Building efficiencies into govt machinery
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1 Monday I read quite a disheartening article on the destruction of drugs worth approximately E million purely because we cannot get our supply chain and distribution chain right. This is a major cause for concern and requires astute and immediate action from the authorities.
We cannot allow vital lifesaving drugs to be destroyed. This story is quite difficult to balance with the narrative of drug stock-outs. It begs a question of how these two extreme cases hold true for one health response system and a single health response system. This to me is telling of the failure for the public service machinery to find efficiencies within the system and deliver seamlessly on the public’s obligations.
Objective of health systems
The objective of the health system is to provide healthcare to a majority of the population at the lowest cost possible. This is the universal goal of a health system. By definition a health system should have inbuilt efficiencies and the fact that we have to destroy drugs worth this much is a sign of failure within the health system, which needs to be arrested.
We need to have a system that is able to push the drugs to the people as and when the need arises, wastages of this magnitude in this resource tight environment are not at all acceptable; something needs to change so that we get critical care to our people.
Supply chain management
This predicament is further telling of the fact that there is need to strengthen our supply chain system as a country. I do not want to believe that the drugs that got spoilt and expired were sourced five years ago; no! Drugs have a very long shelve life, we need capacity within our supply chain system to ensure that we purchase commodities that are a good period away from the expiry date. In order for us to be able to do this we need to diversify our supply chain to have multiple input sources so we can have variety and we can avoid purchasing stock that is about to go bad. This requires investment within our supply chain at the Central Medical Stores to have this capability.
Decentralised inventory management systems It is time we really took decentralisation to the centre of our efforts as a country; we need to have a proper mechanism of interfacing the Central Medical Stores with facilities on the ground. We need to build an inventory management system that will interface the facilities with the Central Medical Stores and have inbuilt demand forecasting mechanisms.
)acilities need to have autonomy in their ordering systems and not have the medical stores just deliver drugs to them because they are about to get old, this is not efficient and we cannot afford inefficiencies at this point. The government machinery needs all the savings that it can amass; we need to stretch the /ilangeni the furthest we possibly can.
Demand forecasting systems
We live in the industrial revolution and,
th therefore, it is imperative that data management systems are improved. We need to equip facilities across the country with the proper demand forecasting skills. This should have heavy focus on the medical stores and should then transcend to the facilities across the country. The investment does not necessarily have to be accompanied by a heavy human resources component, we can focus on big data and artificial intelligence to run these models for facilities and produce forecasts.
The health information management systems can focus on feeding the data into the system so that the artificial intelligence learns from that data. We need to understand that we live in an era where data is the new oil and we have to take advantage of this era as a country.
Overhaul government machinery
I use the words overhaul loosely here because this is telling of the inert failure within our public sector system to infuse efficiencies. That is the mentality we need to overhaul and take advantage of technology that seeks to improve efficiencies and lower costs. Case in point, what we need in the health sector is a simple inventory management system, a simple one just like the one utilised by general dealers, and that would not be so expensive to invest in. The fact that we are failing to catch up with such simple innovations is testament of the anti-progress culture that exists within the government machinery. It is understandable that every organisation has a culture and organisational culture is difficult to change, however, in this case failure to change the culture will lead to the demise of the whole nation. It is imperative that we change the way we do things within government.
Pseudo privatisation
We can build efficiencies into our public sector through pseudo privatisation. This is a scenario where the public sector is run like a private entity and reaps all the efficiencies of the private sector. This will entail introducing performance management systems and enforcing a performance-based rewards system within the public service. We need to link salary to performance and not this blanket-based system of annual salary increments.