Contents

Contents.....................................................1

1.0 Introduction to the Logistics Unit.......................2

1.1 Assignment.............................................4

2.0 Introduction to Operational Planning and Decision Making. 5

3.0 Key issues in operational planning.......................6

3.1 Steps in planning.....................................8

3.1.1 Setting the direction...............................8

3.1.2 Resource Assessment.................................8

Activities in resource assessment.......................9

3.1.3 Identification and Analysis of Alternatives.........9

3.1.4 Alternative Selection..............................10

3.2 Problem Hierarchy.....................................10

4.0 Key issues in Decision Making...........................11

Step 1: Identify the problem..............................12

Step 2: List alternatives.................................14

Step 3: Evaluation of each course of action and selecting the

best alternative..........................................14

1

Step 4: Choice making and decision implementation Implement

the chosen alternative....................................15

Step 5: Monitoring and Evaluation (M&E)...................16

5.0 Conclusion..............................................17

6.0 Bibliography............................................18

1.0 Introduction to the Logistics Unit

The general development of any society encompasses the health

of the individuals in that society. This implies that health

is a dynamic process. In Zimbabwe, the Ministry of Health and

Child Welfare (MOHCW) continuously changes its functions and

structure to better meet the ever-evolving challenges and

demands. The Government of Zimbabwe (GOZ) desires to have the

highest possible level of health and quality of life for all

its citizens. This vision has to be attained through

guaranteeing every Zimbabwean access to comprehensive and

effective health service.

The MOHCW has various departments to ensure that its vision is

achieved. These are the Provincial Medical Directorates,

Central hospitals, Human Resources, Finance and2

Administration, Oral Health Services, Nursing Services,

Traditional Medicines, Laboratory Services, STI, HIV, AIDS and

TB Unit, Policy and Planning, Monitoring and Evaluation,

Quality Assurance, Chief Internal Audit, Epidemiology and

Disease Control, Reproductive Health, Environmental Health;

and Pharmacy Services.

This assignment will be limited to the Pharmacy Services. The

Directorate of Pharmacy Services encompasses the Logistics

Unit (LU) which is responsible for managing essential

medicines and medical supplies including HIV/AIDS commodities

distribution systems and the related Logistics Management

Information Systems (LMIS). In addition, the LU forecasts and

quantifies essential medicines and medical supplies. It

analyses and interprets data in order to report logistics

information, including feedback reports to the various levels

of the MOHCW and its partners such as the Global Fund to fight

AIDS, TB and Malaria (GFATM), United States Agency for

International Development (USAID) and the Clinton Foundation.

The Logistics Unit is made up of The LU Manager, the Deputy LU

Manager, Upstream Logistics Coordinator, Prevention of Mother

3

to Child Transmission (PMTCT) Coordinator, Management

Information Systems (MIS) Officer, three data encoders, an

Administrative Assistant, an Office Orderly and four Logistics

Officers at the Harare office.

Figure 1: Organogram of the LU

Of the fourteen members at the LU Harare office, 2 are

pharmacists, 3 are pharmacy technicians, and the rest have no

pharmacy-related background. This diagram below shows that the

team is composed of members from diverse professional fields.

Each member brings different skills to give a potential fusion

of expertise.

4

LU Manager

Deputy LU

Manager

4 Logistic

s Officers

Upstream Logistic

s Coordinat

or

PMTCT Coordinat

or

Adminstrative

Assistant

Office Orderly

MIS Officer

3 Data

Encoders

Figure 2: LU staff by professional background

Pharmacists; 2

Pharmacy Technicians

; 3

Logistics-related background; 3

Information Technology

background; 4

Office Management;

1

Other; 1

1.1 Assignment

Operational Planning and Decision Making are key to the

success of the organisation, a discussion with examples from

5

the Directorate of Pharmacy Services, Logistics Unit of the

Ministry of Health and Child Care.

2.0 Introduction to Operational Planning and Decision Making

Planning is a mental activity intended toward anticipating,

forecasting, and handling change.  It is meant to yield a

recommended course of action to deal with probable future

developments.  Planning helps in risk management since a

manager can deal with problems proactively rather than

reactively.  It also creates a sense of mission which allows a

manager to motivate and measure the performance of people

under him/her.  Plans are bridges for the gap between where an

organization is and where it wants to be in the future.

Corporate-level managers are concerned with planning overall

corporate strategy, rate of growth, and new markets/products.  6

Business Unit-level managers are concerned with planning a

high degree of coordination with minimal overlapping among

organizational units and the enhancement of resource

utilization among these units.  Line managers and supervisors

plan the implementation of policies and procedures, work

activities, and ways to enhance the effectiveness and

efficiency of work operations.  Planning occurs at all levels

and needs information flow up, down, and sideways in the

organization to be effective.

Plans succeed when they are used, monitored, and changed as

work progresses.  Plans fail if they are not kept up-to-date,

realistic, or clear. It is imperative that whoever is planning

must be able to make decisions, sound decisions. It is also

important to note that failure to plan is a ‘decision’, albeit

a bad one. A decision is a choice between alternatives and

decision making is the process of choosing one alternative

over the others. Making good decisions should be a process. It

is a process of identifying problems and resolving them, or of

identifying opportunities and taking gain of them.

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3.0 Key issues in operational planning

Plans may be classified by short- or long-term, by function,

or by breadth or scope. Long-term plans are done at upper

management levels and encompass a number of years, such as

moving into another market sector.  These long-term plans are

usually strategic plans designed to identify, determine, and

shape the direction of the organization. The DPS has the

National Medicines Policy and makes use of Strategic Plans for

the successful performance of the programs it maintains. These

are crafted by Central Level staff of the Directorate.

Short-term plans are done at lower management levels and

encompass a short period of time, such as for a project or

budget.  These plans are usually operational plans helping

with day-to-day operation. The LU creates work plans which it

submits to the DPS for approval. These are operational plans

which detail the day-to-day undertakings of the unit. Function

plans may be developed for key organizational functions, such

as engineering or finance.  Each of these plans could be

evaluated for potential conflicts between functional areas.

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The LU work plans are also aligned to budgets approved by the

administration department.

Breadth or scope plans may address objectives, policies,

procedures, methods, or rules. There are various programs

under the realm of the MOHCC which are serviced by the DPS.

These include the antiretroviral, TB, malaria, essential

medicines and PMTCT programs. The DPS has developed

distribution systems for each of them. As such, the DPS has

crafted standard operating procedures for each of the systems.

Objectives provide general statements about the mission of the

organization or what is to be done.  These objectives filter

down through the organizational hierarchy where plans are

created to achieve them.

Policies are implemented to accomplish objectives and are

general guides to action, such as the Zimbabwe National

Medicines Policy which allows the creation of an essential

medicines list. Procedures give the steps for accomplishing

the policies, such as standard operating procedures for the

inventory control systems for antiretrovirals which show the

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set of steps in ordering, storing and distributing medicines.

Methods are detailed plans showing the sequence of individual

tasks to complete a specific assignment, such as how to

complete a prototype design. Examples include the job aids in

the standard operating procedures of the various programs.

Rules are prescribed standards of behaviour and place

restrictions on employee behaviour, such as dress codes,

smoking regulations, and sexual harassment preventives. These

are enshrined in the Health Services Regulations. If plans are

prolific, employees may be over constrained and have little

freedom to do their work.  If there are no plans, employees

will be frustrated by not knowing what to do. These documents

serve to guide the employees in their duties to ensure quality

service delivery to patients and clients.

3.1 Steps in planning

Planning is hopefully a logical and systematic activity; a

sequence of steps can be helpful to accomplish planning.

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3.1.1 Setting the direction

The totality of goals and objectives must be defined to serve

as the measure against which success is to be judged. Goals

establish the milestones that warrant achievement. They

delineate the differences between where and what the

organisation is now, and where and what the manager wants to

be in the future. Determine the purpose of planning by stating

your objectives in concrete form.  The objectives should be

specific, achievable, measurable, and operational rather than

abstract. 

They need to have timelines to them. Roles and

responsibilities of the people who will be involved in

planning including those authorizing, coordinating,

developing, approving, and participating in planning should be

discussed and agreed upon. The Directorate of Pharmacy

Services has a mission to ensure that medicines which are

safe, efficacious and of good quality are available,

accessible and affordable (SEQAAA) to all those in need.

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3.1.2 Resource Assessment

Resources are the materials and persons used to achieve goals

and objectives. Types of resources vary greatly but in the

pharmacy services it is useful to group them into five broad

categories: information communications technology, delivery

and monitoring vehicles, finances, facilities and people. The

resource assessment process must be thorough enough to provide

clear indications of the inherent capabilities and limitations

of the resources.

Activities in resource assessment

Identification of other resources and facilities for

implementing the plan, such as materials, supplies,

equipment, and software.

Specification of the methods to execute the plan and what

it will take to get the plan moving.

Developing a cost estimate or budget for the plan, such

as salary, travel, communication, resource, and overhead

costs (overhead costs may be specified as a fixed

percentage of the overall budget and normally cover12

items, such as clerical support, utilities, contract

services, and law services).

3.1.3 Identification and Analysis of Alternatives

The identification and analysis of alternative ways that a set

of resources might be utilized to accomplish goals is the most

challenging step in the planning process. The difficulty stems

from the multitude of alternatives. To further complicate the

formulation of a good plan, various combinations of all of

these enterprises, production and marketing alternatives must

be examined. The DPS conducts half-yearly quantification for

medicines and medical supplies. This process has been made

tougher because of the changes in medicine guidelines for

antiretroviral treatments as well as the scaling up of the

program. This means the quantification team has to explore

different procurement scenarios.

For each alternative or unique combination of alternatives,

the planner must first evaluate resource requirements and

costs to determine if the ranch's resources are sufficient to

implement a practice, or if, for example, some of the13

financial resources would need to be used to acquire other

resources, such as medicines. Next, the expected pharmacy

service levels, and impacts on non-financial goals (free time,

peace of mind, over reaching societal needs) likely to result

from each alternative should be assessed. This is a stage not

focused on by the DPS.

3.1.4 Alternative Selection

Finally, after all the alternative combinations are analysed,

the combination of alternatives which most nearly meets the

totality of pharmacy services goals and objectives is

selected. The selection process should not give undue emphasis

to personal goals are not given undue emphasis over financial

goals. After a plan has been selected as the most appropriate

one, a realistic schedule for it should be devised. This plan

should be monitored and evaluated basing on agreed metrics so

that it can be amended whenever necessary. The 18-month supply

plan for the DPS is monitored through the use of Pipeline

software. The plan is changed if necessary basing on the

actual consumption of the medicines.

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3.2 Problem Hierarchy

Long-term or strategic planning concerns the achievement of

goals of the resource owners over several years. Long-term

plans generally affect major changes in the way resources are

used to achieve goals. Once implemented, plans at this level

cannot be altered quickly. In terms of organizational

structure they are usually under the control of directors and

the Permanent Secretary.

Intermediate time periods require tactical planning. Most

often tactical planning is the responsibility of middle to

upper level management and is more closely related to the

operating function than long-term planning. Intermediate term

planning results in decisions of how to best effect or

implement long-term plans. Decisions resulting from tactical

planning are likely to be repeated at least annually. Short

term or operational planning is characterized by those many

decisions that must be made in a short time-frame. Plans for

the day's or week's activities are examples of operational

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plans commonly made. These are plans made by the LU staff for

their daily activities and can be changed easily.

4.0 Key issues in Decision Making

As Wilcox (1982) stated in his book on grazing management "the

successful rancher is that one who can, firstly identify the

different factors which will affect operation of the ranch,

and secondly, can anticipate the changes in them that will

influence his success. This successful rancher is the one who

avoids crisis in the running of his enterprise..." No operator

should allow himself to get into the crisis situation, but

should arrange his management style to anticipate the changes

which will be necessary in the operation and make those

changes affecting in a timely manner."

Likewise, White et al. (1987) stated "This [anticipating

change] is an impossible task if the ranch has not developed a

logical and practical approach for analysing information,

evaluating plans, and directing daily operations... It is

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doubtful that any person can accurately assimilate the mass of

information and predict the overall ranch outcome without

detailed planning and evaluation." This advice from a grazing

management points to a need for knowledge management within

organisations. It calls for ‘learning organisations.’ The LU

has a Logistics Management Information Systems (LMIS) for

consumption data management.

Greenwell (1998) wrote that the effectiveness of a manager in

using available information has a psychological basis deriving

from memory, perception and problem solving skills and exists

only in the social context in which the manager functions. He

said level of acquired expertise relates to learning and

assimilation of knowledge in the cognitive processes,

judgmental behaviour, social behaviour backed by social

knowledge, creative behaviour, analytical behaviour and

ability to establish and pursue firm practices when necessary.

It is of utmost importance that managers are of sufficient

experience to lend them enough discretion in making decisions

especially where uncertainties may prevail.

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Decision making may be accomplished with the following steps

when there is time and the decision requires analysis before

it is made.

Step 1: Identify the problem.

The first step is to recognize there is a problem and a

decision must be made. Some people just react to problems, but

good managers seek to understand the problem and respond

appropriately. Decision making is essentially a problem-

solving process. This involves understanding the situation and

trying to resolve it. Decision makers should know the

objective in making the decision. As aforementioned,

objectives should be operational, practical, attainable, and

challenging.  Statements of objectives such as mission

statements should include constraints which may refer to how

the objective will be attained, how resources are used, and

how conflicts with organizational goals are avoided. 

Objectives should be ranked according to their importance,

such as "critical", "desirable", or "would be nice". The

challenge in public health is to provide medicines with very

limited resources and increasing needs. Problem diagnosis is

18

the most critical and difficult step as the right problem must

be found and identified. During problem diagnosis, it is

common to confuse symptoms and problems.  This may lead to

poor decisions which are often correct solutions to the wrong

problem. 

Steps in Problem Diagnosis include

Confirm if there is a problem-Compare the results you

have with the results you wanted to achieve.  If they are

the same or better, a problem does not exist.  If you

have inferior results, then a problem exists.

Investigate causal agents-Find the reasons behind

deviations from objectives.

Approach the problem analytically and realistically

finding the distance between wanted and actual results,

major deficiency factors, barriers to success, and

satisfactory solution requirements.

Identify the limitations to the solution, such as cost,

personnel, and information.

Focus on causal problems rather than deviations from

defined standards, such as employee turnover rate which

19

may be due to the personnel department's inadequate

recruitment practice and not anything attributed to the

manager.

Use symptoms to find the problem, such as asking why the

symptom exists - noticing the symptom of conflict between

two departments and then determining why the conflict

exists.

Determine the barriers to challenge identification, such

as some managers thinking the cure is worse than the

disease, procrastination decision making, rationalizing

decisions, or hating to make unpopular decisions. 

Focus on the real problem and its possible causes

Step 2: List alternatives

Managers need to develop a list of possible courses of action

that will solve the problem. Managers must look for standard

answers and also creative answers. The technique

“brainstorming” is an example of creative thinking that can

take place between a manager and the subordinates. In

brainstorming, everyone comes up with as many alternatives as

possible. Employees should experience a nurturing environment

20

where everyone will feel like contributing. Shooting down an

idea will stop the free flow of exchange.

The team should make a thorough and comprehensive effort to

identify all logical alternatives to the problem.  Innovation

should allow for enough flexibility to deviate from the

traditional way of doing things if it is promising to do so,

or taking no action on the problem, to use intuition and

advice from others who have handled similar problems. Managers

must guard against barriers in exploring options such as

egotistic desires to control the solution personally or

wanting to focus on short-term rather than long-term effects.

Step 3: Evaluation of each course of action and selecting the

best alternative.

Evaluating options is part of selecting a desirable

alternative. As part of the evaluation, the potential effects

of each choice should be listed objectively. The merits and

demerits of each alternative should be weighed using pre-

determined metrics. A set of attributes, such as cost,21

resource utilization, risk, and schedule slippage for rating

the alternatives need to be developed from the objectives set

out earlier.  These attributes should be used to come up with

a ranking system for the different choices and result in an

evaluation matrix. A discussion of those effects should lead

to a decision based on what is best for the organization. The

DPS is mainly worried about cost-benefit analyses in choosing

medicines to include in the essential medicines list.

Step 4: Choice making and decision implementation Implement

the chosen alternative.

Ideas themselves on their own do no good. The chosen

alternative must be turned into action. This is critical. All

of your successful analysis won’t do any good if you are

afraid to act. Whether the implementation is easy or hard, you

must take action. In all likelihood, there will not be one or

more perfect alternatives from which to choose because of the

dynamic nature of the organization's environment, incomplete

information, having to reduce the complexity of the problem to

a level at which a human being can handle the possible

22

alternatives, lack of time, and risk. How a decision is

implemented will have a bearing upon its success. 

A plan of action should be created to announce the decision,

to gather the resources to implement the decision, and to

assign responsibility to the individuals who carry out the

implementation.  Keep in mind that people are more apt to

participate in decision implementation if they have been given

the opportunity to participate in the decision making. This is

why the DPS holds quarterly Central Level Pharmacy Services

meetings to have a buy-in from implementing personnel. The

MOHCC also engages various partners such as John Snow,

Incorporated and stakeholders in planning meetings to get

concurrence on the course of action and ensure commitment.

Step 5: Monitoring and Evaluation (M&E)

Monitoring is the routine collection and analysis of

measurements or indicators to determine the ongoing progress

toward objectives while evaluation is the periodic comparison

of objectives, with accomplishments, to determine how well the23

objectives were achieved. In order to determine how accurate

the decision was, one should examine the results over time and

compare them to the desired results of the objectives, make

sure the steps to implement the decision have been carried

out, and determine how well the decision was accepted by those

involved.

The LU collects M&E data to enable program managers to provide

feedback to staff throughout the medicine and medical

consumables supply chain to improve system performance; to

report results to funders and other stakeholders; and to

justify the need for additional resources, when appropriate.

One important reason to do M&E is to improve program

management and, ultimately, the logistics system performance.

Improving program management and system performance are

critical for improving customer service and for ensuring

commodity security— that clients have the products whenever and

wherever they need them. If the problem is not resolved, a

manager must go back through the process and look at other

alternatives.

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5.0 Conclusion

Planning is an activity that helps organizations and projects

proceed with current and future work in an organized and

systematic way. Planning is the primary function of management

and a continuous process where plans are refined and adjusted

over time as more complete information becomes available. It

assists an organization map the direction for the achievement

of its objectives. The process begins with reviewing the

current operations of the organization and identifying what

needs to be improved operationally in the coming periods. It

later involves envisioning the results the organization wants

to achieve, and determining the steps necessary to arrive at

the intended destination.

Decision making is a critical activity that helps to mitigate

risk with difficult problems, such as significant deviations

from planned objectives. Deviations from objectives must be

investigated thoroughly to find the root problem rather than

deal with symptoms. Solutions to the problem may be found

25

through the use of an evaluation matrix allowing affected

parties to participate in the decision making process.

Creativity in decision making can be enhanced by looking at

the problem elements from other perspectives, such as using

charts and graphs. Without decision making different

managerial function such as planning, organizing, directing,

controlling, staffing cannot be conducted.

For anything to be done, a decision has to be made. Therefore,

we can say that decision is important and pervasive element to

implement the managerial function. Decisions can be used to

evaluate staff performance. It is correct to believe that all

employee actions follow their decisions and therefore

decisions made are used to judge the efficiency of an

employee. Any policy or plan is established through decision

making. Without decision making, no plans and policies are

performed. In the process of making plans, appropriate

decisions must be made from so many alternatives. Therefore

decision making is an important process which is helpful in

planning since decision makers evaluate various merits and

26

demerits of every alternative and select the best alternative.

It follows therefore that successful organisational operations

are a result of decide to plan and planning to decide. In this

competitive world; organization can exist when the correct and

appropriate decisions are made. Therefore correct decisions

help in successful operation of business.

6.0 Bibliography

1. Greenwell, M. 1988. Knowledge engineering for expert

systems. Ellis Horwood Ltd. Chichester, England.

2. White, L.D., T.R. Troxel, J.G. Pena and D.E. Guynn. 1988.

Total ranch management-meeting goals. p. 597-603. In:

L.S. Pope (ed), Beef cattle science handbook. Vol. 21.

Spillman Press. Sacramento, Calif.

3. Wilcox, D.G. 1982. The importance of flexibility in ranch

management strategies, p. 15-26. In: Proc. 1982

International Ranchers Roundup (eds. L.D. White and L.R.

Hoermann). Texas Agr. Ext. Serv., Uvalde.

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