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Pictured above: Nursing students and their instructor during a supply chain training course.

Picture by Kwesi Playe

Building a Strong Supply Chain Workforce in Ghana – The Role of Pre-service Training

This case study forms part of a series of case studies commissioned by UNICEF Supply Division and funded by Gavi to showcase success stories in Human Resources for Supply Chain Management.

In Ghana more than 50% of health facilities do not have dedicated supply chain professionals. Although pharmacists and nurses are responsible for the management of commodities at health facilities, they receive little to no training in commodity management. Ideally, the role of supply chain management (SCM) is delineated to dedicated professionals with formal SCM qualifications, such as certificates and university degrees or diplomas.

In order to tackle Ghana’s shortage of supply chain professionals, an ambitious pre-training strategy was deployed to create and rapidly expand the SCM competencies among health care workers. Pre-service training (PST) refers to knowledge and skills delivered to individuals in a specific field of study before they enter the workforce. The terms pre-service training and pre-service education are used interchangeably and refer to undergraduate and postgraduate coursework.

Exposing pre-service students to key SCM concepts and competencies equipped them with urgently needed knowledge and skills to perform these duties. The pre-service training program led to the rapid integration of SCM modules into the curriculum of health care workers in major schools of nursing and pharmacy in the country. It is estimated that over 14,000 health workers were equipped with SCM skills over a four-year period, without the need to remove them from their workstations for in-service training. The sustainability and cost-savings of the pre-service training model was also enhanced by utilizing local institutions to lead the customization and delivery of the SCM curriculum to a group of core trainers. 

The Pre-Service Training (PST) Strategy

The goal of the PST strategy in Ghana was to create a continuous supply of health care workers for the Ghana Health Service (GHS) who were competent in SCM before they entered the workforce.

The objectives of this strategy were to:

  • Work with local stakeholders from relevant institutions (e.g. pharmacy schools, nursing schools, Ministry of Health leadership, regional health leaders, GHS leadership, health workers’ organizations, the Pharmacy Council, the Nurses and Midwives Council) to create consensus about the need for PST and adopt the strategy
  • Identify and select a pool of lecturers and master trainers to work with external consultants to adapt the SCM curriculum to the local context of Ghana
  • Convene a national workshop to develop a pool of lecturers and master trainers who would roll out the SCM training to local universities
  • Integrate the SCM modules into the curricula of local pharmacy schools and nursing schools involved in the training of future health care workers
  • Create a team to monitor the progress of the PST model and propose modifications to the GHS as appropriate


  • Program conceptualization: external consultants carried out a scoping exercise to help propose a structure for the PST program. The consultants, together with the Ministry of Health (MOH) and the GHS, conducted a needs assessment that revealed that although current pharmacy schools, nursing and midwifery courses at the country’s training institutions included some information related to SCM, it was haphazard and not completely incorporated. Within universities and pharmacy schools, topics were primarily theoretical; they did not include formal, in-depth SCM modules; nor did they include hands-on practice to reinforce classroom training. This process was used to enhance the ownership of the PST by different stakeholders. 
  • Engaging national/local/institutional policy makers that regulate education/health/labor: these findings were presented to training institutions, professional bodies, regional health leaders and other stakeholders to discuss and validate. Based on their assessment, stakeholders approved inclusion of SCM in the academic curricula of all health institutions as a sustainable approach to SCM capacity building.
  • Preliminary planning: a stakeholder working group (SWG) was formed to initiate a regular schedule of meetings. The SWG consisted of donors, government officials from health and education ministries, and academic partners. The SWG met to make considerations of supply chain courses already offered, and the specific requirements of local academic institutions, regulatory bodies, and government agencies.
  • PST implementation plan development: the SWG created a national implementation framework with objectives, tasks and roles, timeline, budget, and monitoring and evaluation (M&E) plan.
  • Curriculum development and training needs assessment: the SWG gathered data on training needs using a variety of data collection methodologies such as in-depth interviews, focus groups, and a review of existing documents. In addition, observation visits to relevant academic institutions, as well as to warehouses, stores, and other facilities integral to supply chain management were undertaken in order to gain an accurate understanding of operations at the various levels of the country’s logistics system. Interviews were held with a variety of informants, including personnel currently working in the supply chain, policymakers, representatives from the ministries of health and education, stakeholders from relevant professional associations, training institutions, administrators and students whose courses include or could include supply chain content. All findings were presented to stakeholders for discussion and validation. The incorporation of SCM into the academic curricula of all health institutions was endorsed as a sustainable approach to SCM capacity building.
  • Technical content drafting: a subcommittee for curriculum development was convened from among members of the SWG. The subcommittee consisted of members with knowledge of SCM concepts and adult learning theory. The curriculum was designed to include site visits to health facilities such as clinics, hospitals, or warehouses, allowing students to see first-hand how the public health supply chain works. A technical guide, student materials and plans for site visits were developed. The curriculum subcommittee updated the SCM course content for nursing and midwifery training institutions and incorporated the updates into existing curricula. The subcommittee also developed a model curriculum for pharmacy schools. A complete SCM curriculum was developed as a stand-alone two-credit course.
  • Identification and training of lecturers: a team of lecturers from nursing schools, pharmacy schools and other health care colleges in Ghana convened for a master trainers’ workshop. The trainers also had the opportunity to review and comment on curriculum content, including ways in which it could be made more relevant to their settings. This exercise not only improved the content, but also enhanced their sense of ownership and pride.
  • Implementing the program: The following key knowledge was identified:
  1. Correct filling of inventory control tools (bin cards and store ledgers)
  2. Proper knowledge of storage conditions
  3. How to take stock

The PST program was implemented with support from SWG and SCM professionals. The external consultant attended some of the classroom sessions and completed site visits to provide feedback to the trainers.

Progress and Results

There was a rapid uptake of the PST program in academic institutions in Ghana. By October 2015, an estimated 15,600 nurses and midwifery students (in 104 health training institutions) received formalized SCM training. This exceeded the number of nurses and midwives reached through in-service training workshops and on-the-job training.

“The experience has been fantastic!  For the first time in my life, I have been exposed to the real act of teaching even though I have been a ‘teacher’ for some years now. The entire course has been presented in such a fluid manner that [the] majority of us are [in awe of the] different approaches used to accomplish this task. And that can only come from an organized, knowledgeable team of professionals.” Dr. Barima A. Afranie Senior Lecturer and Head of the Clinical Pharmacy Department.

Lessons learnt:

Benefits to future patients: Equipped with the latest knowledge and skills, new graduates entering the workforce can immediately focus on their supply chain duties instead of taking time to build their competencies through in-service sessions or on-the-job training, benefiting facility operations and, ultimately, the patient. Benefit is also derived when a clinician or mid-wife is adequately equipped to understand the principles of SCM to enable him/her to make management decisions on critical areas such as procurement, ordering, store management etc.

Cost savings: PST reduces the need for costly In-Service Training (IST) and technical assistance. This, in turn, eliminates the need for financial incentives and participant allowances associated with these interventions, resulting in additional budget savings.

Sustainability: Because PST is embedded in and relies on local institutions for its propagation, it enjoys a continuity not afforded to ad-hoc IST, which depends on funding availability and management priorities.

Rigorous knowledge and skills evaluation: PST is supported by national or institutional policies that approve/accredit curricula and specify competency requirements and standards. This helps ensure that the technical content is standardized across institutions while also providing opportunities for program evaluation and continuous improvement.

Professional recognition: PST offers formal recognition and status that bolsters career paths and can lead to acknowledgment of SCM workers as professionals.

Rapid mitigation of workforce deficiencies: PST in SCM helps develop adequate numbers of motivated and qualified SCM workers, helping to address the acute shortage of healthcare workers in developing countries.

Next Steps

Accreditation of the SCM courses demonstrates the commitment of the Government of Ghana, health training institutions, and professional councils. SCM is recognized as an essential part of any well-trained health worker’s education and it should be incorporated into all health training programs. SCM is now established as part of the national exit exam for nurses. With the future implementation of two semester courses in pharmacy programs, pharmacy students will also be required to take an exam on the content.

This story was extracted from the original case study authored by Eomba Motomoke. Download the case study here

The PST Strategy formed part of a collaboration between the Nursing and Midwifery Council, the MOH-HRHD, the Ghana Health Service the USAID I DELIVER PROJECT.

The USAID | DELIVER PROJECT (the project), in partnership with ministries of health and other organizations, improves health outcomes in developing countries by increasing the availability of health supplies. For more than 30 years, USAID has been a world leader in providing health commodities to field programs—a critical component of health program success.

Read the full USAID I DELIVER PROJECT Ghana Country Report here: