Human resources management systems

Within the HAF’s action field of human resources management systems, there are three management areas of key importance: HRH information; workforce planning; and performance management and retention.

HRH information: Effective HRH management generally, and for the health supply chain in particular, requires an information system that provides reliable data to plan for necessary staff, train, appraise staff performance, and provide salaries and incentives for their retention. It is the basis for understanding system-wide requirements, taking appropriate action, and monitoring and evaluating the results. Many countries use or are planning to use human resources information systems—such as CapacityPlus’s iHRIS health workforce information software and tools—that track the number, posting, and staffing gaps of doctors, nurses, and other health workers. Existing systems seldom include data on nonclinical and support workforce personnel who are critical to the supply chain. For example, a World Health Organization (2011b) HRH assessment tool makes no mention of support workers who manage supply chains.

  • Achievable activity: SCM and HRH personnel jointly gather available data on SCM staff to systematically incorporate the data into human resources information systems.

Workforce planning: This entails an understanding of health system-wide needs for supply chain management, covering both the public and private sectors. With regard to the public sector, planning would be reflected in a set of staffing norms and position descriptions. These essential elements should be accompanied by active recruitment and the hiring of qualified staff, as well as training those staff that have some supply chain responsibilities. It means looking at the supply chain needs at the multiple and varied levels of the health system and then employing health staff with supply chain competencies matched to their assigned positions. The World Health Organization’s (2010) Workload Indicators of Staffing Need (WISN) approach and tool can be used to determine how many workers of a particular type are required to cope with the workload of a given facility. For example, the Government of Namibia applied the WISN approach to a range of health facilities, including a regional medical depot, in order to estimate the impact that a new treatment regimen for HIV/AIDS would have on the staffing needs for several health worker cadres. A similar exercise can be done to estimate staffing needs for key supply chain tasks at different levels of the health system, such as the central medical stores or district hospitals.

  • Achievable activity: Estimate staffing needs and review SCM staffing plans for public health facilities at national, district and health facility levels of the health system.

Performance management and retention: Any health staff having supply chain responsibilities should understand their assigned tasks and be guided by up-to-date job descriptions and supportive supervision. To reduce turnover of supply chain workers, leaders need to provide clear career paths with financial and nonfinancial incentives and career development opportunities based on performance, as well as adequate workplace environments and working conditions. The net result will be greater supply chain productivity, reduced turnover of staff, and a sound basis on which to appraise the performance of any health staff with SCM responsibilities. Burkina Faso has a supply chain system that includes a semiautonomous entity, the Centrale d’Achat des Médicaments Essentiels Génériques (CAMEG), which is staffed by both public servants and non-public-sector personnel. It provides differentiated levels of technical responsibilities and a comprehensive employment package, including incentives and rewards for good performance. Uganda’s Ministry of Health, Pharmacy Division, with assistance from the USAID-funded Securing Ugandans’ Right to Essential Medicines Program (SURE), has developed and implemented a central database that tracks activities using trained health supervisors (known as medicines management supervisors). These health supervisors collect detailed facility-level supply chain worker performance assessment information, for the purpose of improving the management of medicines and other supplies at health facilities and guiding decision-making processes at the facility, district, and national levels (see box below). The Rapid Retention Survey Toolkit (Jaskiewicz et al. 2012) developed by CapacityPlus outlines a process for creating evidence-based incentive packages for the attraction and retention of health workers. This approach, which is based on the discrete choice experiment methodology, can be applied not only to clinical workers but also to supply chain workers.

  • Achievable activity: Consider what job descriptions and instructions (if any) are provided to supervisors to take into account SCM tasks in reviewing worker performance.

Uganda’s Supervision Performance Assessment and Recognition Strategy (SPARS)

In 2010-2011 Uganda adopted a national capacity-building strategy, SPARS, to improve management of medicines and health supplies at health facilities based on regular information on performance at facility, district, and national levels, as a means to identify progress and areas in need of improvement. SPARS includes 25 performance indicators categorized into five components, which track dispensing quality, prescribing quality, stock management, storage management, and ordering and reporting quality. Each facility is assessed by a trained district staff member who mentors facility staff to improve on weak areas. The facility report is then integrated into a quarterly district report and subsequently into national reports. A spider graph is updated and displayed each time a facility is supervised.  

The Uganda Ministry of Health, Pharmacy Division is responsible for SPARS implementation. SPARS was developed with support from the Securing Ugandans’ Rights to Essential Medicines program.

Source: Uganda Ministry of Health 2013

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