Contents

Contents......................................................................................................................................1
1.0 Introduction to the Logistics Unit........................................................................................2
1.1 Assignment.......................................................................................................................4
2.0 Introduction to Operational Planning and Decision Making...............................................5
3.0 Key issues in operational planning......................................................................................6
3.1 Steps in planning..........................................................................................................8
3.1.1 Setting the direction..................................................................................................8
3.1.2 Resource Assessment................................................................................................8
Activities in resource assessment...................................................................................9
3.1.3 Identification and Analysis of Alternatives...............................................................9
3.1.4 Alternative Selection...............................................................................................10
3.2 Problem Hierarchy.........................................................................................................10
4.0 Key issues in Decision Making..........................................................................................11
Step 1: Identify the problem.................................................................................................12
Step 2: List alternatives........................................................................................................14
Step 3: Evaluation of each course of action and selecting the best alternative....................14
Step 4: Choice making and decision implementation Implement the chosen alternative....15
Step 5: Monitoring and Evaluation (M&E).........................................................................16
5.0 Conclusion..........................................................................................................................17
6.0 Bibliography.......................................................................................................................18
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1.0 Introduction to the Logistics Unit

The general development of any society encompasses the health of the individuals in that
society. This implies that health is a dynamic process. In Zimbabwe, the Ministry of Health
and Child Welfare (MOHCW) continuously changes its functions and structure to better meet
the ever-evolving challenges and demands. The Government of Zimbabwe (GOZ) desires to
have the highest possible level of health and quality of life for all its citizens. This vision has
to be attained through guaranteeing every Zimbabwean access to comprehensive and
effective health service.

The MOHCW has various departments to ensure that its vision is achieved. These are the
Provincial Medical Directorates, Central hospitals, Human Resources, Finance and
Administration, Oral Health Services, Nursing Services, Traditional Medicines, Laboratory
Services, STI, HIV, AIDS and TB Unit, Policy and Planning, Monitoring and Evaluation,
Quality Assurance, Chief Internal Audit, Epidemiology and Disease Control, Reproductive
Health, Environmental Health; and Pharmacy Services.

This assignment will be limited to the Pharmacy Services. The Directorate of Pharmacy
Services encompasses the Logistics Unit (LU) which is responsible for managing essential
medicines and medical supplies including HIV/AIDS commodities distribution systems and
the related Logistics Management Information Systems (LMIS). In addition, the LU forecasts
and quantifies essential medicines and medical supplies. It analyses and interprets data in
order to report logistics information, including feedback reports to the various levels of the
MOHCW and its partners such as the Global Fund to fight AIDS, TB and Malaria (GFATM),
United States Agency for International Development (USAID) and the Clinton Foundation.
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The Logistics Unit is made up of The LU Manager, the Deputy LU Manager, Upstream
Logistics Coordinator, Prevention of Mother to Child Transmission (PMTCT) Coordinator,
Management Information Systems (MIS) Officer, three data encoders, an Administrative
Assistant, an Office Orderly and four Logistics Officers at the Harare office.
Figure 1: Organogram of the LU

LU Manager

Deputy LU
Manager

4 Logistics

Officers

Upstream
Logistics

Coordinato
r

PMTCT

Coordinato
r

Adminstrative
Assistant

MIS Officer

Office
Orderly

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Data
Encoders

Of the fourteen members at the LU Harare office, 2 are pharmacists, 3 are pharmacy
technicians, and the rest have no pharmacy-related background. This diagram below shows
that the team is composed of members from diverse professional fields. Each member brings
different skills to give a potential fusion of expertise.

Figure 2: LU staff by professional background

Other; 1 Pharmacists; 2
Office Management; 1

Pharmacy Technicians; 3
Information Technology background; 4

Logistics-related background; 3

1.1 Assignment
Operational Planning and Decision Making are key to the success of the organisation, a
discussion with examples from the Directorate of Pharmacy Services, Logistics Unit of the
Ministry of Health and Child Care.

2.0 Introduction to Operational Planning and Decision Making

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Planning is a mental activity intended toward anticipating, forecasting, and handling change.
It is meant to yield a recommended course of action to deal with probable future
developments. Planning helps in risk management since a manager can deal with problems
proactively rather than reactively. It also creates a sense of mission which allows a manager
to motivate and measure the performance of people under him/her. Plans are bridges for the
gap between where an organization is and where it wants to be in the future.

Corporate-level managers are concerned with planning overall corporate strategy, rate of
growth, and new markets/products. Business Unit-level managers are concerned with
planning a high degree of coordination with minimal overlapping among organizational units
and the enhancement of resource utilization among these units. Line managers and
supervisors plan the implementation of policies and procedures, work activities, and ways to
enhance the effectiveness and efficiency of work operations. Planning occurs at all levels and
needs information flow up, down, and sideways in the organization to be effective.

Plans succeed when they are used, monitored, and changed as work progresses. Plans fail if
they are not kept up-to-date, realistic, or clear. It is imperative that whoever is planning must
be able to make decisions, sound decisions. It is also important to note that failure to plan is a
decision, albeit a bad one. A decision is a choice between alternatives and decision making
is the process of choosing one alternative over the others. Making good decisions should be a
process. It is a process of identifying problems and resolving them, or of identifying
opportunities and taking gain of them.

3.0 Key issues in operational planning

Plans may be classified by short- or long-term, by function, or by breadth or scope. Longterm plans are done at upper management levels and encompass a number of years, such as
moving into another market sector. These long-term plans are usually strategic plans
designed to identify, determine, and shape the direction of the organization. The DPS has the
National Medicines Policy and makes use of Strategic Plans for the successful performance
of the programs it maintains. These are crafted by Central Level staff of the Directorate.

Short-term plans are done at lower management levels and encompass a short period of time,
such as for a project or budget. These plans are usually operational plans helping with dayto-day operation. The LU creates work plans which it submits to the DPS for approval. These
are operational plans which detail the day-to-day undertakings of the unit. Function plans
may be developed for key organizational functions, such as engineering or finance. Each of
these plans could be evaluated for potential conflicts between functional areas. The LU work
plans are also aligned to budgets approved by the administration department.

Breadth or scope plans may address objectives, policies, procedures, methods, or rules. There
are various programs under the realm of the MOHCC which are serviced by the DPS. These
include the antiretroviral, TB, malaria, essential medicines and PMTCT programs. The DPS
has developed distribution systems for each of them. As such, the DPS has crafted standard
operating procedures for each of the systems. Objectives provide general statements about the
mission of the organization or what is to be done. These objectives filter down through the
organizational hierarchy where plans are created to achieve them.
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Policies are implemented to accomplish objectives and are general guides to action, such as
the Zimbabwe National Medicines Policy which allows the creation of an essential medicines
list. Procedures give the steps for accomplishing the policies, such as standard operating
procedures for the inventory control systems for antiretrovirals which show the set of steps in
ordering, storing and distributing medicines. Methods are detailed plans showing the
sequence of individual tasks to complete a specific assignment, such as how to complete a
prototype design. Examples include the job aids in the standard operating procedures of the
various programs.

Rules are prescribed standards of behaviour and place restrictions on employee behaviour,
such as dress codes, smoking regulations, and sexual harassment preventives. These are
enshrined in the Health Services Regulations. If plans are prolific, employees may be over
constrained and have little freedom to do their work. If there are no plans, employees will be
frustrated by not knowing what to do. These documents serve to guide the employees in their
duties to ensure quality service delivery to patients and clients.

3.1 Steps in planning

Planning is hopefully a logical and systematic activity; a sequence of steps can be helpful to
accomplish planning.

3.1.1 Setting the direction

The totality of goals and objectives must be defined to serve as the measure against which
success is to be judged. Goals establish the milestones that warrant achievement. They
delineate the differences between where and what the organisation is now, and where and
what the manager wants to be in the future. Determine the purpose of planning by stating
your objectives in concrete form. The objectives should be specific, achievable, measurable,
and operational rather than abstract.

They need to have timelines to them. Roles and responsibilities of the people who will be
involved in planning including those authorizing, coordinating, developing, approving, and
participating in planning should be discussed and agreed upon. The Directorate of Pharmacy
Services has a mission to ensure that medicines which are safe, efficacious and of good
quality are available, accessible and affordable (SEQAAA) to all those in need.

3.1.2 Resource Assessment

Resources are the materials and persons used to achieve goals and objectives. Types of
resources vary greatly but in the pharmacy services it is useful to group them into five broad
categories: information communications technology, delivery and monitoring vehicles,
finances, facilities and people. The resource assessment process must be thorough enough to
provide clear indications of the inherent capabilities and limitations of the resources.

Activities in resource assessment

Identification of other resources and facilities for implementing the plan, such as

materials, supplies, equipment, and software.

Specification of the methods to execute the plan and what it will take to get the plan

moving.
Developing a cost estimate or budget for the plan, such as salary, travel,
communication, resource, and overhead costs (overhead costs may be specified as a
fixed percentage of the overall budget and normally cover items, such as clerical
support, utilities, contract services, and law services).

3.1.3 Identification and Analysis of Alternatives

The identification and analysis of alternative ways that a set of resources might be utilized to
accomplish goals is the most challenging step in the planning process. The difficulty stems
from the multitude of alternatives. To further complicate the formulation of a good plan,
various combinations of all of these enterprises, production and marketing alternatives must
be examined. The DPS conducts half-yearly quantification for medicines and medical
supplies. This process has been made tougher because of the changes in medicine guidelines
for antiretroviral treatments as well as the scaling up of the program. This means the
quantification team has to explore different procurement scenarios.

For each alternative or unique combination of alternatives, the planner must first evaluate
resource requirements and costs to determine if the ranch's resources are sufficient to
implement a practice, or if, for example, some of the financial resources would need to be
used to acquire other resources, such as medicines. Next, the expected pharmacy service
levels, and impacts on non-financial goals (free time, peace of mind, over reaching societal
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needs) likely to result from each alternative should be assessed. This is a stage not focused on
by the DPS.

3.1.4 Alternative Selection

Finally, after all the alternative combinations are analysed, the combination of alternatives
which most nearly meets the totality of pharmacy services goals and objectives is selected.
The selection process should not give undue emphasis to personal goals are not given undue
emphasis over financial goals. After a plan has been selected as the most appropriate one, a
realistic schedule for it should be devised. This plan should be monitored and evaluated
basing on agreed metrics so that it can be amended whenever necessary. The 18-month
supply plan for the DPS is monitored through the use of Pipeline software. The plan is
changed if necessary basing on the actual consumption of the medicines.

3.2 Problem Hierarchy

Long-term or strategic planning concerns the achievement of goals of the resource owners
over several years. Long-term plans generally affect major changes in the way resources are
used to achieve goals. Once implemented, plans at this level cannot be altered quickly. In
terms of organizational structure they are usually under the control of directors and the
Permanent Secretary.
Intermediate time periods require tactical planning. Most often tactical planning is the
responsibility of middle to upper level management and is more closely related to the
operating function than long-term planning. Intermediate term planning results in decisions of
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how to best effect or implement long-term plans. Decisions resulting from tactical planning
are likely to be repeated at least annually. Short term or operational planning is characterized
by those many decisions that must be made in a short time-frame. Plans for the day's or
week's activities are examples of operational plans commonly made. These are plans made by
the LU staff for their daily activities and can be changed easily.

4.0 Key issues in Decision Making

As Wilcox (1982) stated in his book on grazing management "the successful rancher is that
one who can, firstly identify the different factors which will affect operation of the ranch, and
secondly, can anticipate the changes in them that will influence his success. This successful
rancher is the one who avoids crisis in the running of his enterprise..." No operator should
allow himself to get into the crisis situation, but should arrange his management style to
anticipate the changes which will be necessary in the operation and make those changes
affecting in a timely manner."

Likewise, White et al. (1987) stated "This [anticipating change] is an impossible task if the
ranch has not developed a logical and practical approach for analysing information,
evaluating plans, and directing daily operations... It is doubtful that any person can accurately
assimilate the mass of information and predict the overall ranch outcome without detailed
planning and evaluation." This advice from a grazing management points to a need for
knowledge management within organisations. It calls for learning organisations. The LU has
a Logistics Management Information Systems (LMIS) for consumption data management.

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Greenwell (1998) wrote that the effectiveness of a manager in using available information has
a psychological basis deriving from memory, perception and problem solving skills and exists
only in the social context in which the manager functions. He said level of acquired expertise
relates to learning and assimilation of knowledge in the cognitive processes, judgmental
behaviour, social behaviour backed by social knowledge, creative behaviour, analytical
behaviour and ability to establish and pursue firm practices when necessary. It is of utmost
importance that managers are of sufficient experience to lend them enough discretion in
making decisions especially where uncertainties may prevail.
Decision making may be accomplished with the following steps when there is time and the
decision requires analysis before it is made.
Step 1: Identify the problem.

The first step is to recognize there is a problem and a decision must be made. Some people
just react to problems, but good managers seek to understand the problem and respond
appropriately. Decision making is essentially a problem-solving process. This involves
understanding the situation and trying to resolve it. Decision makers should know the
objective in making the decision. As aforementioned, objectives should be operational,
practical, attainable, and challenging. Statements of objectives such as mission statements
should include constraints which may refer to how the objective will be attained, how
resources are used, and how conflicts with organizational goals are avoided.
Objectives should be ranked according to their importance, such as "critical", "desirable", or
"would be nice". The challenge in public health is to provide medicines with very limited
resources and increasing needs. Problem diagnosis is the most critical and difficult step as the
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right problem must be found and identified. During problem diagnosis, it is common to
confuse symptoms and problems. This may lead to poor decisions which are often correct
solutions to the wrong problem.

Steps in Problem Diagnosis include

Confirm if there is a problem-Compare the results you have with the results you
wanted to achieve. If they are the same or better, a problem does not exist. If you

have inferior results, then a problem exists.

Investigate causal agents-Find the reasons behind deviations from objectives.
Approach the problem analytically and realistically finding the distance between
wanted and actual results, major deficiency factors, barriers to success, and

satisfactory solution requirements.

Identify the limitations to the solution, such as cost, personnel, and information.
Focus on causal problems rather than deviations from defined standards, such as
employee turnover rate which may be due to the personnel department's inadequate

recruitment practice and not anything attributed to the manager.

Use symptoms to find the problem, such as asking why the symptom exists - noticing
the symptom of conflict between two departments and then determining why the

conflict exists.
Determine the barriers to challenge identification, such as some managers thinking the
cure is worse than the disease, procrastination decision making, rationalizing

decisions, or hating to make unpopular decisions.

Focus on the real problem and its possible causes

Step 2: List alternatives

Managers need to develop a list of possible courses of action that will solve the problem.
Managers must look for standard answers and also creative answers. The technique
brainstorming is an example of creative thinking that can take place between a manager
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and the subordinates. In brainstorming, everyone comes up with as many alternatives as

possible. Employees should experience a nurturing environment where everyone will feel like
contributing. Shooting down an idea will stop the free flow of exchange.

The team should make a thorough and comprehensive effort to identify all logical alternatives
to the problem. Innovation should allow for enough flexibility to deviate from the traditional
way of doing things if it is promising to do so, or taking no action on the problem, to use
intuition and advice from others who have handled similar problems. Managers must guard
against barriers in exploring options such as egotistic desires to control the solution
personally or wanting to focus on short-term rather than long-term effects.

Step 3: Evaluation of each course of action and selecting the best alternative.
Evaluating options is part of selecting a desirable alternative. As part of the evaluation, the
potential effects of each choice should be listed objectively. The merits and demerits of each
alternative should be weighed using pre-determined metrics. A set of attributes, such as cost,
resource utilization, risk, and schedule slippage for rating the alternatives need to be
developed from the objectives set out earlier. These attributes should be used to come up
with a ranking system for the different choices and result in an evaluation matrix. A
discussion of those effects should lead to a decision based on what is best for the
organization. The DPS is mainly worried about cost-benefit analyses in choosing medicines
to include in the essential medicines list.

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Step 4: Choice making and decision implementation Implement the chosen alternative.
Ideas themselves on their own do no good. The chosen alternative must be turned into action.
This is critical. All of your successful analysis wont do any good if you are afraid to act.
Whether the implementation is easy or hard, you must take action. In all likelihood, there will
not be one or more perfect alternatives from which to choose because of the dynamic nature
of the organization's environment, incomplete information, having to reduce the complexity
of the problem to a level at which a human being can handle the possible alternatives, lack of
time, and risk. How a decision is implemented will have a bearing upon its success.

A plan of action should be created to announce the decision, to gather the resources to
implement the decision, and to assign responsibility to the individuals who carry out the
implementation. Keep in mind that people are more apt to participate in decision
implementation if they have been given the opportunity to participate in the decision making.
This is why the DPS holds quarterly Central Level Pharmacy Services meetings to have a
buy-in from implementing personnel. The MOHCC also engages various partners such as
John Snow, Incorporated and stakeholders in planning meetings to get concurrence on the
course of action and ensure commitment.

Step 5: Monitoring and Evaluation (M&E)

Monitoring is the routine collection and analysis of measurements or indicators to determine
the ongoing progress toward objectives while evaluation is the periodic comparison of
objectives, with accomplishments, to determine how well the objectives were achieved. In
order to determine how accurate the decision was, one should examine the results over time
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and compare them to the desired results of the objectives, make sure the steps to implement
the decision have been carried out, and determine how well the decision was accepted by
those involved.

The LU collects M&E data to enable program managers to provide feedback to staff
throughout the medicine and medical consumables supply chain to improve system
performance; to report results to funders and other stakeholders; and to justify the need for
additional resources, when appropriate. One important reason to do M&E is to improve
program management and, ultimately, the logistics system performance. Improving program
management and system performance are critical for improving customer service and for
ensuring commodity security that clients have the products whenever and wherever they
need them. If the problem is not resolved, a manager must go back through the process and
look at other alternatives.

5.0 Conclusion
Planning is an activity that helps organizations and projects proceed with current and future
work in an organized and systematic way. Planning is the primary function of management
and a continuous process where plans are refined and adjusted over time as more complete
information becomes available. It assists an organization map the direction for the
achievement of its objectives. The process begins with reviewing the current operations of the
organization and identifying what needs to be improved operationally in the coming periods.
It later involves envisioning the results the organization wants to achieve, and determining
the steps necessary to arrive at the intended destination.

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Decision making is a critical activity that helps to mitigate risk with difficult problems, such
as significant deviations from planned objectives. Deviations from objectives must be
investigated thoroughly to find the root problem rather than deal with symptoms. Solutions to
the problem may be found through the use of an evaluation matrix allowing affected parties
to participate in the decision making process. Creativity in decision making can be enhanced
by looking at the problem elements from other perspectives, such as using charts and graphs.
Without decision making different managerial function such as planning, organizing,
directing, controlling, staffing cannot be conducted.

For anything to be done, a decision has to be made. Therefore, we can say that decision is
important and pervasive element to implement the managerial function. Decisions can be
used to evaluate staff performance. It is correct to believe that all employee actions follow
their decisions and therefore decisions made are used to judge the efficiency of an employee.
Any policy or plan is established through decision making. Without decision making, no
plans and policies are performed. In the process of making plans, appropriate decisions must
be made from so many alternatives. Therefore decision making is an important process which
is helpful in planning since decision makers evaluate various merits and demerits of every
alternative and select the best alternative. It follows therefore that successful organisational
operations are a result of decide to plan and planning to decide. In this competitive world;
organization can exist when the correct and appropriate decisions are made. Therefore correct
decisions help in successful operation of business.

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6.0 Bibliography
1. Greenwell, M. 1988. Knowledge engineering for expert systems. Ellis Horwood Ltd.
Chichester, England.
2. White, L.D., T.R. Troxel, J.G. Pena and D.E. Guynn. 1988. Total ranch managementmeeting goals. p. 597-603. In: L.S. Pope (ed), Beef cattle science handbook. Vol. 21.
Spillman Press. Sacramento, Calif.
3. Wilcox, D.G. 1982. The importance of flexibility in ranch management strategies, p.
15-26. In: Proc. 1982 International Ranchers Roundup (eds. L.D. White and L.R.
Hoermann). Texas Agr. Ext. Serv., Uvalde.

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