RT Journal Article
SR Electronic
T1 Applying a Theory of Change for Human Resources Development in Public Health Supply Chains in Rwanda
JF Global Health: Science and Practice
JO GLOB HEALTH SCI PRACT
FD Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs
SP e2300062
DO 10.9745/GHSP-D-23-00062
VO 13
IS Supplement 1
A1 Meier, Erin
A1 Brown, Andrew N.
A1 McHenry, Bridget
A1 Kabatende, Joseph
A1 Gege Buki, Inès K.
A1 Icyimpaye, Joyce
YR 2025
UL http://www.ghspjournal.org/content/13/Supplement_1/e2300062.abstract
AB Key FindingsTo strengthen the human resources (HR) in the Rwanda health supply chain (SC) system, the Human Resources for Supply Chain Management (HR4SCM) Theory of Change (TOC) model was used to assess gaps in 4 pathways: staffing, skills, working condition, and motivation.Of the total 60 outcomes described for an optimized SC workforce, 26 outcomes existed in the Rwanda system, but 31 outcomes were deficient, including insufficient budget to fund SC positions, lack of technical and managerial competencies, lack of necessary tools and equipment, and insufficient mechanisms and skills to communicate supervisor feedback.Using the HR4SCM TOC model enabled the Rwanda Ministry of Health to acknowledge gaps in the system, enhance understanding among decision-makers on the complex factors that affect workforce performance, and select interventions to address the gaps.Key ImplicationsPractitioners should consider using human resources TOC models, such as the HR4SCM TOC, to assess HR management systems for health SCs and design workforce interventions.Governments and technical partners can use the TOC model to articulate the complexities that govern HR in health SCs and to identify how interventions can improve the staffing, skills, motivation, and working conditions of this workforce.Background:The health supply chain (SC) system in Rwanda experienced a number of workforce-related challenges, including insufficient skilled supply chain management (SCM) professionals with the necessary competencies. The Human Resources for Supply Chain Management (HR4SCM) Theory of Change (TOC) provides a methodology to assess human resources (HR) management systems by explaining the preconditions required to achieve optimized workforce performance. We applied this model to design interventions to strengthen the Rwanda health SC workforce.Methods:We compared conditions in the health SC HR system in Rwanda with the 60 outcomes described as necessary for optimized workforce performance in the HR4SCM TOC model. We used a survey and participatory workshop at the central level, followed by structured interviews (N=35) with SC professionals in health centers, hospitals, and regional warehouses (N=20) in Southern Province and Kigali City to identify which outcomes already existed in the Rwandan HR system and which outcomes required strengthening through targeted interventions. We used focus groups (N=2) to refine interventions.Findings:We identified that 31 of the 60 outcomes were not sufficiently in place in the Rwandan health SC HR system. SCM workers had gaps in the technical and managerial competencies and did not have access to adequate training and professional development opportunities for certain required competencies. An SCM career path did not exist, and education was not available for all required SCM qualifications. Fourteen of these outcomes were prioritized for strengthening. We designed 20 workforce interventions with the Ministry of Health to address these deficiencies and selected indicators to monitor the interventions.Conclusion:Applying this HR TOC model enabled a systematic process to identify gaps, develop and prioritize interventions, and select indicators. Practitioners designing and evaluating SC workforce interventions should consider applying this methodology to design more effective, theory-driven interventions to improve SC workforce performance.