The Challenge Facing the Health Supply Chain Workforce
Effective and efficient supply chains are vital in ensuring communities receive the medicines, vaccines and health supplies they need. However, the health supply chain is often the weakest link in achieving global health-related goals such as improving maternal health, reducing child mortality, and combatting diseases. It is estimated that up to one-third of the world’s population has limited access to essential medicines.
Health supply chains are complex. They can be government or privately run or a combination of the two. The supply chain can extend from the national/central level through to a regional or district level, then on to the community level right to the point of delivery. In-country, supply chains may manage a large number of commodities (e.g. traditional government run health supply chains), others may be commodity or program specific (e.g. immunization, reproductive health etc.).
Health supply chains are managed and operated by a multitude of health system personnel (see figure below), typically from diverse cadres and working at all levels of the health system, and may serve other functions as well, i.e., they may not be dedicated solely to supply chain management. They can be working in the public or private sector, though the public sector is of special concern because of the greater challenges in access to qualified personnel, training, incentives and resources for public sector personnel.
Access to health supplies suffers from the low importance given to the supply chain and to the personnel who manage and operate it. This low status is characterized by lack of recognition that specific technical skills are necessary for good supply chain management, limited formal educational qualifications or certifications appropriate for supply chain management, limited technical expertise for supply chain management among health systems personnel, and general disempowerment of supply chain managers within health systems.
Rapidly increasing health assistance from multilateral and bilateral donors has significantly benefited health programs, but has also resulted in huge increases in the quantity and value of supplies flowing through health supply chains – a trend that will continue as newly developed products (many with demanding supply chain requirements) are introduced into developing country health systems.
The health supply chains of middle- and low-income countries, are typically unable to respond reliably even to existing demands, putting both health supplies and health outcomes at risk. Limitations on supply chain performance stem, in part, from the lack of a qualified supply chain workforce within health systems, which in turn is due to human resource policies, strategies and practices that often do not favor the development of a sustainable and strong health workforce for supply chain management. The root cause of the problem is a lack of recognition of the essential strategic role of the health supply chain workforce within health systems and of the technical and managerial savvy required to run a supply chain successfully.
The increase in commodities moving through a supply chain is typically not accompanied by an increase in human resources
Factors that limit include fragmentation of responsibility for managing the overall performance of the supply chain, lack of planning and financing for the supply chain workforce, lack of development and credentialing of supply chain managers, lack of accurate job descriptions, and lack of professional development and professional associations.
More health workers are needed
Moreover, the World Health Organization (WHO) currently estimates that the health workforce deficit stands at no less than 8 million in Asia and 6 million in Africa. The WHO global strategy on human resources for health workforce 2030, adopted at the World Health Assembly in May 2016, is a cross-cutting agenda to attain coverage targets across all service delivery priorities – including supply chain managers. The current trends of health worker production and employment will not be enough; in the African region the forecast worsens between 2013 and 2030.