbytheTalentManagementManual.

Disciplinarypolicyandpractice

DisciplinarypoliciesaremonitoredbyaspecialcommitteeatKEMSA,whichintervenesinthecaseofseriousgrievances.Inothercircumstances,disciplinaryissuescan besolved bythemanagementstaffandheadofthedepartment.

Staffsatisfactionsurvey

AstaffsatisfactionsurveyisconductedeverytwoyearstoallowKEMSAsufficienttimetoactonthefeedbackfromthesurvey. Theresultsaresummarisedinareport,whichisthensharedwithallKEMSAstaff. 

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4.3 MALAWI:CentralMedicalStoresTrust(CMST)

CMSTwasestablishedin2010bytheGovernmentofMalawiandwasregisteredasapublictrustin

2011,becomingfullyfunctionalin2012.CMST’svisionistoimprovehealthinMalawibyensuringa

reliable and continuous access to high qualitymedicines andmedical supplies through efficient

procurement,warehousinganddistributionservicesataffordablecost.


Jobdescriptions

CMST has a list of crucial supply chain positions and has developed job descriptions for itsorganisationalroles.Thedevelopmentofjobdescriptionsdidnotfollowaspecificcompetencyframework: they were drafted according to CMST’s assessment of skills and responsibilitiesrequiredforjobpositions.Jobdescriptionsarenormallyreviewedeveryfourtofiveyearsaspartoforganisationalfunctionalreviews,whichareoutsourcedtoaconsultancyfirm.Themostrecentfunctionalreviewwascompletedin2014andchangeswereimplementedin2015.Asatthetimeofwritingin2020,anotherfunctionalreviewiscurrentlybeingconducted.

Recruitmentprocess

AtCMST,therecruitmentprocessdependsonthegradeofthevacantposition.Interviewpanelsareopentoexternalexpertsdependingonthenatureof the jobrole.Forexample, ifCMST isrecruitinganaccountant,representativesoftheInstituteofCharteredAccountantsinMalawi,andalsooftheAccountantGeneral’sDepartment,willbeapartoftheinterviewboard.TheinternalCMSTcommitteewillincludetheheadoftherelevantdepartment.Foralljobinterviews,fromofficer to director level, CMST invites external panellists to take part. In general terms, therecruitment approach remains the same for both technical and managerial positions. Forexample,anHRmanagerwouldundergothesamerecruitmentprocessasapharmacist.Theonlydifferenceisinthetechnicalexpertiseofinterviewpanellists,whichdependsonthenatureofthejobvacancy.

CMST’sjobgradingsystemconsistsof11grades,fromthetop-levelmanager(Grade1)tothelowestjobgrade(Grade11).TheleadingmanagerialpositionsincludeCEO(Grade1),director(Grade2),linemanager(Grade3),andmiddlemanager(Grade4).

InmakingarecruitmentdecisionCMSTpaysspecialattentiontothecandidate’squalificationsandyearsofexperience.Theminimumrequirementsarehighlightedinthejobadvertisementandfollowedthroughintheprocessofshortlistingcandidates.Beforeinvitingcandidatestoaninterview,CMSTnormallypreparesasetofquestionsand,dependingonthegradeofthevacantposition,alsocreatesacasestudytask,whichissentatleastaweekinadvancetothecandidates,requiringthemtoprepareapresentationaspartoftheirassessment.

According toCMST’sTermsandConditionsof Servicehandbook, vacancies for certain juniorpositions are first advertised internally. Other professional positions, from officer level andabove,areadvertisedbothinternallyandexternally.Ifaninternalcandidateisrecommendedbytheinterviewpanel,CMSTwillselectaninternalcandidate,particularlybecausetheconditionsofservicestipulateaguaranteeofcareerprogressionwithintheorganisation.

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Careerprogression

TheTermsandConditionsofServicehandbook,receivedbyeverynewemployeeuponjoiningtheorganisation,hasasectionthatspecifiesthemechanismandcriteriaforpromotion.Aftertheannual performance appraisal, a director of the department can issue recommendations forpromotion.ThesearesubmittedtotheseniormanagementandreviewedbytheHRDirector,whocansupporttherecommendations.


TNA

Atthebeginningofthefinancialyear,CMSTfinalisestheannualplanningandrequestsheadsofdepartmentstosubmittheirtrainingneeds.TheHRdepartmentconsolidatestheserequestsintoa training plan, which is cost assessed and matched to the training budget. As a youngorganisation,CMSThasfounditdifficulttomatchthedepartmentaltrainingneedstoavailableresources.ThetrainingbudgetislimitedandCMSTattemptstoprioritiseasmuchaspossiblethose training needs that can help address gaps in employee performance identified duringannualappraisal.


CMSTconductsacertainamountofon-the-jobtrainingandtheHRteamhandlestheinductiontrainingfornewemployees,includingdepartmentalmanagers.Technicaltrainingisoutsourcedtoexternalserviceproviders.Forexample, forpurposesof trainingin financeandaccountingCMSTsendsemployeestotheInstituteofCharteredAccountantsinMalawi,whichhasanannualcalendar of training programmes. Similarly, pharmacists will be referred to the Pharmacist,Medicines,andPoisonsBoard,whichcoordinatesthetrainingofpharmacists.Therearealsotwomanagement institutes in the country: the Malawi Institute of Management and the StaffDevelopment Institute. Both organisations are governmental institutions that publish annualtrainingcalendars,whichCMSTfollowsinstructuringitstrainingplan.TheTrustalsoliaiseswiththeInstituteofProcurementandSupplytoplantrainingforpersonnelworkinginprocurementandsupplychain.

CMSTnormallydevelopsannualtrainingplans.Atthecorporatelevel,theTrustcreatesafive-yearstrategicplan.Themostrecentplanfinishedon30June2020.Oneoftheobjectivesofthenew strategicplan for financial year2020–2025 ishuman capitaldevelopment.TheplanstillneedstobeapprovedbytheBoard.Afterapproval,CMSTwilldevelopthestaffdevelopmentandtrainingstrategyforthenextfiveyears.

CMST has benefited from support from the Global Fund and is currently implementing theNational Supply Chain Integration Project, which also focuses on HR and organisationaldevelopment. This project is being managed by organisational development consultants atChemonicsInternational,whoarehelpingCMSTtodevelopthefive-yearHRstrategy.CMST’staskistoensurethattheorganisationhastherightskillsandtherighthumancapacitytoimplementthe new strategic plan, as well as the supply chain integration strategy that CMST has beendeveloping.

Communityofpractice

CMSThasnot createda communityof practice. Instead, it relies onmore formal training: forexample,theGovernmentofMalawipartnershipwithIndiaintrainingpublicservants.TheTrusthasparticipatedinthistrainingwiththeassistanceoftheHRdepartmentoftheGovernmentofMalawi.ThekeyinformantforCMSThighlightedthatthisisanareainwhichtheTrustshould

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undertakemorecollaborationwithotherinstitutions,andthatinthefutureitwillparticipateinadoptingaprofessionalisationframework.



CMST’sTermsandConditionsofServicearetheorganisation’sprimaryframeworkrelatingtocreatingagoodworkenvironment.Thedocumenthasbeenreviewedandthefinalconsultationforthenewserviceswascompletedinthesummerof2020.ThefinaldraftwillbepresentedatthenextBoardmeeting,tobeapprovedandadopted,andwillthenreplacethepreviousversionoftheTermsandConditionsofServicedatingfrom2015.TheTermsandConditionsofServiceincludeaCodeofConduct,whichoutlines thenorms,rules,andresponsibilitiesof staff intheworkplace.

Internally, CMST intends to enhance corporate communication to better inform staff of theorganisation’sobjectivesandmission.Externally, theTrust is reviewing itsbrandandaims torepositiontheinstitutionthroughthenewstrategicplantoimproveitspublicimage.

Useofpolicies

CMSThasthe followingpoliciesinplace(includedasannexes totheTermsandConditionsofService):

• HIVandAIDSworkplacepolicy;• FraudandCorruptionPreventionPolicy;activitiesarecoordinatedbytheInstitutional

IntegrityCommittee.WhenareportisreceivedfromDeloitte(whichmanagesthisarea),theCommitteeinvestigatesandthensubmitsitsownreporttotheCEO.Dependingonthenatureofthereport,theCEOwillinstitutedisciplinarymeasuresand,ifapplicable,referthecasetotherelevantlawenforcementagencies;

• CodeofConduct(outlinescorevalues,mission,rules,andpracticesofstaffconductintheworkplace);

• StaffTrainingandDevelopmentManual(andtherelevantcommittee).

ThedevelopmentofpoliciesatCMSTfollowsaconsultativeprocess.Thisbeginswithchoosingrepresentatives from different departments and sections. If consultants are engaged, theconsultantswillworkwiththeinternalandexternalteamtodevelopthepolicy.Aspartofthedevelopment,variousstakeholdersareconsulted.Oncethedraftisready,itissenttotheBoardforapproval.

Once a policy is approved, printed copies are disseminated to staff for engagement andexplanation.Thishelpstomakestaffawareofthecontentsofthefinaldocumentandtogivethemtheopportunitytoraiseanyquestionswiththeimplementingdepartment.

Supportingwomenormembersofminoritygroups

CMSTaimstodevelopspecificpoliciesintheseareasinthefuture.


CMSTfollowstheLabourActforHealthandSafetyandconductsregulartrainingsandfiredrills.Theorganisationensuresthereisacleanenvironmentand,ifrequired,staffareprovidedwithPPE(thisisnotlimitedtostaffworkinginwarehouses,italsoincludesthoseworkingincleaning,thesecurityteam,deliveryservicesetc.)

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CMSThasawhistleblowingpolicy,whichispartofitsFraudandCorruptionPreventionpolicyandisoutsourcedtoDeloitte.Thisinvolvesanonymousreporting.Deloittegeneratesreports,whicharethensubmittedtotherelevantauthority.



CMST uses the BSC for managing the performance of Board members, while employeeperformanceismanagedbyaspecialtooldevelopedbyconsultants.Infinancialyear2020/21,CMSTwillbegintousetheBSCuniformlyacrossallorganisationallevels.

Incentivepolicy

Non-financialincentivesincluderecognitionforgoodperformanceduringannualappraisals.Staffexchangeprogrammeshelpmotivateemployeestoexploreskillsandworkenvironments.Staffalsotakepartinmeetingswithstakeholders,whichhelpthembetterunderstandthestakeholderperspectiveandincreasestheirsenseofbelonging.Annualassessmentsfocusonperformanceand includeasystemofrewardsandsanctionsbasedon theoverall jobprogress.RewardsatCMST include salary increments, promotions, grade changes, training opportunities, etc.Sanctionscanincludeoralandwrittenreprimands,andrecommendationsformoreon-the-jobtraining.

Performanceappraisals

AppraisalsatCMSTareguidedbyclearjobdescriptionsandstaffobjectives.Thesysteminvolvesan open appraisal, whereby an employee fills the BSC and indicates their level of individualperformance. This is followed by the supervisor's input and assessment. Following this, anemployeeandsupervisorcometogethertodiscusstheappraisalbasedonKPIs.

Promotions

AtCMST,nouniversalcompetency-basedpromotionframeworkisfollowed.PromotionsarealsogovernedbytheTermsandConditionsofServicehandbook.Thereisacriterionforpromotionsbased on annual staff performance assessments. Performance over the years is key topromotions.OtherkeyfactorsforpromotionsatCMSTincludequalifications,experience,etc.

Supervisorysupport

CMSTencouragesopendiscussionsamongststaffandlinemanagerstomotivateemployeesandimproveperformance.


ThekeyinformantforCMSThighlightedthatatransparentcommunicationandfeedbackpolicyencouragesmoreengagementbystaffintheorganisation.Everytwoyearsastaffteam-buildingexercise is conducted,which actsasa forumwherein staff share individual experiences.ThisinitiativeiswellappreciatedbythestaffatCMST.

Intermsofstaffretention,theTermsandConditionsofServiceindicatetheneedtorecruitwell-qualified staff. To achieve this, CMST offers a competitive remuneration package, which hasresultedinlowstaffturnover.

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AstaffsatisfactionsurveyisconductedannuallyatCMSTtounderstandstaffsatisfaction,identifygaps,anddesignpoliciestoimprovestaffsatisfaction.

4.4 SUDAN:NationalMedicalSuppliesFund(NMSF)

NMSF isthesuccessorof theCentralMedicalSuppliespubliccorporation(establishedasa semi-

autonomous organisation in Sudan in 1991). The organisation implemented a comprehensive

reformprogrammein2011andin2015wastransformedintoNMSFaftertheapprovalofanewact

bytheSudaneseNationalAssembly.In2015,NMSFwasgivenmoreflexibilityregardingcommercial

operationsandinthepurchaseandsaleofmedicalproducts.NMSF’skeyobjectiveistoensurethat

essentialmedicinesandmedicalsuppliesofprovensafety,efficacy,andqualityareavailabletothe

populationatreasonableprices.Sincethe1990sithasemployedacost-recoverysystem.


Jobdescriptions

Until2017NMSFdidnothavewell-definedandstructuredjobdescriptionsandapproachedPtDtohelpdevelopthemfortheentireorganisation.Thestructureofjobdescriptionsincludes:

• Jobtitle;• Superior-subordinate relationships and the management level (Director General, or

departmentaldirector,etc.);• Jobpurpose;• Keyresponsibilities;• Qualificationsandexperiencerequirements;• Skillsandknowledgerequirements.

Recruitmentprocess

HR recruitment at NMSF is guided by the Civil Service Act 2007. The requirements andproceduresofrecruitmentfollowtherecommendationsoftheNationalCivilServiceCommission–theSudannationalcommissionforrecruitmentinthecivilservice.

IntheSudancivilservice,therearetwocategoriesofworkforce:skilledemployees(generallyuniversitygraduates, suchasaccountants,doctors,engineers,pharmacists,etc.)andunskilledlabour(workerswithhighschooldiplomaorless,suchasdrivers,cleaners,messengers,etc.).SkilledemployeesbegintheircivilservicecareeratScale9(alsocalledentryscale)andmoveuptothehighestpositioninScale1.ThescaleforunskilledlabourbeginsatScale16andgoesuptoScale10(thehighestscaleforthisgroupofstaff).

ItisthesoleresponsibilityofNMSFtorecruitlow-levellabourers(uptoScale10).Themid-levelemployees(Scale9toScale6)arerecruitedbytheNationalCivilServiceCommission.Inordertorecruit for these positions, NMSF submits a request to the Commission, which assembles arecruitingcommitteethatincludesanNMSFrepresentativeandthatcarriesouttheadvertisingandrecruitmentprocess.Afterrecruitmentiscompleted,theCommissionsendsaformalrequesttoNMSFtoappointtheselectedcandidate.

Aseparaterecruitingcommitteeisassembledtoselectcandidatesforleadershippositions(Scale5 to Scale 1). After the selection is completed, the Director General requests the Board of

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Administration,chairedbytheMinisterofHealth,toapprovecandidates.Afterthat,theMinisterof Health submits a formal request of appointment to the Council of Ministers, through theMinistryofLabour.

The key informant for NMSF highlighted that during recruitment, the recruiting committeeensuresthatcandidatesmeetthejobdescriptionrequirementsandcheckstheirreferences,butspecial attention is paid to experience, including supply chain experience and postgraduatestudies.


Training,andcapacitybuildinganddevelopment

TrainingprogrammesatNMSFareinformedbyTNAatthedepartmental,ratherthanindividual,level. TNA ismore group-based, and is carriedout forprocurement, distribution, andqualityassurance.NMSFfindsitdifficulttotailortrainingtotheindividualneedsofitsmorethan400membersofstaffandtotrainthemonanindividualbasis.

NMSFbegandevelopingtrainingprogrammesin2011butuntil2014itdidnothaveanytraininggovernanceinplace.Originally,theprogrammesofferedmostlytraditionalclassroomtraininginpublichealthsupplychainandsupportingservices,suchasfinanceandIT.NMSFalsoencouragedself-learning among its employees, providing access to e-journals, e-books, and setting up alibrary.Additionally, NMSF began sending staff to conferences relevant to theirwork, and toregionalworkshops.

NMSFhasitsownworkshopforchecking,calibrating,andrepairingmedicalequipment,whichprovideson-the-jobtrainingandapprenticeshipstobiomedicalengineers.However,mentoring,coaching,andtrainingforpharmacistswasintroducedonlyin2018.

TNA informs the training curriculum at NMSF and theHR department has a well-developedenterprise resource planning (ERP) module that holds comprehensive information on everymemberofstaff,includingtheirtrainingandprofessionaldevelopment,whichcanbeaccessedviaamobileapp.

Aspartofthecapacitydevelopmentinitiative,theDirectorGeneralofNMSFmadeonlinetrainingcourses on good governance in the management of medicine, hosted by the Global HealtheLearningCentre,mandatoryforallNMSFpharmacistsandpartoftheirperformanceevaluation.NMSFalsohostedcontinuousprofessionaldevelopment(CPD)programmesincollaborationwiththe Sudanese Pharmacists Professional Union to ensure that pharmacists improve theirknowledge,skills,andcompetencies,andenhancetheircareerprogression.NMSFhasbecomethe national centre for continuing education and the CPD of pharmacists in Sudan. TheorganisationcoverstheannualsubscriptionfeesforaccessingspecialisedsoftwaredevelopedbyCoAcSLtd,for1,000pharmacists.Similarinitiativeshavebeenimplementedforprocurementandsupplychainspecialists. In2019,24employees inthesepositionscompleted theCIPSLevel4(DiplomainProcurementandSupply)modules.

4.4.3 Pathway3:Workenvironment


NMSF initiated changes to its organisational culture, first by completely changing itsphysicalenvironment.Thisincludedrefurbishingstaffoffices,providingnewdesksandcomputers,andinstallingemailsystems.Second,NMSFthenmovedtochangethecultureitself,focusingonhowtoadoptaCodeofConductandhowtomaintain thephysicalenvironment. NMSFstaffcame

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togethertofinaliseandagreeupontheCodeofConduct,whichwasthensignedandplacedineveryemployee’sfile.Third,NMSFmovedontoapplyingtheCodeofConduct,whichincludedthefollowingactivities:

• Maintainingthecleanlinessoftheenvironment(includingcontractingaspecialisttoteachhygienepractices).

• Changingtheculturebyencouragingstafftofocusontheirworkandteachingeffectivetimemanagementtechniques.

• Establishedasmallfootballpitchforstafftoplayon.• Createdacafeteriawithsubsidisedmeals,andaminisupermarket.• Installedacashmachine.• PutinplaceinfrastructureprovidingthehighestinternetspeedinSudan.

Changingtheworkenvironmenthadapositiveimpactontheoverallculture,creatingastrongsenseofloyaltyandbelonging.ThekeyinformantforNMSFemphasisedthatduringaneight-monthperiodafterthetransformation,only8%ofstaffresigned(largelyduetopersonalreasons,suchasmovingabroad).

Useofpolicies

NMSFhasanextensivesetofpolicies,includinganti-corruptionandanti-fraudpolicies,andemailpolicy,andapolicyongoodgovernanceformedicine.NMSFalsofollowsthedisciplinarycodeforcivilservicestaff.However,thereisnopolicyonharassment.


Therearenoformalpoliciestosupportwomen,thoughtheNMSFrespondentstatedthat38%ofstaff at NMSFarewomen. They also stated that ifmanual labourer staff (ofwhomnone arewomen)arediscounted,womenformmostoftheworkforce.ThecurrentDirectorGeneralisawoman.


NMSFprovidesemergencykitsforminorinjuries.


NMSF has a whistleblowing policy which is included in its anti-corruption policy. Thewhistleblowingmechanismtakesthe formofananonymousemailaddress,towhichstaffcanprovideinformationconcerninganywrongdoing.



AtNMSF,KPIsare inplace tosupportstaff tounderstandtheir individualrolesbetterandtocontribute towardsNMSF’s goals. TheHR department has supported and led theway in thetransformationofNMSFbyclearlyaligningtheKPIstotheoverallorganisationalgoals.

Incentivepolicy

In2012,NMSFstartedgivingincentiveslinkedtoperformance.Simplecriteriaweresettosendasignalforimprovedperformance.Bytheendof2018,theincentiveswerefourtimesthegrosssalary,i.e.anemployeeearnedfivetimesthebasesalaryeverymonth.Everymonthalldirectorssubmittedevaluationsofsubordinateswhichwerethoroughlyreviewedbytheseniorleadership.Ascoreofgreater than70wasneededmonthlytobeentitledtoreceive incentives.Since the

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NMSFActwasapprovedstaffnowreceiveanadditionalbenefitpackage(beyondthanthecivilservantpackage).Accordingtothebenefitpackage,pharmacistsareentitledtoreceive50%oftheirbasicsalaryontopofthemonthlysalary;forbiomedicalengineerstheyreceive40%oftheirbasicsalaryontopofthemonthlysalary;andforotherstaffa20%top-upisprovided.Therearealsocashallowances:marriedstaffwithchildrenreceiveeveryyearfourmonthsoftheirgrosssalaryasacashallowance,andmarriedstaffwithoutchildrenreceivethreemonthsoftheirgrosssalary.

Performanceappraisals

The Civil Service Chamber guides performance appraisals at NMSF. The supervisors aremandated to complete assessments anonymously and submit them to theHR department. Aspecialcommitteethenassessestheinputstorecommendcandidatesforahigherjobscale.Thecommittee meets on an ad hoc basis coincided with the cycles of employee performanceappraisals(e.g.forpharmaciststheappraisalisconductedeverytwoyears).

Promotions

AtNMSFtheCivilServiceChamberalsoguidesthepromotionofeligiblecandidates.However,promotionsarenotlinkedtoacompetenceframework.

Supervisorysupport

MentoringandcoachingsupportarestilllackingatNMSF.Theywerestartedlatein2018,basedonthePtDframework.


Engagement policies include changing the physical ambience of NMSF offices, installing newequipment,andprovidingaccesstohigh-speedinternet.NMSFhasalsoundertakenotherstepsto offer a range of benefits to staff, including providing transport for employees, providinguniformstoall staff,andofferingprivatemedical insurance forstaffandtheir families(NMSFpaysthefullinsurancepremium).Otherincentivesincludesubsidisedmeals,andamini-marketandcashmachineinthepremises.Thesestrategieshavehelpedtomaintainastrongsenseofloyalty and belongingness within the organisation and to keep staff turnover at 8% (2018).Overall,trainingopportunities,theworkenvironment,incentives,andsupportfromtradeunionshavecontributedtowardsarobustretentionpolicy.


NMSFfollowstheDisciplinaryActforthecivilservice.


NMSFconductsastaffsatisfactionsurveyeveryyear,andtheresultsarediscussedwiththeemployees.

4.5 Tanzania:MedicalStoresDepartment(MSD)

MSDwas establishedbyaTanzanianAct of Parliament in 1993as anautonomousdepartment

withintheMinistryofHealth,CommunityDevelopment,Gender,ElderlyandChildren.MSD’smission

is to ensure medicines, medical supplies, and laboratory reagents of acceptable quality and

affordablepricearealwaysavailabletoTanzanians.MSDcollaborateswiththeprivatesectorto

create localmanufacturing facilities (as per thePublicPrivatePartnershipAct, 2010)and from

2017,MSDstartedtoprocureitsmedicalsuppliesdirectlyfrommanufacturers,ratherthanfrom

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suppliers.MSD’svisionistobecomeacentreofexcellenceforhealthcommoditiessupplychainin

Africa.

4.5.1 Pathway1:Staffing

Jobdescriptions

MSDwassupportedby the consulting firmAccenture andBMGF indevelopinga competencyframeworkforsupplychain.Theorganisationlookedatthesupplychainsystemfromendtoendto understandwhat level of skills and competencieswas required for chain professionals. Itconductedinterviews,reviewedsetsofqualifications,andcameupwithalistofcompetenciesforsupplychainroles.Afewnewpositionswereaddedtotheexistinglistofcrucialsupplychainjobs, such as Demand and Supply PlanningOfficer for Quantification to quantify themedicalcommodities needs before submitting a request to the procurement team. MSD has alsorecognised the need for stock verifiers and some other positions, such as procurement andwarehousingspecialists.Previously,thesewarehousingpositionswerequitegenericandhadtobe adjusted to reflect specific warehousing functions and processes, such as dispatching,receiving,orcustodianship.

Recruitmentprocess

RequestsforhiringnewemployeesaresubmittedbyMSDdepartmentstotheHRdepartmentviajobrequisitionforms.Atpresent,thesystemofreviewingjobrequisitionsismanual,withtheprospect of its automation soon. The HR specialists check the requisition against theorganisationallistofjobrolesandthenumberofemployeesrequiredforaspecificdepartmentorarea.TheHRdepartmentcanrejecttherequisitionifitdoesnotcomplywithorganisationalcapacity.Uponreceivingtherequisition,HRspecialistsalsolookthroughthelistofemployeeslinedupforrecategorisationtonewpositions,asthesebecomevacant.Recategorisationofstaffreflects the factthatemployeesacquirenewskills,qualifications,andeducation(e.g.Master’sdegreeoradiploma).TheHRdepartmentattemptstomatchtheseemployeestothepositionsfeatured in jobrequisitions. If theorganisationdoesnothave therightpersonnel thatcanberecategorised,thesevacanciesareadvertisedexternally.

MSDisapublicorganisationandaccordingtotheamendmentsmadetothePublicServiceActinNovember2016allpublic organisations inTanzaniamust conduct their external recruitmentcampaignthroughthegovernmentagencythePublicServiceRecruitmentSecretariat.MSDsendsjobadvertstotheagencyforpublicationontheSecretariatportal(www.ajira.gov.tz),aswellasontheMSDwebsiteandothermediaplatforms.TheadvertisementwillsaythattheSecretariatisrecruitingonbehalfofMSD.Incertaincases,thestaterecruitmentagencycanbringstafffromotherorganisationswhohaverequestedatransfertoMSD,iftheymatchtherequiredskills.

TheMSDHRdepartmentdealswithallof thepracticalitiesof therecruitmentprocess,whichincludeperformingvariouschecks,shortlisting,conductinginterviews,andissuingjobofferstoselectedcandidates.Thedepartmentalso followsthesecurityvettingprocedure,as theentireworkforceemployedinthepublicserviceisrequiredtoreceivegovernmentsecurityclearance.

Thedepartmenthasaninterviewmatrix,andaquestionnairethatincludesthetechnicalside,aswellasasectiononrequiredcompetencies, job fitness,andqualifications.Forexample, if theorganisation is seeking to employ a Quality Assurance Officer, the HR will ask the QualityAssurance Manager to draft a set of technical questions based on a specific job description(especially if thedepartmentseeks a trainedbiomedical engineeror apharmacist towork inquality assurance). To this list of technical questions, the HR department adds a number oftraditionalHRquestions to ensure that the candidatesare fit for the roles.According to staff

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regulations,theDirectorofHumanResourcesservesasChairandtheHRManagerasSecretaryoftheinterviewpanelforalljobpositionsatofficerlevelandabove.Thepanelalsoincludesakeytechnicalspecialistfromtherelevantdepartment.

Ifthereisalargepoolofqualifiedcandidates,theyarefirstaskedtositanassessmenttest.Thisis conducted for all technical and supporting positions, except from managerial roles anddirectors.Forthesejobroles,theassessmentisusuallyoutsourcedtoarecruitmentcompany.(Previously, theassessmentofcandidatesapplying fordirectorialpositionswasconductedbyDeloitte).Thekeyinformanthighlightedthatwhenpositionsofactingdirectorsbecomevacantin the future, MSD will not engage a consulting firm again, but rather search for suitablecandidatesinternally.

Oncetheselectionprocessiscompleted,theHRdepartmenttakesnewemployeesthroughthemandatory induction process. They are assigned to supervisors and enter a six-monthprobationary period. From the very beginning, new employees are communicated clear jobtargetsandexpectations,aswellastheavailablesupporttheymightrequireinperformingtheirjobs,especiallyiftheycamestraightfromuniversityorschool,orhaveonlyundertakenashort-terminternship.

Careerprogression

Toprovideclearcareerstructuresforemployees,MSDhasdevelopedaSchemeofService.Theoutlook of the Government of Tanzania is decidedly pro-qualification, which means that ifemployeesattainacertainqualification,theycanmoveuptoadifferentlevel,accordingtotheirexperience,joboutput,andperformanceevaluation.TheSchemeofServicehasfourtosixstepsineveryjobrolebeforeanemployeecangettoamanagerialposition,providedthatitisvacant,offering a straight career path for all employees. For example, one can start as WarehouseAssistant and then grow to Principal Warehouse Assistant. The road to promotion involvesacquiringsufficientexperience,scoringatleast‘B’oraboveintheperformanceevaluation,andobtaining certain qualifications after sitting an examination and undergoing professionalevaluation regulated by the Procurement and Supplies Professionals and Technicians Board(PSPTB).


TNA

TNA atMSD is conducted annually. Government institutions are required to follow theOpenPerformanceAppraisalSystem(OPRAS),butMSDhasrequestedpermission to follow itsowninternal performance management system. This is called DRIVE and consists of five majorcomponents:knowyourdirection,reviewwhereyouare,improveonyourperformance,validatethe results, and enjoy your rewards. A special section on the appraisal form is dedicated toprofessionaldevelopment.Thishastobecompletedandmarkedbyboththesupervisorandtheemployee,andtheymustagreeonareasofdevelopment.Thedepartmentwillalsoaddcertaintrainingneedsandbothassessmentswillbetakenintoconsiderationinthedevelopmentofatrainingplan.TheHRdepartmentcriticallyreviewsperformanceappraisalandtrainingneedsforms to ensure that they comply with real performance objectives and the needs of theorganisation.Forexample,employeesmayrequestmoretraininginprojectmanagement,whiletheHRdepartmentmaydecidethatduetochangestheirwork,theseemployeesactuallyrequiremoreexposure.Togiveoneexample:MSDhiresalotofpharmacistsandplacesthemincustomerservice, sales, andprocurement.Theorganisationrecognises that these employees, originallytrainedaspharmacists,requiredadditionaltrainingtoperforminnewroles.

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MSDlooksatTNAfromtheperspectiveofemployeeperformanceandfromthebusinesspointofview.Forexample,theorganisationisembarkingonmanufacturingitsownpersonalprotectivepacks,whichrequirestheProduction/ManufacturingTeamtoundergospecialisedtraining.TheHRdepartmentisalsoengagedindevelopingastrategicplanforthenewfinancialyear(whichbeginson1July)thatdefinesthebusinessfocusoftheorganisation.

Trainingandlearning

Thetrainingprocessitselfisamixtureofin-houseandoutsourcedtraining.MSDdoesnothaveaselected group of institutions to outsource training to, but it often collaborates with PSPTBbecauseofitsspecialfocusonthesupplychain.In2020,theCOVID-19pandemichaschangedthewaytrainingisconductedatMSD:thebudgetfortraininghasbeensignificantlyreducedandmostofthetrainingisconductedin-houseusingdigitaltechnology.

Continuingprofessionaldevelopment

TheStaffRegulationsManualstipulatesthatMSDwillsupportthemembershipofallitsstaffinrelevantprofessionalassociations,andwillcovertheassociatedmembershipcosts,subscriptiontoacademicjournals,etc.Forexample,theorganisationencouragespharmaciststoregisterandparticipate in seminars run by the Commonwealth Pharmacist Association. MSD pays themembershipfeesandthecostsofparticipatinginseminars,whichprovideemployeeswithnewknowledge, mentoring, and coaching. MSD lawyers are registered with the Tanganyika LawSociety. Warehousing and procurement staff, pharmacists, doctors, and finance and auditpersonnelaremembersoftheirrespectiveprofessionalassociations.

ThekeyinformantforMSDhasindicatedthatthementorshipsystemwithintheorganisationisnotyetrobust.Currently,ithasonlyasmallpoolofon-the-jobmentorsandtheHRdepartmentattempts tosupport some formofmentoringbyorganisingaseries of talks, deliveredby theDirectorGeneral,andmeetingsbetweenMSDmanagersandCEOsofotherorganisationstoshareexpertise.


Creatingastrongorganisationalculture

Thekey informant forMSDstated thattheorganisationaims toensureemployees’voicesareheardandencouragesanorganisationalculturewhichvaluesdiversityandprovidesaconducivework environment. The organisation’s values are respect, passion, integrity, courtesy, andinnovation.

Useofpolicies

MSDhasthefollowingpoliciesinplace:

• Ananti-harassmentpolicy;• ACodeofConduct(signedbystaffwhentheyjoin).

Additionally, its disciplinary process is governed by the Public Service Act 2002 and PublicServiceRegulations2003.Newstaffregulationshavebeeninplacesince1July2020,whichdetailthedisciplinaryprocesses, includingthelegalprocess,addressinginternalgrievances,andtheCodeofConduct.


Asmentionedabove,MSDhasananti-harassmentpolicy.WhilstMSDonlyemploysTanzanians,itemploysstaffofdifferentethnicitiesanddoesnotdiscriminatebasedonreligionorgender.

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MSD also encourages people with disabilities to work for it and has conducted purposefulrecruitmentinthisarea.MSDhasalsorecruitedstaffwithtotaldisabilitiesandhassupportedthembyprovidingthemwithwheelchairs.

Creatingasafeworkenvironment

MSDensurescompliancewithOSHstandards(asgovernedbytheOccupationalSafetyandHealthAuthority,OSHA),andensuresthatallemployeesareworkinginasafemannerandhavesafetygear.MSDuseshealthinspectorswhocheckconditionsandensurethattheorganisationoperatesinasafeenvironmentthatwillnotharmworkersortheirsurroundings.

SpecificmeasuresMSDhasinplaceinclude:

• Conductingquarterlymedicaltests(priortoCOVID-19);• Providingahepatitisvaccinetoworkers;• Conductingcampaigns,suchasencouragingemployeestohaveHIVtests;• Providingtherightgownsandshoesforstaffworkingincoldvaccinestores;• Providingtransporttothoseworkingatnight;• Providingotherstaffbenefits,suchasmobileairtimecredit,transportallowance,andfuel.



Forperformancemanagement,MSDusesitsowninternalsystem,DRIVE.It isasystemthatisbasedonobjectivesbeingagreedinMay–JuneeveryyearandonthefilingoftheobjectivestotheHRdepartment,whichcommencestheperformanceyear.ManagersreviewtheBSCobjectiveswhich have been assigned to their directorates.Managers choose relevant objectives for theemployeesanddiscussthesewiththem.TheobjectivesmustfollowtheSMARTprinciples:i.e.bespecific,measurable, achievable, realistic, and timely. Employees and themanagermustbothdiscuss and understand all the objectives as themanager will review progress against themthroughout the year. Employees should know their own individual responsibilities regardinghelpingMSD to achieve its goals.This aims to enhance personal accountability and enablesemployeestowritedownactionstobetakentomeettheobjectives.TheHRwillfinallyreviewtheobjectivesandcheckthequality.Incentivepolicy

Thereisaninternalincentiveschemewhichincludeshardshipallowancesforemployeeswholiveinhard-to-reachareas,honorariatorewarddesiredresults,providingphones,airfans,andtransportallowances,etc.Performanceappraisal

AtMSD,performancereviewsarecarriedouttwiceayear,inDecemberandMay.Managersarerequiredtoclearlycommunicateanexplanationforallratingstotheemployeeandtobeclearinsuggestingwaysinwhichtheycanimprove.Thisreviewisusuallycarriedoutinaprivateplace,whereboththepartiesfeelcomfortableandarenotinterrupted.Managerandemployeeagreeonatimeandplacethatgivesenoughtimeforthediscussion.Whenthemid-yearreviewisheld,the‘what’objectiveisdiscussed,toidentifyanysupportthattheemployeemightneed,andthe‘how’objectiveisdiscussedtoimprovetheachievementofdeliverables.Themanagerselectsanagreedratingandwritescommentsonstrengthsandthescopeofimprovement.TheannualappraisalisguidedbytheoverallDRIVEscore.

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Promotion

MSDfollowscompetence-basedpromotions:competenciesforsupplychainhavebeendevelopedand supported by BMGF and Accenture. Like any public sector organisation in Tanzania,afterhavingspentfouryearsinservice,employeesareeligibleforpromotionsasmandatedbythe Public Services Act. However, MSD ensures that such promotions always aligned to thecompetence.PromotionsarealsoguidedbytheDRIVEscore.Ifanemployee’sperformanceisnotasdesired,thentheyareputonaPerformanceImprovementPlananditisclearlycommunicatedthatemployeesarenotentitledtobepromoteddespitebeingeligibleforthesame.Retentionandengagementpractices

TheStaffRegulationManualstatesthattwoprofessionalmembershipswillbesupportedbyMSDandthemembershipfeesarecoveredbytheemployer.Themembershipsalsoprovideaccesstospecialisedacademicjournalsandotherresourcesthathelpemployeestoengageinself-studyandenhancetheirprofessionalknowledge.MSDallowsstaffenrolledinhigherdegreecoursestotake long-term study leaves. The key informant for MSD emphasised that the organisationpromotesaninclusiveworkenvironmentandintroducedarangeoffinancialincentives.Theseincludeagratuityscheme,whichoffersapay-outtoallstaffeverytwoyears,aswellasawardsandcashincentivesforinnovationandcreativity,initiatedbytheICTdirectorate.AlthoughMSDdoes not have a specific retention scheme, these engagement policies have resulted in lowattritionrates.Disciplinarypolicyandpractice

DisciplinarypoliciesandpracticesaregovernedbythePublicServiceAct2002anditsregulationsof2003.TheyarealsoincorporatedintotheMSDStaffRegulation2020.Staffsatisfactionsurvey

MSDconductsastaffsatisfactionsurveyonceeveryyearthroughtheHRdepartment.ThistakesplaceinthePublicServiceWeek.ThefeedbackofemployeesiscollectedthroughSurveyMonkeyandguidesaplanofactions.

4.6 Uganda:NationalMedicalStores(NMS)

NMS was established as a statutory corporation in Uganda in 1993. In 2009, NMS underwent

significantchanges,includingreceivingpre-financingandthecentralisationofalargepartofthe

drugsandmedicinessuppliesbudget.NMS’smandateistoprocure,store,anddistributeessential

medicines and medical supplies to all public health facilities in Uganda, as well as serving

governmenthealthfacilitiesanddistributingvaccinesacrossthecountry.


Jobdescriptions

Job descriptions for positionswithinNMS are featured in the JobDescriptionManual,whichdefinesthejobholder’skeyroles,requiredqualifications,competenciesandresponsibilities,andwhichspecifiesthepurposeofeachjob.Theinitiativetodraftjobdescriptionscamefromheadsofdepartments,andinitiallyaconsultanthelpedNMStocreatejobdescriptionsforthemanual(incollaborationwithheadsofdepartmentsandinconsultationwithvariousstakeholders).JobholderaccountabilitieswerediscussedwiththeNMSmanagementandapprovedbytheBoardoftheorganisation.Jobdescriptionsarecontinuallyupdated,totakeaccountofneworganisationalneeds.

52

The JobDescriptionManual isnotspeakingacompetency framework, thoughtherearesomesimilaritiesbetweenthem.

Recruitment

NMS has an established organisational structure, which specifies all positions within eachdepartment.Everyjobrolemusthaveaminimumoffivekeyaccountabilities,keyresearchareas,andqualificationsrequiredtoperformeachjob.

When a position becomes vacant, the head of the respective department notifies the HRdepartmentbysubmittinga jobrequisition form.TheHRdepartment thenplacesan internaladvert to first try and find a suitable candidate internally. If theHRdepartment can identifypotential candidates, it will initiate the application and shortlisting process. The shortlist isapproved by the topmanagement of the organisation and the candidates are invited for aninterview. If the HR department is unable to establish qualifying internal candidates, topmanagement recommends that thepositionbe advertised externally.The adverts areusuallyplacedontheNMSwebsiteandsocialmedia,aswellasinnationalprintmedia,andareexpectedtorunforaminimumofsevendays.

ApplicationsaresenttoNMSbycourieroronline.TheHRdepartmentcollatestheseandsubmitsarequesttothetopmanagementtoappointashortlistingcommittee.Thetaskofthecommitteeis to go through all the applications and check themagainst the specific requirementsof thevacant job, i.e. qualifications, experiences, and desired competencies. Once the shortlisting iscompleted,thelistispresentedtothetopmanagementagainforapproval.

Thenextstepdependsontheoverallnumberofapplicantsandvacancies.NMSeitherconductsoralinterviewswithshortlistedcandidatesorrequirescandidatestotakeanaptitudetestoratechnicaltest.TestsareoftenconductedwhenNMSreceivesmanyapplications.Ifthenumberofcandidatesislow,thenNMSproceedsstraighttointerviews.However,certaintechnicalpositionsrequire amandatoryprofessional test to establish the competence level of the candidate. Forexample,whenselectingacoldchaintechnician,NMSchecksthecandidate’sknowledgeofthecoldchainandessentialtechnicalskills.

Toconduct interviews, the topmanagementappointsaninterviewcommittee thatselects thebestcandidateforthejob,whoislaterapprovedandappointedbythetopmanagement.

Interviewsandappointmentsaredifferentdependingonthelevelofthejobvacancy.CandidatesforthepositionsofCEOandBoardSecretary(whoalsodoublesasDeputyCEO)areappointedbytheMinisterofHealth.NMS’seightheadsofdepartmentsareinterviewedandappointedbythefullBoardofDirectors.Themiddlemanagement(e.g.theheadoftransportandlogisticsoranHRofficer)andoperationalteamsareinterviewedbyacommitteeconsistingoftopmanagement,whichincludesheadsofrelevantdepartments(suchasStoresandOperations,HR,Procurement,Quality Control, Internal Audit, ICT, etc.). All other technical personnel (e.g. engineers,pharmacists,etc.)areinterviewedbyheadsofdepartments.

Thekey informant forNMSstatedthat intheprocessofselectingcandidatestheorganisationplacesmostemphasisontheirbehaviouralassessmentandabilitytofitwellwiththerestoftheteam.Experience is an importantpart of the assessment, butNMS currentlydoesnothave aspecialscoreforexperienceoreducation.NMStakesallaspectsintoaccountduringselection,though it identifies theperson’scharacteras themost important. Incertaincases,to increasegenderparity,thecommitteeconsidersgivingpreferencetoafemalecandidate.

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Careerprogression

Everyemployeesignsafour-yearfixed-termcontract,whichisrenewableafterthetermperiod.Once a vacancyopens, individuals can apply for it and, if qualified, be appointed to that role.Beforetakingupanewrole,theemployeemustresignfromtheirpreviouspost.

Previously,NMS’sorganisationalstructurewasnarrow,anditwasnotpossibleforemployeestoconsidercareerprogressionwithinthissystem.NMShassincetriedtoexpanditsstructureandnowoffersvariouslevelsthroughwhichemployeescannavigatevariouscareerpathsandfindinternal opportunities. Whilst NMS does not have a traditional career ladder approach, theorganisationdoesnotimposerestrictionsonstaff.Ifanopportunityarisesandanemployeefeelsthattheyhavethenecessaryexperienceandqualifications,theycanapply.

The respondent from NMS noted that conventional career ladders lock people in, forcingemployees togo throughseveral intermediarysteps toprogress to thenext levelorposition.However,atNMSanassistantwarehouseofficerwiththenecessaryskillsandqualificationscanapplyforaseniorwarehouseofficerpositionwithoutneedingtoserveinintermediarypositionsforseveralyears.Therespondentnotedthatthisapproachisflexibleandlessrestrictive,asitdoesnottieindividualstoapath.Ifacareeropportunityarises,andthecandidatedemonstratesallthenecessaryqualificationsandskills,theycanapply,evenifthevacancyisnotwithinthecandidate’spathway.NMSthereforehasmanyemployeeswhocrossdepartments:forexample,moving from stores and operations,where theywere performing stock control, to becomingsenior procurement officers. This approach also supports skills transfer: that same personmovingfromstockcontroltoprocurementwillbeawareoftheentirevaluechainintermsofprocurementandlogisticsmanagement,astheyhavebeenatthereceivingendofthestockandnowcanbringthisexperiencetocontractinitiationandprocurementmanagement.Inthisway,thisapproachhelpsstafftobenefitfromawiderangeofexperiences.


TNA

NMS conducts TNA annually at the individual, departmental, and organisational level. Thetrainingneeds of employees are identified from performance appraisals reports, and the topmanagementprioritisestrainingneedsfortheentireorganisation.Eachperformanceappraisalformcontainsadevelopmentneeds section,where an employee is expected to indicate theirindividualdevelopmentneeds.Oncethosetraininganddevelopmentneedsareestablished,theHRdepartmentconsolidatesthemintoonegeneralannualneedsassessment.

Trainingandlearning/capacitybuildinganddevelopment

Incertaincases,NMSreliesonitsownresourcestoconducttraining.Forexample, ifgapsareidentifiedintheITcompetenciesofitsemployees,theICTdepartmentwillcomeupwithaplanto help rectify those issues. However, NMS’s training programmes are mostly facilitated byexternalorganisations.

ThetrainingcoursesthemselvesmaytakeplaceatNMSfacilities,runbyexternaltrainers,thoughNMS also selects employees to attend trainings, seminars, and conferences outside theorganisation and abroad. NMS does not have contracted partnerships with these externalorganisationsbutinvitesemployeestoattendwhentheyfindasuitabletrainingprogramme.

NMSencourages the long-termprofessionaldevelopmentof itsemployees.Forexample, ifanemployeeisamemberofaprofessionalbody,NMSwillcoverthecostoftheannualsubscription.Every employee is entitled to join two professional bodies and NMSwill pay for up to twomembershipsubscriptionseveryyear,ifthemembershipisrelevanttotheemployee’srole.NMS

54

encourages staff to attend training programmes and courses, andpays for CPD, such as CPDworkshops,whichitfacilitatesandsponsors.

In certain circumstances, NMS also covers the cost of acquiring a new qualification, if it isnecessary for theemployee’sperformance inthecurrentrole. Itspreference,however, is thatemployeestakelong-distanceorpart-timecoursesthatdonotaffecttheirdailyworkanddonotrequire taking a long leave to complete the course. NMS can grant leave if the employee isscheduledtositanexambutcannotofferlongleavesofabsence.


Creatingastrongorganisationalculture

ThekeyinformantforNMSemphasisedthattheorganisationseekstocommunicateandinstiltheorganisationalcultureinemployeesrightfromtheinductionperiod.NMSaimstocreateanon-discriminatoryandsafeenvironmentthatisconducivetowork,forallstaff.

NMS has its own specific HRmanual – theNationalMedical StoresHumanResourceManual,which explains theduties and responsibilities of every employee, andorganisational rulesofconduct.OtherstepsNMStakestocreateagoodoverallworkenvironmentincludethefollowing:

• Providingeveryemployeewith thenecessaryrequirements for themtodotheirwork(e.g. mobile airtime credit, internet access). Staff in client-facing roles have a smallentertainmentallowanceformeetingwithkeyclients.NMSalsoprovidesafuelallowancetomembersofthemiddlemanagement.

• Providingmealsintheworkplace.NMSoffersbreakfastandlunch,andprovidesdinnerfor staffworking anight shift (this is not a common practice among organisations inUganda).

• Providingtransportationforstaff(e.g.staffbus).

Useofpolicies

PoliciesNMSemploysincludethefollowing:

• Policiestostopdiscriminationbasedongenderandotherfactors;• Adisciplinarycodeandprocedure,availableintheorganisation’sHRmanual;• An HIV and other chronic diseases workplace policy. This protectsindividualswith

medicalconditions;• Healthandsafetypolicies–toprotectindividualsfrominjuryandharm;• Sexualharassmentpolicy–toprotectcolleaguesfromsexualharassment;• ACodeofConduct,asanannextotheHRmanual,whicheveryemployeemustreadand

sign;• NMSfollowsthenationalpolicyof theAnti-CorruptionAct.Corruptionisalsocovered

undertheDisciplinaryCode;• Afraudpolicyandriskmanagement;• Legaland regulatory compliance to ensurebehaviours andpracticesare conducted in

accordancewithnationalandlocallaws.

Tohelpraiseawarenessofthepolicies,employees’inductionincludesacomprehensivereviewof HR policies. NMS also regularly conducts staff sensitisation and continuously reviewsorganisationalpolicies.

NMScreateditsowntrainingdivisioninJuly2020andiscurrentlydesigningaprogrammeofmodulesrelatingtoitsdifferentpolicies,involvingstaffstudyingorreadingthepoliciesandthen

55

answeringquestionsonthepoliciestoearnpoints.Staffcanthenaccessrewardsviathesepoints(e.g.toreceiveapromotionorbeassignedaseniorrole,staffmustfirstearnacertainnumberofpoints,whichcanonlybeachievedbyattemptingspecificmodules).Modulescanfocusontopicssuchasleadership,NMS’spolicies(e.g.fraudpolicy,financialmanagementetc.),innovationetc.


NMS’s recruitment policy and HR policy emphasise non-discrimination based on anycharacteristic. The organisation has a very clear policy regarding attracting,maintaining,andmotivatinganequalworkforcethatalwaysmeetsthecorporategoalsofbusinessneeds.

Creatingasafeworkenvironment

NMShasfocusedoncreatingasafeworkenvironmentbyintroducingthefollowingmeasuresandpolicies.NMShasaspecificsectionwhoseroleistoensurethatemployeesareprovidedwiththenecessaryprotectiveequipment(includingsafetyshoes,overalls,andhelmets)andworkinasafeenvironment(e.g.preventingexposuretohighlevelsofnoise).

NMSprovidesnecessary and relevant insurance cover to staffat theworkplace andprovideshealthandsafetytraining.Relatingtofiresafety,NMSinstalledfirealarms,markedfireassemblypoints,andorganisedfiresafetytraining.

NMSalsoprovideswelfarepackagesthroughmedicalinsurancecoverforstaff,theirspouses,anduptofouroftheirchildren.


NMShasariskmanagementpolicy,whichcomesunderitsriskmanagementprocedures.Thispolicyemphasisesthatanymeansofwhistleblowingisacceptable,andthepolicyhighlightsthatthe anonymity and identity of whistleblowers should be protected. The policy outlines howinformationreceivedshouldbeinvestigatedandtreatedwithconfidentiality.Ifaculpritisfound,itdetailshowtheyaremanaged.


Performancemanagementandengagementpractices

Employee motivation is primarily achieved by highlighting KPIs and maintaining clarityregarding roles at NMS. This is reviewed every six months to ensure the staff have a clearunderstandingofindividualtargets.Motivationisalsolinkedtoopportunitiestoinnovateandtostaffparticipationinthedecision-makingprocess.Othermeasurestoenhancemotivationincludea robust reward systemand competitive salarypackages (NMS’s salaries are consistentwithmarket rates), safe work environment, policies against discrimination, welfare packages(including insurance, familymedical benefits),meals at theworkplace (e.g. lunch and dinnerdependingontheworkshifts),andastrongcompanybranding.Incentivepolicy

AllNMSstaffarepaidanattractivesalarythatisconsistentwiththemarketrate.Incentivesalsoincludeentertainmentallowancesforclient-facingjobroles,fuelallowancesforstaffatmid-levelandfortop-levelmanagement,transportfacilitiesforemployees(staffbus),etc.Anannualleaveallowanceanda25%gratuityisofferedtoNMSstaff.

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Performanceappraisal

NMSconductsannualperformanceappraisalsforthetopandmiddlemanagementandbi-annualappraisals for the lower-level staff (officersandassistants)during July(review for January toJune)andJanuary(reviewforJulytoDecember).Promotion

NMSdoesnotconductpromotions.Everyemployeereceivesa four-yearcontract. Initially,allvacantpositionsareadvertisedinternally,andNMStriestofillthemthroughexistingcandidates.If the internalcandidatesfulfilalltheperformance-basedeligibilitycriteria, theyareofferedafreshcontract,whichisregardedasnewrecruitmentandnotapromotion.Supervisorysupport

NMSencouragesinter-departmentcoachingandmentoringofemployees,especiallyforjunior-levelstaffwhoaresupportedthroughageneralinductionandattachedtoaseniorstaffmemberresponsibleforconductingmentoringactivities.Disciplinarypolicyandpractice

Thedisciplinarycodeguidesalldisciplinarycasesandadisciplinaryprocedureisalsofollowed,asstipulatedintheHRmanual.Staffsatisfactionsurvey

NMShasnotconductedastaffsatisfactionsurveyinthepastbutthereareplanstoconductsuchasurveythisyear,withtheinvolvementofinternalandexternalstakeholders.

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5. Conclusion

5.1 Pathway1.Staffing

Successful recruitment of the health supply chain workforce depends on how closely thecompetencies of the recruited individuals match the requirements of crucial supply chainpositions. Job descriptions, developed based on a competency framework, have become acommonbestpractice,asdemonstratedby75%ofthesurveyrespondentsandtwooutofthesixcasestudyparastatalhealthsupplychainorganisationsinSub-SaharanAfrica.Bestrecruitmentpracticesapplya flexiblestep-by-stepapproach toensurea fair, transparent,andcompetitiveselectionprocess.Thestudyexaminedvariousmechanismsemployedbyorganisations in thefocus countries to conduct planning, advertise supply chain positions, and manage jobapplications,aswell assessing candidates’ competencies andpastperformance throughpanelinterviewsandtechnicaltests.Thesix-casestudyparastatalsupplychainorganisationsconductinternal or external recruitment (or both), in some cases outsourcing the hiring of topmanagementpositionstoprofessionalservicesfirms.Assessmentofrelevanteducationandthelengthoffieldexperience,ratherthantechnicalexpertise,wasreportedasthecrucialcomponentofrecruitmentprocessby42%oftherespondents,whileperformanceduringinterviewwasseenasadecisivefactorinhiringacandidateby35%ofsurveyrespondents.Similarly,inmostofthesixcasestudyparastatalorganisationsqualificationandthe lengthofprofessionalexperienceplayapivotalroleintheselectionprocess,andmostoftheorganisationsconductwrittenororaltechnicaltestsaspartofrecruitment.

Effective employee compensation is instrumental for attracting and retaining employees;therefore,awell-designedsalarystructureisconsideredimperativeforeffectivelymanagingandrewarding the performance of supply chain personnel. Most survey respondents (59%)acknowledgedthattheirorganisationslackbenchmarkedsalaryrangesand69%ofrespondentsindicatedthatsalarymarketanalysisisnotconductedintheirorganisations.Someofthehealthsupplychainorganisationsexaminedinthecasestudiesreferredtolimitationsintheirabilitytooffer competitive salaries and benefits, due to constraints imposed by state regulations onsalariesandremuneration.

5.2 Pathway2.Skills

Adequate technical, managerial, and leadership skills are essential for effective employeeperformance. TNA aims to identify knowledge and skills gaps depending on requiredcompetenciesandthetrainingobjectives,bothorganisationalandindividual.Ithelpsemployeestobridgethosegapsandensurethattheirperformancecomplieswiththebusinessneedsoftheorganisation.AlthoughTNAiscommonlyperceivedasanintegralpartofHRdevelopmentandtransformation,50%of survey respondents indicated that their organisationsdonot conducttrainingassessment,and35%ofrespondentshighlightedthatTNAintheirorganisationsdoesnot lead to the development of a training strategy or plan. The study emphasised that bestpracticesinthesurveyedorganisationsaimedatsupportingCPDofsupplychainspecialistsaretailoredtoaddressspecificskillsneedsthroughtrainingandleaning,providecertificationsandencourageobtaininghigherdegrees,andsupportmembershipsinprofessionalassociations.

Professionalisation of SCM specialists, although a new area of HR development, is gainingincreasingattentionfromhealthsupplychainorganisationsinAfrica.Itstaskistoprepareand

58

supporthighlycompetentmanagersandpractitionersthroughtrainingandcareermanagementbyestablishingglobalstandardsforhealthSCMjobfunctions,skillsneedsanalysis,harmonisedlearningcurricula,andaccreditationofsupplychainworkers.

Communitiesofpracticepromote theprofessionalisationofsupplychainworkers indifferentareas,creatingashareddomainforlearning,networking,andthesharingofideas,methodsandexperiences.Thesurveyrespondents indicated thatacommunityofpracticecan takevariousforms, such as on-the-job training,moderateddiscussions,webinars andworkshops, etc.Thestudyfoundthatsupportingcommunitiesofpracticeisconsideredasanimportantstimulusforcontinuousprofessionalandleadershipdevelopmentofemployees.

5.3 Pathway3.Workingconditions

Organisational culture is a key part of creating a supportive work environment. The studyidentifiedseveralkeypolicyareastosupportorganisationalculture,encompassinghealthandsafety policies, anti-harassment policies, creating a good environment for women, codes ofconduct,andequalopportunities.Allsixcasestudyparastatalorganisationsstatedthattheyhavea code of conduct in place. Regarding overall organisational culture, one KII respondentemphasised the importanceof changing the cultureby first ensuring there is agoodphysicalenvironment.Ways of creating a good physical environment for staff include creating sportsteams,ensuringacleanenvironment,andprovidingsubsidisedmealsataworkplacecanteen.

Some of the six-case study parastatal health supply chain organisations promote women orminority groups through specific groups or departments (e.g. a Gender MainstreamingCommittee and a Disability Mainstreaming Committee at KEMSA, and a Gender and YouthDirectorate atEPSA).OtherproceduresmentionedbyKIIs includeusing affirmative action ineitherrecruitmentorpromotion,havingaclearpolicyonattractingandmaintaininganequalworkforce,andexaminingdisaggregateddataonthegendersplitatdifferentlevels.

Having an overarching code of conduct or ethics in place was the most common policyinterventionlistedbysurveyrespondents(63%haveoneinplace),andthesewerealsofoundtobeinplaceatallofthesixcasestudyparastatalorganisations.OtherpoliciesmentionedinKIIscovered a range of areas: anti-corruption, anti-fraud, anti-discrimination, HIV and chronicdiseases,sexualharassment,andhealthandsafety.Policiesalonearenotsufficienttoimproveworking conditions: policies should be regularly reviewed, and steps taken to ensureimplementation. KIIs mentioned how their organisations sensitise employees on, anddisseminate,theirpoliciesbymeansofconsultation,regularreviews,printingouthardcopies,anduploadingsoftcopiestotheintranet.NMSinUgandaisalsointheprocessofdesigningonlinemodulescoveringitspolicies.

The study also examined theuseofwhistleblowers to create a goodworking environment, amechanismthatwasreportedtobeinplaceby41%ofsurveyrespondents.FouroutofthesixKIIsalsostatedtheyhaveawhistleblowingpolicymechanism.Keypracticesidentifiedfromthesurvey respondents and the KIIs in creating a whistleblowing policy mechanism include anindependentlymanaged anonymous hotline and the use of specific email systems to ensureanonymity.

EffectiveOSH,encompassingpsychosocialthreatsandgender-basedviolence,aswellasphysicalharm, isan importantpartof increasingworkermotivationand theoverallenvironment.Thestudy identified six key policy areas or interventions that support OSH, including budgeting,checkliststoensurecompliance,riskassessments,andoverallpoliciesandproceduresinplace.Themostimplementedinterventionreportedbysurveyrespondentswastheimprovementofthe

59

workplace conditionsandproviding staffwith thenecessary toolsandequipment toperformtheirjobs(81%).Otherimportantareasmentionedbykeyinformantsincludedcarryingouttests(e.g.lightingconditions,airquality),providingmedicalcoverandfreehealthchecks,registeringnear incidents,andprovidingprotectiveequipment tostaff.Multipleorganisationsmentionedthattheycomplywithnational-levelhealthandsafetylegislation.

5.4 Pathway4.Motivation

MotivatingthehealthSupplyChainworkforceiskeytoimprovingperformanceandcommitment.Thestudyconcludedthateverycountryhas identified itsuniquecombinationof intrinsicandextrinsicmotivators.Forexample,performancemanagementissupportedusingKPIsatEPSA,KEMSA,andNMSF.MSDuses its internalappraisalsystem,calledDRIVE,whileNMSseeks tomotivateemployeesthroughchangestotheworkenvironmentandorganisationalculture.

A range of performance incentives andwork benefits are utilised across the six case studyparastatalorganisationstoenhancethemotivationofstaff.ThisincludesrewardingemployeeperformancewitharecognitionletterandadinnerwiththeCEOatKEMSA;providinghardshipallowances, honoraria, and transport allowances at MSD; and providing an entertainmentallowance for client-facing job roles, fuel allowances for middle and top management, andtransportforstaffatNMS.

Performance appraisals are central to motivation across the six case study parastatalorganisations. These are conducted annually or bi-annually, using either the BSC tool or 90-degreeor180-degreeappraisalmethods.

Promotionsalsoemergeasanimportantmechanismofemployeemotivation.TheyareguidedbytheCareerProgressionPlanatKEMSA,theConditionofServicehandbookatCMST,andtheCivilServiceChamberatNMSF.MSDfollowsacompetence-basedpromotionsystem,whereasNMSdoesnotexercisepromotionsatall, instead invitingemployees toapply foravailable internalpositionsatvariouslevelsaftertheexpirationoftheirfixed-termfour-yearcontract.Thestudyrevealed thatmentoring, coaching, andsupervision activitiesareoften limited at the six casestudyorganisations. Someof theorganisations are lacking SOPs formentoring and coaching,others encourage staff to seek mentoring opportunities outside their organisation throughparticipationinworkshopsandseminars.

Thestudyidentifiedavarietyoftoolsthatareusedtoimproveemployeeengagementandstaffretention.Afewofthesixcasestudyorganisationshavedevelopedstructuredretentionschemesandpolicies(e.g.KEMSA’sTalentManagementManual),whileothersresorttovariousmonetaryand non-monetary incentives, work benefits, and organisational changes. These range fromprivatehealth insuranceand freehealthchecks, tovariousallowances, subsidisedmeals, stafftransportation,andtradeunionsupport.

Disciplinaryproceduresandrulesarewelldocumentedacrossthesix-casestudyorganisationsandareregulatedbyeitherdisciplinarypolicies,codesofconduct,orgovernmentalregulationsand acts. Staff satisfaction surveys are conducted annually or biennially in all the case studyparastatalorganisations,exceptforNMS.Thelatterhasnotconductedsuchasurveyinthepastbut plans to introduce one in 2020, and to extend participation to internal and externalstakeholders.

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Appendix1.Comparativetables(casestudies)

ThefollowingfourcomparativetablessummariseHRMpracticesatthesixcasesstudyparastatalorganisations.

A.1Pathway1.Staffing

Sub-themeKEMSA,

Kenya

NMSF,

Sudan

NMS,

Uganda

EPSA,

Ethiopia

MSD,

Tanzania

CMST,

Malawi

Recruitmentprocess

Has12jobgrades.

Recruitmentfortop

managerial

positions(Grades1–

3)isoutsourced,but

candidatesare

interviewedbythe

KEMSABoardof

Members.

Recruitmentfor

Grades4–12is

conductedin-house.

Advertisingisboth

internaland

external(depending

ontheposition).

Interviewpanelis

appointedbyCEO.

Dependingonthe

levelofthejob,the

panelmayinclude

CEO;HRmanager;a

technicalspecialist

intherelevantarea;

Has16jobscales:

Skilledemployees

(Scales1–9)and

unskilledlabour

(Scales10–16).

Candidatesfor

positionsinScales

1–5selectedbythe

specialRecruiting

Committee,

approvedbythe

Boardof

Administrationand

appointedbythe

CouncilofMinisters.

Candidatesfor

positionsinScales

6–9arerecruitedby

theNationalCivil

ServiceCommission.

Candidatesforjobs

inScales10–16are

recruitedbyNMSF.

Vacanciesarefirst

advertised

internally,according

todepartmentaljob

requisitionforms.

TheHRdepartment

conductsthe

applicationand

shortlistingprocess.

Shortlistsapproved

bythetop

managementbefore

candidatesare

invitedfor

interview.

Ifpositionscannot

befilledinternally,

HRdepartment

initiatesexternal

recruitment.

Advertsareplaced

ontheNMSwebsite,

socialmedia,andin

thenationalprint

mediafora

Vacancies

advertisedin

government

newspaperand

postedonEPSA

noticeboards.

Accordingtothe

CivilService

Commission

guideline,priorityin

fillingvacanciesis

giventotheexisting

workforce.Onlyin

theabsenceofa

suitableinternal

candidateisthejob

advertised

externally.

Writtentest(taken

atAddisAbaba

University)

precedesthe

interview,whichis

Employment

requestsare

submittedbyMSD

departmentstothe

HRviajob

requisitionforms.

Beforeinitiating

recruitment,theHR

explores

opportunitiesfor

staffre-

categorisation.If

not,allvacancies

canbefilledby

recategorisedstaff,

theHRadvertises

positionsexternally.

Accordingtothe

PublicServiceAct

(2016),theMSD

recruitment

campaignis

conductedthrough

thePublicService

11jobgrades,

rangingfrom

leadingmanagerial

positions(Grades1–

4)tomiddleand

lower-leveljobs

(Grade11).

Recruitmentis

regulatedbythe

Termsand

Conditionsof

Servicehandbook.

Certainjunior

positionsadvertised

internally.Other

positions,from

officerleveland

above,are

advertisedboth

internallyand

externally.

Recruiting

committeedrafts

61

headorassistant

headofthe

department.

minimumofseven

days.

Shortlisting

committeeis

organisedbytheHR

departmentand

approvedbythetop

management.

NMSconducts

aptitudetestsor

technicaltests

dependingonthe

natureofthejoband

thevolumeof

applications.

Separateinterview

committeesare

organisedfor

differentlevelsof

jobposition.

thecrucialphaseof

recruitment.

Recruitment

Secretariat.

TheMSDHR

department

performschecks

andshortlisting,

conductsinterviews

andmakesjob

offers.

Aninterviewmatrix

isemployed

(includingtechnical

questionnaire,

sectionsonrequired

competencies,

qualifications,and

jobfitness).

Assessmenttests

areconductedfor

technicaland

supporting

positions.

Professional

assessmentof

candidatesfortop

managerialrolesis

outsourcedtoa

recruitment

company.

interviewquestions

andpreparesacase

studytasktobe

completedby

candidatesin

advanceand

presentedaspartof

theirassessment.

Job descriptions Basedona

competency

framework;include

clearlydefinedand

Basedon

competency

frameworkand

developedbyPtD.

Developed

accordingtotheJob

DescriptionManual.

DevelopedbyCivil

ServiceCommission,

notbasedona

competency

Basedonthe

competency

framework

developedby

Jobdescriptionsdo

notfollowa

competency

framework,but

62

detailedobjectives,

essential

professional

qualificationsand

competency

requirements.

Developedin

assistancewiththe

StateCorporation

Advisory

Committee.

Includeclear

objectives,

responsibilities,

qualifications,skills,

andexperience

requirements.

Noseparate

competency

framework

available.

Draftedwiththe

assistanceofa

consultantandin

collaborationwith

headsof

departments.

Containclearjob

objectives,

responsibilities,and

essential

professional

qualifications.

Approvedbythe

Boardofthe

organisationand

regularlyupdated.

framework,and

alignedwithother

civilservice

organisationsinthe

country.

Accenturewith

supportfromBMGF.

Thecrucialsupply

chainpositionswere

reviewed,andjob

descriptionsrevised

andexpanded

followingthe

framework.

includejob

objectives,essential

skills,qualifications,

andresponsibilities.

Payscaleandsalaries

Guidedbystate

regulationson

salariesand

remuneration.Nine-

bandpaystructure

foreachjobfamily.

KEMSAconducts

salarymarket

analysisandcan

negotiatesalaries

withspecialistsin

highdemand.

Clearpay

benchmarking

linkedtosupply

chaincareersat

NMSFandthejob

gradingsystem.

Payandgrading

scalesareclearand

tendtobealigned

withsupplychain

careersand

consistentwith

marketrates.

Salariesaredefined

bytheCivilService

Commission

accordingtojob

gradesandfollow

thepayscales

establishedfor

institutionsunder

theauspicesofthe

MinistryofHealth.

Salarymarket

analysisisnot

conducted.

Clearsalary

benchmarking

linkedtosupply

chaincareers.Salary

marketanalysisis

alsoconducted.

Structured

accordingtojob

grades,includes

salaryincrements.

63

A.2Pathway2.Skills

Sub-themeKEMSA,

Kenya

NMSF,

Sudan

NMS,

Uganda

EPSA,

Ethiopia

MSD,

Tanzania

CMST,

Malawi

TNA,andtrainingstrategyandplanning

TNAisconducted

annually,informed

byperformance

appraisals.

Trainingrequests

aresubmittedto

theTraining

Committee,which

plansthetraining

calendar.

Mandatory

leadershiptraining

ingovernment

school(forGrades

1and2roles).

Special

professional

trainingfor

technical

personnelto

obtainpractising

certificateata

relevant

professional

body/institute.

Alltrainingis

outsourced.

TNAisconducted

annually.Training

followsa

comprehensive

trainingstrategy

andplan.Training

usuallyconductedat

departmentallevel.

Varioustraining

coursesandCPD

programmes

providedatNMSF

andthededicated

trainingcentre(esp.

forpharmacists).

TNAisconducted

annuallyand

informedby

performance

appraisalreports.

Trainingismostly

outsourcedto

external

organisationsor

conductedin-house

byexternaltrainers.

TNAhasbeen

conductedatthe

organisational,

departmental,and

individuallevel

(supportedbyPSA).

Trainingstrategy

andplanningare

beingdeveloped.

TNAisconducted

annually,informed

byperformance

appraisals.

MSDhasdeveloped

itsownappraisal

system(DRIVE).

TheHRdepartment

reviewstraining

needsrequestsand

draftsatraining

plan,dependingon

employee

performanceand

organisational

needs.

MSDconductsa

mixtureofin-house

andoutsourced

training,and

partnerswith

variousinstitutions

(e.g.PSPTB).

TNAisconductedas

partofperformance

appraisalsystem.

TheHRdepartment

consolidates

trainingrequests,

draftstheannual

trainingplan,

definesthebudget

(currentlyquite

limited).CMSTis

currentlyplanning

thestaff

developmentand

trainingstrategyfor

financialyear

2020/25(aspartof

theNationalSupply

ChainIntegration

Project).

64

Professionalisation,mentoring,supervision,on-the-jobtraining

Coaching,

mentoring,andon-

the-jobtraining.

Mentorshipand

supervision

decisionsaremade

jointlybetween

headsof

department,

supervisors,and

employees.

NMSFencourages

networkingwith

professionals(incl.

SudanPharmacist

Union),performing

researchrelatedto

medicalsupply

chain,trainingand

educating

individualsatother

organisations,and

developinganethic

ofcontinuous

professional

improvement.

NMSencourages

stafftojoinrelevant

professional

associations,covers

incurred

membershipand

subscriptionfees.

NMSFsupportsstaff

intakingpart-time

qualificationcourses

bycoveringthefees.

MeasuresforCPD,

workshops,on-the-

jobtraining,self-

sponsoring,and

countysponsorship

fortraining.

PSAissupporting

EPSAinestablishing

thededicated

Trainingand

ResourceCentreto

conductalltraining

andCPDactivities

in-house.

Supportsstaff

membershipof

professionalbodies

andcovers

associatedcosts.

Mentorshipisnot

yetrobust:thereisa

smallpoolofon-the-

jobmentorsandthe

HRorganises

variousmentoring

activities.

Conductssomeon-

the-jobtraining.

Technicaltrainingis

outsourcedto

externalinstitutions

andprofessional

bodies.CMST

followstraining

calendarofthese

institutionstodraft

itstrainingplan.

A.3Pathway3.Workenvironment

Sub-themeKEMSA,

Kenya

NMSF,

Sudan

NMS,

Uganda

EPSA,

Ethiopia

MSD,

Tanzania

CMST,

Malawi

Overallorganisationalculture

Astrong

organisational

culturethat

promotesexcellence

andchange.

Staffsignaconflict

ofinterestformand

supplierssignan

agreement thattheycommittolegaland

ethicalpractice.

NMSFhaschanged

organisational

culturebyfirst

upgradingphysical

workenvironment

(e.g.installingnew

desks,computers,

emailsystems,high-

speedinternet,etc.).

NMSFhastaken

stepstoimprove

employeewelfare

(e.g.transportation

towork,private

medicalinsurance).

Organisational

cultureis

communicatedto

employeesduring

theinduction

process.

NMShasaHR

manualexplaining

employeeconduct.

Providesworkplace

meals,staff

transport,fuel

allowancefor

middle

EPSAhas

establishedaSupply

AgencyEthicsUnit

inaccordancewith

theRegulationsof

theCouncilof

MinistersRegulation

144/2000.

EPSAisintroducing

apoolofcultural

ambassadors

(followingthe

AdmasProgramme

organisational

culturediagnostic).

MSDusesaKPIto

ensurework

environmentis

conduciveto

improvedHR

planningand

management.

Termsand

Conditionsof

Servicearethe

primaryframework

increatingagood

workenvironment

(currentlyatfinal

stageofbeing

updated).

65

Othermeasures

includedeveloping

staffrecreational

area,buildinga

cafeteria,mini-

market,cashpoint,

AdoptedaCodeof

Conductand

providestrainingon

howtomaintaina

cleanandsafe

working

environment.

management,

mobileairtime

credit,smallclient

entertainment

budget(if

applicable).

Policiestopromotewomenormembersofminoritygroups

Gender

Mainstreaming

Committeeensures

thatinterestsand

concernsofboth

womenandmenare

notcompromised.

Examinesgender

ratiointhe

workplaceat

differentlevels.

Disability

Mainstreaming

Committeefocuses

onsupportingstaff

livingwith

disabilities.

Supportsminority

groupsin

procurement.

RecruitmentandHR

policiesemphasise

non-discrimination

basedonany

characteristic.

Clearpolicyon

attracting,

maintaining,and

motivatingequal

opportunities

workforce.

EPSAhasaGender

andYouth

Directorateand

followsaffirmative

actionin

recruitment,

training,andother

similaractivities.

Hasananti-

harassmentpolicy.

Encourages

recruitmentof

peoplewith

disabilitiesandhas

practised

affirmativeactionin

recruitment.

66

Policiesthatpromoteorganisationalculture

KEMSAhasaCode

ofEthics,signedby

newstaff.

Newpoliciesare

sharedatameeting,

onKEMSA’s

intranet,andinhard

copies.Mostpolicies

arereviewedevery

twoyears.

CodeofConduct

(appliedfollowinga

jointdiscussion

involvingall

employees).

Extensivecorpusof

policiesincluding:

• Anti-corruptionpolicies;

• Anti-fraudpolicies;

• Emailpolicy;

• Goodgovernanceformedicines.

NationalMedical

StoresHuman

ResourceManual.

Policiestostop

discrimination

basedongenderand

otherfactors.

HIVandother

chronicdiseases

workplacepolicy.

CodeofConduct

(everyemployee

mustreadandsign).

Fraudpolicyand

riskmanagement.

Sexualharassment

policy.

Healthandsafety

policies.

Followsnational

Anti-CorruptionAct.

Continuously

reviewspolicies,

conductsregular

staffsensitisation.

NMSinprocessof

creatingonline

modulesdedicated

toorganisational

EPSAhasarecently

updatedCodeof

Conduct,which

includes

informationon

healthandsafety,

anti-harassment,

andanti-

discrimination.

Anti-harassment

policy.

CodeofConduct.

HIVworkplace

policy.

Fraudand

Corruption

PreventionPolicy.

CodeofConduct

(outlinescore

values,vision,and

mission).

Policiesdeveloped

byaconsultative

process,andonce

finalisedstaffhave

opportunitiesto

raisequestions.

Copyofeachpolicy

isgiventostaff.

67

policies(andother

topics).

OSH(includingpoliciesandprocedures)

DirectorateofOSH

helpstoimplement

policies.Directorate

ofOSHcarriesout

tests(e.g.air

sampling.assessing

lightingquality,

sufficientminimum

workspace)and

provides

recommendations.

Providesmedical

covertostaff,

annualfreemedical

examinations,anda

familyfunday,

whichincludes

healthtesting.

Carriesoutannual

auditsandregisters

nearincidents,

ensurestheuseof

PPE.

Insuresstaffagainst

workplaceinjuries.

OSHregulations.

First-aidkits.

Healthandsafety

policy.

Specificsectionto

ensureemployees

areprovidedwith

necessaryPPEand

haveasafework

environment.

NMSprovidessafety

weartostaff,

includingshoes,

overalls,and

helmets.

Healthandsafety

training,firesafety

proceduresforthe

workplace.

Medicalinsurance

coverforstaff,their

spouses,andupto

fourchildren.

OSHSOPs.

Ensurescompliance

withstandards,

governedbythe

OccupationalSafety

andHealth

Authority.

ThisincludesPPE

forstaffworkingin

coldvaccinestores,

transportationfor

staffworkingnight

shifts,mobile

airtimecredit,etc.

Conductsquarterly

medicaltests(prior

toCOVID-19),

hepatitisvaccine,

andawareness

campaigns(e.g.

encourages

employeestotake

HIVtests).

FollowsLabourAct

forHealthand

Safety.

Conductshealthand

safetytrainingsand

firesafetydrills.

Ensuresthereisa

cleanenvironment

andstaffuse

protective

equipment(e.g.

warehouseworkers,

cleaningteam,

securityteam,etc.).

Detailsofwhistleblowingmechanism(ifapplicable)

Specialcommission

protects

whistleblowers’

identity.

Themechanism

ensures

whistleblower

anonymity.

Themechanism

emphasisesthatany

formof

whistleblowingis

acceptableand

anonymityof

whistleblowers

shouldbeprotected.

Thereisno

mechanism

currentlyinplace,

butplanstocreate

one.

Themechanism

ensuresanonymity

andisoutsourcedto

Deloitte.

68

A.4Pathway4.Motivation

Sub-theme KEMSA,

Kenya

NMSF,

Sudan

NMS,

Uganda

CMST,

Malawi

MSD,

Tanzania

EPSA,

Ethiopia

Performancemanagementpolices

KPIsstrengthenthe

performance

management

processand

improvestaff

motivation.KEMSA

staffareencouraged

byfosteringasense

ofbelonging.

KPIstosupportstaff

performance

managementand

theunderstanding

ofindividualtasks

andorganisational

goals.

KPIsreviewedevery

sixmonthsto

ensurestaffhave

clearunderstanding

ofindividualtargets.

CMSTuses

theBSCtomanage

performanceof

Boardmembers.

Therestofthestaff

areassessedby

different

performance

managementtools,

developedby

consultants.

MSDusesitsown

internalappraisal

systemcalled

DRIVE,basedon

agreedperformance

objectives

submittedtotheHR

annuallyinMay–

June.

Corporateand

directorate-level

KPIsinplace,which

aregovernedbythe

monitoringand

evaluation

framework.

Incentivesandbenefits

Employeerewards

andrecognition

systeminclude

annual

salary increments, a

recognitionletter

signedbytheCEO,a

dinnerwiththeCEO,

etc.

NMSFintroduced

performance-based

rewardsand

incentivesin2012.

Thesystemapplies

ifanemployee

scoresabove70

pointsin

performance

appraisal.NMSF

offersstaffan

additionalbenefits

package.

NMSstaffarepaid

attractivesalary

consistentwiththe

marketrate.

Incentivesand

benefitsalsoinclude

entertainment

allowanceforclient-

facingjobroles,fuel

allowancesforstaff

atmid-andtop-level

management,

transportforstaff

(staffbus),etc.

Non-financial

incentives,suchas

recognitionforgood

performanceduring

annualappraisals,

staffexchange

programmes,staff

engagementin

stakeholder

meetings,etc.

Anorganisational

incentivescheme

includeshardship

allowancesfor

employeeswho

resideinhard-to-

reachareas,an

honorariumin

recognitionfor

contributionto

work,mobile

airtimecreditand

transport

allowances,etc.

Noperformance-

basedincentivesare

inplace.

Appraisal KEMSAconductsbi-

annualperformance

appraisals;utilises

90-degreeand180

degree-

performance

appraisalmethods.

TheCivilService

Chamberguides

performance

appraisal.

Supervisorsare

mandatedtofillthe

assessment

NMSconducts

performance

appraisalbythetop

managementtwicea

year:inJuly(review

forJanuaryto

June)andin

Anopenappraisal

systemwherebyan

employeefillsthe

BSCand

indicatesthelevelof

individual

performance.

Performancereview

conductedtwicea

year(inDecember

andMay).

EPSAhasbeenusing

theBSCas

performance

managementtool,

butnotuniformly

throughoutthe

organisation.

69

anonymouslyand

submitittotheHR

department.

January(reviewfor

JulytoDecember).

Promotion Promotionsdepend

onskills,experience,

performance,

competence,

disciplinaryissues,

availabilityof

vacancy,etc.

Civil

ServiceChambergui

despromotionof

eligiblecandidates.

However,

promotionsarenot

linkedto

competence

framework.

NMSdoes

notconductpromoti

ons.Everyemployee

receivesafour-year

contract.Initially,all

vacantpositionsare

advertised

internallyandtried

tobefilledthrough

existingcandidates.

Promotionsaregove

rnedbythe

ConditionofService

handbookandbased

onannualstaff

performance

assessments.There

isnocompetency-

basedpromotion

framework.

MSDfollows

competence-based

promotionslinked

tothecompetency

framework.

Promotionsarealso

guidedbytheDRIVE

appraisalsystem

score.Tohelp

underperforming

employees,MSDhas

introduceda

Performance

ImprovementPlan.

Promotionsarenot

linkedto

competencies.

Educational

qualificationsand

yearsofexperience

areusedasthemain

criteriafor

promotion.


PublicService

Rulestandards

requireCEOsand

directorstoundergo

leadershiptraining

atgovernment

school.Managersin

Grades3and4

undergospecial

management

training.Members

oftechnicalstaff

needtocompletea

numberof

professional

traininghoursto

collectpointsfor

apractising

certificateattheend

ofeverycalendar

year.

Capacity

developmentcan

includeself-learning

(usinglearning

facilitiesand

resourcesofthe

NMSFTraining

Centre).Staffare

encouragedto

participatein

conferencesand

workshopsinthe

region,andother

relevanttraining

offeredtothestaff.

TNAidentifiesthe

trainingneeds

whichsupportthe

developmentofan

annualtraining

program.The

performance

appraisalalso

guidestraining

opportunitiesasthe

developmentofstaff

iscentraltoNMS. 

Trainingismostly

outsourcedbasedon

theareaofworklike

accounting,

management,

pharmacy,etc.On-

thejobtrainingand

stafforientationare

conductedin-house.

AtMSDTNAis

conductedannually

aspartofthe

performance

managementsystem

calledDRIVE.

Trainingisaligned

withthechanging

businessneeds,

SupplyChain

landscape,

andMSD’sneed.A

mixofin-houseand

externaltraining

opportunitiesare

providedtothe

staff.

Atpresent,thereisa

TNAandatraining

plan,whichhas

beenendorsedby

otherpartnersof

EPSA.Atraining

strategyisbeing

developedandwill

beendorsedsoon.

70

Supervision KEMSAprovides

supervisorysupport

throughcoaching

andmentoring.

Mentoringand

coachingactivities

beganin2018but

arestillscarceat

NMSF.

NMSencourages

inter-departmental

coachingand

mentoringof

employees,

(especiallyfor

junior-levelstaffas

partofgeneral

induction).

CMSTencourages

mentorshipasopen

interactionbetween

staffmembersand

linemanagersto

forgesenseof

guidanceand

support.

MSDprovides

mentorshipsupport

foremployees.Staff

areencouragedto

participatein

seminarsand

workshops,which

includeanelement

ofmentoringand

coaching.

Participationfees

arecoveredbyMSD.

Nomentoring,

coaching,and

structured

supervisionscheme

availableatan

organisationallevel.

PSAcurrently

supportsEPSAin

theimplementation

ofthisscheme.

Engagementandretentionstrategies

KEMSA’sretention

policyisbasedona

TalentManagement

Manual.KEMSA

providesaone-week

induction

programme,study

leaveforcompleting

trainingordegree

courses,etc.Asa

resultofitsretention

strategies,KEMSA

hasbeenabletokeep

staffturnoverata

lowlevel.

Engagementpolicies

includedchanging

theambienceofthe

office,

providingbetteracc

esstocomputers,

ERPsystem,

providing

transportationfor

employees(inair-

conditionedmini-

vans),

introducinguniform

s,providingprivate

medicalhealth

insuranceforstaff

andfamily

members,

subsidisedmeals,

mini-market,cash

pointsontheNMSF

premises,etc.

NMSisfocusedon

retainingthebest-

performing

employees,

conducting

employee

motivation

programmesand

prioritisinginternal

recruitmenttohelp

retainthequalified

workforce.

CMSToffers

competitive

remuneration

package,conducts

team-building

exercises(everytwo

years),andcommits

totransparent

communicationand

feedbackpolicy.

Theseeffortshelp

keepstaffturnover

atlowlevel.

MSDdoesnothavea

specialretention

schemebutoffersa

rangeofbenefits

andactivitiesto

sustainemployee

engagement.These

includeofferinga

clearcareer

progression,paying

formembershipin

uptotwo

professional

associations,

offeringagratuity

schemewithapay-

outtoallstaffevery

twoyears,etc.These

benefitshave

contributedtovery

lowattritionrates.

Thelackofcareer

pathsand

organisational

retentionpolicies

hascontributedtoa

declineinemployee

engagementand

increasedemployee

turnover.


Thedisciplinary

policiesare

monitoredbya

NMSFadherestothe

DisciplinaryActfor

theCivilService.

Thedisciplinarycod

eguidesAll

disciplinarycases

followadisciplinary

Disciplinarypolicies

areapartofthe

Termsand

Disciplinarypolicies

andpractices

aregovernedbythe

PublicServiceAct,

EPSA followsthe

civil

service disciplinary

codeofconduct.  

71

specialcommitteein

KEMSA.

codeand

disciplinary

procedures

explainedintheHR

Manual.

Conditionsof

Service.

2002andits

regulationsof2003.


Thesurveyis

conductedevery

twoyears.

Thesurveyis

conductedevery

yearandtheresults

arediscussedwith

employees.

Thesurveywasnot

conductedinthe

past.Thereare

planstoconductthe

staffsatisfaction

surveyin2020and

extendittointernal

andexternal

stakeholders.

Thesurveyis

conductedannually.

Thesurveyis

conductedannually

bytheHR

department.

Thesurveyis

conductedannually

attheorganisational

andhub/location

level.

72

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