• Editors' Summary
• Credits

1. A New Look at Logistics
2. Clients Come First
3. People and Performance
• Leadership
• Improving Staff Performance
• Sustaining Good Performance
4. The Role of Information
5. Forecasting and Procurement
6. Distribution
7. Toward Contraceptive Security

• Figures
• Tables
• Side-bars
• Bibliography

• Programs face funding crisis
• Benefits of better logistics
• Improving staff performance
• Tips on building policy support
• Checklist: Assessing the supply chain
• How to make accurate forecasts
• Push or pull distribution
• The commercial sector can help

• POPLINE
• Media/Materials Clearinghouse
• Other issues
• To order copies
• CCP Home Page

This issue of Population Reports was prepared in collaboration with the DELIVER Project of John Snow, Inc.

Published by the Population Information Program, Center for Communication Programs, The Johns Hopkins University Bloomberg School of Public Health, 111 Market Place, Suite 310, Baltimore, Maryland 21202, USA

People and Performance

Family planning programs rely on skilled workers and good leadership to deliver contraceptives to clients. In family planning supply chains every employee is important, as is the service provider who works directly with the client. Businesses have recognized the value of people to the supply chain and have invested in strengthening their human resources through leadership, supervision, staff development, motivation, and training (90). The same holds true for family planning programs: Improving staff performance improves logistics performance.

Strong leadership is vital to good family planning program performance (55, 118). In a long, complex supply chain, leaders at every level help to keep contraceptives and other supplies moving by:

• Establishing national and local strategies for selecting, allocating, and delivering supplies and services,
• Setting and communicating program performance expectations, and
• Ensuring that workers are knowledgeable, skilled, and committed (127).

Some leaders occupy formal supervisory positions—for example, as managers—while others have job titles that may not indicate their leadership role or may not have job titles at all.

In each family planning program some top managers should focus solely on contraceptive logistics, or else logistics may not get enough attention (141, 149). To provide effective leadership in logistics management, supervisors must understand how the supply system works, build good working relationships with warehouse or logistics managers, and collaborate and share information with the clinic managers and other staff they supervise (14).

Family planning program managers may not understand the value and function of contraceptive logistics (82, 84, 138). For example, in Turkey in 1996–1997, surveys in 17 provinces found that local health facility managers who were required to supply service statistics saw the task as a bureaucratic obligation with no relevance to their own jobs. They had no training in using data to monitor service delivery or to manage the flow of supplies and therefore had little incentive to collect good data. Not surprisingly, without useful data and trained personnel, the common results were contraceptive stockouts, poor storage conditions, and expired commodities (41, 94, 135).

FPLM/JSI In Jordan a senior family planning logistics officer meets with a group of midwives to discuss contraceptive supply issues. Like logistics system workers themselves, service delivery workers need to understand the supply chain and their role in it.

Policy-makers can strengthen logistics. Government policies can support and strengthen logistics systems in many ways: Policy-makers can provide more resources, focus attention on improving supply chains, and help staff develop their logistics management skills. Policy-makers often play a pivotal role, as in Mexico, where logistics receives substantial financial and political support (115), and in Chile, where the Ministry of Health views logistics as protecting their investment in contraceptives and has provided funds to improve inventory tracking (114).

Policy-level support can come from either a “bottom-up” or a “top-down” approach. In a bottom-up approach, programs begin by strengthening logistics at the field level. Successes in the field help generate policy-level interest and support because improved logistics systems provide greater efficiency and accountability.

In 1998, for example, Malawi’s family planning program first established a field-level distribution and logistics information system that reduced contraceptive stockouts, thus making more contraceptives available to more clients. These improvements attracted policy-level support, and new policies led to improvements in other areas of the supply chain, including the LMIS (6).

In contrast, a top-down approach first builds policy-level commitment for logistics and then—with the support of in-formed policy-makers—makes improvements to supply chain operations. For example, in 1997, the Jordan Ministry of Health decided to improve the country’s contraceptive logistics system. It provided nationwide training and distributed procedures manuals to all service delivery and directorate-level supervisory staff who had been trained. The Ministry also introduced a new information system to collect and report both logistics and service statistics data, which provided policy-makers evidence of success that helped assure continued support (113, 116).