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Table of Contents

ACRONYMS & ABBREVIATIONS USED ............................................................................ 2 SUMMARY ............................................................................................................................... 3 INTRODUCTION ..................................................................................................................... 4 1.0 FINDINGS ........................................................................................................................... 4 1.1 PROCUREMENT AND CONTRACTING .................................................................... 4 1.2 EARNED VALUE MANAGEMENT (EVM) AND PERFORMANCE MANAGEMENT ................................................................................................................... 6 1.3 STRATEGIC HUMAN RESOURCE MANAGEMENT ................................................ 7 2.0 REFLECTIVE STATEMENT ........................................................................................... 11 BIBLIOGRAPHY .................................................................................................................... 12 APPENDIX 1 WHO- STOP TB PARTNERSHIP INITIAL REPORT .... Error! Bookmark not defined. APPENDIX 2 PERSONAL DEVELOPMENT PLAN ......... Error! Bookmark not defined.


CSF CPS EVM FLD GDF HRD HRM KPI PDP SHRM STBP TB TRC WHO Critical Success Factors Contracting and Procurement Service Earned Value Management First-Line Drugs Global Drugs Facility Human Resource Development Human Resource Management Key Performance Indicator Personal Development Plan Strategic Human Resource Management Stop Tuberculosis Partnership Tuberculosis Technical Review Committee World Health Organisation

This report is constructed by evaluation of three themes of Project Management practice i.e. Procurement and contracting process, Earned Value Management (EVM) and Performance Management and Strategic Human Resource Management in light of STBP governance framework. Procurement and contracting process based on four levels: Planning, conducting the procurement and contracts, administer or monitoring the procurement process but finally level procurement closure is termed as on-going cycles of procurement stages. As this programme is based on eradication of TB disease form world procurement and contracting is also on going which is mainly related to procurement of drugs and contracting of healthcare personnel services and procurement closure process can only take place when there will be no more procurement will be required. Further this report evaluates the Procurement process in light with academic theories and framework and their correlation. EVM and performance management is evaluated in STBP on the bases of KPIs and CSFs to determine if the performance targets have been met or research the required threshold in order to achieve the objectives of the programme. Role of leadership is evaluated in management of conflicts and implementation of SHRM framework. SRHM is considered as a vital process in the programme as performing health workforce is vital not only to achieve the goal of programme but also to develop a performing healthcare system. SHRM in the STBP programme is supported by various academic HRM framework models (i.e. Harvard HRM framework, Contextual, and dynamic framework for SHRD) are evaluated in depth in this report to construct the correlation between the theory and practice within STBP programme.

This report is continuity to initial report which was on various practices of the International Projects Management such as; Project governance framework and organisational transformation in WHO- Stop TB (STBP) Partnership programme (See Appendix 1). This report will focus on critical evaluation of three aspects of PM practices in STBP programme such as; Procurement and contracts management, Earned Value Management and strategic Human Resource Management in context with STPBs Governance framework.

In this section of report, findings from of literature will be compared and analysed in context with findings of STBP programme.


Procurement process is employed for every project to acquire the necessary resources in order to achieve project objectives. It includes Procurement strategy or planning contracting of suitable suppliers or buyers and at last those procurement contracts are managed and procurement process is closed. Four levels have been identified in the project procurement process (PMBoK, 2008:313; APMBoK, 2006:75; Ribeiro, 2009:29); Plan Procurement Conduct Procurement /contracting Administer Procurement Procurement Closed

In STBP procurement process is a complimentary to the WHO/Contracting & Procurement Services (WHO/CPS), is a team of purchasing and logistics specialists, that supports WHO's efforts to provide essential health products worldwide. Purchasing of high quality, low cost diagnostic and drugs for disease treatment has to be done by a representative in the WHO regional or country offices on behalf of the ordering organization, using WHO intranet (WHO, 2012). The WHO/CPS catalogue which is available to WHO staff via the WHO intranet ordering site known as WebBuy, where all latest drugs for various regional diseases can be ordered to be delivered to WHO regional community health centres. All WHO programmes are responsible for their own procurement and contracting under WHO/CPS guidelines. In STBP procurement is mainly done for drugs/medicines for its member states and affected communities. Total value of STBP worldwide GDF procurement for year 2010 was $132 million. This figure includes freight, insurance, procurement agent fees, quality control and pre-shipment inspection, as well as the value of goods procured (STBP-GDF Report, 2010). It is worth mentioning that as discussed previously in initial report (Appendix 1) that STBP does not fund its projects or programme but its only provides a platform to effectively manage those projects within it programme. All GDF procurement is 100% donor funded by International Organisations. According to Walker and Rowlinson (2008:126) corporate governance framework of project facilitate the procurement and contracting process with accountability and ensures ethical standards are in place for the process in order to safe guard the interests of stakeholders of project. STBP-GDF Procurement is governed by a technical review committee to approve orders and assistance requests. Countries who are in 4

need of GDF grants for FLDs must submit an application to the Technical Review Committee (TRC). The TRC has 12 15 members nominated by key GDF stakeholders, including potential donors, technical agencies and countries. The composition of the TRC reflects the need for expertise in several areas, including TB control, procurement, and experience in TB programme management and contracting. The TRC reviews grant applications and makes recommendations to the Stop TB Partnerships Coordinating Board. The recommendations outline which grant applications to accept, the amount and nature of the grant, the steps necessary for programmes to meet conditions for GDF support, and the non-drug aspects of the programme that require assistance. The recommendations and decisions of the TRC are approved by the Board and implemented by the GDF Secretariat (GDF-TRC, 2012). As mentioned above WHO main policy standards is to procure high quality drugs to achieve this objective while procuring or contracting for drugs or related services quality. In STBPs GDF project procurement or contacting must pass through a six tier authorisation and recommendation process which includes getting authorisation from related Drug regulatory authority to WHO medicine monitoring and surveillance programme for quality assurance. Purpose of this quality assurance process is to ensure global consistency regarding quality standards set for the procurement and supply of anti-TB medicines and diagnostics items and to avoid duplication of effort. During the project implementation, many procurement cycles are undertaken concurrently or sequentially in order to produce the deliverables and attain the project objectives (Ribeiro, 2009:29). In STBP- GDF procurement planning is consists of five procurement cycles as illustrated in the Figure 1.1;

These procurement cycles are; Initiation state, Procurement stage, Stage where purchase order is process with suppliers, Logistics, Administer or monitoring of procurement process. These procurement cycles have explained how procurement is planned in each cycle with the duration of the cycle and how that cycle is analysed. Procurement process at STBP and its projects does not close as programme consists of on-going social development projects and until TB is eradicated from the affected communities these procurement cycles will be planned and implemented throughout the programme.


Solanki (2009) has interpreted EVM as historically an essential part of procurement process because after acquiring resources the project management needs to implement performance management mechanism with the project governance framework which facilitates on the issues of overall performance of project. KPIs to project performances are used as a measure to focus of aspects of project performance towards objectives rather than detail of progress of work packages (Parameter, 2011). Morris and Pinto (2011:21) has described KPIs as project specific performance that is performance of project processes such as effectiveness of project control mechanism, degree of project cost reduction by using designed procurement practices and by measuring the amount of change happening in the project. In STBP KPIs are of four types as Rockert (1978) cited in Howell (2009:2) which are specific to its industry of this programme, organisation strategy, environmental KPIs and the ones which are temporal to its funding targets, Budget Targets and its Global Plan 2011-2015 where KPIs for Programmes have been set to meet the targets of its projects. (CSF) are defined in the Global plan 2011 2015 which are critical to success of its projects such as development of TB vaccine for children who are most vulnerable to disease all over the world (Morris and Pinto, 2011:22). Latest guidelines from STBP for its working groups to set KPIs which are achievable under current circumstances, promotes partner organisations and stakeholder engagement, defines stakeholder roles and responsibilities, promotes transparency in funding process, and improve overall communication, coordination among all stakeholders, promotes accountability and evaluation of goals and should be strategically aligned with STBP Goal 2011-2015 (STBPthe partnering initiative, 2012). Bourne & Bourne (2011:9-15) have mentioned that performance management of an organisation or project is not an exact science but it is related to environment of organisation and leadership is responsible for creating such environment and culture in which good performance can be delivered. Leaders have to support management in their development and use of any performance measurement system which must be strategically aligned with organisation core strategy. Role of leadership is to build competence within organisation to avoid the conflicts to be avoided and get underground which occasionally flaring up in dysfunctional way or lead to large conflicts with in organisation (Runde et al., 2007). In STBP 16 stakeholders from various partner international organisations had contacted the Governing Board and coordinating committee in 2011 to raise a conflict with WHO-TB department on funding disputes and demanded transparency in allocation of funding for TB projects as it was perceived within stakeholder organisation that 70% of STBP funding has been allocated to WHO-TB department which was seen as an unfair distribution of funds. In response STBP coordinating board had formed a subcommittee which was supported by WHO-Director General in order to set KPIs on 6

performance of funding and spending aspects of project with measures to increase coordination between stakeholder organisations with WHO-TB department (Treatment Action Group, 2011). Role of project leadership and Strategic Human Resource Management (SHRM) are critically inter-related with each other, Human Resource Management (HRM) is essential for a project to manage the issue related to performance of employees and conflict resolution at work (Bratton and Gold, 2001:56)


The resource based view of an organisation or project postulates that internal knowledge and skills represent important sources of competitive knowledge (Garavan, 2007). Torrington et al. (2008) further explains that HRM in a project organisation is used to fulfil various objectives and roles those are employed in accordance with project organisation specifics or to match the needs. According to STBP Human resource development (HRD) for implementation of the Stop TB Strategy is integral to overall HRD in the health system and the development of the health workforce is concerned with the different functions involved in planning, managing, and supporting the professional development of the health workforce within the health system. HRD aims to secure the right people, with the right skills and motivation, in the right place, at the right time. SHRD in STBP can be firther explained with the help of The Harvard analytical framework for HRM by Bell et al. (1984) cited in Cakar et al. (2003) which is consisted of two parts; HR system and HRM strategic map (Figure 1.2).

The Human resource system represents labour realtions and personnel administrative perspectives under four human resource categories: which are employees influence, employess resource flow, rewards and work systems. HRM strategic map show that how HRM is closely connected with both external environment (i.e. stakeholder interests) and internation organisation (i.e. situational factors). In STBP it has been identified that Developing the health workforce is one of the key issues in overall health systems development. The quality of service delivery, including interventions for comprehensive TB 7

control based on the Stop TB Strategy, depends largely on the performance of personnel, enabled by the availability of sufficient facilities, equipment and drugs, and a supportive environment. Garavan (2007) has presented the four levels of contextual and dynamic HRD framework (Figure 1.3) which are necessary to understand the contribution of SHRD in an international organisation these levels are; global environment, strategy, structure and the leadership, job value and uniqueness, individual expectations, employbility and career. This model recognises the importance of multiple stakeholders and partnership that has emerged in STBP programme in the design, development and implementation of SHRD.

Figure 1.3: Contextual and dynamic framework for SHRD (Source: Garavan, 2007:17)

The STBP Human Resources for Health (HRH) Action Framework (Figure 1.4) has been designed to assist countries in developing and implementing strategies to achieve an effective and sustainable health workforce. This framework was developed with the contribution of representatives from various stakeholders of programmes such as partner countries, multilateral and bilateral agencies, donors, nongovernmental organizations (NGOs), and the academic community.

Figure: 1.4 The STBP Human Resource for Health (HRH) framework (Source: (STBP-HRD planning, 2008) the Framework is applicable in all countries, its use will be influenced by the elements specific to the country context (for example, the economy, the political situation), including the labour market (the capacity of the health workforce in general, international labour influences). The outcomes of applying the Framework will also be influenced by the strength of other components in the countrys health system (for example, the availability of drugs and equipment, the level of technology available, and the number and condition of health facilities) (Garavan, 2007). In recent STBP-HRD strategy planning report (2008) it has been identified that STBP programmes and its related projects are facing HRM challenges at three level i.e. macro level, intermediate level, micro level. At the Macro Level, the main issues and challenges relate to: the size and composition of workforce, distribution of workforce across the projects in various countries, the general parameters of working conditions, incentive systems, payment mechanisms and labour relations for health workers. At the Intermediate Level, health workforce issues relate to the application of policies and decisions made at a higher level, which are addressed in a more or less autonomous manner, depending on the degree of decision-making and management decentralization. Also important at this level is the capacity to provide and ensure that the peripheral or micro level is appropriately equipped and capacitated to do the job. At last Micro Level, health workforce management is less 9

concerned with groups and categories of personnel, as is the case at the other levels, but rather with individuals. Issues are more likely to be performance management, including relevance of acquired skills, supervision, evaluation or conflict resolution (STBP-HRD planning, 2008). At all levels, health workforce decisions and practices impact the outcomes of the health-care system. Without incentives to encourage providers to work in remote or poorer regions of a country, workers migrate, with subsequent inequities in access to services. Basic training that is not relevant to the needs of the population results in a health-care system less effective at improving health status. Poor management of personnel and unsatisfactory working conditions, usually associated with a discouraged workforce, which make it difficult for health-care systems to respond to consumers expectations. A greater involvement of stakeholders leads to psychological ownership which is a precondition for implementing effective HRD programmes and other learning interventions (Wognum & Fond Lam, 2000; Nohria et al., 2008). The projects those are based in developing countries on average there are 1-2 health workers available for in the healthcare system per each 1000 persons and there performance depends on various factors, including motivation, training, supervision, salaries, working conditions, and job certainty and stability (STBP- HRD Planning, 2008:17). Factors which have been related to affect the performance of health workforce are Capability (Can do) and Motivation (Will Do). (Furgure 1.5)

Figure 1.5: Factors affecting the perfformance of health workforce at STBP (Source: adapted from STBP-HRD planning, 2008) In recent STBP reports during the past years it has been highlighted that developing capable, motivated, and supported health workers is essential for overcoming bottlenecks to achieve 10

national and global health goals. Workforce training aim to teach the skills and knowledge that health workers specifically need: detecting cases of pulmonary TB, determining the appropriate drug therapies for TB patients, providing directly-observed treatment, informing patients about TB, and monitoring the success of TB case detection and treatment at the health facility level. The course does not teach basic medical techniques familiar to health workers, such as how to give injections or the importance of sterilizing needles and syringes (STBP-Training, 2010). To achieve the objectives of a performing workforce stakeholder involvement is critically important, where at STBP programme while the challenges are daunting and will require long-term investments from all stakeholders beyond the health sectors, opportunities also exist. After years of neglect and underinvestment, the central role of the health workforce to the effectiveness of health programmes and health outcomes is finally recognized and HRD framework has been developed which is supported by all stakeholders of programme and will be implemented systematically.


This has been learned in this report and initial report (See appendix 1) that seven themes of Project Management practices i.e. Concept of ICPM, Corporate Governance framework, PM Management Maturity Model & Capability, Transformational change and leadership, Procurement and Contracts Management, Performance and EVM, and Strategic HRM are foundation for PM professional development. Above named themes have been used to construct a Personal Development Plan (PDP) ( See appendix 2) which has helped in setting targets of what needs to be learned?, how to achieve the targets?, what resources are used to facilitate this learning?, what will be learning outcome?, and at last what are target dates to complete this learning plan?. Resources used to gain knowledge on said themes are mentioned in details in PDP (Appendix 2). First report was written covering the four themes (appendix 1) with a target review day of 20/03/2012 and completion date of 25/03/2012. Similarly in second part second report was written covering last three themes to achieve targets set in PDP. Stop TB Partnership (STBP) Programme was used as a case study to understand the PM in practice, I have learned that how STBP fits the definition of international programme or projects, how programme is managing its multiple stakeholders in over 200 countries with diverse cultural teams in projects. International collaborations and networks between organisations were learned from this programme as it holds about 1000 partner organisations in the programme. PM Maturity and capability was evaluated with the help of OPM3 model and it is learned that STBP programme is a mature programme and it is a learning organisation with its purpose to bring a change in society with eradication of TB quality assurance and risk management are managed successfully. Performance Management and EVM has been highlighted in report and it was learned that performance of health workers is key to success of this project and suitable training programmes have been deployed in the STBP to gain competitive advantage. At last this programme has been successfully evaluated in light of seven themes of PM and all KPI or success criteria have been achieved in PDP (appendix 2)


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