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Acknowledgements
I would like to extend my gratitude to Florence Mawindo for providing invaluable guidance
and proofreading this assignment. This assignment would not have been possible had it not
been for the ideas and information from Albert Makone, ongai Macherenga, !oyful
Mapuranga, "dson Muchemwa, #eorge $hinomona and Terence $higwada.
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1.0 Introduction
The general development of any society encompasses the health of the individuals in that
society. This implies that health is a dynamic process. In 8imbabwe, the Ministry of 9ealth
and $hild :elfare ;M<9$:= continuously changes its functions and structure to better meet
the ever>evolving challenges and demands. The #overnment of 8imbabwe ;#<8= desires to
have the highest possible level of health and ?uality of life for all its citi@ens. This vision has
to be attained through guaranteeing every 8imbabwean access to comprehensive and
effective health service.
The M<9$: has various departments to ensure that its vision is achieved. These are the
(rovincial Medical 6irectorates, $entral hospitals, 9uman -esources, Finance and
Administration, <ral 9ealth 1ervices, ursing 1ervices, Traditional Medicines, +aboratory
1ervices, 1TI, 9I*, AI61 and T7 nit, (olicy and (lanning, Monitoring and "valuation,
uality Assurance, $hief Internal Audit, "pidemiology and 6isease $ontrol, -eproductive
9ealth, "nvironmental 9ealthB and (harmacy 1ervices.
This assignment will be limited to the (harmacy 1ervices. The 6irectorate of (harmacy
1ervices encompasses the +ogistics nit ;+= which is responsible for managing essential
medicines and medical supplies including 9I*5AI61 commodities distribution systems and
the related +ogistics Management Information 1ystems ;+MI1=. In addition, the + forecasts
and ?uantifies essential medicines and medical supplies. It analyses and interprets data in
order to report logistics information, including feedback reports to the various levels of the
M<9$: and its partners such as the #lobal Fund to fight AI61, T7 and Malaria ;#FATM=,
nited 1tates Agency for International 6evelopment ;1AI6= and the $linton Foundation.
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+, Manager
6eputy +,
Manager
4 +ogistics <fficers
,pstream
+ogistics Coordinato
r
(MT$T Coordinato
r
AdminstrativeAssistant
<ffice <rderly
MI1 <fficer
)
6ata"ncoders
The +ogistics nit is made up of The + Manager, the 6eputy + Manager, pstream
+ogistics $oordinator, (revention of Mother to $hild Transmission ;(MT$T= $oordinator,
Management Information 1ystems ;MI1= <fficer, three data encoders, an Administrative
Assistant, an <ffice <rderly and four +ogistics <fficers at the 9arare office.
Figure 1: Organogram of the L
<f the fourteen members at the + 9arare office, ' are pharmacists, ) 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. "ach member brings
different skills to give a potential fusion of expertise.
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Figure !: L staff b" #rofessional background
(harmacistsB '
(harmacy TechniciansB )
+ogistics>related backgroundB )
Information Technology backgroundB
<ffice ManagementB %
<therB %
1.1 Assignment
An analysis of the +ogistics nit of the 6irectorate of (harmacy 1ervices;6(1= under the
Ministry of 9ealth and $hild 1ervices basing on twelve characteristics of a successful
football team.
1.! $ur#ose
The 6irectorate of (harmacy 1ervices has a mission to ensure that medicines which are safe,
efficacious and of good ?uality are available, accessible and affordable ;1"AAA= to all
those in need.
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It is the information hub which consolidates data from 16(s to ?uantify national needs and
inform procurement.
The + receives $onsumption5-e?uisition;$5-= forms from 1ervice 6elivery (oints ;16(s=
which detail the number of patients receiving antiretroviral medicines by regimen as well as
the consumption of the said medicines. These $5- forms are then approved by +ogistics
<fficers who generate an order which will be filled by the ational (harmaceutical
$ompany, a ?uasi>government entity responsible for distribution and storage of
pharmaceuticals. The movement of $5- forms, information and commodities is shown on
Figure ). The twelve given characteristics of a successful football team are described in detail
below together with the application to the +.
!.1 Clear 'isual goals
Dat@enbach and 1mith ;%44= intimated that goals are ideas. A goal is a consciously planned
and desired result towards which people are endeavouring. There must be consensus as
regards the goals between the team members for the goals to be the foundation of the teamHs
vision. This motivates the members while providing a common purpose and direction. :est
;%44= emphasised the need for organisations to have a clear purpose encompassing the
underlying values. The + is a part of the 6(1 and has clearly laid down goals and
obectives. The Dey -esult Areas ;D-As= are documented and agreed upon as a directorate.
This assignment found out that the clarity of organisational goals is certainly evident with the
exception perhaps of the lowest levels of personnel. These personnel are typically those
without a pharmacy>based background.
Figure %: Linkages between the L as a team and the other #arts of the #ublic health
su##l" chain
7L (anagement manages and
leads the + team providing
direction, motivation and guidance.
Logistics Officers approve orders and
generate Facilit" feedback )e#orts
electronically and send to *at$harm. They
com ile a re ort to submit to + mana ement
(I+ Officer compiles
and analyses data and
sends to +ogistics
<fficers and reports to
L mana er
Facilit" sends $5-
form to the +,ata encoder enters data
into the electronic system
for order approval and
send to +o istics
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!.! Attainable goals
8
*at$harm packs medicines
and medical supplies
according to orders and
distributes to the facilities
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The ministry is decentralising Antiretroviral Treatment ;A-T= services and the + is leading
the training of nurses at rural health centres to manage A-T medicines and *oluntary Medical
Male $ircumcision commodities. The increase in programs has strained the staff at the +.
Three trainings may run concurrently and may compromise the ?uality of trainings as well as
affect order approvals by the +ogistics <fficers. (rogram managers in the M<9$: and the
6(1 should improve their coordination and synchronisation of activities.
!.% )ecognising achie'ers
1uccessful teams usually have members who excel and drive the team in times of crisis. In as
much these super achievers tend to have a positive influence on teamsB they have a propensity
to re?uire the limelight all the time. If leaders fail to recognise the talent in others, the
efficiency and effectiveness of other team members will decline as supported by 1kinnerHs
theory of reinforcement of behaviour. 1kinnerHs theory was based on ". +. ThorndikeHs earlier
work on the law of effect. 1kinner found out that behaviour which was reinforced tends to be
repeated while that which was not reinforced was extinguished as shown on Figure .
Figure -: An illustration of the law of effect
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1witch off (unishment-eward
7ehaviour eed
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This means that leaders should praise and offer critical feedback to members who have
successfully met challenges. A discussion with + staff showed that this recognition has not
been forthcoming. It would appear that no feedback comes from the managers regarding task
undertaken or reports submitted. The previous deputy + manager would complement one
+ogistics <fficer though for consistently offering ?uick responses to issues and reports.
!.- Immediate feedback
Feedback means letting someone know on a timely and continual basis how they are
performing. This includes both positive and negative observations. +eaders should use
descriptive rather than udgemental language to make particular statements or give general
statements supported by specific examples. Team members and organisations re?uire accurate
and timely feedback to maintain and5or improve their effectiveness. The managers should
analyse reports submitted and provide feedback on tasks undertaken by the team.
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9ackman ;%44&= recommended a balance between the more traditional individual reward
systems with team>based incentives that are contingent upon the whole teamHs performance to
emphasise cooperation rather than competition. The + manager is reported to provide
feedback on rare occasions to subordinates. + staff believes that the management has little
or no time to scrutinise reports send to the managers. This lowers morale and commitment of
the team members and subse?uently lowers performance.
!. The satisfaction of social needs
#ood social relationships maintain effective teams. This is the third step on MaslowHs
hierarchy of needs. In order to avoid challenges of loneliness, depression and anxiety, people
need to feel loved and accepted by other people. Dirkman and -osen ;%444= wrote that
Esocial networks within and beyond teams facilitate a better understanding of team tasks and
an increased belief in the teamHs effectiveness. The + has no initiative to have in place
group activities.
It is noteworthy though that the employees themselves make contributions towards birthdays,
births and deaths within families of members as well as end of year parties. These are efforts
by team members to socially interact outside of work duties. The + should try to form even
sports teams, religious groups or provide lunch ;maybe once a month or a ?uarter with
various themes=. These would provide team members with an opportunity to interact without
the pressures of the work environment. MaslowHs theory points out that peopleHs needs are
not ust met by hard cash. :ell paid people may still have needs that re?uire satisfaction.
Furthermore, MaslowHs hierarchy offers leaders a whole range of options to use for building
team satisfaction. It is often inexpensive to have team socials such as a barbecue.
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!./ +atisfaction of esteem needs
The fourth level of MaslowHs hierarchy is the need for respect and appreciation. :hen the
physiological needs are met and social relationships flourish, esteem needs become more
prominent. The need for feelings of accomplishment, prestige and personal worth begin to
receive more attention in motivating behaviour. (articipation in professional activities,
academic accomplishments and personal hobbies play a role in fulfilling esteem needs.
(harmacists at the + are sponsored to go to a !oint $ongress between the (harmaceutical
1ociety of 8imbabwe and the $ollege of (rimary $are (hysicians of 8imbabwe.
(harmacy Technicians are sponsored to attend the oint congress5conference of the 8imbabwe
(harmacy Technicians Association. Members of the $hartered Institute of (urchasing and
1upply are not sponsored. 1ome members of the + believe that part of their esteem
re?uirements are met as they train and supervise 1ervice 6elivery (oint ;16(= staff.
Feedback on these activities from the leaders would help motivate the + staff more.
!. (oti'ation and influence of grou# #ressure
Members in a team believe that the group has a better understanding of the situation and
special expertise. The team members may experience extreme discomfort that discourages
them from speaking out against the group even if it is wrong. The team is made up people
with different backgrounds and areas of expertise. In turn, each motivates others by excelling
in their line of work. The + should strive to recruit the best candidates for its positions and
resist pressure to ErewardH long service within the M<9$: without due regard to
?ualifications.
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This in turn should help the inter>influence between members of the team. These members
should undertake continuous training so that they keep abreast of developments in their
particular fields. Interaction between the professionals would probably help in improving
motivation. Maple ;%432= suggested that the professionalHs self>image was the most
influential in team members understanding and interacting with each other. As a result of the
diverse backgrounds of the professionals at the +, the team members seek to excel so that
they do not bring the name of their profession into disrepute.
!. +tri'ing to meet higher indi'idual standards
Individual contributions are a pre>re?uisite of characteristics of effective team work. 7rill
;%420= wrote that establishing and managing relationships between individuals who have a
variety of personalities and a range of professional and non>professional experiences is a
critical component of teamwork. The + has no formal structures in place to measure
individual performance. In as much as the + staff may want to excel, feedback from the
leaders is rarely forthcoming therefore motivation is low. The reasons that necessitate and
promote group pressure and influence above result in individuals who seek to perform to the
best of their abilities and search for continuous improvement of the skills.
!.2 $lanning tactics together
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1trategic leaders work through teams to solve challenges and develop policy alternatives. The
leader is accountable for the effective functioning of the team and developing a stable
structure as the team engages in its work. (lanning tactics as a group helps leaders get a better
understanding of communication styles and motivating drives which can assist them to better
predict how the team will interact, potential challenges that may arise and how they may
approach shared goals. The + develops its work plans as a team. Members share
information on upcoming programs and a consolidated provisional plan is decided upon. This
is then shared with and input sought from the rest of the 6(1. As a result of numerous
programs running concurrently, coordination is of utmost importance for successful execution
of the plans.
!.10 3'aluating #erformance as a team regularl"
(eer evaluations give team give team members an opportunity to assess the performance of
their co>workers. "mployees have been observed to be honest about their assessment of a
team memberHs performance especially as it relates to interpersonal relationships with other
team members. There are two fundamental dimensions of team functioning. These are the
task and the social factors that influence how members experience the team as a social unit.
Teams need to review their performance taking into account their obectives and reflect on
ways in which the team can provide support to each other and resolve conflicts.
The + has no formal structures to evaluate the performance of individuals regularly but
rather relies on problems reported by 16(s of stockouts or expiration of medicines. The
performance of programs is assessed through the analysis of MI1 data. (harmacy services
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pertaining to malaria are assessed through "nd>ser *erifications as well as an analysis of
data gathered through the 8imbabwe Informed (ush 1ystem ;8I( 1ystem=. The 8I( system is
a supply chain solution where a moving warehouse ;Truck= visits the 16(s and delivers
medicines according to consumption in the previous ?uarter of a year while factoring in
seasonality and expiry dates of medicines.
This same system collects data used to assess the availability of anti>tuberculosis medicines
at 16(s. "ssential medicines are supplied as (9$( kits and as bulky items from the central
warehouse. The (9$( kits are delivered during the 8I( 1ystem deliveries. uarterly review
of programmatic progress is good monitoring practice.
!.11 34istence of a high degree of trust among all members
A key building block of successful teams is a strong sense of shared trust among team
members. An absence of trust impedes on the ability of individuals to build rapport and trust
thereby diminishing productivity. A lot of what makes teams successful is embedded in
understanding the individual behaviours and motivating needs of the team members.
+ogistics <fficers have been allocated provinces to service in terms of order approvals.
These provinces ideally send their reports known as $onsumption5-e?uisition forms in
different reporting to avoid congestion during order deliveries. 1ometimes challenges re?uire
that orders for provinces serviced by different +ogistics <fficers are packed at the same time.
This situation creates pseudo>competition for transport. "ach +ogistics <fficer will push for
deliveries to their provinces. +ogistics <fficers out in the field become less assured that their
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Eprovinces of interestH will receive ade?uate attention. This allocation of provinces
encourages competition rather than cooperation and re?uires rethinking.
!.1! The leader5ca#tain is #art of the team
1trong teams have clear leadership. Team leadership is oriented on satisfying the needs of a
team with a view to enhance team effectiveness. :hatever the form of leadership, it should
be known and supported by all team members for the leadership to add value to the team. A
team working together interdependently on a highly important task results in shared
leadership, this is better than if one person were sitting in a control centre, issuing orders. The
+ team is such that the leader is the + manager.
There are concerns that even though he is part of the team, he usually is not involved in the
activities that the team does. 9e appears to be mostly active in attending meetings and other
activities without his team. The higher rates supposedly offered for the activities he attends
do little to motivate the other + members. sing the analogy of the football team, it appears
the + management may not be the captain of the team but rather the coach. This would
mean that the one member of the + team should step up and lead the team towards its goals.
%.0 ,iscussion of findings
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Figure : $harmacists attrition between 7ul" and ,ecember !01!
(harmacist appointments (harmacist terminations0
5
10
15
20
25
30
Increase in facilities that are offering A-T services is evidenced by the graph below showing
an upwards change in facilities reporting to the +. It is should be noted that Manicaland and
Mashonaland "ast report during the even months; August, <ctober.= while Mashonaland
:est, Mashonaland $entral and 9arare report during the odd months.
Figure : Facilities recei'ing A)T medicines and re#orting to the L
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