4.1 Results
4.1.1 Practices of Humanitarian Logistics of PHE Pharmaceuticals
Humanitarian logistics management practices would include logistical management of the commodities from their origin to destination from a humanitarian logistics management point of view. Among these, five operations selected for inventory management in this study are highly practiced. Transportation management, on the other hand, is poorly practiced. In general, the humanitarian logistics management practice of PHE pharmaceuticals is moderately practiced (3.11) (See Table 3).
Table 3
Respondents’ perceptions of the humanitarian logistics practices of PHE pharmaceuticals in the MOH, EPSS and EPHI, Addis Ababa, Ethiopia, September 2021 (n = 92)
Humanitarian Logistics Management Practices of PHE Pharmaceuticals
|
|
Procurement management practice
|
Mean (± SD)
|
Build procurement strategy based on a preliminary need assessment
|
1.96(0.74)
|
Has systems to quantify public health emergency pharmaceuticals
|
1.80(0.71)
|
Considers a number of procurement options
|
1.87(0.71)
|
Purchase orders placed and delivered on time and at a reasonable price
|
2.00(0.83)
|
Appropriately manages in-kind donations and procured Pharmaceutical
|
2.10(0.87)
|
Manage contracts and resolve challenges
|
4.11(0.75)
|
Grand mean of procurement management practice
|
2.31
|
Distribution management practice
|
|
Distribution hubs well established to save operating costs
|
3.84(1.18)
|
There exist an effective distribution management tool
|
3.84(1.19)
|
There exist a timely distribution of pharmaceuticals
|
3.83(1.05)
|
Distribution considers both demand and available stock
|
3.86(1.12)
|
Central distribution facilities are used for the distribution
|
3.78(1.10)
|
Grand mean of distribution management practice
|
3.83
|
Warehouse management practice
|
|
There exist a sufficient and proper warehouse for temporary storage
|
3.86(0.94)
|
Warehouse floor optimization and standardization is conducted regularly
|
3.30(1.26)
|
Warehouse is suitable for order processing
|
3.04(1.32)
|
Warehouse strictly adheres to good pharmaceutical storage procedures
|
3.30(1.16)
|
Tracking and tracing systems are used at the warehouse
|
3.25(1.20)
|
Grand mean of warehouse management practice
|
3.35
|
Inventory management practice
|
|
There exist prepositioning and optimal resource allocation
|
4.13(0.68)
|
There is a practical supply and demand evaluation
|
4.26(0.69)
|
There exist optimization of inventory turnover
|
4.09(0.77)
|
There exist first-expire-first-out inventory management system
|
4.08(0.68)
|
There exist reservation of a safety stock of pharmaceuticals
|
3.96(0.77)
|
Grand mean of inventory management practice
|
4.10
|
Transportation management practice
|
|
Mode of transportation considers the urgency of the demand
|
1.96(0.74)
|
Pharmaceuticals transported to where they are needed rapidly
|
1.80(0.71)
|
There exist partnership with 3rd party transportation organizations
|
1.87(0.71)
|
Multiple transportation optimization techniques employed to reduce cost
|
2.00(0.83)
|
Vehicles employed depending on the nature of pharmaceuticals
|
2.10(0.87)
|
Grand mean of transportation management practice
|
1.95
|
Grand Mean of Humanitarian Logistics Management Practices of PHE Pharmaceuticals
|
3.11
|
Note: Mean (±SD) standard deviation, weighted average interpreted according to (Alfarra, W.A., 2009) suggestion |
(Source; Own Survey, 2021) |
Procurement Management
The findings in this survey revealed that the practice of developing procurement strategies (1.96, SD = 0.74) and systems for supply chain planning activities (1.80, SD = 0.71) is poorly practiced. Contract management (4.11, SD = 0.75), however, is highly practiced. Procurement management is poorly practiced in all organizations, as evidenced by mean score values of (2.38, SD = 0.29), (2.28, SD = 0.39), and (2.30, SD = 0.14) in MOH, EPSS, and EPHI, respectively.
Qualitative respondents also illustrate this practice as follows:
“…my organization has a practice of identifying the needs of pharmaceuticals based on joint Emergency Preparedness and Response Plan (EPRP). However, the procurement and stockpiling of quantified pharmaceuticals is not satisfactory due to inadequate budget allocation and poor resource mobilization activities. Despite the payment effected by both the MOH and EPHI, the EPSS is unable to procure and deliver pharmaceuticals on time as per the agreement between the organizations. Donation management at MOH, EPSS, and EPHI is not effective. Delay in port clearance and payment of unnecessary demurrage and warehouse cost is common.’’(Male, 21 years of experience, MOH)
Distribution Management
In terms of distribution management, respondents agreed that the use of central distribution networks (3.78, SD = 1.10) and the suitability of delivery sites to save operating expenditures (3.84, SD = 1.18) are highly practiced. Distribution management practice varies from highly practiced to extensively highly practiced in MOH, EPSS, and EPHI, as demonstrated by mean scores of (3.87, SD = 0.69), (3.77, SD = 1.00), and (4.44, SD = 0.59).
However, this is evidenced by key informants. One of the respondents illustrated this practice as follows.
“….there are situations where distributions had been managed well, but this is very occasional experience. All in all, the distribution management system is below average considering delivery schedule, timeliness and absence of incomplete/partial delivery…” (Male, 11 years of experience, EPSS)
Warehouse Management
In this study, respondents perceived that maintaining an adequate and suitable warehouse (3.86, SD = 0.94) is a highly practiced warehouse management activity. Warehouse appropriateness for correct order processing was 3.04 (SD = 1.32), and the application of good storage principles (3.30, SD = 1.16), on the other hand, was moderately practiced. In general, the overall warehouse management of PHE pharmaceuticals has been determined to be moderately practiced (3.35, SD = 0.88).
Key informants also evidence it. One of the respondents illustrated this practice as follows.
“…. The EPSS attempts to dedicate a distinct warehouse for emergency response operations. This enabled the organization to deliver the supplies required at the right time and quantity” (male, 9 years of experience, EPHI).
Inventory Management
Realistic supply and demand evaluation (4.26, SD = 0.69) is found to be an extensively highly practiced activity in this survey. Effective resource allocation (4.13, SD = 0.68) and the FIFO inventory management system (4.08, SD = 0.68) are also highly practiced. Inventory management practices vary across organizations, in which extensively high practices were recorded at MOH (4.20, SD = 0.56).
Transport Management
Regarding transportation management, respondents agreed that transportation mode selection based on the urgency of the commodity (1.96, SD = 0.74) is poorly practiced. Furthermore, drugs are not transported quickly enough to where they are required (1.80, SD = 0.71). The overall mean score value of (1.95, ±SD = 0.39) indicates that transportation management is poorly practiced. This finding is similar to a study conducted in Ethiopia (Wodaje, 2019) that showed that the extent of transportation management practice is extensively poorly practiced in Plan International Ethiopia (Mean = 1.47).
Key informants also evidence it. One of the respondents illustrated this practice as follows.
“…the organization attempts to deliver the supplies required at the right time and quantity. However, transportation problems coupled with infrastructural conditions make it challenging to deliver relief items on time. More emphasis is given to strengthening transportation practices to avail pharmaceuticals on time to minimize the response rate. Ooutsourcing fleet management may be helpful in such conditions.’’ (Male, 11 years of experience, EPSS).
4.1.2 Difference in Respondents’ Perception of Humanitarian Logistics Management Practices of PHE Pharmaceuticals
Generally, the study showed a moderate mean score for the overall humanitarian logistics management humanitarian logistics management practice of PHE pharmaceuticals (3.11). However, the difference in practices observed between organizations in which moderate practice scores were observed at MOH and EPSS and high practice scores were reordered at EPHI. Humanitarian logistics management practices for PHE pharmaceuticals range from moderately practiced in the MOH (3.08, SD = 0.51) and EPSS (3.09, SD = 0.66) to extensively practiced in the EPHI (3.49, SD = 0.29). One-way ANOVA was computed and showed a significant difference among group mean scores in terms of warehouse management practices and overall humanitarian logistics management practices, where EPHI appeared to have a higher mean score than MOH and EPSS (P-value < 0.034) (see Table 4).
Table 4
Differences in respondents’ perceptions of practices of humanitarian logistics management of PHE Pharmaceuticals in MOH and EPSS, Addis Ababa, Ethiopia, September 2021
Variable
|
N
|
Mean (± SD)
|
F-score
|
p-Value
|
Procurement Management
|
MOH(n = 20)
EPSS(n = 67)
EPHI(n = 5)
|
2.38(0.29)
2.28(0.39)
2.30(0.14)
|
.584
|
.560
|
Distribution Management
|
MOH(n = 20)
EPSS(n = 67)
EPHI(n = 5)
|
3.87(0.69)
3.77(1.00)
4.44(0.59)
|
1.238
|
.295
|
Warehouse Management
|
MOH(n = 20)
EPSS(n = 67)
EPHI(n = 5)
|
2.92(0.67)
3.77(0.84)
4.48(0.18)
|
12.440
|
.000
|
Inventory Management
|
MOH(n = 20)
EPSS(n = 67)
EPHI(n = 5)
|
4.20(0.56)
4.09(0.65)
4.10(0.38)
|
.694
|
.502
|
Transportation Management
|
MOH(n = 20)
EPSS(n = 67)
EPHI(n = 5)
|
2.10(0.33)
1.92(0.41)
2.00(0.14)
|
.439
|
.646
|
Humanitarian Logistics management Practices
|
MOH(n = 20)
EPSS(n = 67)
EPHI(n = 5)
|
3.08(0.51)
3.09(0.66)
3.49(0.29)
|
3.502
|
.034
|
Note: Mean (±SD) standard deviation, weighted average interpreted according to (Alfarra, W.A., 2009) suggestion |
(Source; Own Survey, 2021) |
4.1.3 Challenges of Humanitarian Logistics Management Practice of PHE Pharmaceuticals
In this study, challenges were categorized into five categories; each category was represented by four questions. Respondents rated challenges by their frequency of occurrences that hinder effective logistics management practices. Generally, all challenges affect the practice influentially in which organizational challenges took the first position by level of occurrence, followed by (3.86, ±SD = 0.62) economical (3.78, ±SD = 0.84) and technical challenges (3.70, ±SD = 0.83) (see Table 5).
Table 5
Challenges of humanitarian logistics management practices of PHE Pharmaceuticals in MOH and EPSS, Addis Ababa, Ethiopia, September 2021 (n = 92)
Challenge Category HLM Practices
|
Number of Items
|
Mean (± SD)
|
Mean Rank
|
Chi-Square
|
p-Value
|
Rank
|
Social challenges
|
4
|
3.67(0.54)
|
3.11
|
58.000
|
0.000
|
1
|
Environmental challenges
|
4
|
3.60(0.56)
|
3.30
|
27.543
|
0.006
|
2
|
Technical challenges
|
4
|
3.69(0.54)
|
3.51
|
50.174
|
0.000
|
3
|
Economic challenges
|
4
|
3.78(0.53)
|
3.62
|
76.348
|
0.000
|
4
|
Organizational challenges
|
4
|
3.86(0.57)
|
4.00
|
41.304
|
0.000
|
5
|
Grand Mean of challenges of HLM Practices
|
20
|
3.72
|
|
|
|
|
Note: Mean (±SD) standard deviation, weighted average interpreted according to (Alfarra, W.A., 2009) suggestion |
(Source; Own Survey, 2021) |
This finding is similar to a study conducted by (Karuppiah et al., 2021) that stated that social challenges took the first position (weight = 0.0581) among challenge categories of humanitarian logistics practices. Another study conducted in Gambia (Rivera et al., 2020) showed that organizational capacity, administrative structure and financial resources were challenges of national disaster management. Furthermore, this finding is supported by studies conducted in Ghana and Ethiopia (Kovacs and Spens, 2009); (Fenta, 2017) stated that brain drain high staff attrition is common.
Another study conducted in Namibia (Baporikar and Shangheta, 2018) stated that proper sourcing, transportation problems and difficulties in identifying initial demand were major challenges of response operations. Furthermore, studies conducted by (Tay and Chew, 2018); (Jiang and Yuan, 2019) stated that poor and unpredictable operating conditions and supply and demand uncertainty pose a significant challenge in emergency logistics. Additionally, a study conducted in Iraq (Al-Dahasha and Kulatunga, 2018) identified that a lack of modern technology and equipment and multiple sources for the decision are major sources of challenges in humanitarian operations.
Among these 20 challenges, lack of competent local transportation service providers (mean rank = 8.66), unsuitable topography (mean rank = 8.73), lack of partnership with 3rd party transportation organizations (mean rank = 8.78), high staff turnover (mean rank = 8.99) and uncertainty in demand and supply (mean rank = 9.08) are the top five and most frequently occurring challenges of logistics management practices. Based on the table below, we can conclude that the agreement or concordance among the respondents is not due to chance regarding the challenge of the humanitarian logistics management practices of PHE pharmaceuticals, as P < 0.00 with a W = .06 (see Table 6). This finding is similar to a study conducted by (Karuppiah et al., 2021) that stated that social challenges took the first position (weight = 0.0581) among challenge categories of humanitarian logistics practices. Furthermore, they elaborated that the facility location problem has the highest weight (0.0737) among the challenges.
Table 6
Rank order analysis on challenges in humanitarian logistics management practices of PHE Pharmaceuticals in MOH and EPSS, Addis Ababa, Ethiopia, September 2021 (n = 92)
Challenges on humanitarian logistics management practices
|
Mean Rank
|
Rank
|
Lack of competent local transportation service providers
|
8.66
|
1
|
Unsuitable topography; Facility location problem
|
8.73
|
2
|
Lack of partnership with 3rd party transportation organizations
|
8.78
|
3
|
High staff turnover among supply chain experts.
|
8.99
|
4
|
Uncertainty in demand and supply
|
9.08
|
5
|
Lack of concerns for warehouse infrastructure
|
9.52
|
6
|
Lack of competent local pharmaceutical manufacturer/suppliers
|
9.95
|
7
|
Limited investment in adoption of ICT solutions
|
10.17
|
8
|
Inability to make decisions rather, other program staffs
|
10.18
|
9
|
Lack of sufficient communications lines and infrastructures
|
10.32
|
10
|
Inadequate financing for logistic strategic preparedness
|
10.35
|
11
|
Low ICT utilization for supply chain efficiency improvement
|
10.79
|
12
|
Lack of capacity to use of the obtained fund right away.
|
10.80
|
13
|
Lack of adequate experience and familiarity
|
11.35
|
14
|
Limited access of essential logistics information between organizations
|
11.40
|
15
|
Role confusion between organizations
|
11.60
|
16
|
Lack of joint logistics set up & implementation to reduce the lead time
|
12.18
|
17
|
Cultural and linguistic barriers
|
12.26
|
18
|
Limited coordination
|
12.30
|
19
|
Uncompetitive of market behavior in the local economy
|
12.57
|
20
|
Kendall's W = 0.060
Chi-Square =104.894
df = 19
Asymp. Sig. = 0.000
|
(Source; Own Survey, 2021) |
4.1.4 Qualitative findings on challenges HLM practice
Overall, 17 challenges were identified from 7 respondents. Environmental, organizational, and technical challenges still took priority. The key informants agreed that the smooth process of humanitarian response operations at the MOH, EPSS and EPHI is affected by different challenges that hinder effective and efficient logistics performance. The most common challenges were identified as poor demand planning, limited coordination, preparedness and financing, prolonged custom clearance procedures and delays in market authorization and limited local manufacturing capacity. (See Fig. 3).
a. Challenges related to demand planning
Participants reported a lack of MOH, EPSS and EPHI in collaboration with donors prepared essential public health emergency management pharmaceutical lists, with three months of forecasted quantity initially and then repeated quarterly in accordance with possible scenarios of public health emergencies considering the fact that at least nine months of safety stock are required. However, only half of the suggested national emergency stockpiles can be attained due to a lack of supply planning, mismatch with the financial requirements of the projection, limitations in logistics capabilities and data quality problems.
One respondent elaborates this idea:
"The practice of demand planning and stockpiling activity is at its infancy and needs a revolution to make it come to the real ground at the national level.” (Male, 11 years of experience, EPSS)
Another respondent added:
“The professionals assigned to the position do not have enough knowledge about advanced demand planning and inventory optimization. For example, they do not have adequate knowledge, skills and tools to predict future demand, differentiate outcomes, and conduct and follow up supply planning based on output. It's obvious that the nation will suffer from logistics disruptions in managing pharmaceuticals, reducing the health outcomes of the patients.” (Male, 16 years of experience, MOH)
b. Limited coordination
Participants indicated that a multidisciplinary team of logistics experts deployed at the National Emergency Operation Center (EOC) on each national public health emergency declaration to manage emergency response. Actors of the supply chain, such as EPSA, Ethiopian Food and Drug Authority and donor organizations, were represented to attain better multiagency coordination and collaboration on activities of the chain members and seamless integration of the relevant business processes.
They also pointed out that humanitarian logistics lack a system with a better level of coordination between governmental and non-governmental organizations.
“The designed and deployed transitory supply chain management structure is not recognized as a core unit at the national level. The unit can’t attain a strategic management of public health emergency preparedness and responses through active information sharing and better multiagency coordination and collaboration unless there is a formal inclusion of logistics management in organizational structure.” (Male. 9 years of experience, EPHI)
Another respondent added
“The coordination level between humanitarian organizations and governmental organization is low and each organization is delivering similar donations and leads to a duplication of efforts. Some products are not even found in the national essential medicine list.” (Male, 11 years of experience, EPSS)
One respondent said,
“Long market authorization poses a significant challenge in utilization of innovative medicines to treat public health emergencies. For example, during the COVID-19 pandemic, several medicines received approval from the WHO; however, it makes it difficult to import and utilize them in our country. Such delays are the main source of illegal market.” (Male, 16 years of experience, MOH)
c. Limited preparedness and financing
Over the past year, the government allocated multimillion dollars for disaster preparedness and responses through shifting budget lines/ accounts and contingency reserves to ensure commodity security. Similarly, most countries’ legislation allowed the activation of contingency funds and reserves during the pandemic.
One respondent said,
“Usually, 10 percent of the annual Ministry budget was reserved for health-related unseen emergencies and would be used for disaster preparedness and response.” (Male, 16 years of experience, MOH)
Another respondent added
“The global and local market shortcomings due to limited preparedness, low public–private partnerships and shortage in foreign exchange pose a significant challenge in access to essential medicines. Therefore, legislations on provision of duty-free import permit, foreign currency priority services and local pharmaceutical manufacturing prepared and enter into force for the private sector (manufacturers, wholesalers and non-government health facilities), government health facilities and NGOs importing both raw materials and finished goods to be used for prevention and treatment.” (Male, 21 years of experience, MOH)
D. Poor custom clearance processes
The participants highlighted another major challenge: poor custom clearance processes at ports in terms of noncompliance with shipping documents and the donation management requirements of the nation.
One respondent said,
"The custom clearance process for donated commodities is hectic. Partial delivery of both shipping documents and parcels, lack of adequate knowledge, and poor coordination between the EPSS and EPHI. I can be a witness for spoilage of our consignment due to such kind of problems.” (Male, 11 years of experience, EPSS)
4.1.5 Performance of Humanitarian Logistics Management of PHE Pharmaceuticals
Different indicators can be used to measure the performance of the supply chain process from a humanitarian logistics management point of view. Five indicators were selected for this study, and the performance indicator on asset management took the first high performance score, followed by agility and cost performance indicators. In general, the perceived humanitarian logistics management performance of PHE pharmaceuticals is high (3.58). However, a difference in performance score is observed between organizations in which moderate performance score observed at MOH and extensively high-performance score is reordered at EPHI (See Tables 7 & 8).
Table 7
The perceived level of humanitarian logistics management performance indicators of PHE Pharmaceuticals in MOH and EPSS, Addis Ababa, Ethiopia, September 2021 (n = 92); (A)
Performance indicators of HLM
|
Number of items
|
Mean (± SD)
|
Reliability
|
5
|
3.50(0.91)
|
Responsiveness
|
5
|
3.48(0.89)
|
Agility
|
5
|
3.66(0.98)
|
Cost
|
5
|
3.60(0.97)
|
Asset Management
|
5
|
3.68(0.97)
|
Grand mean of HLM performance of PHE Pharmaceuticals
|
25
|
3.58
|
Note: Mean (±SD) standard deviation, weighted average interpreted according to (Alfarra, W.A., 2009) suggestion. |
(Source; Own Survey, 2021) |
Reliability
The results in this study show that the extent of delivering the right pharmaceuticals at the right place with necessary documentation is high (3.42, ±SD = 1.15). The extent of limited reported complaints during the execution of the logistics operation is also high (3.72, (± SD = 1.08). In general, the perceived performance of humanitarian logistics management in terms of reliability at EPSS, EPHI, and MOH is high (3.50, ±SD = 0.91).
Responsiveness
Regarding the responsiveness of logistics management, respondents perceived that the extent of responsiveness to donation-to-delivery time is high (3.65, ±SD = 0.86). However, the existence of proper follow-up of rapid responses to the requests at any level is moderate (3.33, ±SD = 1.04). In general, the perceived performance of humanitarian logistics management in terms of responsiveness at EPSS, EPHI, and MOH is high (3.48, ±SD = 0.89).
Agility
With regard to the agility of humanitarian logistics management, respondents perceived that the extent to which they adapted quickly to a system to manage additional demand was high (3.86, ±SD = 0.94). Furthermore, the ability to accommodate changes in the volume of pharmaceuticals required without any problems is also high (3.75, ±SD = 1.22). In general, the performance on agility of humanitarian logistics management among respondents from MOH, EPSS, and EPHI ranges from moderate to very high, as shown by mean values of (2.63, ±SD = 0.84), (3.87, ±SD = 0.78), and (5.00, ±SD = 0.00).
Cost
In this study, respondents were asked to measure MOH, EPSS and EPHI position on performance of logistics management along various dimensions. The results in this study show that the extent of adoption of a good cost management strategy is high (3.72, ±SD = 1.22). On the other hand, the optimization of transportation cost through shipment consolidation is moderate (3.39, ±SD = 1.25). In general, the perceived performance of humanitarian logistics management in terms of cost at EPSS, EPHI, and MOH is high (3.60, ±SD = 0.97).
Asset management
Regarding the asset management of humanitarian logistics management, respondents perceived that the extent of automated warehouse asset management is high (3.89, ±SD = 0.87). The performance in warehouse assets tracking is high (3.82, ±SD = 1.18). In general, the perceived performance of humanitarian logistics management in terms of asset management at EPSS, EPHI, and MOH is high (3.68, ±SD = 0.97).
4.1.6 Differences in Respondents’ Perception of Humanitarian Logistics Management Performance of PHE Pharmaceuticals
Generally, the study showed a higher mean score for the humanitarian logistics management performance of PHE pharmaceuticals (3.58). The grand mean score of the humanitarian logistics management performance of PHE pharmaceuticals was 2.73, 3.76 and 4.69 for MOH, EPSS and EPHI respondents, respectively. One-way ANOVA was computed and showed a significant difference among group mean scores, where the EPHI appeared to have a higher mean score than the MOH and EPSS (P-value < 0.000) (see Table 9).
Table 8
Differences in respondents’ perceptions of the humanitarian logistics management performance of PHE Pharmaceuticals in MOH & EPSS, Addis Ababa, Ethiopia, September 2021
Variable
|
|
Mean a (± SD)
|
F-score
|
p-Value
|
Place of Work
|
MOH(n = 20)
EPSS(n = 67)
EPHI(n = 5)
|
2.73(0.49)
3.76(0.46)
4.69(0.17)
|
54.655
|
.000
|
Note: Mean (±SD) standard deviation, weighted average interpreted according to (Alfarra, W.A., 2009) suggestion. |
(Source; Own Survey, 2021) |
4.1.7 Inferential analysis of the perception of Humanitarian Logistics Management Performance
The results indicate a strong positive correlation between logistics performance and warehouse management practice (r = .533, p = .0.01); logistics performance and economic challenges (r = .788, p < .001); logistics performance and technical challenges (r = .775, p < .001); logistics performance and social challenges (r = .734, p < .001); and logistics performance and environmental challenges (r = .732, p < .001).
Likewise, the association between procurement management and transportation management was highly positive (r = .940, p < .001). The relationship between organizational challenges and economic challenges was also positive and strong (r = .841, p < .001). In addition, the results depict a significantly strong correlation between social challenges and economic challenges (r = .825, p < .001) and environmental and economic challenges (r = .838, p < .001) (see Table 9).
Table 9
Correlation matrix of variables associated with the humanitarian logistics management performance of PHE Pharmaceuticals in MOH and EPSS, Addis Ababa, Ethiopia, September 2021 (n = 92)
|
1
|
2
|
3
|
4
|
5
|
6
|
7
|
8
|
9
|
10
|
11
|
Performance
|
1
|
|
|
|
|
|
|
|
|
|
|
Procurement Management
|
-0.036
|
1
|
|
|
|
|
|
|
|
|
|
Distribution Management
|
0.099
|
-0.202
|
1
|
|
|
|
|
|
|
|
|
Warehouse Management
|
.533**
|
0.018
|
.273**
|
1
|
|
|
|
|
|
|
|
Inventory Management
|
-0.174
|
.319**
|
-0.063
|
-0.084
|
1
|
|
|
|
|
|
|
Transportation Management
|
0.040
|
.940**
|
-0.151
|
0.075
|
0.104
|
1
|
|
|
|
|
|
Economic Challenges
|
.788**
|
-0.062
|
.342**
|
.535**
|
-0.192
|
0.031
|
1
|
|
|
|
|
Organizational Challenges
|
.691**
|
-0.076
|
.395**
|
.450**
|
-0.090
|
0.010
|
.841**
|
1
|
|
|
|
Social Challenges
|
.734**
|
0.055
|
.327**
|
.498**
|
-0.196
|
0.149
|
.825**
|
.750**
|
1
|
|
|
Environmental Challenges
|
.732**
|
0.034
|
0.188
|
.632**
|
-0.154
|
0.111
|
.838**
|
.652**
|
.736**
|
1
|
|
Technical Challenges
|
.775**
|
0.049
|
.309**
|
.627**
|
-0.190
|
0.140
|
.718**
|
.711**
|
.770**
|
.696**
|
1
|
*p<.05; **p<.01; ***p<.001 |
(Source; Own Survey, 2021) |
4.2 Discussion
The findings of this survey provide valuable insights into the current state of procurement and supply chain management practices in the organizations under study. The low scores in procurement management activities indicate a lack of effective practices, which can significantly impact the efficiency and effectiveness of the supply chains. The results highlight the need for improvement in developing procurement strategies and systems for supply chain planning activities. This suggests that there has been a lack of attention and focus on these critical aspects of procurement and supply chain management in organizations.
However, it is worth noting that contract management was found to be highly practiced, indicating that the organizations have established effective processes and systems for managing contracts. While contract management is crucial, it should not overshadow the importance of other procurement and supply chain management activities that require improvement.
These findings align with a systematic review conducted by Jahre (2017) in the humanitarian logistics literature, which revealed a lack of sourcing and procurement strategies in the context of risk management and supply chain strategies. This suggests that the organizations under study are not utilizing a wide range of strategies that can enhance their procurement processes. In contrast, previous studies conducted in other organizations reported higher levels of practice in specific procurement and supply chain management activities. For example, Deribe (2020) found extensive high practice in quantifying commodities based on need evaluations in International Medical Corps Ethiopia, and Geremew (2020) reported high practice levels in ordering and delivering orders on time, as well as proper management of in-kind donations in Care Ethiopia. On the other hand, Mwanjumwa and Simba (2015) highlighted ineffective procurement rules in addressing difficulties in the International Committee of the Red Cross in Kenya. These variations in findings across different organizations underscore the challenges in implementing effective procurement practices and the need to address these challenges to improve overall procurement and supply chain management performance.
The qualitative responses from the survey participants further support the quantitative findings and provide additional context. The respondents mentioned the highly practiced use of central distribution networks and the suitability of delivery sites to save operating expenditures, indicating effective strategies and systems for managing distribution activities. However, there were variations in distribution management practices among the organizations, suggesting that some organizations have implemented effective distribution strategies and systems, while others may still have room for improvement.
These findings are consistent with a similar study conducted by TEFERA (2020) in aid organizations operating in the Somali region, which found high practice in timely distribution. However, a study on Save the Children Ethiopia by Deribe (2020) revealed a different finding, indicating a poor application of a competent distribution management strategy. This highlights the variations in distribution management practices even within the same sector or context. The qualitative response from a key informant also supports the quantitative findings, describing the distribution management system as below average overall.
Regarding warehouse management, the findings indicate that maintaining an adequate and suitable warehouse is highly practiced in organizations. However, there is room for improvement in warehouse appropriateness for correct order processing and the application of good storage principles. The moderate overall warehouse management practice score contradicts similar studies conducted at MSF-Spain, Action Against Hunger, and Plan International in Ethiopia, which reported high and poor levels of warehouse management practice, respectively. These differences could be attributed to factors such as access, awareness, and training, which may vary between the different studies. The qualitative response from a key informant highlights the importance of proper warehouse management for effective emergency response.
Moving to inventory management, the findings indicate extensive high practice in realistic supply and demand evaluation, effective resource allocation, and the FIFO inventory management system. These practices are crucial for evaluating supply and demand, allocating resources efficiently, and managing inventory effectively. The variations in inventory management practices across organizations further emphasize the importance of implementing effective inventory management strategies. The study revealed moderate mean scores for overall humanitarian logistics management practice in PHE pharmaceuticals. However, there were differences in practices observed between organizations, with MOH and EPSS showing moderate practice scores and EPHI demonstrating high practice scores. The one-way ANOVA showed a significant difference among the group mean scores in terms of warehouse management practices and the overall humanitarian logistics management practice, with EPHI having a higher mean score compared to MOH and EPSS.
The results of this study indicate that the perceived performance of humanitarian logistics management in terms of reliability is high, with a focus on delivering the right pharmaceuticals at the right place with necessary documentation. The extent of limited reported complaints during logistics operations is also high, indicating a reliable performance overall. These findings align with a previous study conducted in five humanitarian organizations by (Santarelli et al., 2013), which reported an average delivery date reliability of 75%. This suggests that the organizations under study have achieved a high level of reliability in their logistics operations.
In terms of responsiveness, the respondents perceived a high extent of responsiveness to donation-to-delivery time. However, the proper follow-up of rapid responses to requests at any level was perceived as moderate. Nevertheless, the overall perceived performance of humanitarian logistics management in terms of responsiveness was high. This finding is consistent with a study conducted in Kenya (Mohamed, 2012), which revealed that most organizations monitor the relief supply chain and respond immediately to minimize supply chain risk. This suggests that while the organizations in this study exhibit a high level of responsiveness to donation-to-delivery time, there is room for improvement in the follow-up of rapid responses.
Regarding agility, the respondents perceived a high extent of adaptability to manage additional demand and accommodate changes in the volume of pharmaceuticals required. The performance on agility varied among the organizations, ranging from moderate to very high. These findings are in line with a previous study conducted in five humanitarian organizations (Santarelli et al., 2013), which found a high ability to absorb changes in both the type and volume of commodities. This indicates that the organizations under study have demonstrated a high level of agility in their humanitarian logistics management practices.
In terms of cost management, the respondents perceived a high extent of adoption of a good cost management strategy. However, the optimization of transportation costs through shipment consolidation was perceived as moderate. The overall perceived performance of humanitarian logistics management in terms of cost was high. These findings are consistent with a previous study conducted in five humanitarian organizations, which reported a 100% presence of financial audits. They highlight the need for organizations to focus on optimizing transportation costs through consolidation to further improve cost management. This result is in agreement with the study conducted in five humanitarian organizations (Santarelli et al., 2013) that showed that the presence of financial audits was 100%. Another study conducted in Afghanistan (Reithinger and Coleman, 2007) shows that cost-effectiveness assessments of health treatments in complex disasters are rare, indicating a significant deficiency in evidence-based humanitarian service delivery due to the inability to obtain credible financial and operational data.
Regarding asset management, the respondents perceived a high extent of automated warehouse asset management and warehouse asset tracking. The overall perceived performance of humanitarian logistics management in terms of asset management was high. These findings align with a study conducted in the Southeast Asian region (Maghsoudi and Pazirandeh, 2016), which found that organizations perceived a higher level of information and resource visibility for proper stock handling during disaster operations.
The study showed variations in the perceived performance of humanitarian logistics management among the organizations under study. The one-way ANOVA indicated a significant difference among the group mean scores, with EPHI having a higher mean score compared to MOH and EPSS. These findings suggest that EPHI demonstrates a higher level of performance in humanitarian logistics management compared to the other organizations.