How to Get the Maximum Possible of your Team: My New Challenges at NMSF (2/2)

When I left the National Medicines and Poisons Board (NMPB) to be the Director General of the National Medical Supplies Fund (NMSF), on 5th September 2010, after almost three years. In my first week at the NMSF, I noticed a huge gap between NMPB and NMSF staff and I easily recognized the challenges of bringing the NMSF staff to the same level of that of the NMPB. The majority of NMPB staff were young, enthusiastic and highly motivated pharmacists, whereas the NMSF’s staff dominated by typical civil service, bureaucratic and relatively old pharmacists, who worked to the book.

NMSF's employees were of different educational background (e.g. pharmacists, biomedical engineers, accountants, Information Technology, and so on) and dominated by storekeeper, drivers and unskilled workers (e.g. those who are responsible for loading and off-loading of trucks) with diverse views and opinions. Therefore, they need to be motivated differently (i.e. there is no "One-size-fits-all" policy). As a new NMSF's Director General, my challenging role was how to motivate the workforce of such diversity.

Similar to the NMPB, the NMSF staff are civil servants, governed by public service's laws and regulations. This means that NMSF has only limited influence on the selection of its personnel, their qualifications, and experience. However, NMSF’s status as a parastatal organization allows it, to some extent, to develop its own workforce policies without necessarily having to follow standard government workforce policies.

In 2011, NMSF embarked on a reform process which significantly changed the way NMSF operated its medicine supply system, improving geographical, physical, and economical accessibility to quality medicines and other health products. NMSF needs to be commercially oriented to meet its objectives of recovering medicines costs and raising sufficient revenues to become self-financing and viable. NMSF aims to become an efficient and cost-effective organization, while adhering to its public objective of operating in the best interest of the Sudanese population. A key element of achieving this objective is to develop and maintain a motivated and engaged workforce. Such reform included a comprehensive human resources development program. With technical support of PtD (https://peoplethatdeliver.org/), the NMSF has developed its training strategy based on the recommendations of the assessment to identify the NMSF’s training needs that has been conducted by a team of experts from the University of Leeds, United Kingdom. To execute its training strategy, the NMSF allocated an annual average training budget of over $400,000. The annual number of trained employees increased from 40 employees in 2010 to over 1,430 in 2018. Between 2011 and 2018, all NMSF staff participated in more than 460 courses internally (282) and externally (180 courses). The number of beneficiaries during this period was 6,667, with 5,868 employees participating in internal training courses and 799 attending overseas courses (Mohamed Ali and Steel 2020[i], PtD 2015[ii]).

With the support of well-trained and highly motivated senior management and staff, I initiated and led the transformation of the Sudan national Supply Chain for health products circulating in public sector health facilities. In two-year, the NMSF became efficient and cost-effective organization, while adhering to its public objective of operating in the best interest of the population of Sudan.

During my time at NMSF, I have my own policy of developing leadership skills of young promising pharmacists (<40 years of age). One of my strategies is to make them highly responsive to the people health. In the following sections I present two out of so many cases that reflect the power of motivated employees:

1.???? I remember I was on my mid-way from the village to Khartoum (the village is 350km far from Khartoum). At a café, I checked a Facebook Sudanese Pharmacists Group. I read a post written by a pharmacist who works for health insurance, Blue Nile State. In the post, he claimed that they received a consignment from NMSF that contained a wrong labeled syrup. I immediately called pharmacist Abubakr Saloha, one of the young pharmacists and the NMSF’s customer care manager. I asked him to urgently call for a meeting at the office of the NMSF Director General at 7:00pm with the group of NMSF young pharmacists (namely: Muhanad [Manager of e-Sales department], Mujahid [senior pharmacist at Quality Assurance Directorate] and Ahmed Elshiekh [Acting Manager of the Inventory Control Department]). Despite it was a weekend, I dropped my wife at home, and immediately drove to NMSF to chair the meeting. We did the Magrib prayer (after sunset prayer) and started our meeting. At the beginning I asked if any of them heard about the case. Some of them answered yes. After constructively criticizing them for not taking any action, I started to discuss with them a "what to do" and how. To my expectations, they admitted their shortcoming, and all of them agreed on immediate action. We agreed to meet again after one hour. I left them to agree on everyone task. After an hour, they came back with full report on the case including information on the quantity of the wrong labeled product, where it was, where things went wrong, and the actions taken. To confirm the case, they contacted the pharmacist who wrote tbe post. After confirming the case, they called the responsible NMSF storekeeper and members of the emergency committee (This was the committee responsible for operating NMSF warehouses after working hours) to physically count the stock of the product and track if other customers received the same. Finally, they phoned the contact person of the product supplier (unfortunately the supplier was a local manufacturer) and got the problem settled with the supplier on the following day, in coordination with the General Directorate of Procurement and Contracting.

2.???? One night, I sent an SMS to Osman Karar, the manager of the Shipping Department after 22:00 saying that the police hospital in Khartoum claimed their hospital beds and mattresses had not arrived. I received an SMS from the manager of the Shipping Department at 02:30 saying he was now at the police hospital offloading trucks full of beds and mattresses. I knew it was not an easy task to summon storekeepers, drivers and labourers who lived in different areas far from the NMSF. This incident shows how the NMSF staff sacrifice their rest and work outside of normal hours to satisfy NMSF customers. Highly motivated staff can do extraordinary things nobody has asked them to do. This is another evidence of how the NMSF’s staff have changed from being typical bureaucratic civil servants to being highly dedicated, hard-working, loyal and customer-oriented employees.

Take Away Messages

The take away messages are where a problem arose, action must be taken to rectify it and measures should be adopted to prevent recurrence. The urgency of the reaction depends on how serious the impact of the problem on the people health and what will be the risk to the reputation of the Medical Supplies Agency (MSA). To be successful, MSA should be reliable, resilience, responsive to its customer's concerns, and be able to closely monitor the media (organizations work in unprecedented era of social media) and swiftly verify its claims and act accordingly. In addition, leaders must show their commitment to the organization (by, e.g. sacrifice their private affairs), inspire their subordinates to be alert, creative and customer oriented. Without such commitment, there is little motivation for staff to do an excellent job. Further, the reported NMSF’s cases highlight the importance of vision and leadership within the pharmaceutical supply chain function. A strong leadership function has resulted in a committed and motivated workforce operating within a conducive work environment. Equally important is the awareness among senior managers of the need to get the best out of the staff, which is required for continual improvement within all sections of the organization. Lastly, it is the role of the organization’s leaders to motivate all employees irrespective of category, as motivated staff lead to more efficiency and cost-effectiveness in the business. And consequently, MSA sustains its mission of ensuring access to quality essential medicine and health products at all times at a reasonable cost to people and the government.

[i] Mohamed Ali, G.K. and Steele, P.A. 2020. 3,121 Days in the Driving Seat of the National Medical Supplies Fund: Lessons to be shared for Future Application.

[ii] PtD 2017. A Semi-Autonomous Supply Chain Agency with Strong Leadership. [online], available at: www.nmsf.gov.sd/includes/pdf/SCS-PtD-2017.pdf [accessed May 2019].