This title was first published in 2003. Logistics are the set of activities that move products through the supply chain to the ultimate customer, these are of vital importance to the success of health programmes in the developing world. This volume comprises the best practices learned and promoted by the Family Planning Logistics Management (FPLM) project, set up in 1986, run by John Snow, Inc., and funded by the U.S. Agency for International Development. The project covered approximately 40 countries in Africa, Asia, Latin America and the Caribbean, and collaborated with national family planning and health programmes and non-governmental organizations that were interested in improving their supply chains. Using a range of international case studies, the book highlights the importance of logistics and transportation in health and family planning programmes, and focuses on the approaches and tools that are most effective for their settings.
An estimated forty million people carry the human immunodeficiency virus (HIV), and five million more become newly infected annually. In recent years, many HIV-infected patients in wealthy nations have enjoyed significantly longer, good-quality lives as a result of antiretroviral therapy (ART). However, most infected individuals live in the poorest regions of the world, where ART is virtually nonexistent. The consequent death toll in these regionsâ€"especially sub-Saharan Africaâ€"is begetting economic and social collapse. To inform the multiple efforts underway to deploy antiretroviral drugs in resource-poor settings, the Institute of Medicine committee was asked to conduct an independent review and assessment of rapid scale-up ART programs. It was also asked to identify the components of effective implementation programs. At the heart of the committee's report lie five imperatives: Immediately introduce and scale up ART programs in resource-poor settings. Devise strategies to ensure high levels of patient adherence to complicated treatment regimens. Rapidly address human-resource shortages to avoid the failure of program implementation. Continuously monitor and evaluate the programs to form the most effective guidelines and treatment regimens for each population. Prepare to sustain ART for decades.
Despite the spread of automation and new supply chain management paradigms, logistics remains dependent on a rather specific set of skills and competencies, whether for managerial, administrative, or blue-collar jobs, such as trucking or warehousing. This dependence implies that the logistical performance of businesses, industries, and nation states is strongly influenced by the quantity and quality of the workforce. Insufficient resources of a competent and properly trained workforce in logistics adversely affect the quality of service, reduce productivity in sectors dependent on logistics, and ultimately reduce trade competitiveness. While other interventions that affect logistics performance—such as international infrastructures, trade corridors, regulations, and services—have already been reviewed extensively, this report is the first to cover the contributions of human resources and explore how to develop skills and improve competencies, especially in developing countries. The study proposes a framework for the skills needed according to the logistics activity (such as transportation or warehousing) or the type and level of responsibility. Based on several sources, including recent surveys carried out by the World Bank and the Kühne Logistics University, the report uncovers where the skills constraints are according to the type of job or countries. Findings include that logistics is an industry struggling to hire skilled workers, although with differences between developed countries (where trucker shortages are more acute) and developing economies (where managerial shortages are more widespread). Typically, blue-collar logistics jobs have lower status and lower pay than blue-collar jobs in other industries; they are thus less attractive for skilled workers. In developing countries with a potentially available workforce, lack of vocational preparation for careers in logistics means that less-skilled workers are not easily re-skilled. Logistics tasks at the upper end of the occupational hierarchy and those with high information technology content often require an upskilling of employees to keep pace with new technology. Yet the problem is not confined to recruitment. The surveys point to limited resources, money, and staff time allocated to training, especially in developing countries. Realizing the promise of quality jobs from the growth of logistics worldwide requires a coordinated effort by logistics companies, professional associations, training providers, and policy makers. Through a combination of facilitation, regulation, advice, financial instruments, and land use planning, governments can exert significant influence.
Healthcare improvements is constantly relevant and an important topic. Healthcare is frequently being called upon to be more cost-efficient and still fulfil demands regarding waiting times, quality and availability. Experience from structural changes in other contexts gives reason to be positive about the potential for logistics improvements in the healthcare sector as well. From a logistics perspective patients pass different care functions, units, organisations and health facilities. It is assumed that logistics management knowledge applied in healthcare can lead to lower costs, shorter waiting times, better patient service, shorter treatment times and increased capacity. This dissertation therefore presents an exploration of how logistics management theories can be operationalised in a healthcare context to understand care chain effectiveness. Theoretically, the operationalisation is done by systems theory creating compatibility between logistics management theories and the healthcare context. As a first step, features for a logistics system forms features for achieving care chain effectiveness. High care chain effectiveness is thus a desired condition and the care delivery system is the tool to achieve it. As the final step in the operationalisation the features for care chain effectiveness are in turn used to analyse today’s practices. Empirically, the research is based on qualitative data from a single case study with multiple units of analysis. It includes four care units at one of Sweden’s university hospitals, where the data is gathered through interviews, insight into management systems and document analysis. One of the main results is the 21 areas identified for analysing today’s practices by means of features for care chain effectiveness. Another main result is the four important concepts revealed through the operationalisation: Lead time - the episode of care from order to delivery as the amount of time for patient cases between first contact with healthcare and the last.Patient order fulfilment - fulfilment of patients’ needs, broken down into several smaller steps performed over time within different care units in one or several organisations, consisting of five sub-processes - order handling, diagnosis, treatment, follow-up, and discharge.True demand – patients’ needs that is to be met and thus sets what care to deliver, i.e. the production plan and the subordinate resource plan.System boundaries - defines which care units to include when focusing on the care delivery system’s performance as a whole and should be more important than the performance and productivity of each individual care unit. A number of direct suggestions for care chain improvement can also be found in the concluding remarks, for example that objectives linked to economic influx or penalty narrow the system and that lead time data on an aggregated level is needed to cover episodes of care. The theoretical contribution of the dissertation is to the field of logistics management through the methodological development of using these theories in a new context. The managerial contribution is to healthcare managers through providing opportunities to improve care chains primarily by means of a greater understanding of care delivery systems.
Annotation Provides information on progress and trends, including poornonpoor disparities; health systems reform as a means of laying building blocks for the efficient and equitable delivery of effective interventions; the financing of health spending through domestic resources and aid; and improving the effectiveness of development assistance in health. Linking the health Millennium Development Goals? agenda with the broader poverty-reduction agenda, this book is a valuable resource for policymakers in developing countries and development practitioners working in the health, nutrition, and population sector as well as students and scholars of public health.
'The Cost of Being Landlocked' proposes a new analytical framework to interpret and model the constraints faced by logistics chains on international trade corridors. The plight of landlocked developing countries (LLDCs) has naturally received special attention for decades, leading to a specific set of development priorities based upon the concept of dependence on the transit state. Therefore, the standard approach used to tackle the cost of being landlocked has been predominantly aimed at developing regional transport infrastructure and ensuring freedom of transit through regional conventions. But without sufficient attention given to the performance of logistics service delivery to traders, the standard approach is unable to address key bottleneck concerns and the factors that contribute to the cost of being landlocked. Consequently, the impact of massive investment on trade corridors could not materialize to its full extent. Based on extensive data collection in several regions of the world, this book argues that although landlocked developing countries do face high logistics costs, these costs are not a result of poor road infrastructure, since transport prices largely depend on trucking market structure and implementation of transit processes. This book suggests that high logistics costs in LLDCs are a result of low logistics reliability and predictability, which stem from rent-seeking and governance issues. 'The Cost of Being Landlocked' will serve as a useful guide for policy makers, supervisory authorities, and development agencies.
