From our experience working with Africa’s health and development sectors, it is clear that misinformation about supply chain issues in Africa abound. And false assumptions – such as a lack of supplies where there is none or that more vehicles could solve problems – do not serve the people in the many distinct countries of the continent.
What can help uncover the real issues? For starters, an African perspective to building capacity and empowering public health leaders in the region could drive new solutions to their unique supply chain challenges.
Starting with the backbone of public healthcare
The backbone of public health in low- and middle-income countries is typically the Central Medical Store (CMS). The CMS procures and distributes medicines to public sector health facilities at the national level. Typically owned and financed by the government, the CMS is organised as part of a country’s civil service – often the Ministry of Health.
The top executives who run CMSes face substantial challenges, exacerbated by the lack of ability to effectively introduce new policies, new technologies and new products or the inability to handle surges in demand for health commodities. They are also faced with externally driven crises such as frequent changes in national leadership or a sudden reduction or change in funding.
At the organisational level, some CMSes face regular leadership transitions, resulting in a loss of shared knowledge. With many executives new to the role of strategic manager, they may lack confidence in their own leadership and management capabilities.
In early 2020, CEOs from these CMSes contacted the Empower School of Health, looking for an educational platform to learn relevant skills. As technicians who rose through the ranks, these executives learnt the nuts and bolts of the pharmaceutical business well. However, they needed additional leadership, managerial and supply chain management skills to complement their technical knowledge.
Public-private partnership towards sustainable transformation
At that time, the newly established global public health supply chain team at Johnson & Johnson learnt that there was an opportunity for supply chain leaders to learn from each other and advance their skills. With this in mind, and with a focus on strengthening the public sector by leveraging know-how from the private sector, the Empower School of Health, the Humanitarian Research Group at INSEAD, the global public health supply chain team at Johnson & Johnson, and local experts started to work towards a tailored training solution for the CMSes’ CEOs.
The result was a pilot programme for public health executives in Africa known as CEO Forum Africa, leveraging Empower’s South-South focus on education and INSEAD’s deep research-based knowledge. With a unique combination of complementary skills from the private and public sectors, the team worked together to help executives from the CMSes develop new leadership and management skills and mobilise them to combat the healthcare challenges they face.
The original plan included peer-to-peer learning support and digital innovation to establish long-term educational gains moving forward. The programme, which hosted between five and seven top executives and their direct reports from Ghana, Rwanda, Zambia, Zimbabwe and Malawi, aims to foster sustainable transformation, both at the level of a country team and also at the individual level.
Mentorship for two-way exchange
First, we selected countries for a pilot programme and conducted a full needs assessment. Next, we kicked off the inter-country learning programme, including capacity-building workshops. Lastly, we rolled out the mentoring and coaching programme.
But we could not have done this on our own. Johnson & Johnson supported the programme with important financial and time contributions, in addition to connecting CEOs with mentorship opportunities with pharmaceutical executives in Africa who understood their healthcare delivery contexts.
In implementing the pilot programme, the uncertainty brought about by the global pandemic meant we had to tread lightly. Our initial plan to bring the CEOs from the five CMSes together was not achievable. We had also hoped to have a team for each country, to evaluate their skills and how their individual talents could come together under the umbrella of leadership, but this was a daunting challenge.
Eventually, the programme shifted to a digital platform. Mentoring circles are naturally easier face-to-face, so the shift to online was less than ideal. At the best of times, CMS executives are extremely busy; in the middle of a public health crisis, the complexity of the pandemic added additional hurdles.
But these were not unsurmountable challenges. The accessible network of mentoring circles developed through the programme helped to shore up participants’ support. Ultimately, the authentic contact between mentors who had already dealt with many of the same issues faced by CMS professionals and our participants was highly productive.
The right mix matters
The mentoring circles comprised of four to eight people from different countries per group, mentored by leaders from Johnson & Johnson, Empower and other partners. There were two inter-country mentoring circles, one single country (Zimbabwe) circle and a “women in leadership” circle. Because these circles were varied, we could compare the effectiveness of different approaches to mentoring.
The mentoring forum also provided the international private sector executives who served as mentors with important insights on the strengths and weaknesses of the African public supply chain. This shared expertise has the potential to create better solutions that consider the African perspective in context. The participants appreciated the coaching and mentoring, particularly the one-to-one coaching, where they could speak privately to a certified DISC coach to express their needs and discuss personal skill gaps.
One country, Zimbabwe, had six CMS executives in the programme, with mentorship support from Empower, INSEAD, Johnson & Johnson and most importantly, Ropafadzai Hove, former CEO of a CMS. Her input was crucial in creating a clear output, a vision for their team goals and strategies for the year. It was the first time this group had strategized in this way, which was powerful and useful.
The Zimbabwe CMS executives were all part of the same team. This grouping not only allowed them to build on their own strengths and weaknesses, but also to identify complementarities with the rest of the team. In terms of leadership and management capacity building, there was a natural link between personal development, country team cohesion and overall progress.
Put simply, an experienced local champion who can nudge the country team and provide support during the process helped improve engagement and the overall result. Hove said, “Having mentors sharing comparable backgrounds, coupled with international and national experiences resulted in an immediate connection.”
Building a community of practice and beyond
The global nature of the pandemic has demonstrated over and over again how interconnected we all are. Since the pathway to leadership in the CMS remains unchanged, future executives will meet the same hurdles as past CEOs, confronted with decisions for which they may have the technical expertise but require additional strategic and supply chain experience. Clearly, there is a need for more capacity-building programmes.
In this pilot programme, we were thrilled by what we have achieved:
- 23 participants completed DISC assessments and received a report on their areas of strengths and weaknesses in leadership or management capacities
- Three capacity-building workshops focused on setting an organisational strategy, setting actionable goals and objectives, and developing and managing a talent pipeline
- Effective sharing of South-South experience and expertise through mentoring
- Discussions of the importance of women leadership in the health sector
The CEO Forum Africa aims to engage, strengthen and mobilise leaders of public health supply chain organisations by building a community of practice. By engaging not only leaders but also direct reports, and through ongoing mentorship and skills-building opportunities, we can build sustainable leadership over the long term.
Moving forward, we hope to integrate a robust, useful digital platform and apply what we have learnt from the pilot to help other CMS executives in Africa. Ultimately, support for the CEO Forum Africa is more than sponsoring a handful of executives, it is designed to empower public health that will impact billions.
Edited by:Rachael Noyes
Leave a Comment