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Strengthening the Supply Chain Workforce through Mentorship and On the Job Training

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This poster was presented by Hery Firdaus and Bethany Saad at the International Conference on Family Planning (ICFP) in Kigali, Rwanda in November 2018.
Over the past decade, contraceptive prevalence rates in Indonesia have remained stagnant in part due to inconsistent access to contraceptives at service delivery points. To address critical gaps in the system, JSI collaborated with stakeholders to design a comprehensive package of data centric interventions to strengthen the supply chain workforce, empowering them with new tools, skills and information to enable holistic and continuous supply chain improvement through mentorship, on-the-job training and feedback.

It was noted that during qualitative interviews, provincial and district staff recognized the significant role of mentorship and on-the-job training activities in improving accuracy of recording and reporting and adherence to both inventory management and storage procedures. They pointed out the importance of not only the performance management aspect of the mentorship program, but also its effect on improving communication and coordination between levels. The use of digital tools has made mentoring data visible to all levels of the system and mentors have better understanding of the facilities needs. The use of WhatsApp to communicate has also improved collaboration and coordination between mentor and mentee. The program has been extremely successful and popular with all stakeholders and all districts involved in this project have adopted it and included it in their program budgets.

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Strengthening the Supply Chain Workforce through Mentorship and On the Job Training

  1. 1. STRENGTHENING THE SUPPLY CHAIN WORKFORCE THROUGH MENTORSHIP AND ON-THE-JOB TRAINING IN INDONESIA INTRODUCTION Reliable, responsive supply chains deliver quality contraceptives when and where they are needed. Through the ‘My Choice’ project, JSI is partnering with Indonesia’s National Population & Family Planning Board (BKKBN) to strengthen family planning supply chain systems across four provinces in Indonesia, ensuring women have consistent access to a range of contraceptive options. Over the past decade, contraceptive prevalence rates in Indonesia have remained stagnant in part due to inconsistent access to contraceptives at service delivery points. To address critical gaps in the system, JSI collaborated with stakeholders at each level to design a comprehensive package of data centric interventions to strengthen the supply chain workforce, empowering them with new tools, skills, and information to enable holistic and continuous supply chain improvement. A baseline assessment conducted in 2015 identified critical bottlenecks within the family planning supply chain system • The family planning program lacked standardized processes and a mechanism for routine monitoring and supervision of the supply chain. • Minimal communication and coordination between each level of the supply chain caused inefficiencies in the system. • High staff turnover made capacity building challenging. • Poor recordkeeping procedures at health facilities resulted in low quality reports. PROGRAM IMPLEMENTATION CONCLUSION Increase in ownership, accountability and motivation among staff. There are strengthened relationships between the decentralized levels of the health system, fostering a collaborative approach towards a common goal of improved contraceptive availability and overall performance of the supply chain system. Feedback and recognition of health workers by mentors has motivated them to take more ownership of their tasks. The mentor program has ensured that new staff get the support they need to learn the tasks and perform their jobs. The use of digital tools has made mentoring data visible to all levels of the system and mentors have a better understanding of the needs of the facilities and can provide targeted support. The use of WhatsApp to communicate has improved the collaboration and coordination between mentor and mentee as they are not only relying on face to face meetings. The program has been extremely successful and popular with all stakeholders. All districts have adopted it and included it in their program budgets. RESULTS Conducting regular mentorship and on-the-job training of logistics practices by using standardized checklists and providing timely feedback to health workers is an important way to reinforce training, promote adherence to logistics system procedures, and increase worker motivation. The mentorship program was designed to complement other project interventions with an aim to holistically strengthen the supply chain system. Mentors at province and district levels conducted routine visits to district warehouses and service delivery points. The project conducted baseline (Sept 2015) and endline (Jan 2018) surveys to measure the impact of all interventions. KEY FEATURES Efficient knowledge transfer: A blended learning approach that complements classroom trainings and reinforces standard operating procedures. Personal coaching and direct feedback: A mechanism for health workers to receive one on one coaching, feedback and recognition that fosters motivation and continuous performance improvement. Increased data visibility: A mobile checklist tool has been developed using Magpi that structures the visit and provides an additional dimension of information that can be used for supply chain performance improvement. Improved multi level collaboration: Provides a forum that encourages participatory decision making and breaks the silos between levels of the supply chain, strengthening the relationship between mentors and mentees. Continuous learning: Routine mentor visits foster an environment for continuous improvement and addresses a key challenge of high staff turnover. National Population & Family Planning Board HERY FIRDAUS ⚫ BETHANY SAAD ⚫ SARAH ANDERSSON ⚫ NURFADLIAH ⚫ OMAR BALSARA JSI RESEARCH & TRAINING INSTITUTE, INC. www.jsi.com/mychoiceindonesia jsi.idfp@gmail.com GOAL METHODOLOGY The mentorship program was introduced in 2016 in four provinces and 11 districts in Indonesia. Each province and district assigned staff to become mentors which included members of the family planning, warehouse and data divisions. Mentors were trained on how to conduct mentorship and on-the-job training using the electronic checklist tool. ‘My Choice’ project staff worked with mentors to develop an annual schedule and accompanied them on a few visits to provide guidance and quality assurance. 40 DISTRICT MENTORS 20 PROVINCE MENTORS Conducted 1282 routine mentorship and on-the-job training visits to 541 HEALTH FACILITIES to 68 WAREHOUSES District mentor uses a job aid to provide on-the-job training to a midwife at a health facility. District mentor uses an electronic checklist to collect health facility supply chain data during a visit. WHAT HAPPENS DURING A MENTOR VISIT? Mentors use an electronic checklist to guide the visit and collect vital data including product availability, logistic records and reports, and storage conditions. Mentors provide on the job training and coaching to the health worker using paper or video based job aids. Using a feedback form, mentors recognize high performance, identify areas of improvement, and provide recommended actions with mutually agreed timelines. In between visits, mentors use WhatsApp groups to follow up and provide remote support to health facilities. At baseline, only 57% of SDPs had received mentorship or supervision that included family planning or supply chain management. At end line, approximately 86% of SDPs had received mentorship or supervision - an increase of almost 30-percentage points. Out of all health facilities surveyed, 87% said they received on-the-job training during a mentor visit and 97% said they found it useful. During qualitative interviews, provincial and district staff recognized the significant role of mentorship and on-the- job training activities in improving accuracy of recording and reporting and adherence to both inventory management and storage procedures. They pointed out the importance of not only the performance management aspect of the mentorship program, but also its effect on improving communication and coordination between levels. Capacity building or knowledge transfer is not complete with one classroom training or mentor visit. Repeated routine visits shows improved performance with every visit. 64% 72% 65% 93% 73% 68% 98% 82% 73% % Using stock cards (all methods) % with accurate stock cards (matching physical count) % with accurate reports (matching stcok cards) First visit Second visit Third visit IMPACT OF ROUTINE MENTOR VISITS ON RECORDS AND REPORTS On-the-job training and classroom training were also credited for contributing to improvements on improving staff motivation and morale. WhatsApp groups provide a useful mechanism for quick feedback and answers to questions and requests for emergency orders. Staff noted challenges to conducting supportive supervision, which include many competing activities and lack of budget for visits. They also discussed that the frequency of supportive supervision is not as important as the quality of the visit which should include joint problem solving, on-the-job training, and use of the feedback form. Overall product availability has improved in the project districts with average stock out rates for contraceptives decreasing by 47%. To strengthen the supply chain workforce within the family planning program and inculcate a culture of multi level collaboration and continuous quality improvement through routine mentorship, on-the-job training and feedback. “Health facilities historically did not really care about accurate records. The Mentorship and On-the-job training program has provided a mechanism for us to inform facilities about the importance of maintaining accurate records. Now health facilities are consistently conducting physical stock count at the end of each month.” HEAD OF FP PROGRAM & FINANCE DIVISION, BREBES DISTRICT, CENTRAL JAVA “Health facilities follow up the recommendation that the mentor writes in the feedback form. Mentorship and On-the-job training program improves the collaboration and communication between mentors and midwives” MENTOR, GOWA DISTRICT, SOUTH SULAWESI TESTIMONIALS

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