Coordination theory and medicine supply chain

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CHAPTER TWO THEORETICAL REVIEW OF SUPPLY CHAIN COORDINATION

 Introduction

This chapter presents the theoretical orientation of supply chain coordination. In this regard the theoretical orientation of supply chain coordination is accordingly discussed to ground the study. Furthermore, the supply chain concept in the health sector is explained from the global perspective to the Ugandan context and the emerging challenges.

Theoretical review

The issue of coordination has been topical in various fields of management and organisational effectiveness and efficiency. For example, the earlier scholars have been attempting to put up models and various theoretical frameworks to enhance the supply – chain coordination of their time, some of the elements of these have stood the test of time. Nevertheless, time has been controverting some of the intentions – prompting more empirical actions from contemporary researchers and scholars to delve into further pragmatic scrutiny; for greater responsiveness and relevance. This study was supported by the Coordination Theory, according to Malone and Crowston (1994). The theory conjectures that for greater effectiveness and efficiency, an organisation ought to continually identify and assign tasks, with their respective interdependencies (coordination dimensions) – connoting that coordinating the supply – chain is a critical element that must ensure that all activities in the supply –chain should be systematically glued together, for superior performance. Malone and Crowston hinged their theory on the efforts of earlier theorists in the dominion of supply-chain coordination – as highlighted, hereinafter.
This chapter reviews some of the efforts of the earlier empiricists, including Fredrick W. Taylor (1914); Thompson (1967:15); Stover (1970:70); Van de Van, Delbecq & Koenig, (1976:332); Mintzberg (1989:101); Malone and Crowston (1994); and Crowston and Osborn (1998:8). The empirical trajectory is further punctuated by the contemporary development of refined theoretical frameworks to match with respective contemporary times, e.g. Ballou et al (2000); Lambert and Cooper (2000); Meca & Patnayakuni, Rai & Seth (2006: 13); Rai, Patnayakuni, & Seth (2006); Timmer (2008); Arshinder, et al (2008); Okhuysen & Bechky 23 (2009); Akhtar, et al., (2012); Ramanathan & Gunasekaran (2014); Labiad, Beidouri & Bouksou (2014); Labiad, et al., (2014:618); and Soosay & Hyland (2015).
In 1914 Fredrick W. Taylor, had emphasised standardisation of manufacturing processes for effective coordination and performance of work tasks. According to Okhuysen & Becky (2009: 465) Taylor’s assertion ensured that the inputs were available at the right time and the right place for particular tasks to be performed through dimensions such as scheduling and coordination. Taylor’s contribution on structural importance to enhance coordination of tasks was underscored by Henri Fayol, who stressed unity of command using the top-down approach with a focus onto organisational structural coordination as an essential component of coordinated management. Whereas Fayol’s ideas focused on design of relationships between positions in organisations, Taylor’s idea provided for coordinated activity through designing of work processes.
In 1967, Thompson reiterated the importance of organisational structure in augmenting coordination performance (1967:18). His study led to the coining the concept of “mutual adjustment” to cater for unplanned contingencies and to the wide spread use of coordination theory in a variety of disciplines to design structured tasks for performance. His other scholarly efforts in various studies on coordination theory advocated for the use of plans based on pre-established schedules, routines, and rules (Thompson, 1967:56).
In 1970, Stover pushed further the efforts of Thompson (1967). According to Stover (1970:70), scheduling or timetabling in the rail sector as a coordination dimension significantly led to enhanced performance. Although the findings from this study hyped the rationale for planned processes and structures, it was not articulate on how incidental changes would be managed because of shocks in the environment, causing failures to account for the eventualities in performance of tasks. His approach gave rise to dimensions or incidental requisites such as interpersonal communication and feedback, proposed by Van de Van, Delbecq & Koenig, (1976:332).
Coordination was later identified with regulatory guidelines as requisites used to manage task-related processes, in order to achieve organisational objectives (Mintzberg, 1989: 101). For Mintzberg (1989), the dimensions of coordination, once effectively managed, were deemed fundamental to hold the organisation accountable, via the formalised actions. For that matter, their use would be substantially determined by the task to be performed, purpose and context.
Mintzberg proposed six coordination dimensions that ought to be deemed necessary for adequate supply and distribution of a specific commodity. The first was standardisation of skills and knowledge, followed by standardisation of norms in which standards on behaviour of organisational staff are set to enable personnel to relate and work with each other. The, standardisation of work processes which are specified to the people performing interrelated tasks and standardisation of coordination of outputs by specifying the results of different work units or subunits (performance targets are defined and known by staff). Also, mutual adjustment where coordination is through simple processes of informal communication and lastly, direct supervision where the manager instructs subordinates with interrelated activities regarding what to do at a particular point in time.
Later on, Malone and Crowston (1994) found out that coordination is a concern across departments, which help to determine task interdependence based on structures. These include structural or formal (centralisation or decentralisation, standardisation, and control of behaviour) and informal dimensions (informal communication, personal contacts, and socialisation (Reger & Gerybadze, 2009:7). Nevertheless, the definitive conceptualisation put forward by Malone and Crowston (1994) appeared too optimistic as the scholars considered the coordination modes according to process realignment. They did not highlight the question of combining different dimensions of coordination in large organisations. Coordinating complex environments may require a diversity of outputs (products, services, markets); specialised inputs with strong interdependencies; and managing unanticipated change and goal setting (Huiskonen & Pirttilak, 2002:178).
However, in 1998 Crowston and Osborn (1998:8) linked the relative desirability of dimensions to the use of new information systems, such as computer systems that make it easier to find existing solutions to a problem in a database or within the business processes. According to Crowston and Osborn (1998: 42), such a system is therefore likely to reduce duplication and coordination costs with business processes. This contention was upheld and improved by contemporary researchers, such as Scott and Davis (2007:29), who highlighted the fundamentality of employee behaviour towards information sharing, stated rules that result into harmonisation of desired cooperation, responsiveness, mutual understanding and joint decision making to resolve problems. These orientations resulted in the advocacy of structures, roles and organisational rules as modelled by Okhuysen & Bechky (2009:467), to enhance organisational coordination.

 Coordination theory and medicine supply chain

Medicines are strategic products in any health system and, therefore their supply chain coordination ought to be given top priority (Jaberidoost, Nikfar, Abdollahiasl, & Dinarvand, 2013). Medicine supply chains are complex and different from the manufacturing chains, be-cause they usually have large and extended pipelines requiring high levels of product availability with high uncertainty in supply and demand (Cho & Zhao, 2017; 2018; McKone‐ Sweet, Hamilton, & Willis, 2005). Hence, the need to investigate and acknowledge operations in the health care sector so as to enhance decision – support frameworks, remains ultimate (Uthayakumar & Priyan, 2013). Regrettably, as nations continue to search for better health supply chains, relevance is often proved to remain rather scanty; presenting wanton challenges, such as: (1) absence of demand information, (2) lack of coordination, (3) inventory management (4) human resource dependency, (5) stock out (6) order management, (7) warehouse management, (8) expiration, (9) shipment visibility, and (10) temperature control (Privett & Gonsalvez, 2014). These issues are addressed by and contained in the coordination theory, hence its relevance to the current study. In the subsequent sub-sections the global and Ugandan medicine supply and distribution chains, are respectively reviewed.

Global medicine supply and distribution chain

From the global perspective, Yadav (2015:145) published a general model for the distribution of essential medicines in developing countries, to harmonise their coordination. Figure 2 summarises this model.

CHAPTER ONE  ORIENTATION AND OVERVIEW OF THE STUDY
1.1 Introduction
1.2 Contextualisation of the problem
1.3 Problem Statement
1.4 Research Objectives
1.5 Significance of the study
1.6 Scope of the study
1.7 Brief preview of research methodology
1.8 Outline of chapters
1.9 Summary
CHAPTER TWO  THEORETICAL REVIEW OF SUPPLY CHAIN COORDINATION
2.1 Introduction
2.2 Theoretical review
2.3 Coordination theory and medicine supply chain
2.4 Summary
CHAPTER THREE  LITERATURE ON THE DIMENSIONS OF SUPPLY CHAIN COORDINATION AND AVAILABILITY OF ACTs
3.1 Introduction
3.2 Supply chain coordination frameworks
3.3 Critical supply chain dimension
3.4 Logistics dimensions
3.5 Management environment dimensions affecting availability of ACTs
3.6 Summary
CHAPTER FOUR  RESEARCH METHODOLOGY
4.1 Introduction
4.2 Research philosophy
4.3 Research design
4.4 Research approach
4.5 Assessing of validity and reliability
4.6 Ethical considerations
4.7 Summary
CHAPTER FIVE  QUALITATIVE DATA ANALYSIS AND PRESENTATION
5.1 Introduction
5.2 Demographic information
5.3 Overview of supply chain coordination in general hospitals in Uganda
5.4 Supply chain coordination of malaria treatment pills in general hospitals in Uganda
5.5 Logistical activities dimensions and SCM in GH of Uganda
5.6 Management environmental dimensions that affect ACTs in Uganda: Market perspective
5.7 Macro environmental dimensions that affect ACTS in Uganda
5.8 Summary
CHAPTER SIX  QUANTITATIVE ANALYSIS AND INTERPRETATION OF FINDINGS
6.1 Introduction
6.2 Response rate and Data screening
6.3 Demographics distribution
6.4 Parametric test assumptions
6.5 Exploratory Factor Analysis (EFA)
6.6 Confirmatory factor analysis (CFA)
6.7 Analytic Hierarchy Process (AHP)
6.8 Chapter summary
CHAPTER SEVEN  SUMMARY OF FINDINGS, DISCUSSION, CONCLUSIONS AND RECOMMENDATIONS
7.1 Introduction
7.2 Research objectives and questions
7.3 Discussion of research questions and hypotheses
7.4 Summary of the study and main research objective
7.5 Contributions and implications
7.6 Limitations of the study
7.7 Areas for future research
LIST OF REFERENCES
APPENDICES
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