Health Challenge Confronting Africa Commerce Essay


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One major health challenge confronting Africa is the effect of malaria, considering the fact that it claims the lives of more than one million people each year, most of them are pregnant women and children under the age of five. Malaria presents a major socio-economic challenge to African countries and this challenge cannot be allowed to go unnoticed since good health is not only a basic human need but also a fundamental human right and a prerequisite for economic growth (Streeten, 1981; Asante and Asenso-Okyere, 2003). Artemisinin-based Combination Therapy (ACT) is a recommended drug by WHO. ACT is any malaria drug which has been combined with Artemisinin derivative. Examples of malaria drugs which combine with Artemisinin derivative are Ammodiaquine, Lumefantrine and Piperiquine. Artemisinin derivatives are Artemether, Artesunate and Dihydroartemisinine. Although funding in the public sector has increased remarkably over the years, most treatments are administered over-the-counter through general shops, pharmacies and hawkers. Because these outlets are poorly regulated, the distribution, quality, price and administration of anti-malaria drugs vary significantly. The problem of drug resistance could be attributed to inappropriate use of drugs, lack of medical supervision, weak public health system, shortage at government clinics or even lack of access, and all these could be linked to the supply chain system. In Ghana, essential medicines are defined within the National Drugs Policy framework, 2004 and procured through the public procurement arrangements, which are regulated by various acts and legislations. Though malaria drugs have long been distributed through a large number of sector channels including public, private, local chemical stores and on the streets, information on the integration and collaboration in this market is very minimal. There is very little evidence on the drugs' supply including distribution channels, interventions that are being implemented to influence its availability and prices, supply chain mapping. This current study is positioned to assess this situation by examining the malaria drug supply chain management in Western region. The study also assesses the vulnerability of the malaria drug supply chain management system. The rest of the paper is structured as follows: Chapter two covers the literature review, chapter three discusses the methodology employed, chapter four includes discussion of the results and finally, chapter five is the summary, conclusion and recommendations.


A problem in many countries, especially the developing countries is the irregular or lack of access to essential drugs at health facilities. The availability and rational use of appropriate drugs are essential for successful implementation of proper healthcare strategy. The efficient and effective management of drugs can improve important public health outcomes and reduce expenditures. Especially in this globalization era, customers, ever more demanding and powerful than before, are seeking for products and services with higher criteria. In order to meet customers' requirements and satisfactions, companies have to be proactive against globalized markets which can be changed and influenced by several factors. With an increase of use of technology like internet, e-commerce there is no more barriers in business nowadays. Margins of companies were shrinking due to increasing demand from customers on lower prices. Companies identified the improvement of their supply management as the best alternatives for competitiveness and sustenance. The activities of the drug management cycle selection, procurement, distribution, and use of drugs are interdependent. The optimal functioning of the cycle requires the careful management and coordination of these activities hence drug supply chain management. Drug management is different from the management of other commodities and it is important in controlling costs and in preventing morbidity and mortality. Drug supply management is an efficient and effective management of drugs which can improve important public health outcomes and reduce expenditures. Currently managers are more required to improve the efficiency of their programs; the managers must aim at the most rational use of drugs and develop mutually beneficial relationships with the private sector, to assist in ensuring the availability of important drugs to the public. It is also critical in ensuring that the right drugs are available at right place, at right time and in the right dose and quantity required for the patient. Christopher (1998) claimed that companies have to achieve both cost leadership and service leadership to have an efficient supply chain management.

According to Basu et al, (2008) Supply chain management is a set of approaches utilized to efficiently integrate suppliers, manufacturers, warehouses and stores, so that merchandise is produced and distributed at the right quantities, to the right locations, and at the right time, in order to minimize system-wide costs while satisfying service level requirements. Supply chain management has been developed for customers who play the most important role in businesses. This session also introduces the idea of indicator-based assessments for monitoring and evaluating the performance of the drug management cycle. The interest in being able to evaluate the performance of the public-sector drug system is fostered by challenges posed by recent health care reforms and concern for achieving equity and financial sustainability of new programs. The aim for the most rational use of drugs and develop mutually beneficial relationships with the private sector, to assist in ensuring the availability of important drugs to the public. Awareness of supply chain management came up just before 1960's (Huan et al, 2004) increased in 1980's and had a dramatic increase in 1990's. More companies focus on supply chain for successes and as a core competence, since quality at that period is just a threshold competences (for survival). Hence supply chain creates a competitive advantage (Cooper et al, 1997).

Drug logistics is the science and art of bringing the right drugs at the right places in the right time in appropriate quantities .The drug supply systems are fields of pharmacy practice that add extra knowledge to the pharmacist different from that acquired at the college .This necessitates the introduction of pharmacy practice to the pharmaceutical curriculum.

Drug management is different from the management of other commodities and it is important in controlling costs and in preventing mortality. Drug supply management is an efficient and effective management of drugs which can improve important public health outcomes and reduce expenditures. Currently, professionals are more and more required to improve the efficiency of their programs. The managers must aim at the most rational use of drugs and develop mutually beneficial relational use of drugs and develop mutually beneficial relationship with the private sector, to assist in ensuring the availability of important drugs to the public. It is critical in ensuring that the right drugs are available at the right place, at the right time and in the dose and quantity required for the patient.

Ghana is a country in West Africa with a population of about twenty four (24) million as at year 2010. To meet the health needs of the people the government of Ghana in 2004 introduced National Health Insurance Scheme (NHIS) for the citizens as a result of this, a great concern and attention was to be paid to drugs to be supplied to patients who may enjoy this facility. The Pharmacy Council, which operates under the Pharmacy Act 1994, (ACT 489) Section 29 and 31, is the organization responsible for the issuing of certificates to supply drugs from premises, prescription of class A and B drugs, the importation and exportation of drugs as well as manufacturing. The Council works hand in hand with the Ghana Food and Drugs Board. It also rest on these two bodies to regulate the laws governing the usage of drugs (medicine) either produced in the country or imported from outside. The most challenging issue for these two independent bodies in the country is to make sure that manufacturers of pharmaceutical drugs use the right proportions of various ingredients of drugs to proof the efficacy of drugs and to avoid drug counterfeiting.


The activities of the drug management cycle selection, procurement, distribution systems in the Ghana health service is quite underdeveloped and facing lot of challenges in terms of its contribution to effective drug management in the public health system. Among the inherent problems include how the main actors within the supply chain could integrate managerial processes and activities to ensure a seamless chain that will maintain the quality of drugs before it get to the final user.

The Spread of counterfeit or substandard drugs is a modern day menace which has been recognized internationally, especially so, in developing countries. The problem assumes added significance in view of rapid globalization. The market of counterfeit drugs is a well-organized, white collar crime. In recent times, Ghana has been facing problems of counterfeiting drugs and drugs with doubtful sources of preparation. Most of the manufacturing companies in Ghana are working seriously on prevention of drug counterfeiting and on keeping their drugs at the right temperature and in the proper warehouses as the products pass through the supply chain. To be able to get the right sources of raw materials and process them to reach the final consumer, effective and efficient optimization of supply chain management is needed in order to reduce cost and guarantee customer satisfaction through just in-time delivery.

The challenge for any national malaria control program is to ensure that effective malarial drugs are easily accessible by the population at risk of the disease. It is strongly believed that drug must be prepared with the right proportions of ingredients to enhance its efficacy and ability to cure diseases that affect human beings. It is of first importance for pharmaceutical companies to make sure that drugs which are not prepared with the right ingredients from right sources do not reach consumers. There is therefore a need for the national malaria program to partner with the major actors, development agents, non-governmental organizations and the private sector to expand the access to malarial drugs especially in the poor and rural communities. Ghana as a developing country faces challenges of using counterfeit drugs from importers and manufacturers in the country. The problem not only incurs monetary loss to companies but causes serious health hazards to mankind and also lowers customer confidence and inevitably affects negatively customer satisfaction.

Poverty, high cost of medicines, lack of an official supply chain easy accessibility to computerised printing technology, ineffective law enforcement machinery, and light penalties provide the counterfeiters with an enormous economic incentive without much risk. The consequences of the use of such medicines may vary from therapeutic failure to the occurrence of serious adverse events and even death. Proper drug quality monitoring, enforcement of laws and legislation, an effective and efficient regulatory environment, and awareness and vigilance on part of all stakeholders can help tackle this problem.

Regulatory authorities like the Pharmacy Council, Food and Drug board and manufacturers have been tasked by law to track drugs all the way through the supply chain to the customer. Italy has shown the way in this regard. Since 2001 every package carries a quality stamp which has a batch number that allows the product to be traced. The US Food and Drug Administration (FDA) have recommended that pharmaceutical companies start using "track and trace technology" and product authentication technologies to provide a greater level of security for drug products.

It is against this background that the researcher intends to investigate into malaria drug supply chain management system to assess the vulnerability, availability and accessibility of the malaria drug and how counterfeit drugs could be tracked and removed from the distribution network.


The following questions would have to be answered in order to achieve the objectives below;

What are the supply chain management processes in malaria drug management in the public health institution?

What are the risk factors in malaria drug management in the public health institution?

How do legislations and regulations affect effective malaria drug management?

What are the challenges confronting malaria drug distribution, storage and supply in the public health institution?


The main objective of this study is to find out how drug can be managed effectively in controlling costs and preventing morbidity and mortality.

The objectives of the work are;

To identify the supply chain management processes in malaria drug management in the public health institution.

To ascertain the risk factors in malaria drug management in the public health institution.

To identify how legislations and regulations affect effective malaria drug management.

To establish the challenges confronting malaria drug distribution, storage and supply in the public health institution.



To offer Public Health Institution the opportunity to appreciate the role of effective supply chain management of malaria drug in improving the quality of life of patients.

To add to the body of knowledge.

Findings can be used across other health institutions and for future researchers who might conduct studies in similar field.


.The main focus of this research was on supply chain management issues in the public health institutions in the Sekondi-Takoradi metropolis, Western Region. Regional Medical Stores, Takoradi Hospital, Esikado Hospital, Effiankwanta Regional Hospital and Kwesimintsim Polyclinic Hospital. To achieve the objectives, the study had focused on the systems of supply dimensions; policies, selection, procurement, distribution, financing and security.

The research encountered the following limitations;

Data quality is a major limitation of this study looking at the lapses in supply chain processes and logistics management information system, it is important to get quality data because it has a significant effect on the research findings and quality.

Another limitation is that of incomplete information. The use of questionnaires is likely to produce incomplete information for the analysis since it is possible some respondents may not provide full information as expected.

Another difficulty is that the small sample size will also not allow us to make any generalization about supply chain management practices in the public health institutions in Western Region, Ghana. This is because the study would be limited to the Sekondi - Takoradi metropolis, and only 50 questionnaires are intended to be administered by the researcher not rejecting the fact that a broader sample size would give a more vivid implication about the challenges, risks, and legislations with regards to supply chain processes of malaria drug.

The reluctance on the part of some interviewees and respondents to release information for safety and security reasons.

Funds will also pose a challenge, since the selected areas are scattered and will need funds to move from one place to another in gathering information.

Time is also a limiting factor, and also the researcher has to combine his job and the research at the same time, hence leaving her with limited time to cover a wider scope.

Finding time to administer questionnaires and arrange for interviews by researcher came with some form of opposition as some interviewees saw the whole exercise as a waste of precious man hours. It is however expected that none of these limitations will over-ride the significance of the research.


Chapter One introduces the background information to the research and states the research problem under study. The research is then justified on the basis of it important contributions to both theory and practices. The objectives of the study and research questions are presented, followed by the relevance of the study. Finally, the outline of the entire research is discussed.

Chapter Two reviews the body of knowledge relating to the effective management of drugs through the drug management cycle model. Also in controlling costs, availability of good quality drugs at the right place, right time and to prevent morbidity and mortality.

Chapter Three begins with the justification of the chosen research paradigm, and identifies the appropriate research method within the paradigm. This criterion for judging the quality of case study is discussed and the industry selection follows briefly. The data collection procedure is presented, followed by the date nellyism method. The limitations and ethical considerations constitute the last two sections of Chapter Three. The final section, the chapter summary, concludes this chapter.

Chapter Four discusses the research findings, including a description of the case study and data display. Based on the collected data, the research questions will be answered. This chapter then will present a discussion for the results. The final section, the chapter summary, concludes this chapter.

Chapter Five presents the conclusions of the research. Firstly, the three research questions are discussed and the contribution to both theory and practice are presented, followed by the limitations of the research. The next section presents the recommendations for further research. The final section, the chapter summary, concludes this chapter.




The concept of supply chains can become clearer and comfortable if examined from a variety of important theoretical perspectives. We focus specifically on the theoretical underpinnings with respects to supply chain concept offered by prominent theoretical perspectives that are used as a conceptual underpinning articles.

2.1 Theoretical Literature

2.1.1 Network theory

Network theory describes, explains, and predicts relations among linked entities (Thorelli, 1986). Supply chains are, in essence, a form of network, thus, network theory has the potential to reveal interesting truths about chains. A supply network is all the operations that are linked together so as to provide goods and services through to end customers. In large supply networks, there can be many hundreds of supply chains of linked operations passing through a single operation. Some researchers use the term "network" to describe a network of actors, while others use it to discuss a network of processes or activities and resources. The supply chain network consists of the member firms and the links between these firms. All firms participate in a supply chain from the raw materials to the ultimate consumer. The closeness of the relationship at different points in the supply will differ according to the level of partnership appropriate for particular supply chain links (Lambert et al, 1998)

In the context of this study, the two perspectives of actors and processes were considered (Lysons and Farrington, 2006). The network theory deals with the interactions among actors that are engaged in various activities in the network (Schary and Skjott-Larsen, 2003; Engstro¨m and Slivo, 2008). Lysons and Farrington (2006) identify a network structure as a series of strategic alliances that an organisation forms with suppliers, manufacturers and distributors to produce and market a product. It is the results of complex interactions within and between companies in relationships over time (Ford et al., 2003; Lysons and Farrington, 2006).

The terms of supply network and supply chain management are often used interchangeably notwithstanding the distinction between them. Supply network management concerns flow between operations in the whole network whiles supply chain management concerns flow between a strings of operations. (Nigel et al, 2006). Various authors have emphasised the network character of supply chain management (SCM) and proposed the analytical integration of SCM and the theory of networks (Omta et al., 2001). Under this approach, Lazzarini et al. (2001) introduce the term "netchain" while Nassimbeni (1998) wrote about "supply network". Supply chain can be seen as a network consisting of actors with relationships to one another (Engstro¨m and Slivo, 2008). Snow et al. (1992), make a distinction between internal, stable and dynamic structures. According to them, internal network firms own most or all of the assets associated with the business and endeavour to capture entrepreneurial and marketing benefits without engaging in much outsourcing. Dynamic networks are those with extensive outsourcing. The lead firm identifies and assembles assets owned wholly or largely by other enterprises on whose core skills it relies.

Strong and weak ties are key concepts within network theory. As the names suggest, strong ties involve firms that are tightly coupled and loose ties involve firms with more tenuous links (Granovetter, 1973). Each type presents certain advantages to supply chains. Strong ties provide greater reliability, for example, while loose ties enhance flexibility. Within traditional supply chains, strong and weak ties are formed on a case-by-case basis without much concern for the overall network configuration. In contrast, best value supply chains approach these issues strategically. A blend of strong and weak ties that matches supply chain needs (such as reliability and flexibility) is created in order to maximize supply chain performance.

Managing from initial suppliers to end customer's network is an enormous undertaking. Managing the entire supply chain is a very difficult and challenging task. The most significant paradigm shift of modern business management is that individuals businesses no longer compete as independent entities, but rather as supply chains. Now, the competition becomes supply versus supply chain. The supply chain is not a chain of businesses with one-to-one but a network of multiple businesses and relationship (Drucker, 1998). It is important to sort out some basis for determining which members are critical to the success of the supply chain and thus, allocated managerial attention and resources (Cooper et al, 1997).

2.1.2 Transaction cost economics (TCE)

Transaction cost economics (TCE) offers a natural fit with supply chain management research because it centers on the ''make or buy'' decision whether a firm should make a product within the confines of its organizational boundaries or purchase it from an outside provider (Williamson, 1975). The central goal is to maximize performance by minimizing transaction costs within and between organizations. Given the natural fit and previous use of the TCE in supply chain research, TCE was a popular theory in this special issue as well. According to TCE, managers should minimize transaction costs through selecting their approach to the make or buy decision. Transaction costs are the expenses generated by identifying fair market prices, negotiating, and carrying out economic exchange (Williamson, 1991). Under some conditions, internalizing an activity minimizes such costs, while under others, buying a product or service from another firm is best. Supply chain managers must balance these contingencies to find a suitable balance of relationships across a chain. Within traditional supply chains, short-term transaction costs are the overriding concern. This creates the potential for opportunism, wherein one firm takes advantage of another firm. Given this context, trust between supply chain members is often difficult to establish and maintain. In contrast, the members of best value supply chains focus on total costs, not just short term transaction costs, as the basis of make or buy decisions. There is recognition that acting opportunistically has long-term implications a supplier that is viewed as overly self-serving may find it excluded from supply chains unless it offers a product or service that is very unique. This exclusion represents economic costs that wise firms are unwilling to risk. As a result, short-term costs are relegated to a secondary role, and members devote their efforts to building long term, trusting relationships that benefit all participants.

2.1.3. Agency theory

Agency theory, which was discussed in this issue by Morgan et al., also offers a natural fit with supply chain management research. This theory centers on occasions wherein one entity (the principal) delegates authority to a second (the agent) to act on its behalf (Eisenhardt, 1989). Problems arise in these relationships because agents often behave in ways that benefit them, not

principals. For example, stockholders delegate authority to top managers to run corporations. A chief executive officer may exploit his/her role as an agent by acquiring another firm in order to boost his/her own compensation, regardless of the potential for the D.J. 576 Ketchen Jr., G.T.M. Hult / Journal of Operations Management 25 (2007) 573-580 acquisition to add value to the company and enrich the stockholders. Accordingly, principals must closely monitor agents' decisions; create reward structures that reinforce desired activities, or both. Supply chains are replete with relations involving one firm delegating authority to another. As a result, conflicts of interest often arise within traditional supply chains. Participants must choose between courses of action that benefits their firm versus one that benefits the chain as a whole. Most managers in this situation will select the former option because their primary loyalty lies with their home firm. Best value supply chains recognize and account for this tension. As discussed above, best value supply chains leverage tools such as reward structures and cultural competitiveness to ensure alignment among participants' interests. This removes the temptation to take advantage of other supply chain members. Members of best value supply chains also recognize that the sequential nature of supply chains dictates that they are agents in some links and principals in others. Thus, opportunism in one's role as an agent can be punished by other firms in the chain.

2.1.4 Resource dependence theory (RDT)

Resource dependence theory (RDT) centers on how some firms become reliant on others for needed inputs such as goods and materials, and how firms can manage such relationships (Pfeffer and Salancik, 1978). The asymmetric interdependence that exists in these inter-firm relationships is critical to reduce environmental uncertainty for some firms. As supply chain members work together closely, they often become more dependent on each other. Thus, RDT has a high level of value in the supply chain context. The articles by Ireland and Webb and Crook and Combs discuss RDT's implications for key aspects of supply chain management. Within traditional supply chains, each member tries to avoid becoming overly dependent on others for fear of being exploited. At the same time, making others dependent on one's own firm can create a position of strength. In contrast, best value supply chains recognize that taking advantage of resource dependencies can have unintended and grave consequences. For example,

in recent years many aerospace manufacturers maneuvered to make their part suppliers highly dependent on them, and then used this leverage to squeeze the suppliers' margins. This abuse eventually led the part suppliers to begin bypassing the manufacturers and selling spare parts directly to end-users. The result was a dramatic drop in the manufacturers' fortunes (Rosetti and Choi, 2005). Thus, from the perspective of best value supply chains, dependencies should be used to create mutual forbearance and trust, not to drive aggressive exploitation of one chain member by another.

2.1.5. Institutional theory

Institutional theory is the centerpiece of the article by Rogers, Purdy, Safayeni and Duimering. This theory emphasizes the role of environmental pressures, many of them subtle and evolving, on firm activities (DiMaggio and Powell, 1983). A foundational element of institutional theory is that organizations become homogeneous as a function of isomorphism over time.

Traditional supply chains tend to rely heavily on industry recipes and best practices to guide supply chain management activities. Copying what works for supply chain icons such as Wal-Mart and Federal Express is often seen as a prudent approach. In contrast, best value supply chains use industry recipes and best practices to inform, but not dictate, supply chain management activities. Such chains recognize the potential folly of mimicry. For example, attempting - and failing - to duplicate Wal-Mart's strategic supply chain management activities was one of the key blunders that led Kmart into bankruptcy.

2.1.6 Game theory

Game theory uses mathematics and hypothetical scenarios to draw conclusions about the likelihood of decisions and actions (Axelrod, 1984). Game theory plays a key role in the article by McCarter and Northcraft. Although this theory has been criticized as overly mechanistic, it can produce remarkable insights and conclusions. For example, game theory suggested that the United States and the Soviet Union would not escalate from the ColdWar to actual large-scale combat because the complete destruction of each side would almost certainly follow. This prediction held true for D.J. Ketchen Jr., G.T.M. Hult / Journal of Operations Management 25 (2007) 573-580 577 decades until the dissolution of the Soviet Union in the 1990s. Trying to predict others' actions is a key element of game theory. Within the supply chain setting, members of traditional chains have reason to be suspicious of each other's motives. As discussed by McCarter and Northcraft, some members use tactics such as free riding, hold up, and leakage to benefit themselves and to the detriment of the chain. The results include protective behavior and suboptimal chain performance along key issues such as speed, quality, cost, and flexibility. In contrast, mutual dependence and trust overcome members' temptation to pursue self-serving

behavior within best value supply chains. The result is not jointly beneficial suspicion as in U.S.-Soviet relations, but rather a positive sense of collaboration that builds agility and adaptability at the supply chain level.

2.1.7 Social capital theory

Social capital theory centers on the ''softer side'' of organizational activity. Social capital theory recognizes that the firms composing supply chains are themselves composed of people, and that the interpersonal skills and relationships among these people (such as the ''credits'' and trust they build with each other) shape supply chain activities and outcomes (Nahapiet and Ghoshal, 1998). This theory plays a prominent role in the articles by Ireland and Webb, and Krause, Handfield, and Tyler. Within a traditional supply chain, each person has conflicted loyalties between the firm and chain. The resultant mix of shared and firm-level goals, values, and experiences circumscribes shared sense making and limits performance. In contrast, the alignment among best value supply chain members creates a context wherein shared goals, values, and experiences create shared sense making and improved performance.

2.1.8 Strategic choice theory

Strategic choice theory stands in contrast to externally focused approaches such as institutional theory. Strategic choice contends that managers' decisions play a tremendous role in organizational success or failure (Child, 1972). A central issue in strategic choice theory is strategic renewal and repositioning. A foundational assumption is that firms can enact and actively shape their environment. Strategic choice figures prominently in Miles and Snow's article. Within traditional supply chains, strategic decisions are made with concern for the firm as the primary driver. This approach constrains firms to using a generic strategy such as prospector

(Miles and Snow, 1978) or low cost leader (Porter, 1980). Within best value supply chains, however, strategic decisions are made with concern for the chain as the primary driver. This strategic supply chain management opens the door to unique blended strategies that transcend the firm and provide the chain with increased agility and adaptability. Some logical research questions grounded in strategic choice include: To what extent are best value supply chains better at shaping their fates than traditional supply chains?, and Are best value supply chains significantly more likely than traditional supply chains to be able to enact their environment?

Finally, the resource-based view examines how certain assets and capabilities lay a foundation for competitive advantage and superior performance (Barney, 1991). The basic approach of the resource based view is viewing the firm as a bundle of resources, D.J. 578 Ketchen Jr., G.T.M. Hult / Journal of Operations Management 25 (2007) 573-580 and asserting that resource heterogeneity exist among firms. The closely related knowledge-based view targets the role of wisdom as an asset and capability (Grant, 1996). The articles by Holcomb and Hitt, and Miles and Snow feature these views. The traditional approach to supply chains contends that unique resources reside within firms. Supply chain management is thus a tool to complement these resources. In contrast, best value supply chains reflect the assumption that unique resources exist at the supply chain level, and that supply chains can be inimitable competitive weapons.

2.2 Evolution of SCM

The supply chain literature review was conducted to study the past researches. Before the 1950s, logistics was thought of in military terms (Ballou, 1978). It had to do with procurement, maintenance, and transportation of military facilities, materials, and personnel. The study and practice of physical distribution and logistics emerged in the 1960s and 1970s (Heskett et al., 1973). The logistics era prior to 1950 has been characterized as the "dormant years," when logistics was not considered a strategic function (Ballou, 1978). Around 1950s changes occurred that could be classified as a first "Transformation." The importance of logistics increased considerably, when physical distribution management in manufacturing firms was recognized as a separate organizational function (Heskett et al., 1964). The SCM concept was coined in the early 1980s by consultants in logistics (Oliver and Webber, 1992). The authors emphasized that the supply chain must have been viewed as a single entity and that strategic decision-making at the top level was needed to manage the chain in their original formulation. This perspective is shared with logisticians as well as channel theorists in marketing (Gripsrud, 2006). SCM has become one of the most popular concepts within management in general (La Londe, 1997) since its introduction in the early 1980s (Oliver and Webber, 1992). A number of journals in manufacturing, distribution, marketing, customer management, transportation, integration, etc. published articles on SCM or SCM-related topics. The evolution of SCM continued into the 1990s due to the intense global competition (Handfield, 1998). Berry (1994) defined SCM in the electronics industry. Drucker (1998) went as far as claiming there was a paradigm shift within the management literature: "One of the most significant changes in paradigm of modern business

management is that individual businesses no longer compete as solely autonomous entities, but rather as supply chains. Business management has entered the era of inter-network competition and the ultimate success of a single business will depend on management's ability to integrate the company's intricate network of business relationships." In fact, it was the first paper of SCM in the service industry. Sampson (2000) explored the customer supplier duality in the service organizations as it pertained to SCM in the service industry. Kathawala and Abdou (2003) explored supply chain application to the service industry. O'Brien and Kenneth (1996) proposed an educational supply chain as a tool for strategic planning in tertiary education. The study was based on a survey among employers and students. Survey findings revealed that integration and coordination among students and employers should have been promoted. Cigolini et al. (2004) explored a framework for SCM based on several service industries including automobile, grocery, computers, book publishing etc.

SCM requires a change from managing individual functions to integrating activities into key supply chain processes. Supply chain is a sequence of events intended to satisfy a customer and it includes procurement, manufacture, distribution and waste disposal, together with associated transportation, storage and information technology. A supply chain is that network of organisations that are involved, through upstream MRR and downstream linkages, in the different processes and activities that produce value in the form of products and services in the hands of the ultimate consumer.

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