A STUDY ON THE ROLE OF TRANSPORTION SYSTEM IN

QUALITY HEALTH CARE PRODUCTS DELIVERY

CHAPTER -1
1.1 INTRODUCTION

Transport (BE) or transportation (AE) is the movement of humans, animals,

and goods from one location to another. In other words, the action of transport is defined as a
particular movement of an organism or thing from a point A (a place in space) to a point B

Modes of transport include air, land (rail and road), water, cable, pipeline, and space. The

field can be divided into infrastructure, vehicles, and operations. Transport enables trade
between people, which is essential for the development of civilizations.

Transport infrastructure consists of the fixed installations,

including roads, railways, airways, waterways, canals, and pipelines and terminals such
as airports, railway stations, bus stations, warehouses, trucking terminals, refueling depots
(including fueling docks and fuel stations), and seaports. Terminals may be used both for
interchange of passengers and cargo and for maintenance.

Means of transport are any of the different kinds of transport facilities used to carry people or
cargo. They may include vehicles, riding animals, and pack animals. Vehicles may
include wagons, automobiles, bicycles, buses, trains, trucks, helicopters, watercraft, spacecraf
t, and aircraft.

Modes

Main article: Mode of transport

A mode of transport is a solution that makes use of a particular type of vehicle,

infrastructure, and operation. The transport of a person or of cargo may involve one mode or
several of the modes, with the latter case being called inter-modal or multi-modal transport.
Each mode has its own advantages and disadvantages, and will be chosen on the basis of cost,
capability, and route.

Governments deal with the way the vehicles are operated, and the procedures set for this
purpose, including financing, legalities, and policies. In the transport industry, operations and

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ownership of infrastructure can be either public or private, depending on the country and
mode.

Passenger transport may be public, where operators provide scheduled services, or private.
Freight transport has become focused on containerization, although bulk transport is used for
large volumes of durable items. Transport plays an important part in economic growth
and globalization, but most types cause air pollution and use large amounts of land. While it
is heavily subsidized by governments, good planning of transport is essential to make traffic
flow and restrain urban sprawl.

Human-powered

Main article: Human-powered transport

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Human-powered transport remains common in developing countries.

Human-powered transport, a form of sustainable transport, is the transport of people

and/or goods using human muscle-power, in the form of walking, running, and swimming.
Modern technology has allowed machines to enhance human power. Human-powered
transport remains popular for reasons of cost-saving, leisure, physical exercise,
and environmentalism; it is sometimes the only type available, especially in underdeveloped
or inaccessible regions.

Although humans are able to walk without infrastructure, the transport can be enhanced
through the use of roads, especially when using the human power with vehicles, such as
bicycles and inline skates. Human-powered vehicles have also been developed for difficult
environments, such as snow and water, by watercraft rowing and skiing; even the air can be
entered with human-powered aircraft.

Main article: Animal-powered transport

Animal-powered

Animal-powered transport is the use of working animals for the movement of people

and commodities. Humans may ride some of the animals directly, use them as pack
animals for carrying goods, or harness them, alone or in teams, to pull sleds or
wheeled vehicles.

Air

Main article: Aviation

An Air France Airbus A318 lands at London Heathrow Airport.

A fixed-wing aircraft, commonly called an airplane, is a heavier-than-air craft where

movement of the air in relation to the wings is used to generate lift. The term is used to
distinguish this from rotary-wing aircraft, where the movement of the lift surfaces relative to

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the air generates lift. A gyroplane is both fixed-wing and rotary wing. Fixed-wing aircraft
range from small trainers and recreational aircraft to large airliners and military cargo
aircraft.

Two things necessary for aircraft are air flow over the wings for lift and an area for landing.
The majority of aircraft also need an airport with the infrastructure for maintenance,
restocking, and refueling and for the loading and unloading of crew, cargo, and passengers.
While the vast majority of aircraft land and take off on land, some are capable of take-off and
landing on ice, snow, and calm water.

The aircraft is the second fastest method of transport, after the rocket. Commercial jets can
reach up to 955 kilometres per hour (593 mph), single-engine aircraft 555 kilometres per hour
(345 mph). Aviation is able to quickly transport people and limited amounts of cargo over
longer distances, but incurs high costs and energy use; for short distances or in inaccessible
places, helicopters can be used.As of April 28, 2009, The Guardian article notes that "the
WHO estimates that up to 500,000 people are on planes at any time.

Land

Main article: Land transport

Land transport covers all land-based transport systems that provide for the movement
of people, goods, and services. Land transport plays a vital role in linking communities to
each other. Land transport is a key factor in urban planning. It consists of two kinds, rail and
road.

Rail

Main article: Rail transport

Intercity Express, a German high-speed passenger train

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The Beijing Subway is one of the world's largest and busiest rapid transit networks.

Rail transport is where a train runs along a set of two parallel steel rails, known as a railway
or railroad. The rails are anchored perpendicular to ties (or sleepers) of timber, concrete, or
steel, to maintain a consistent distance apart, or gauge. The rails and perpendicular beams are
placed on a foundation made of concrete or compressed earth and gravel in a bed of ballast.
Alternative methods include monorail and maglev.

A train consists of one or more connected vehicles that operate on the rails. Propulsion is
commonly provided by a locomotive, that hauls a series of unpowered cars, that can carry
passengers or freight. The locomotive can be powered by steam, by diesel, or
by electricity supplied by trackside systems. Alternatively, some or all the cars can be
powered, known as a multiple unit. Also, a train can be powered
by horses, cables, gravity, pneumatics, and gas turbines. Railed vehicles move with much less
friction than rubber tires on paved roads, making trains more energy efficient, though not as
efficient as ships.

Intercity trains are long-haul services connecting cities;[3] modern high-speed rail is capable

of speeds up to 350 km/h (220 mph), but this requires specially built
track. Regional and commuter trains feed cities from suburbs and surrounding areas, while
intra-urban transport is performed by high-capacity tramways and rapid transits, often making
up the backbone of a city's public transport. Freight trains traditionally used box cars,
requiring manual loading and unloading of the cargo. Since the 1960s, container trains have
become the dominant solution for general freight, while large quantities of bulk are
transported by dedicated trains.

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Road

Main article: Road transport

Road transport

A road is an identifiable route, way, or path between two or more places.[4] Roads are

typically smoothed, paved, or otherwise prepared to allow easy travel;[5] though they need not
be, and historically many roads were simply recognizable routes without any
formal construction or maintenance.[6] In urban areas, roads may pass through
a city or village and be named as streets, serving a dual function as urban space easement and
route.[7]

The most common road vehicle is the automobile; a wheeled passenger vehicle that carries its
own motor. Other users of roads include buses, trucks, motorcycles, bicycles,
and pedestrians. As of 2010, there were 1.015 billion automobiles worldwide. Road transport
offers complete freedom to road users to transfer the vehicle from one lane to the other and
from one road to another according to the need and convenience. This flexibility of changes
in location, direction, speed, and timings of travel is not available to other modes of transport.
It is possible to provide door-to-door service only by road transport.

Automobiles provide high flexibility with low capacity, but require high energy and area use,
and are the main source of harmful noise and air pollution in cities;[8] buses allow for more
efficient travel at the cost of reduced flexibility.[9] Road transport by truck is often the initial
and final stage of freight transport.

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Water

Main article: Ship transport

Automobile ferry in Croatia

Water transport is movement by means of a watercraft—such as a barge, boat, ship,

or sailboat—over a body of water, such as a sea, ocean, lake, canal, or river. The need for
buoyancy is common to watercraft, making the hull a dominant aspect of its construction,
maintenance, and appearance.

In the 19th century, the first steam ships were developed, using a steam engine to drive
a paddle wheel or propeller to move the ship. The steam was produced in a boiler using wood
or coal and fed through a steam external combustion engine. Now most ships have an internal
combustion engine using a slightly refined type of petroleum called bunker fuel. Some ships,
such as submarines, use nuclear power to produce the
steam. Recreational or educational craft still use wind power, while some smaller craft
use internal combustion engines to drive one or more propellers or, in the case of jet boats, an
inboard water jet. In shallow draft areas, hovercraft are propelled by large pusher-prop fans.
(See Marine propulsion.)

Although it is slow compared to other transport, modern sea transport is a highly efficient

method of transporting large quantities of goods. Commercial vessels, nearly 35,000 in
number, carried 7.4 billion tons of cargo in 2007.[10] Transport by water is significantly less
costly than air transport for transcontinental shipping;[11] short sea shipping and ferries remain
viable in coastal areas.

Other modes

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Trans-Alaska Pipeline for crude oil

Pipeline transport sends goods through a pipe; most commonly liquid and gases are
sent, but pneumatic tubes can also send solid capsules using compressed air. For
liquids/gases, any chemically stable liquid or gas can be sent through a pipeline. Short-
distance systems exist for sewage, slurry, water, and beer, while long-distance networks are
used for petroleum and natural gas.

Cable transport is a broad mode where vehicles are pulled by cables instead of an internal
power source. It is most commonly used at steep gradient. Typical solutions include aerial
tramways, elevators, escalators, and ski lifts; some of these are also categorized
as conveyor transport.

Spaceflight is transport out of Earth's atmosphere into outer space by means of a spacecraft.

While large amounts of research have gone into technology, it is rarely used except to put
satellites into orbit and conduct scientific experiments. However, man has landed on the
moon, and probes have been sent to all the planets of the Solar System.

Suborbital spaceflight is the fastest of the existing and planned transport systems from a place
on Earth to a distant "other place" on Earth. Faster transport could be achieved through part
of a low Earth orbit or by following that trajectory even faster, using the propulsion of the
rocket to steer it.

TRANSPORT DEFINITION

Part of the economic activity intended to satisfy human needs by means of geographic
change position of people or things Transportation tries to erase the obstacles due to distance
Ways in which transport is part of the productive activity

•As phase of the production process

•As a production process

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•Goods distribution

TRANSPORT FUNCTIONS

General function: Control of space and time Specific functions:

• Integration of societies and territories

• Displacement needs satisfaction

• Strategic reasons (to promote a region)

• Establish connection between the productive system and the consumption regions

• Ensure the access to different geographic regions

• Economic activity in itself that generates wealth and jobs

GROWTH TRANSPORTATION FACTORS

1. Population growth
∆ Population ∆ People transportation
∆ Consume ∆ Production Material Transportation
2. Mobility increase

∆ Mobility: Number of km travelled by citizen

 Transport evolution
 Bigger speeds
 Less time When time is saved in travelling, the saved time leads to an increase of
mobility
 It is statistically proved that travel time investment is stable with time Bigger
mobility
 Bigger demand of transportation

TRANSPORT EFFICIENCY

Influence efficiency transport factors:

•Improvement and increase of infrastructures

•Time travel reduction

•Decrease of specific consumption

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 •Load capacity increase

•Specialization of means

•Environmental negative impact reduction

•Safety increase

SOCIAL TRANSPORTATION COSTS

Environmental impact

•Pollutant gas emissions

•Acoustic pollution

•Vibrations

•Visual impact: Infrastructures, dirt, deposits…

Traffic

•Transport time increase

•Consumption increase

•Environmental impact

The Role of Transport in Healthcare Delivery

Hall et al (2006) conducted a study in the Eastern Cape province of South Africa with
a view to understanding the impacts of transport to healthcare service delivery. Their findings
demonstrated not only the need for improved transport services in the delivery of health, but
also the importance of using the right type of vehicles. Their study also revealed that during
the rainy season, it was exceedingly difficult for delivery vehicles laden with drug supplies to
access health facilities largely because of poor road infrastructure running along hilly, often
broken and generally difficult terrain that characterize the province. In wet weather, these
roads become muddy and slippery. In fact, health transport problems are indeed most severe
in the wet season for most rural areas not only in South Africa but also in other developing
countries (Gray & Suleman (1999). This severity is felt much more keenly in emergency
cases. In a study done by Mobility and Health (2008) in Namibia, it was demonstrated that
transport for emergency cases comes at a higher cost for people living in rural and largely
marginalized areas. Very often, patients get too exhausted or die while waiting for
Ambulances, which take over three hours on average to report at the scene after a callout. In

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South Africa, there is a huge backlog in terms of the provision of emergency medical services
(EMS) especially in the public health sector. This situation is exacerbated by the short supply
of specially designed and equipped vehicles as well as well-trained staff or paramedics – the
hallmark of EMS.

Small wonder then that organizations such as t he Southern African Rural Poverty Network
(SARPN) have clamored for the generation of a national EMS strategic plan (as part of a
concerted efforts to achieve the British Journals of Marketing Studies Vol.2, No.4, pp. 30-51,
August 2014 Published by European Centre for Research Training and Development UK
(www.eajournals.org) 36 ISSN 2053-4043(Print), ISSN 2053-4051(Online) Millennium
Development Goals) using the 2010 FIFA Soccer World Cup as a fillip (SARPN, 2007).
Lack of adequate and affordable transport services particularly in remote rural and
marginalized areas, under-girded by sound transportation infrastructure, are obstacles to
achieving meaningful service delivery. Clearly, without proper transport infrastructure and
services, healthcare facilities in these areas will remain under-serviced in terms of
maintaining adequate levels of medical supplies and retaining medical staff as well as
eliciting confidence and therefore regular utilization of the facilities by locals (Mashiri et al,
2007b; Mashiri et al, 2008). As part of the overarching framework of the National Transport
Policy for South African, it is envisaged that policies in the transport sector will be outward
looking, shaped by the needs of society in general (Department of Transport, 1996). Among
those needs is transport for health service delivery. The importance of transport services is
summarized by Hall et al (2006) as:

“…Adequate and appropriate vehicles, which are efficiently managed, are essential for
delivery of quality healthcare within a health system. The correct number and vehicle mix,
suitable for topographical area in which the service is provided, is required. A comprehensive
management system for monitoring and evaluating transport services is essential…”

Transport Accessibility to Healthcare Facilities

People travel in order to gain access to goods, services, employment, friends and
family, leisure pursuits and healthcare. Many people travel much greater distances than in the
past for routine purposes, as a result of the increasing affordability and accessibility of
driving. Overall motoring costs are at or below 1980 levels, over which time average
disposable income has increased by 90%, and planning decisions are based around the
expectation of car use by all (DfT, 2003)..Consequently, a survey conducted by Department

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of Transport, UK showed that 28% of households who are without access to a car find it
harder to travel to get to shops, employment, healthcare and other services. While only 7% of
those in the highest income quintile have no access to a car, 62% of those in the lowest
income quintile are without such access (DfT, 2003).Access to appropriate transport services
is a major issue for communities isolated by their remoteness, or as a consequence of social,
cultural or economic factors (National Public Health Partnership, 2001). People who do not
have their own means of transport suffer considerable disadvantage within the community,
particularly if they live in low density areas. Use of health care services declines as the
individuals’ distance from the facility increases. Distance has been related to delays in
treatment, increased mortality for some health problems such as ischemic heart disease. A
study conducted in the village of Vanathavillu in the north-western Province of Sri Lanka by
Wettasasinghe and Pannila (2002) illustrates that even where rural communities are better
served with intermediate and motorized transport and a paved road, transport of those who
are too ill to travel by bus is prohibitively costly. Added to this is the problem of gaining
access to medical staff once the health outlet has been reached. Due to the low ratio of health
workers to the populations they serve, villagers need to travel early and queue for many hours
if they are to have any chance of being seen by qualified medical staff.

Impact of Inadequate Transport on Health

There are few studies that have quantified the health impacts of poor transport to
health facilities in developing countries. A few case reports have been published and these
are discussed in the context of rural poverty, gender and health. The distribution of health
facilities in rural areas is usually sparse, particularly of hospital-based facilities. (Babinard
and Roberts, 2006) Contrary to this, there is usually a concentration of health facilities and
manpower in urban areas, where disproportionately more health professionals are also found.
It is in rural areas where transportation and other infrastructure may also be at their most
deficient and where the effect of poor transport on health is likely to be greatest. The World
Health Organization (WHO) has set a target maximum distance from health care of 8kms. In
practice only 40 to 60 per cent of the poorer country populations have this level of access. For
example in the Orumia region of Ethiopia only 43 per cent reach this target (TRANSAID,
1999). Therefore transport and outreach services are crucial in enabling rural communities
gain access to health care.

The Costs of Transport to Access Healthcare Services

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 Transport costs of accessing health facilities have been calculated to represent 25% of
the total outlay on health in north-east Brazil (Terra de Souza et al 2000) and 28% in
Cameroon (Sauerborn et al 1995). Wyss et al (2001) in a study of the costs of TB care for
households in urban Tanzania found that households spent between US $ 13 and $20
accessing drug therapy during their shortcourse treatment using the cheapest forms of
transport. Research findings from Bangladesh reveal that in the breakdown of patient costs,
travel to service centres requires the greatest financial outlay of all health costs after
expenditure on medicines (CIETcanada 2000).For HIV/AIDS patients undergoing treatment,
the costs of transport to health facilities represents an extreme burden on financial resources
already under strain from reduced income and productivity of patients and their careers. In
Chad, a study by Wyss et al (2004) revealed the costs of transportation using public services
to be the second greatest expenditure for AIDS patients after that of medicines.

Rural Transport Services and Vehicle Availability

The problems caused by the lack of reliable, well-maintained rural road systems are
worsen by the lack of motor vehicle capacity caused by relatively small vehicle fleets and the
poor condition of the vehicles that exist in these communities.Survival and continued use of
many vehicles have depended on the ingenuity of good indigenous mechanics in modifying
vehicles to the prevailing conditions including the spare parts available. Notwithstanding
these remarkable achievements, vehicle capacity and availability remain inadequate. Even
where motor able roads exist, transport services are unreliable and infrequent in most rural
areas; where available, such services are forhire and the majority of rural inhabitants cannot
afford them (Carapetis et al, 1984).

Access to Health Services in Rural Ghana

Use of health facilities in Ghana is still low. Assistance in birth delivery proves the
insufficient delivery of health care: Whereas 79% of births in urban areas are supervised by a
medical practitioner, the rural figure is only 33%.( Heyen-Perschon,2005). Here, 36% of
births are supervised by midwifes and the remaining third is unsupervised. In some regions in
the north, unsupervised deliver is the norm. It is been found that in Malawi and Ghana
children are at times born on the roadside while pregnant women are walking to the clinic
(Grieco, 2005). 70% of the poor population is citing costs as one key reason for non-use of
medical services. This includes cost for medicine, treatment but also transport to and from the
facility. In addition to this, physical location of health facilities does not meet households’

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needs, meaning distance as a major obstacle to the rural population. (Hanson 2004). Up to
70% of the rural poor needs more than 30 minutes to the next health facility. But this reflects
only the portion of the rural population, consulting medical personnel. The assumption, that
access is a main bottleneck of health care is proved by the fact that more than the half of the
rural population (55%) is not consulting medical personnel. Clearly, distance is not the only
impediment to health care access treatment fees commonly impose an even greater barrier
(Airey, 1995; AU/UNECA, 2005) but in emergencies (where treatment fees are certainly
waived in some places and cases) distance and transport failures imposes a critical hurdle
(Murray and Pearson 2006).

Transports for Healthcare Professionals and Care Workers

The lack of transport to ensure timeouts transfer of patients between levels of health
care and for delivery of medicines, vaccines, and other essential equipment is a commonly
heard cry from health workers, particularly from those working in rural areas, but is often
overlooked and rarely researched. A multi-country study on transport management in the
health sector carried out in four sub-Saharan countries demonstrated the importance of a
functional transport system for ensuring the effective and efficient delivery of health services
(Nancollas. 2001). Bundred and Levitt (2000) have likened inequalities that exist between
and within countries, to those that exist between developed and underdeveloped areas to
better understand the raison d’être for health professionals’ location decisions. The authors
came to the inescapable conclusion that

professionals migrating from poor to developed areas are often influenced by perceived better
opportunities such as income and good working conditions. Translated into tangibles, ‘good’
working conditions’ would imply, among others, easily accessible and well-equipped medical
facilities. In the same vein, healthcare workers such as home-based care workers often visit
patients in their homes. The Institute for Transport and Development Policy (ITDP) (2003)
argues that about 70% of adults and over 80% of children living with HIV/AIDS are in Africa
– living in the most underdeveloped areas. Persons living with HIV/AIDS cannot always visit
healthcare facilities due to difficulties they face in travelling – they often require the
assistance of healthcare workers due to physical weakness in environs characterized by
inadequate and unaffordable transportation services (Mashiri et al, 2007a; Mashiri at al,
2007b,). While the need to mobilize healthcare workers who do outreach work is recognized,
the need for improved transport services cannot be over-emphasized.

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Emergency Medical Services

These are a type of emergency service dedicated to providing out-of-hospital acute

medical care and/or transport to definitive care, to patients with illnesses and injuries which
the patient, or the medical practitioner, believes constitutes a medical emergency. The use of
the term emergency medical services may refer solely to the pre-hospital element of the care,
or be part of an integrated system of care, including the main care provider, such as a
hospital.. Emergency access to care is particularly vital for developing countries and its rural
communities to accessing available preventive and curative services, and also supports
indirect determinants of health including livelihoods and education (Babinard P, Roberts,
2006). Emergency medical services may also be locally known as: first aid squad, ambulance
service, Emergency care in the field has been rendered in different forms since the beginning
of recorded history. The New Testament contains the parable of the Good Samaritan, where a
man who was beaten is cared for by a Samaritan Luke 10:34 (NIV). - "He went to him and
bandaged his wounds, pouring on oil and wine. Then he put the man on his own donkey, took
him to an inn and took care of him." The goal of most emergency medical services is to either
provide treatment to those in need of urgent medical care, with the goal of satisfactorily
treating the presenting conditions, or arranging for timely removal of the patient to the next
point of definitive care.

Availability of Transport for Emergency Healthcare

The response times of emergency services will be influenced by the transport

infrastructure. In developing countries this has not been well quantified either but short
response times for ambulances are accepted policy and practice in reducing mortality and
morbidity from life threatening conditions. Transport plays a critical role in the effective and
efficient delivery of health care. It enables people to access services and health workers to
reach communities, especially in sparsely populated rural areas (Babinard and Roberts,
2006). Minimum standards for response times are normally set as part of delivering a service
of acceptable quality. For serious trauma, the 'golden hour', or the first hour after trauma, is
accepted as the period of time beyond which further delays result in increased fatalities.
Delayed transport can worsen outcomes in maternal health e.g. increased maternal mortality
due to delays in transport include eclampsia and hemorrhage. According to Hamlin (2004)
obstetric fistulas are a preventable through a combination of access to adequate transport
services and effective management of child delivery services. This is also true for

15
cardiovascular disease and other medical emergencies, where shortening the time to
definitive care results in health gain. A case series from Malawi describes childhood deaths
from meningitis and cerebral malaria whilst awaiting transport from the health centre to
hospital.

Top 10 Healthcare Companies in India

 Apollo Hospitals Enterprises Ltd.

 Aster DM Healthcare Ltd.
 Dr. Lal PathLabs Ltd.
 Fortis Healthcare Ltd.
 Healthcare Global Enterprises Ltd. ( HCG)
 Indraprastha Medical Corporation Ltd. ( Indraprastha Apollo Hospital, Delhi)
 Narayana Hrudayalaya Ltd.

 Piramal Enterprises Ltd.

Apollo Hospitals Enterprises Ltd

It is an Indian hospital chain based in Chennai, India. Apollo Hospital was founded in
the year 1983. Its products are Hospitals, pharmacies, and Diagnostic centers. Apollo
Hospital is India’s leading corporate hospital and pioneer in the private healthcare revolution
in the country. The group has medicine units across various countries. It is one of the top 10
healthcare companies in India.

Aster DM Healthcare Ltd

One of the leading healthcare companies in India, Aster DM Healthcare was founded
in 1987. It is headquartered in Dubai. The company operates hospitals, clinics, diagnostics
centers, medical centers, and pharmacies in the middle east, India, and the Philippines. It is
one of the top 10 healthcare companies in India. With Fundoodata paid plans you can get
access to more information about the company like the number of employees, turnover,
decision-makers details, and more. Click here to know more.

Dr. Lal PathLabs Ltd

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 Dr. Lal Pathlabs Ltd was founded in the year 1949 and is headquartered in Delhi,
India. The company is an international service provider of diagnostic and related healthcare
tests and services. The company is running various laboratories at present. The company
offers a vast range of tests and other health checkups as well. The company is one of the top
10 healthcare companies in India. To get more information about the company like key
executives’ details, turnover, or number of employees subscribe to Fundoodata paid plans.

Fortis Healthcare Ltd

Fortis Healthcare Ltd was founded in the year 2001 by Malvinder Mohan Singh.  It is
a chain of specialist hospitals in India having branches in all top cities. It has many healthcare
verticals including daycare specialty facilities and others. The company operates through the
Clinical Establishments Division and Medical Services Division. The company operates in
healthcare delivery services in India, Dubai, Mauritius Sri Lanka. It is one of the top 10
healthcare companies in India. With Fundoodata paid plans you can get access to more
information about the company like the number of employees, turnover, decision-makers
details, and more. Click here to know more.

HealthCare Global Enterprises Ltd (HCG)

HealthCare Global Enterprises Ltd is engaged in managing cancer hospitals, cancer

centers, and medical diagnostic services, including scientific testing and consultancy services
in the pharmaceutical and medical sector. The company is also involved in retail sales of
pharmaceuticals, medical and orthopedic goods, and toilet articles.

The company operates a cancer care network under the HCG brand. The company offers
cancer diagnosis & treatment services through radiation therapy, medical oncology, and
surgery, and fertility treatment services, as well as reproductive medicine services.

Indraprastha Medical Corporation Ltd (Indraprastha Apollo Hospital,

Delhi)

Indraprastha Medical Corporation Ltd was founded in the year 1996 and is
headquartered in New Delhi. The company is owned by the famous Apollo Hospital Group. It

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is one of the top 10 healthcare companies in India. The company provides diagnostic,
medical, and surgical facilities for patients. The company provides various medical services
in various areas. With Fundoodata paid plans you can get access to more information about
the company like the number of employees, turnover, decision-makers details, and more.
Click here to know more.

Narayana Hrudayalaya Ltd

Narayana Hrudayalaya Ltd operates a network of hospitals and diagnostic clinical centers in
India and internationally. The company operates through the medical and healthcare services
business segment. It offers medical, surgery and diagnostics, and support services. The
company operates a network of over 20 hospitals, approx. 7 heart centers and over 20
primary care facilities, across India and a hospital in the Cayman Islands. The company was
founded in the year 2000 and is headquartered in Bangalore, India. To get more information
about the company like key executives’ details, turnover, or number of employees subscribe
to Fundoodata paid plans.

Piramal Enterprises Ltd

Piramal Enterprises Ltd was founded in the year 1988. It is headquartered in Mumbai,
Maharashtra, India. The company is well known in the pharmaceutical sector and is among
the top healthcare companies also. The company operates through 3 main segments-
Healthcare, Financial Services, and Information Management. Its healthcare segment
includes pharma solutions, critical care, consumer products, and imaging. The company
offers its products under brands, including Saridon, Lacto Calamine, I-Pill, Polycrol,
Tetmosol, Untox, and Throatsil. With Fundoodata paid plans you can get access to more
information about the company like the number of employees, turnover, decision-makers
details, and more. Click here to know more.

Care Health Insurance Ltd

It is one of the top 10 healthcare companies in India. The specialist health insurer is
involved in servicing and distribution of health insurance products. The leading healthcare
company is promoted by Religare Enterprises Limited. It is a leading diversified financial
services group. The company is providing a different range of services including financial,

18
preventive health solutions, healthcare delivery. It is one of the top 10 healthcare companies
in India.

Wockhardt Ltd

Wockhardt Ltd was founded in the year 1960 by Habil Khorakiwala. It is global biotechnology and
pharmaceutical company headquartered in Mumbai, India. Wockhardt is a global company having
manufacturing plans in different countries including Ireland, the US, France, Ireland. With Fundoodata paid
plans you can get access to more information about thecompany like the number of employees, turnover,
decision-makers details, and more

HEALTH CARE SERVICES

• Health services should be organized to meet the need of entire population and not merely
selected groups.

• The best way to provide health care to underserved rural and urban poor is to develop
effective Primary Health Care services supported by an appropriate referral system.

• Three levels of health care organization :

• Primary,

• Secondary and

• Tertiary level

19
PRINCIPLES OF PRIMARY HEALTH CARE

• Equitable distribution

• Community participation

• Intersectoral coordination

• Appropriate technology

ELEMENTS OF PRIMARY HEALTH CARE

• MCH services including family planning

• Immunization

• Provision of essential drugs

• Prevention & control of local endemic diseases

• Treatment of common illnesses & injuries

• Safe water supply & basic sanitation

• Provision of food supply & nutrition

• Health Education about prevailing health problems and its Prevention & control

PRIMARY LEVEL OF HEALTH CARE

• At least half of the world’s people still lack full coverage of essential health services

• Primary health care can cover the majority of a person’s health needs throughout their life
including preventive, promotive, curative, rehabilitation and palliative care

• First level of contact of individuals and the community with the health system

• Provided by Sub centers, PHCs, -ANM, ASHA, AWW, VHG, TBA

SECONDARY LEVEL HEALTH CARE

•At this level, more complex problems are taken care mostly which require secondary level of
preventive and curative services.

• These services are provided at Districts hospitals and Community health centers

• The First referral level (FRUs)

20
TERTIARY LEVEL HEALTH CARE

• This level of health care is provided at the state/regional/central level institutions

• Requires specific facilities and highly specialized health care professionals

• These institutions serve as referral units for primary and secondary levels

CHIEF BLOCK OFFICER/BLOCK LEVEL HEALTJH OFFICE

21
Daily Delivery Service

Delivery is the process of transporting goods from a source location to a predefined

destination. ... Postal, courier, and relocation services also deliver goods for commercial
and private interests.

transportation from a production plant to a regional distribution centre

•distribution centre operation
•outbound freight
•wholesale distributor’s receiving and warehousing operations
•wholesaler distributor’s mark-up for information processing and customer service
•transportation to the provider
•inventory
transportation from a production plant to a regional distribution centre
•distribution centre operation
•outbound freight
•wholesale distributor’s receiving and warehousing operations
•wholesaler distributor’s mark-up for information processing and customer service
•transportation to the provider
•inventory

22
COMPANY PROFILE :

WILDCRAFT

23
3-Ply Non-Woven Fabric Disposable Surgical Mask

The company's products are sold in 175+

exclusive stores and 4,000 multi-branded stores in
India, growing by 20-30 stores each year. In
December 2014 the company announced they would
explore the middle and southeast Asian markets.

Wildcraft products are also available across Middle

East & South Asian countries.

In February 2017, it did a tie-up to place Wildcraft in Europe. "From the revenue side, 5-6%
of our business comes from exports at present," said co-founder Gaurav Dublish. Wildcraft is
also planning to strengthen its presence in 5 lac+ population townships over the next 18–24
months.

Experience
Wildcraft India

o Sr Manager Logistics and Process Improvement

Jun 2019 - Present2 years 6 months
Bangalore

o Manager Logistics and Process Improvement

Jul 2016 - May 20192 years 11 months
Bangalore , India

24
 •Enhanced operational efficiency by Identifying bottle necks in supply chain and
eliminated bottle necks by analyzing existing SOPs, client delivery and service
Management.
•Vendor/ Partner development, formulated Service Level Agreements to provide best
services in class to our clients and customer.
•Planning, organizing and controlling of Warehouse’ over-all operations Setup layout &
space management work organization chart, procedures such as SOP, 5S.
•Manage stock control, the self-assured receipt, storage, retrieval, packaging and timely
delivery of goods, shipment loading & transferring, cross docking, documentation.
o Sr. Executive Warehouse & Transportation
Jul 2014 - Jun 20162 years
Bangalore,india
•Maintained physical condition of warehouse by planning and implementing new design
layouts, inspecting equipment, issuing work orders for repair and requisitions for
replacement..
•Focused on Root cause analysis and problem resolution for all logistics operations
Logistics Executive
Reid & Taylor India Limited
Aug 2006 - Sep 20093 years 2 months
Bengaluru, Karnataka, India
Handling Warehouse operations - Inward and Outward
Reporting to Warehouse Manager.

Logistics officer
Arvind Brands Limited
Mar 2003 - Aug 20063 years 6 months
Dispatches and Mis Reports.

Hand Sanitizers

25
STERILLIUM

The first Sterillium® bottle left BODE Chemie’s German plant in Hamburg-Stellingen on 4
June 1965. Back then, hardly anyone could imagine the product’s triumphal success within
such a short time and that its name would become synonymous with hand disinfection.
Based on this competitive advantage, BODE has leveraged the expertise gained to develop a
sophisticated product portfolio, which is tailored to different hand disinfection needs, and
ranges from the still-modern skin-friendly classic Sterillium®, the colourant and fragrance-
free Sterillium® classic pure and the extensively active Sterillium® med to the extremely
powerful, virucidal Sterillium® Virugard.

Established in the year 2009 at Chennai, Tamil Nadu, we “ Officebazzar E-store Pvt.

ltd” are a Private Limited based firm, are involved as the wholesaler, trader and retailer of
a wide assortment of Ink Cartridge, Pen Drive and many more. These products are known
for their extreme quality at the practical price in the stimulated time. Under the esteemed
guidance of “Atul Patel (Chairman)” our organization has achieved a vast customer base in
the market. 
Factsheet

Basic Information

26
 Nature of Business Wholesale Supplier

 Supplier
 Distributor
 Manufacturer

Additional Business  Wholesaler

 Trader
 Retailer

Company CEO Atul Patel

Officebazzar Tower, No.29/15, Subeda

Registered Address
Chennai- 600014, Tamil Nadu, India

Total Number of Employees Upto 10 People

Year of Establishment 2016

Legal Status of Firm Limited Company (Ltd./Pvt.Ltd.)

Annual Turnover Rs. 5 - 10 Crore

Statutory Profile

Tan No. CHEO0*****

Banker

GST No. 33AACCO4097Q1ZV

27
 CIN No. U74999TN2016PTC113544

Packaging/Payment and Shipment Details

 Cash
 Cheque

Payment Mode  DD
 Online

Shipment Mode By Road

OXIMETER

BPL PULSE OXIMETER

BPL Medical Technologies has served the medical community for over five decades. Since
1967, our high standards of product performance has made us the leading choice for hospitals, clinics
and practicing physicians across the country. Our commitment to service support is reflected in our
wide network of customer care centers with a team of over 600 service personnel located even in the
farthest corners of the country. This makes us one of the largest and the most accessible medical
equipment company. BPL is widely trusted for its reliable products and dependable service to its
customers. Our products are manufactured in an ISO 13485 certified facility and conform to global
standards of quality assurance and best practices. Our collaboration with the best brands across the

28
world and our high-quality manufacturing facilities provide our customers the latest technology at
affordable prices. Our range of products includes Electrocardiographs, Patient Monitors,
Defibrillators, Anesthesia Works tations, Stress Test Systems, Oxygen Concentrators, Color
Dopplers, X-Rays , Foetal Monitors, Foetal Dopplers and Home healthcare equipments. BPL is
committed to bringing in innovative products in future, and expand its customer support network that
would provide localised solutions to healthcare providers.
Website

http://bplmedicaltechnologies.com/

Industries

Medical Devices

Company size

201-500 employees

Headquarters

BANGALORE, Karnataka

Type

Privately Held

Founded

1967

Specialties

Medical Devices, Medical Equipment, Ultrasound, Medical Imaging, X-Ray, Radiology,

Critical Care, Cardiology, and Maternal Care

Pulse oximeters can help you monitor the oxygen saturation of hemoglobin in the arterial
blood non invasively. Measuring oxygen saturation is as important as measuring pulse rate
and hence pulse oximeters are valuable piece of equipments that can help decide oxygen
flow. Working on the principle of photodetection, the pulse oximeters emit infrared rays to
detect the oxygen saturation in blood. BPL has come up with smart pulse oximeters that help
you keep a check on the trend. Understand more about how they work here: Pulse Oximeter
Principle and PI.

Pulse oximetry is a noninvasive method for monitoring a person's oxygen saturation.

Peripheral oxygen saturation (SpO2) readings are typically within 2% accuracy (within 4%

29
accuracy in the worst 5% of cases) of the more desirable (and invasive) reading of arterial
oxygen saturation (SaO2) from arterial blood gas analysis.[1] But the two are correlated well
enough that the safe, convenient, noninvasive, inexpensive pulse oximetry method is valuable
for measuring oxygen saturation in clinical use.

The most common approach is transmissive pulse oximetry. In this approach, a sensor
device is placed on a thin part of the patient's body, usually a fingertip or earlobe, or
an infant's foot. Fingertips and earlobes have higher blood flow rates than other tissues,
which facilitates heat transfer.The device passes two wavelengths of light through the body
part to a photodetector. It measures the changing absorbance at each of the wavelengths,
allowing it to determine the absorbances due to the pulsing arterial blood alone,
excluding venous blood, skin, bone, muscle, fat, and (in most cases) nail polish.

Reflectance pulse oximetry is a less common alternative to transmissive pulse oximetry.

This method does not require a thin section of the person's body and is therefore well suited
to a universal application such as the feet, forehead, and chest, but it also has some
limitations. Vasodilation and pooling of venous blood in the head due to compromised
venous return to the heart can cause a combination of arterial and venous pulsations in the
forehead region and lead to spurious SpO2 results. Such conditions occur while
undergoing anaesthesia with endotracheal intubation and mechanical ventilation or in patients
in the Trendelenburg position.

CHAPTER - 2

RESEARCH METHODOLOGY

Research methodology is a science. It is a method that can be used to solve the

research

problems. It helps in studying how research is done scientifically. Research methodology

provides various steps that can be adopted by the researcher studying his research problems.

Methodology has many dimensions. The scope of research methodology is wider that of
research methods. Research methodology not only includes research but also considers the
logic behind those methods. It explains why we are using a particular method and why we

30
arenot usinganother so that research results are capable of being evaluated either by the
researcher or by others. It also explains why a research has been undertaken, how the
research problem has been defined, in what way and why the hypothesis has been formulated,
what data have been collected how to calculate various statistical measures like mean,
median, mode, standard deviation etc.,how to apply a particular research technique, which of
the various research methods available is more relevant and so on. Research methodology
deals with objectives of a research study, the method of defining the research problem, the
type of hypothesis formulated the type of data collected, methods used for collecting and
analyzing the data etc. According to Kerlinger, “Research methodology is the plan, structure
and strategy of integrating so as to obtain answer to research problems and to control
variables.”

RESEARCH DESIGNA

Research design is a plan of proposed research work. The research design is simply a
specific presentation of various steps in the process of research. Research design means
adopting that type of technique of research, which is most suited for this research and study
on the problem. In fact, the research design is the conceptual structure within which the
research is conducted. It constitutes the blue print for the collection, measurement and
analysis of data. Research design must contain a clear statement of the research problems
procedures and techniques to be used for gathering information, the population to be studied
and methods to be used in processing and analyzing data. Based upon the purpose and
problems of investigation there are three important research design methods. They are;

1) Exploratory research design

2) Descriptive research design

3) Casual research design

This study is descriptive in nature explain descriptive research

POPULATION

The entire aggregation of items from which sample can be drawn is known as
population. It is a collection of individuals or of their value which can be

31
numericallyspecified. Population can be finite or infinite. A population containing a finite
number of items is known as finite population. And a population containing an infinite
number of items is known as infinite population.

SAMPLING TECHNIQUES

Sampling is the procedure of obtaining information about an entire population by only

examining a part of it. Simple random sampling is based on the concept of random selection
or

chance sampling. Here, every item of the universe has an equal chance of inclusion in the

sample. It is a form of lottery method where the units are chosen from the whole group by a

mechanical method. This is why the researcher has chosen simple random sampling. This is

almost a blunt selection. Random sampling ensures that the law of statistical regularity is

followed. This implies that it the sample chosen is a random one, the chances are that the
sample will have the same composition and characteristics as the universe. This is why
random selection is considered as the most useful method for obtaining a representative
sample.In this study purposive sampling is done.

SAMPLE SIZE

Size refers to the number of items selected from the universe to constitute a sample.
For this particular study the researcher has chosen a sample size of 3 companies, namely

1. Wildcraft

2. Sterillium

3. BPL Pulse oximeter

SOURCE OF DATA COLLECTION

Secondary data are those which have been collectedby some other person and
published so a researcher is said to make use of secondary data already compiled by some
other person. Secondary data are usually in shape of finished products. Secondary data is
available easily and at low cost published and unpublished records like accounting and
financial records, personnel records, register of members, inventory records are also

32
examples of secondary sources. Secondary data is easily accessible and does not cost much to
researcher depending on its availability. Secondary data’s use ensures the availability of data
for making scientific generalizations from the studies. Secondary data is used as a benchmark
to test the findings of research for making comparative analysis. Researcher has obtained
secondary data from the following: Company records and manuals

 Broachers

 Websites

 Books and magazines

Supply Chain Management Excellence - focus on transportation

Healthcare organizations face growing complexities in the shipment of products

throughout the healthcare system. Geographically dispersed locations, frequent delivery
schedules and coordination specifications, and logistics requirements can stretch internal
capabilities and lower operating margins. In addition, many  healthcare companies are
unaware of their logistics/courier spend and run their transportation operations inefficiently
and under capacity.

Sedlak’s logistics management experts help healthcare companies achieve the right balance
of speed to customer and economies of scale to maximize service and reduce costs.

Exceptional Capabilities in Logistics Management

 Logistics operations assessments

 Logistics insource/outsource analysis
 Accessorial charge and freight payment audits
 Last mile and parcel delivery optimization
 Fleet optimization
 Routing and tracking systems selection and implementation

Supply chain management and distribution strategy

33
 For retailers of any size or market, a spot-on supply chain strategy isn’t a luxury; it’s
an imperative. Devising and implementing a sound strategy takes deep experience in every
aspect of the retail supply chain – from projecting future business requirements to building
vendor relationships to making positive changes in inventory levels, product flow,
transportation strategies and more.

Leading and burgeoning retailers turn to the supply chain and logistics experts at Sedlak for
the answers to support their competitive advantage and business growth.

Unsurpassed Expertise in Supply Chain and Logistics Strategy Development

In today’s fast-paced, customer-driven, multi-channel environment, retail supply

chains and logistics challenges are complex. Providing high customer service levels while
managing costs to maintain business growth can be a daunting task for both operations
directors and executives. Our strategy experts distill the intricate nuances and complexities of
your unique supply chain into straightforward and unbiased go-forward solutions. We
combine our decades of experience, insight and success with the industry’s most
sophisticated analytic methodologies to provide a clear and objective third-party perspective
to help you develop a supply chain and logistics strategy to confidently move your business
forward.

Retail Supply Chain and Logistics Strategy Services

 Current and future supply chain evaluation

 Sales channel strategy development
 Statistical development and strategic analysis
 Inventory allocation and flow strategies
 Vendor relationship management
 Technology and capital investment business case development
 Long-range forecasting

Supply chain management excellence through distribution network optimization

34
 Retail distribution networks face frequent change. Whether it’s a new acquisition or
market, a shift in customer demand or supplier sourcing, or a need for consolidation, your
network is an evolving entity that can support or hinder business growth. A truly optimized
distribution network can address change while offering significant advantages:

 Maintain or improve customer service while reducing inbound and outbound

transportation costs, inventory levels and carrying costs, and fixed and variable costs
 Achieve an ideal balance between the total number of distribution centers and their
geographic locations relative to customer demand
 Ensure capacity by prescribing an ideal size, purpose and configuration for each
distribution center
 Anticipate seasonal peaks and business changes with infrastructure and operational
flexibility

Unparalleled Expertise in the Tools, Functions and Impacts of Distribution Network

Design

Sedlak has conducted network analyses in support of retail distribution planning since
the 1960s; our work has addressed networks of all sizes and complexities for retailers across
the market spectrum. Our experts have a deep knowledge of network design that helps our
clients understand the models and develop creative alternatives that challenge the status quo
and address all critical aspects of your distribution operations. We focus on strategy, not just
models, to fully support your business objectives while minimizing your distribution costs.

We utilize the industry’s most sophisticated tools and methodologies, and can scale our
analyses to address your most specific questions or your broadest strategy needs. Our analysts
can compile and analyze data in various forms and from multiple systems, and use predictive
analysis to determine your business’ future infrastructure requirements. We also can employ
“What If” analyses to illustrate the specific tradeoffs and impacts of alternate network
configurations.

As an end-to-end supply chain advisory firm, Sedlak’s professionals also can convert your
network strategy into tactical plans for deployment and fully support implementation within
the prescribed timeframe.

35
Retail Distribution Network Optimization Services

 Distribution network design

 Fulfillment strategy evaluation and design
 Capacity studies
 Consolidation analyses
 Location analysis and site selection
 Transportation optimization
 Inventory deployment and flow strategies
 Statistical KPI development and performance assessment

Facility planning and warehouse layout design

Deploying a new retail distribution center, or retrofitting and existing facility, is an

exceptionally complex and formidable project. There are numerous variables to consider at
every stage of the process, and a lack of attention to detail can profoundly impact operational
integrity, customer service and your bottom line.

Sedlak specializes in distribution-intensive and fast-moving consumer goods; but retailers of

all sizes and varieties have turned to us to be their trusted partner for planning and designing
their facilities and operations.

Unrivaled Expertise in Retail Facility and Operations Design

For 60 years, Sedlak has built its reputation in designing facilities and operations in
the retail industry. Retail facility planning and design continues to be the “sweet spot” of our
business. We thoroughly understand the challenges of today’s fast-paced, consumer-driven,
multi-channel retail environment and provide distribution facility and operations solutions
that deliver remarkable results.

Our collaborative approach and proactive engagement obtain validation and stakeholder
concurrence at every stage to enable projects that are completed on time, on budget, and at

36
the targeted capacity—all while maintaining ongoing operations. Our time-tested processes
are focused on flawless execution, with strict attention to detail and an emphasis on
performance metrics, and our recommendations are based on detailed data analysis and deep
retail distribution experience.

Sedlak maintains professional industry relationships to stay on top of industry trends and
encourage competitive pricing in vendor bidding. However, our experts employ completely
independent, unbiased use of technologies in support of overall process improvement and the
best interests of our clients.

Retail Facility and Operations Design Services

 Conceptual design of new and/or existing facilities

 Material handling systems design
 Operations process flowcharting
 IT support systems design
 Economic analysis, including ROI, capital estimating and budgeting
 Engineered layout drawings and specifications development
 Simulation modeling
 Competitive bid management and vendor evaluation
 Transition planning
 Implementation project management

Retail material handling solutions

Sedlak’s material handling systems design and implementation goes hand-in-hand

with our facility and operations design services. We specialize in independent, unbiased
solutions that

focus on overall process improvement—not just technology. Our recommendations are

basedon detailed data analysis and deep retail distribution experience, and are tailored to your
unique business needs. Our engineered drawings and attention to detail minimize vendor

37
change orders and streamline the implementation process, resulting in solutions that fit your
needs perfectly.

Sedlak maintains professional industry relationships to stay on top of industry trends and
encourage competitive pricing in vendor bidding; however, we do not profit from equipment
sales or receive any financial incentives from vendors, so you can be assured that our experts
are working only for your best interests.

Our on-site project management services provide you with the security of knowing that the
equipment will be installed, thoroughly tested and operational, without any disruption to your
ongoing operations.

Retail Material Handling Solutions Services

 Material handling systems design

 Economic analysis, including ROI, capital estimating and budgeting
 Engineered layout drawings and specifications development
 Simulation modeling
 Competitive bid management and vendor evaluation
 Transition planning
 Training coordination
 Installation project management

CHAPTER - 3

DATA PRESENTATION, ANALYSIS AND DISCUSSION

3. The Organizational Structure of the Mankranso District Hospital

The study was conducted in District hospital which serves the six sub-districts namely
Mankranso, Pokukrom, Mpasaso, Wioso, Sabronum and Biemso all in the Ahafo-Ano South
District

38
From the table 3.1 it can be deduced that major hindrances, influencing peoples visit to the
Hospital were inadequate facilities, Poor Road networks, and transportation cost.

23% respondents argued that there weren’t enough health facilities in to give them proper
care while another 32% respondents blamed the Road network; the other 45% respondents
blamed it on high transportation cost. Probing further, it came to light that 32% got access to
vehicles from within their communities to the Health centre, 45% had to walk to neighboring
towns to get access to vehicles to convey them to the facility, 23% walk to the main road to
be able to access some form of transportation to the Health Centre.

Table 3.1 shows that, 16% respondents had to wait between 0- 30 minutes to get a vehicle,
while another 48% respondents had to wait close to an hour to be conveyed and the
remaining 36% respondents made it in 2 hours after waiting.

The Role of Transportation in Quality healthcare

Table 3.1The role of transport in quality healthcare

Variables Frequency Percentage

Main constraints

39
 1 Few facilities 27 23%
2 Poor roads 38 32%
3 Transportation cost 54 45%
Accessibility to transportations
1 From community 39 32%
2 Foot to neighboring 53 45%
towns
3 By the main road 27 23%
Duration of wait
1 0-30 minutes 19 16%
2 Up to an hou 57 48%
3 About two hours 43 36%

. The bottom of table 3.1 shows that out of the 119 respondents 18% argued that
the roads linking the health centre from their communities is in a good shape,
another 24% argued that the roads are fairly good; the last fraction of 58%
respondents argued that the roads linking their communities and the health centre
are in a poor state.

Source: researcher’s survey

40
 In terms of cost, table 3.1 shows that, 70 respondents said it is expensive to travel to
the health centers whiles 49 respondents thought it to be moderate. None of the respondents
thought the fair is cheap. The table 3.1 again shows that 13% travelled to the health centre in
one trip, another 52% in two trips and the remaining 35% made it in three transit trips to seek
medical treatment. Some of the respondents had witness death of relative when finding their
way to the health centre because of the above constraints coming their way. The bottom of
table 3.1 shows that out of the 119 respondents 18% argued that the roads linking the health
centre from their communities is in a good shape, another 24% argued that the roads are
fairly good; the last fraction of 58% respondents argued that the roads linking their
communities and the health centre are in a poor state. The survey shows that most of the
households find it harder to travel to get to healthcare and other services because of few
health facilities, poor roads and high transport cost.

Accessibility of Transportation to health care

Table 3.2 Accessibility of Transportation to health care

Source :(Researchers survey)

Table 3.2 shows the nature of accessibility to the health facility. From the table 3.2,
out of 119 respondents, 72% have access to vehicles to convey them to the facility, another
18% use motor bike/bicycle whiles the other 10% get to the facility by some other means
(walk).

In terms of mileage, 17% respondents had to travel few kilometer to access the facility,
another 23% respondents had to cover within 5km to access the facility, whiles the remaining
60% respondents had to cover over 10km to access the facility. This 60% shows that, higher

41
number of patient has longer travel distance before accessing health care. The target
maximum distance from health care is 8 kilometers in enabling rural communities gain access
to health care (WHO TRANSAID, 1999). In this instance, the higher percentage (60%)
shows below the set target. The table 4.2 again shows the most difficult times to access the
facility was within the period of July and September as all 119 respondents stated, given it a
100% confirmation.

Due to the deplorable nature of the road, it is difficult to use the road during the rainy season.
According to some residents, accessing health care is not easy as vehicles are stack in the
mud for hours and sometimes no movement at all. In these periods, rivers over flow their
bound, bridges are covered with flood whilst others are broken down with mighty trees fallen
unto the road making it extremely difficult to use the road. It has been recorded in such wet
season when an emergency pregnant woman has to lose her life because the vehicle could not
move to transport her early to the hospital.

Availability of transport in referral cases

Table 3.3 Availability of transport in referral cases

Source :( Researchers survey)

From the table 3.3, 10 respondents representing 8%, had access to an ambulance from
the Hospital while 102 respondents that is 86%, made it with commercial transport, 7
respondent’s which is 6% used motor cycle/bicycle during an emergency case. All
respondents had some form of assistance in cases of emergency is just about 17% who
express regret of no assistance in such situation. 78% respondents had neighbor help them in

42
getting commercial vehicles to convey them to the health facility 8% respondents were lucky
to have neighbors with private vehicles to assist the situation.

The last 14% respondents had to be carried by others to the facility. Although Ghanaians are
notable to be hospitable all the time, in the rural set up, they are much more caring to their
neighbours in case of emergency. But the number of private vehicles can be counted easily.
Those with commercial vehicles mostly stay in Kumasi and environs transporting people here
and there. At the day time they do help but during the night, problem compounds.

Since there is only one (1) ambulance anytime there is series of emergency patient are false to
find their own transport. For instance, if the ambulance has already set off to the Regional
hospital waiting for it to be back will cause danger if another patient is to wait for its arrival,
therefore has to find different alternative. The Ambulance response to emergency cases is
very limited to the communities; others do not realize it services been effective. The
Ambulance has a critical role to play because of the need for urgent evacuations to the
hospital since there are preventive and curative services in it as compared to commercial
transport means to save his life.

The impact of transportation on health service delivery.

Table 3.4 The impact of transportation on health service delivery.

Source :( Researcher’s survey)

43
From the table 3.4, 7% of health workers have their transportation being taken care by their
administrations, the other 93% of health workers have to look for their own means of
transport to work. Out of the 30 health workers who responded to the questionnaire, 24 out of
the total have not been doing outreach programmes in the surrounding communities and only
6 health workers have been embarking on outreach programmes in the communities. Thus,
80% of health workers in the community had no form of outreach programme while 20%
conducted outreach programme to educate the inhabitants of the community. The table 3.4
shows that transportations is the major constraints that hinders health workers from
conducting outreach programme, as 24 respondents blamed the situation on inadequate
vehicles to transport them to the place where the outreach programmes is scheduled and 6
respondents had access to vehicles that help them to do outreach programmes .The outreach
programme is usually for critical prenatal and neonatal periods, preventive and curative
services and also supportive health advice on livelihoods and education. The people are ill
informed about common diseases because health workers cannot go for outreach programs.
From the table 3.4 it is evident that all respondents to the questionnaire argued that
transportation played a major role in effective health care delivery as all were in favour of the
argument. All respondent to this question positively affirm that, transport plays a critical role
in the effective and efficient delivery of health care which enables people to access services
and health workers to reach all surrounding communities. Transport is also essential for
delivering supplies of resources such as drugs and personnel to health centres, and for
transferring patients between health facilities and to the different levels of care.

Table 3.4 again shows that all 30 health care workers agreed that the Ambulance was the
safest way to transport referred cases indicating a 100% positive choice. The Ambulance has
a critical role to play because of the need for urgent evacuations of patient to the hospital
since there are preventive and curative services in it as compared to commercial vehicle. It is
fast, convenient and urgently attended to at the referred hospital on arrival as a delay in
treatment can make difference between life and death.

The response times of emergency services will be influenced by the transport infrastructure.
Short response times of ambulances are accepted policy and practice in reducing mortality
and morbidity from life threatening conditions where shortening the time to definitive care
results in health gain. In cases of emergencies qualified health personnel have to accompany
the patient and not the relatives to the hospital. But it is on few occasions that some patients
luckily use the Ambulance. The last section of table 3.4 shows that, the patients have to

44
provide their own means of transport when there is no ambulance at the hospital or when the
hospital vehicle is faulty. Out of the 30 respondent of the health workers , 12 of them argued
that the hospital does assist the relatives in looking for vehicle in emergencies and this
represent 40% of the respondents whiles the other 18 health workers representing 60%, stated
that relatives of patients have to arrange for transport during emergencies.

Table 3.5 The impact of transport on staff to work in Mankraso District

Hospital

Transport on staff to work in mankrso distric hospital

The table 3.5 above shows the reporting and departure time of health workers that is how
long it take them to report to work and when they sign out from work. From table 3.5, out of
the 30 respondents 6 workers, representing 20% of the health workers go to work between
7:30am to 8:00am, another 6 workers go to work between 8:00 am to 8:30am, representing

45
20% of the total. The remaining 60% got to work after 8:30am. It was reveal that most of the
health workers go to work late and lateness of health workers affects quality health care
delivery.

The health workers who responded to the questionnaire, 24 of them close from work between
2pm and 4pm representing 80% of the total respondents, the remaining 20% that is 6
respondents close from work after 4 pm. This shows that, most of the health workers close
from work late and because they have to look for their own means of transport, they are
always in a rash because of long distance they have to travel to their homes.

In terms of distance covered to work, 20% of the respondents covered within 5 kilometers to
work whiles another 43% covered between 5 kilometers and 10 kilometers to work every
day. The last fraction of 37% covered over 10 kilometers to 15 kilometers to work daily. 60%
health workers found their way to work by vehicle and 40% of the health workers got to work
by foot. The distance they cover before getting to work usually make them tired before the
start of work.

Lastly, table 3.5 shows the duration spent to get to work by respondents. 23% of the
respondents spent less than 30 minutes to get to work whiles 20% spent within an hour to get
to work the remaining 57% spent greater than an hour to get to work. Transportation is seen
as an integral part of health care delivery, without transport people cannot be carried from
one angle to the other. Basically the research shows that most of the health workers live far
from the hospital and due to that, they do not spend enough time to attend to the patient
resulting in poor healthcare delivery. They are always in hurry to leave back to their homes.
This situation compounds in times of emergencies.

Sedlak Delivers Operational Success and Sustainable Competitive

Advantage

Sedlak has helped scores of retailers, both large and small, achieve operational
successes that result in higher profit margins, reduced operating costs and increased customer
satisfaction through process improvement, inventory efficiencies and prudent capital
deployment. Our experts evaluate every aspect of your operations, from space utilization to
material handling processes to equipment and IT systems to your workforce, and compare
your operational metrics to industry best practices.

46
Our assessment process is designed to identify key operational challenges, uncover potential
savings and build a business case for any modifications to your facility layout, systems, labor,
utilities, transportation and inventory. Our recommendations are sound and practical – we
don’t seek change for the mere sake of change – and our assessment report will prioritize
solutions based on cost, benefits and ease of implementation. It will also provide steps for
execution. We have helped clients streamline their distribution processes, increase
efficiencies and capacities, achieve higher productivity levels, reduce costs, and even extend
the useful life of their facilities.

For retail clients interested in implementing a formal labor management program, our experts
conduct time studies and develop engineered standards and standard operating procedures for
each operational activity. We can help you implement a labor management system (LMS) for
tracking and reporting.

Retail Distribution Operations Improvements Services

 Facility/operational assessments
 Process audits
 Product slotting modeling
 Energy savings studies
 Productivity enhancements based on best practices
 Engineered standards
 Labor management programs
 Standard operating procedures (SOPs) development

Some Common Facility and Operational Improvements

Past retail distribution center and warehouse optimization assessments have yielded some
common recommendations. It’s our pleasure to share them with you:

 Labor management systems (LMS): An LMS can be a smart tool for businesses with
the ability to make such an investment. However, even companies without such
means can boost labor performance through tactics like developing standard operating
procedures.

47
  Routine training programs: Programs can include refresher sessions for existing
employees, basic training for new-hires, and cross-training.
 Ergonomics. Employees come in all sizes, and systems are not always designed with
operator ease of use in mind. Fortunately, ergonomic solutions tend to be relatively
inexpensive, and can be as simple as adjusting the height of a table, buying new pick
carts, or re-slotting SKUs to facilitate easier access to fast-movers.
 Slotting. Few companies use efficient slotting techniques, but there are great
programs available for constant SKU/location assignment optimization. Even a basic
Excel spreadsheet with relevant sales data can yield meaningful results—just be sure
to include product cube in your analysis and keep it up to date. The facility and
operations experts at Sedlak would be happy to help you with a simple slotting
initiative.
 Save steps and reduce touches. Can you stock the pick location from receiving? Can a
report or process be adjusted to more closely match the needs of the operation? What
about interleaving putaway and picking tasks so that employees don’t travel through
the warehouse or distribution center with an empty fork, pallet or cart? Often, basic
procedural and operational changes can make a big difference.
 Lighting. Employees need good lighting to perform their jobs effectively. Cost- and
energy-efficient lighting options for warehouses and distribution centers, including
LEDs, are readily available and the potential ROI is often substantial, so there are few
excuses for literally keeping your employees in the dark.

Considering 3PL services for Supply Chain Management?

Outsourcing distribution operations to a third-party logistics (3PL) provider can offer

valuable advantages and opportunities. It is also a complex endeavor with far-reaching
effects. The right 3PL can provide a retail business with the flexibility it needs to develop
new products, expand capabilities and add markets. A 3PL that doesn’t meet performance
standards can adversely impact customer service levels, hinder business growth, or worse.

Sedlak’s experts have helped numerous retailers in a variety of markets determine whether to
insource or outsource their distribution operations and leverage their 3PL relationships to
maximize efficiencies and improve customer service at the right cost.

48
The Sedlak Advantage: Unmatched Expertise in Retail Facility and
Operations Planning and Remarkable Knowledge of the 3PL Industry

Our expertise in retail distribution operations combines with our broad knowledge of
3PL providers in the retail space to enable our clients to make decisions around outsourcing
and readily navigate the 3PL landscape.

In-House versus 3PL: For retailers considering in-house versus 3PL for their
distribution operations, Sedlak’s experts assist with comparing the costs/benefits of this
critical decision by analyzing business objectives, core competencies and distribution
requirements to arrive at a go-forward recommendation. We can also help a retail business
decide which aspects of its distribution operation are most suited to outsourcing.

3PL Performance: Sedlak’s 3PL assessment process benchmarks existing 3PL

performance against stringent metrics to determine whether you are receiving the quality,
cost-effective service you deserve.

Selection: If outsourcing some or all of your distribution operations to a 3PL is the right
path, or if it’s time to seek a new 3PL provider, Sedlak provides professional guidance at
every turn. Our experts clearly define the third-party support requirements and manage the
bid process to enable a successful partnership. Once the right 3PL is identified, our expert
advisors will establish a framework for success—and help you achieve it over time. For more
complex facilities, our professionals work with the 3PL provider to develop a facility and
operations design that will meet your needs at the right cost.

Insourcing: We also help retail clients that seek to reverse their outsourcing and bring
distribution operations back in-house through our facility and operations planning and design
services and related services.

Retail Client 3PL Consulting Services

 Core competency reviews

 Outsourcing assessments
 3PL structure and relationship design
 Operational criteria development

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  3PL selection management
 Contract preparation and negotiation
 Transition planning
 Implementation oversight
 3PL performance audits
 Operations and productivity improvements
 Facility and material handling systems design and upgrades
 IT systems upgrades
 Insourcing assistance

Logistics and Supply Chain Management in Healthcare Explained

Supply chain
A supply chain is a network of interconnected stakeholders and businesses that
engage with a product, such as medical supplies, to deliver it from the manufacturer to
healthcare customers. The goal of supply management is to connect all those networks and
organize an efficient end-to-end strategy that improves shipping speed and reduces cost
without decreasing the product’s value or quality (patient).

Logistics
Logistics is the generating of detailed processes that map out and coordinate the
complex transportation of products by providing reliable, safe, and timely shipping. It is the
heart of any supply chain and focuses on coming up with innovative ways to facilitate the
flow of information and products from suppliers to healthcare customers, throughout the
manufacturing and distributing processes. It only aims to increase efficiency in its material
handling solutions.

In other words, a supply chain involves all aspects of a product cycle, while logistics is a
component of a supply chain that addresses efficient product movement. When a healthcare
organization wants to create an end-to-end approach for delivering medical products, its
supply chain is efficiently managed to produce the most value. When an organization has an
optimal and transparent supply chain it is set up for better collaboration between stakeholders
and partners. This successful working relationship leads to greater innovation and efficacy in
their logistics solutions and provides the groundwork to confront any supply chain challenge.

50
Healthcare Solutions Reform and Moving to Value-Based Healthcare
Value-based healthcare is an innovative healthcare model that many healthcare
organizations, pharmaceutical providers, and health insurers are trying to implement to
improve patient health and reduce costs.
Value-based healthcare solutions are about making a shift from the quantity of care to the
quality of care. We can define it as a healthcare model based on compensation for outcomes.
In a traditional quantity of care or fee-for-service system, medical providers operate on a pay-
per-use type of compensation system. In value-based healthcare, the overall health and
wellness of patients are crucial to ensure compensation.
Instead of taking a reactive approach to the treatment of disease, value-based care takes a
proactive approach. Many healthcare providers already include elements of value-based care
in their health plans, and it is a focal point of trying to reduce health costs. The rise of chronic
disease and larger aging populations are driving both developing and developed countries to
implement more effective healthcare delivery methods.

Improvements in Supply Chain Management as Savings Opportunities

In healthcare, patients are the healthcare customers, and their desired outcome is
improved health at a more affordable price. When an injured patient comes to the emergency
room, he or she is not concerned with the healthcare provider’s equipment preference or how
they can make a difference in their treatment or healthcare costs. They just want to feel better,
heal, and improve. Healthcare products are unlike other products in many ways, making
the healthcare supply chain different from that of a consumer product supply chain.
Healthcare is highly regulated, and patients’ expectations are fluid, so their supply chain
management system and logistics processes need to adjust quickly in order to be more
effective and affordable.
The cost of managing a healthcare supply chain is frequently one of the larger costs realized
by hospitals and other healthcare systems. Healthcare executives know that reducing
healthcare supply chain costs, improving productivity, and gaining supply chain visibility are
top priorities for their organizations. Improvements in the supply chain are one of the areas in
healthcare to offer the biggest savings opportunities. Instead of just focusing on product costs
entirely, the supply chain team focuses on invisible and distribution costs as well.

51
Furthermore, one of the biggest factors that affect supply chain costs are the healthcare
providers and practitioners themselves. Healthcare professionals, surgeons, and physicians
tend to have their individual preferences for the tools and medical devices they use. Basing
your distribution center and inventory management decisions on healthcare practitioners’
preferences isn’t the most cost-efficient solution. Still, many organizations allow this to affect
their warehouse management and purchasing decisions. Failing to update physicians’
preferences and a lack of uniformity can lead to excess product waste, inefficient use of
supplies, and increased (invisible) costs.

Data collection and analysis is another important factor that can help improve logistics
processes and reduce costs. It has become critical to understand how much it costs to provide
patient care. The healthcare supply chain is one of the most valuable assets for collecting
actionable data. The solutions needed for accurate data capture and analysis along the supply
chain can provide better insights into product needs – stabilizing inventory, reducing waste,
and bringing costs down. An automated logistics system and supply chain can support a
higher level of patient care by improving patient outcomes.

Benefits of Investing in Healthcare Logistics

By investing in innovative and more effective logistics systems, companies can
increase the value they provide by reducing both the time and money spent on product
transportation from one point to another. For those seeking opportunities to improve their
health system processes, a solid logistics foundation can facilitate reliable, timely, and safe
delivery of medical products at a reasonable cost.

Daily logistics operations can vary but typically consist of tasks such as shipping,
warehousing, and order processing. This may include air freight, air cargo, or ocean freight if
operations involve global logistics. This may also involve partnering with trucking companies
equipped to transport healthcare products. Furthermore, logisticians also collect and analyze
data to deliver summaries to their supply chain solutions partners. This is done to increase the
visibility of products as they move through the supply chain cycle.

To increase transparency and trust between logistics partners, all parties involved need to
establish open communication lines and coordinate live tracking updates to improve customer
support. In the health system, timing is everything because products are potentially life-

52
saving devices. Therefore, your supply chain must run as effectively as possible to reliably
ensure that products will reach your healthcare organization on time (without incurring
additional costs).

Steps to Effectively Navigate Healthcare Logistics in 2020

From providing patients transportation (to and from the doctor) to delivering
prescriptions, innovation in healthcare logistics can facilitate the evolution of your supply
chain. Shipping, device sanitation and maintenance, storage and inventory management, and
waste management are some of the biggest challenges in healthcare logistics. When dealing
with frustrating, manual procedures (that must be carried out by healthcare physicians),
increasing labor costs, and lack of efficient storage space, building an alternative logistics
solution can be challenging.

Let’s take a look at several key solutions to the logistics challenges that healthcare
organizations are facing today.

1.Overnight product shipping

Many medical device and pharmaceutical companies are stuck with a one-size-fits-all
mindset. Relying only on overnight shipping costs can add up over time, while the
expectations for a faster delivery are rising on a global level. To meet the pharmaceutical
logistics demand for overnight shipping, healthcare organizations experience higher costs.
Furthermore, different products vary in demand, the value per unit, service expectations, and
profitability, so relying on just one supply chain process with different characteristics causes
inefficiencies (short supply for some products and high inventories for others).
This problem can be solved by leveraging a decentralized warehouse network that allows for
cost-effective and faster delivery of medical products (even in urgent situations). With a lean
supply chain, healthcare organizations can segment their product base by customer
requirements and product characteristics to develop a more efficient transportation plan. And
thanks to a decentralized warehouse system, they can fulfill orders with smaller and more
frequent shipments.

53
2.Lack of automation
Highly manual processes and a lack of visibility lead to increased costs throughout the
supply chain. Organizations are not reaping the benefits of data-based decision making
because they rely on manual data management and entry, which also leads to higher labor
costs and a higher risk of inaccuracies. In the healthcare industry, we are facing a lack of data
standardization, including data processes, interchange, and capabilities.

By automating their manual processes, healthcare providers can reduce costs that arise in data
collection, ordering, and other processes. They can automate purchase orders, invoices, and
requisitions, which will help them manage their data better and increase data visibility.
Establishing a partnership with a 3PL (third-party logistics) company can help them easily
automate these processes because 3PLs already have the technology needed to do so.
3.Inventory shortages or excess stocks
Inventory shortages (as well as excesses) occur due to the unpredictability in the
medical product market. Healthcare manufacturers must align their production cycles with
the patient-demand patterns and manage the manufacturing frequency accordingly. Slow-
moving products and long-lead times can lead to decreased visibility that doesn’t support the
demand for some products.
However, the use of supply chain technology will allow medical manufacturers to see what
products are on-hand and what needs to be supplied. The more transparency there is in the
healthcare supply chain, the gaining of supply chain visibility becomes easier as does
avoiding excess costs that result from incorrect inventory numbers. With this technology that
can be provided by 3PLs, organizations will be able to prevent excess stocking of products,
all thanks to the ability to track and monitor product inventory via increased visibility.

Technologies That Can Help Improve Healthcare Logistics

Today’s technology is experiencing exponential progress, meaning that innovative

solutions addressing main pain-points in healthcare logistics are emerging faster and more
frequently. To automate their supply chain management, healthcare organizations can rely on
technologies such as:

54
Product tracking tools
By adopting Auto-ID and Data Collection (AIDC) technology, you can improve the accuracy
of data capture while automating the entire process. It will also allow you to track which
patients use which products so that you can avoid stocking up on unnecessary products with
short expiration dates.

Logistics optimization tools

Since healthcare is expected to become more personalized and is moving beyond the
walls of medical centers, healthcare organizations have started to leverage artificial
intelligence and machine learning by adopting various AI-supported logistics tools. UPS and
Amazon are some of the leaders in the development of these tools that are designed to help
drivers to, for example, take the most optimal routes or get clinicians, patients, and products
to the right locations at the right time.

Smart logistics platforms

Real-time pricing services and freight bookings are some solutions that healthcare
organizations can use to lower labor and material costs (in procurement) and boost their
efficiency. Smart logistics platforms are designed to connect shippers and carriers, helping
everyone involved reduce the inefficient and lengthy process of locating and booking new
freight capacity. By hiring the right 3PL provider, healthcare organizations can leverage their
partner’s smart logistics technology to operate more efficiently.

AI and IoT
AI is being integrated into different technologies because of its ability to leverage Big
Data to predict healthcare patients’ future needs. In logistics, AI-based applications are used
to ensure the availability of products by helping to predict shortages and backorders. Also,
IoT applications bring their own benefits to healthcare logistics, allowing for faster and more
accurate collection, analysis, and visualization of actionable data.
How Can 3PLs Help Improve Healthcare Logistics?
More and more healthcare providers are deciding to partner with third-party logistics
companies specializing in healthcare. Some of the advantages that come with a 3PL
partnership include:

55
1.Access to smart logistics technologies
Third-party logistics companies already have the technology required for streamlining
supply chains, and as their partner, you gain access to it. This means a more automated and
streamlined supply chain management thanks to tech features such as transportation
management systems (TMS), freight audit and payment solutions, route and consolidation
optimization tools, data analysis, real-time order tracking, and more.

2.Decentralized warehousing
Having a half-full warehouse is an unsustainable solution because you will need to
spend money on maintaining the entire infrastructure, even the parts not being used. Third-
party logistics companies have their own warehouse infrastructure you can use or they can
help you store products in a shared facility. In both cases, this solution will help you
eliminate unnecessary expenses and control your costs.
3.Specialized logistics expertise
If you are not acquainted with the best practices and trends in healthcare logistics,
hiring a 3PL that is specialized in healthcare logistics can be majorly beneficial in the
improvement of your logistics process. Third-party logistics companies already understand
your needs and have an established network of carriers and other partners, which will
contribute to more efficient overall operations.

4.Benefits of using a qualified network of carriers

A 3PL is most likely already in touch with thousands of carriers with whom it
maintains good relationships. With such a diversified network of trusted personnel at your
disposal, you can rest assured that your products are safe and sound in their hands.

Ultimately, a 3PL will take many daily and time-consuming tasks off your shoulders, leaving
your health practitioners with more time to focus on the most important work – helping
patients. Tasks like order tracking, driver and facility communication, performance reporting,
and various administrative tasks won’t be required of your healthcare professionals anymore.
At the same time, you will benefit from a more efficient supply chain management.

CONCLUSION

56
 The study has look at the impact of transportation on health care delivery. The
affected parties (the patient and the health workers) have been discussed. Based on the
findings of the study the following conclusions are reached. Transport to and from the facility
is very high, as physical location of health facilities does not meet households’ needs,
meaning distance as a major obstacle to the rural population. A higher percentage of the rural
poor needs to travel for hours to the next health facility. Most of the households find it harder
to travel to get to healthcare and other services because of few health facilities, poor roads
and high transport cost. Even where motorable roads exist, transport services are unreliable
and infrequent; where available, such services are for-hire and the majority of rural
inhabitants cannot afford them. However, this same study found that, the Ambulance
response to emergency cases is very limited to the communities; others realized it services
been ineffective. Although, the ambulance has a critical role to play because of the need for
urgent evacuations to the hospital since there are preventive and curative services in it as
compared to commercial transport means to save life. The outcome of the research on health
professional at Mankranso indicated that, lack of transport to convey staff to and from work
causes them to wait for long hours and struggle with other passengers for transport. These
frustrations make staff already tired by the time they get to work. The already tired workers
get irritated and not motivated to do their best. Also transportations is a major constraints that
hinders health workers from embarking on outreach programmes because of inadequate
transport infrastructure and service .The outreach programme is usually for critical prenatal
and neonatal periods, preventive and curative services and also supportive health advice on
livehoods and education. At a time when demand for quality healthcare is rising, healthcare
systems across the globe face depleting resources. Governments and healthcare organizations
face growing pressure to reduce costs while maintaining the quality of their services.
According to the OECD and World Economic Forum, U.S. health expenditures are expected
to increase by $3.5 trillion between 2010 and 2040. The governmental response to this trend
means enforcing healthcare reforms and recognizing the need for improved collaboration
with the private sector.
Establishing the right partnerships with 3PL providers and trading partners is one of the key
solutions to this growing problem that is shaking up the healthcare industry. Each party
involved should have a defined role in the supply chain cycle and contribute to creating a
frictionless logistics system. Third-party logistics providers across the U.S. are partnering
with healthcare organizations to ensure they’re able to meet their patients’ needs, despite
constant changes in product shipment capabilities, aptness, and volumes. By providing time

57
and cost savings, 24/7 access, and timely responses to shipment inaccuracies and delays,
3PLs are proving their value to the healthcare industry. Lean end-to-end logistics solutions
often empower employees and increase productivity because they help build a culture of
continuous improvement.

To conclude, the results of 3PL involvement in the healthcare industry are evident, and the
benefits are long-lasting and wide-ranging. Healthcare organizations need improved
flexibility, responsiveness, scalability, resourcefulness, cost-effectiveness, and trust in order
to cut down on unnecessary supply chain costs.

RECOMMENDATIONS

Based on the findings, it was recommended that, Health workers need to be provided
with buses to convey them to and from work and for outreach programs. To solve
transportation problem facing the health workers, the services of a public transporter should
be engaged to convey from vantage points to and from work. Hospital management should
negotiate with the transport driver on the amount to be paid per week and staff made to pay
on weekly basis. Hospital management should also bear the cost for the outreach
programmes. Again, it is precondition for appropriate policy action to improve rural access
and mobility in order to safe and sustain lives in the rural communities.

Non-availability of medicines is a major factor in poor health outcomes in LMICs. While the
causes are complex—they include inadequate human resources, weak health systems, poor
access to services, and lack of finance—the performance of supply chains is clearly
suboptimal. Increased donor and government investment in medicine procurement must be
accompanied by investments in LMIC supply chains and personnel in order to build more
flexible and seamless supply chains. This means strengthening existing supply chains,
investing in infrastructure, introducing new technologies and new financing systems, new
innovations, expanding the role of the private sector, and smart integration of current vertical
systems. All of these efforts will be founded on increased human resource capacity. Medicine
supply chains are people supply chains and depend not just on financial and technical inputs
but also capacity building.

BIBLOGRAPHY

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