Written by: Benoît Silve, Bioforce Institute Over the last several years, as investments in vaccines and essential drugs have grown, there has been increased interest in helping supply chains deliver health commodities and equipment more effectively to the people who need them. To improve supply chain performance it is common to focus on the technical aspects of supply chain improvements: better performing refrigerators, more timely repairs and maintenance, and effective information systems, for example. One of the most fundamental improvements that can be made, however, is to increase the capacity and competence of supply chain managers and health logisticians. In most developing countries health logistics is not considered a profession; there is little training and high turnover, the job is rarely strategic, and there is no clear career track. However, as demonstrated in many high-income countries, professionally trained logisticians and supply chain managers are needed to improve supply chain performance; they fulfill a strategic role in planning and successfully implementing all manner of activities to support health care initiatives. Bioforce Institute, a nonprofit institute created by Charles Mérieux in 1983, has been providing training in support functions, particularly logistics, to aid organizations for more than 25 years. Bioforce has long recognized that providing “technical training in logistics” does not sufficiently impact health operations. Training on its own is not effective if the organization is not adapted to the context, nor if the person trained is not assigned to a relevant and long-lasting job. When logisticians are valued as professionals, on the other hand, and supported by appropriate training, they have the potential to take over numerous support functions that are currently burdening the doctors, nurses, and pharmacists; divided among other personnel; or not addressed at all. Indeed, health logisticians play an enabling role at the peripheral/district level. Far from representing additional expenses on the ministry of health budgets, employing and retaining qualified logisticians will likely increase the efficiency of health programs and structures and lower the wastage rate of increasingly costly products and equipments. Logistics experts in Africa recently endorsed seven key areas of expertise that professional logisticians should have,[sup][/sup] including the ability to: 1. Plan logistical activities of health structures and programs at the district level. 2. Administrate and coordinate logistics of health programs and structures. 3. Manage the supply chains for vaccines, drugs, and other health products. 4. Coordinate the use and maintenance (including subcontracting) of medical and technical equipment. 5. Coordinate the maintenance of facilities and housing including water and the sanitation of health structures. 6. Ensure effective logistical support of health emergencies and humanitarian operations. 7. Foster intersectoral collaboration and community participation. While these competences may be modified according to national policies, they provide a useful basis for countries to start from when developing the role and responsibilities for logisticians. International training center in Burkina Faso To provide professional training, the first regional training reference center, the “Center for Expertise Research and Development for Health Logistics” was launched in Burkina Faso in 2007. The center provides in-service international training in health logistics and also works closely with the Ministry of Health in two regions to demonstrate that a well-trained logistics workforce can have a measurable impact on health care provided down the supply chain “to the last mile.” The Center has already trained several hundred people across Francophone African countries in supply chain management and logistics skills. The training program is comprehensive, including management aspects such as budgeting or purchasing as well as logistical aspects such as monitoring a fleet of vehicles. Training is also provided all over Africa to fit the needs of specific partners, such as the United States Agency for International Development | DELIVER project and the United Nations Children’s Fund (UNICEF). The center is now working in partnership with IRSP (Regional Public Health Institute, Ouidah, Benin), World Health Organization African Regional Office, UNICEF, and Agence de Médecine Préventive to conduct an international preservice training for health logistics in Benin based on the seven competencies quoted above. The future of health logistics as a profession If there were one single unifying factor for all low-income countries to improve medical care at the lowest cost, it would be to create professional positions for health logisticians. Those countries that invest in the human aspect of supply chains by developing professionally trained logisticians and supply chain managers will see both immediate and long-term benefits. Nurses and doctors who are currently performing logistics functions can focus on delivering quality health care. Equipment performs better and lasts longer with more attentive maintenance. Supplies arrive undamaged and on time at the right location and in the right amounts to meet the needs of the clients of health services. Logisticians will stay in their jobs becoming more experienced and competent every year. When complemented with other initiatives that are improving supply chain equipment, protocols, and systems, investment in human resources will ensure that the goal of streamlined, efficient, sustainable, and continually improving supply chains is reached. We invite you to comment on or post a question relating to this article by clicking the “reply” button on this page. You will have to log in or register; the process is very simple. Return to the Optimize newsletter. [sup][/sup]. As endorsed by a recent World Health Organization/African Regional Office meeting of logistic experts in Kinshasa, Republic of Congo (May 2010).
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