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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