Workflow analysis in Laos: A tool for learning, improving processes and developing SOPs

The primary goal was to improve procurement performance and transfer skills and capacity to the national HIV/AIDS, malaria, and tuberculosis programs. The GMS team, in collaboration with the Ministry of Health's Office of the Global Fund Principal Recipient (PR), conducted a diagnostic analysis to identify areas for improvement. The PR manages seven grants worth $61.5 million and faces challenges in procurement and supply management (PSM). Key issues include a shortage of qualified staff, fragmented functions across multiple programs, and weak adherence to guidelines and procedures. These problems result in delays and systemic weaknesses, leading to critically low levels of stock-outs of key medicines and supplies. To address these challenges, the GMS team and PR opted to use workflow mapping to identify gaps, errors, and inefficiencies. This approach involved participatory learning and creating "options for decision making" through a learning-by-doing workshop. Teams of procurement staff and program managers plotted out various procurement processes on wall space marked with swim lanes, accompanied by a lively debate on actions, decisions, and responsible persons. The combined teams, with GMS assistance, critiqued and revised each flow diagram, achieving multiple results beyond expectations. Efficient processes were defined, compliance gaps and errors were rectified, standard operating procedures were delineated, and a deadline set by the Global Fund to Fight AIDS, Tuberculosis, and Malaria was met. The PR's Assistant Manager, Dr. Rattanaxay, commented that GMS' support for organizational development needs would result in long-term benefits. The GMS approach focused on improving procurement performance while transferring skills and capacity to the national programs. The initiative aimed to address the challenges in PSM, including a shortage of qualified staff, fragmented functions, and weak adherence to guidelines and procedures. By using workflow mapping and participatory learning, the GMS team and PR were able to identify areas for improvement and develop efficient processes, ultimately leading to improved grant performance and better services for patients in need. The success of the GMS initiative in Laos highlights the importance of workflow analysis and participatory learning in improving procurement performance and transferring skills and capacity. The approach used by the GMS team and PR can be applied to other organizations facing similar challenges, enabling them to improve their grant performance and provide better services to those in need.