Breaking Barriers to Close the Gender Gap in Health Supply Chain Management

Students graduating from the integrated supply chain management course delivered by GHSC-PSM.

Topics:

Governance

Projects:

Date

March 9, 2023

Supply chain management has historically been perceived as a male-dominated workforce, with men occupying the majority of management roles in distribution and warehousing. This perception, alongside limited educational opportunities, has made it more difficult for women to gain entry or advance in the supply chain industry.

Nevertheless, women are increasingly becoming supply chain professionals and executives across the globe. According to a 2022 Gartner Survey, women comprise 39 percent of the world’s supply chain workforce and make up 34 percent of first-line managers and 19 percent of senior executives. While this is progress, it indicates that women are less represented in senior management or executive roles. For the supply chain to be inclusive, progress needs to be made within individual countries to harness the dividends of such an enterprise.

“When I oversaw the pharmaceutical sector at the [Luanda Sanatorium] Hospital, they never had a woman in this post, so it was a challenge to make sure they followed my lead and respected me as a leader. This made me feel challenged to carry out the functions that were entrusted to me, demonstrating that this work is not only performed by men.” - Dr. Sandra da Silva, Head of Logistics Activities, National Malaria Control Program, National Directorate of Public Health

Dr. Sandra da Silva

Blazing the trail for a more inclusive supply chain in Angola

As reported by the World Economic Forum, Angola already has one of the highest labor participation rates for women—ranking 10th in the world as of 2022. However, due to other factors, such as wage equality, years in school, and financial inclusion, Angola is ranked 125th out of 145 countries in its progress to closing the gender gap. Men dominate the country’s health supply chain, with women often excluded from leadership roles due to cultural biases—such as the perception that only men can perform certain jobs — and lack of access to education and training.

Understanding this disparity, the USAID Global Health Supply Chain Program - Procurement and Supply Management (GHSC-PSM) project advocated to the Angolan Ministry of Health for more women to be trained in logistics and supply chain management and given equal opportunities for promotion to leadership positions. One of the winning arguments in this advocacy was that GHSC-PSM’s supply chain advisors comprised mostly women.

The first spark of change happened in 2019 when GHSC-PSM supported the Ministry of Health in conducting a workshop that catalyzed a series of actions to promote equal opportunities for women in health supply chain management. The first action was to form a gender technical working group in the Ministry of Health. This team had one mission— to promote gender equality and equity in the management of the health supply chain in Angola by creating opportunities for women to be trained and fostering conversations to address biases, such as the perception that women are not fit to perform specific roles in the supply chain. With technical support from GHSC-PSM, the gender technical working group created and launched the Gender Transformative Approach to Healthcare in Angola — an initiative to promote women’s inclusion in the health supply chain system.

Angola’s Gender Transformative Approach to Health Care is an initiative by the Angolan Ministry of Health designed create opportunities for health sector stakeholders to challenge gender norms and address unequal power structures that disadvantage women in the management of the health supply chain system. Its purpose is to create an environment inclusive of women in leadership positions at every step of the health supply chain cycle, from the selection of health products to their distribution.

New Avenues and Opportunities

The second spark in the chain of events created an opportunity for women to make career transitions into leadership positions in the health supply chain. GHSC-PSM developed a 12-month postgraduate integrated supply chain management course (also known as GICAS in Portuguese) and provided technical support to the Angolan National Institute of Public Health to deliver the course to 34 public health sector professionals, 25 of whom were women. This formal training provided students with a certification in supply chain management tools and best practices, and a safe space to break biases and challenge inequitable gender norms about women’s participation as managers and decision makers.

“During the course, we learned that the attribution of functions must be given equally without any discrimination based on gender, but by meritocracy.” - Dr. Sandra da Silva, Head of Logistics Activities, National Malaria Control Program

Dr. Sandra da Silva worked at the Sanatorium Hospital’s pharmaceutical unit for many years. After completing the GICAS course, the National Malaria Control Program (NMCP) recruited her as the Head of Logistics Activities. In her new role, Dr. da Silva trains and supervises healthcare staff and oversees distribution planning to ensure medicines are delivered at the right time to the right people.

“After the course, other colleagues and I were integrated into the Ministry of Health, one of them as head of the Medicines Warehouse in the province of Luanda” - Dr. Catarina Alexandre, Head of Logistics for Reproductive Health, National Directorate of Public Health.

For Dr. Catarina Alexandre, the GICAS course was a pivotal turning point in her career. Before taking the course, Dr. Alexandre was a Clinical Analyst at the National Directorate of Public Health. After completing the course, she went on to lead commodity logistics for family planning in the Department of Reproductive Health.

“When there was no manager for reproductive health products, there was a lot of disorganization in the area. Now that I've taken the lead, I can organize things, and this is reflected in commodity security” - Dr. Catarina Alexandre

Dr. Catarina Alexandre

“I was already managing health commodities [at the Sanatorium Hospital], but the postgraduate GICAS course opened new avenues for me because now I understand that health supply chain management is not merely dispensing commodities to the user, but knowing the commodity origin, planning, distribution and much more.'' – Dr. Sandra da Silva

“When there was no manager for reproductive health products, there was a lot of disorganization in the area. Now that I've taken the lead, I can organize things, and this is reflected in commodity security” - Dr. Catarina Alexandre

Enhancing the role of women at the last mile for family planning commodities

Ensuring that people have access to lifesaving medicines and supplies when and where they need them is essential, and the last mile distribution stage in the supply chain is a critical and frequently challenging step towards achieving this goal.

GHSC-PSM assists national governments in enhancing supply chain efficiency by promoting country-based interventions for health supply chain personnel working in last mile facilities. In Angola, women lead family planning activities across the provinces, including commodity logistics, and are responsible for ensuring that commodities get to the right clients at the right time. However, some of these women often hold biases (resulting from gender norms) about who should access FP services. In some cultures, a woman may not access family planning services without consent from her spouse.

To address these biases at the last mile and as a complement to the integrated supply chain management course, GHSC-PSM trained health technicians to lead supportive supervision visits across all of Angola’s provinces. This exercise was designed to strengthen local supply chain management capacity for family planning commodities and foster conversations around gender norms and women’s rights to access family planning services. This third spark of change was critical in ensuring that family planning services at the last mile respond appropriately to the needs of clients without discrimination or bias.

According to Dr. Maria Kieza, the Reproductive Health and Family Planning Supervisor for Benguela Province, her performance improved after the supportive supervision exercise as it provided the opportunity to learn and interact with other supply chain health professionals—including women. These interactions enhanced her problem-solving skills and improved her understanding of guiding women to make informed choices about their reproductive health. This was important to Dr. Kieza because she is responsible for ensuring that anyone in Benguela who needs family planning has the service and supply available at the local health facility.

‘‘The supportive supervision visits not only increased my knowledge of best practices for storing reproductive health and family planning commodities but also trained me on how to raise awareness on informed choice of contraceptive methods among end users and community members.’’ - Dr. Maria Kieza

Dr. Maria Kieza

Drs. Catarina, Maria, and Sandra’s stories demonstrate how when women have the tools they need to participate in the supply chain, this can open an array of career opportunities and build institutional capacity for the supply chain overall. As a result of these programs, the health supply chain in Angola is increasingly more diverse and inclusive. Today, women play a crucial role in the health supply chain in Angola and are increasingly responsible for managing the distribution of life-saving medicines and supplies to hospitals and clinics across the country.

“[A] woman was recently appointed to lead the Central Procurement Agency for Medicines and Medical Supplies (CECOMA) and the appointment process was based on meritocracy and competence. With the creation of the gender technical working group [within the National Directorate of Public Health], the government's efforts to build confidence in women's abilities to perform logistical functions is increasingly being consolidated.” - Helena António, GHSC-PSM Gender Specialist, Angola

Drs. Catarina, Maria, and Sandra are proud of the progress they’ve made and advocate for women to be given equal opportunities for leadership and advancement. They believe that as the health supply chain workforce becomes more inclusive, it will become better at meeting the health needs of all Angolans.

“Today, there are many women working in logistics management activities across the country. Benguela and Bengo provincial warehouses are managed by women. The Provincial Supervisors of the 18 provinces of Angola are all women. This is not about occupational segregation, but about competence and meritocracy.” - Helena António

To learn more about lessons learned from GHSC-PSM's work at the last mile, please refer to this technical report: Driving Last-Mile Solutions to Ensure Access to Public Health Commodities

‘‘The supportive supervision visits not only increased my knowledge of best practices for storing reproductive health and family planning commodities but also trained me on how to raise awareness on informed choice of contraceptive methods among end users and community members.’’ - Dr. Maria Kieza

Breaking Barriers to Close the Gender Gap in Health Supply Chain Management

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