In our class on operations management we learned about the perils of long queues in a service-oriented business and strategies to eliminate waiting time, such as reducing service time and establishing pooling efficiencies.
I just returned from a field research visit to Kenya’s Coast province. The hub of the province, the town of Mombasa, is a renowned tourist mecca and jumping off point for some of the most stunning beaches East Africa has to offer.
But outside downtown Mombasa, poverty is conspicuous and sprawling. I was visiting retail pharmacy chains, large hospitals, NGOs and small-scale providers and learning about the differences in the health needs of the population there compared with inland areas.
Traditional healers on the roadside
One unique and distinct barrier to accessing formal health services among the population in the Coast is an entrenched traditional belief system. For example, many low-income patients will consult a muganga, or witch doctor, as a first-line of defence when they are sick. The alleged medicinal concoctions offered by these mugangas are mostly bogus mixtures of powders and herbs that are typically useless and sometimes harmful. On top of that, the muganga will demand payment with the threat of a curse. Families have been known to sell their goats – prized assets – to pay muganga fees. Worse, some expectant mothers believe that their baby will be still-born if they do not consult a muganga during pregnancy.
A local doctor and I lamented that these practices continue to have a detrimental effect not only on his business, but more importantly on the population’s health. If an individual is truly sick, mugangas will only serve to delay seeking effective treatment and could lead to complications. Further, muganga fees may send a family even further into poverty and leave them unable to seek additional treatment.
With a month left of my internship, the push is on for me to finish developing the performance evaluation and measurement framework that I was hired to develop.
Several interesting challenges have been encountered in the development of this framework.
The most interesting and frustrating challenge has been helping some members of management understand the issue and importance of alignment. Specifically, the performance measures chosen should be aligned with the organisation’s goals and it is these goals that drive the development of the performance measures and not the other way around.