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Our Work


Routines are the true engine of delivery. For them to work, everyone – starting with the system’s leader – must take them seriously and use them to maintain a consistent focus on progress.

For over 5 years, the Chief Minister of Punjab, Pakistan, has used stocktake routines to drive progress on his most important priorities. The individual Ministers responsible for delivering on these priorities welcome the challenge and focus they bring.

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Delivery associates leading stocktakes in Punjab, Pakistan
Ali Jan Khan, Secretary of Primary and Secondary Health

Stocktakes help me drive delivery on my Health priorities, which, among other things, include child vaccination rates, number of births with skilled birth attendants, health worker availability, availability of medicine, equipment functionality, and quality of public health facilities. If something is on the stocktake agenda, we know it must be delivered. At each stocktake, the Chief Minister holds me accountable for my health priorities. This puts positive pressure on me and my team to deliver outcomes before the next stocktake, and we deliver.

Before every stocktake, I review the progress of each indicator in detail with my team and the Special Monitoring Unit (SMU). Where there are issues, we expedite the resolutions with extra effort to ensure they are either resolved or 'in progress' by the time stocktake is held. The stocktake gets the whole system moving and it enables me to sort out issues by involving stakeholders from outside my Department as well.

Just to give an example: before a recent stocktake, I was reviewing progress with my team and noticed medicine distribution was low. Following field visits and inquiries, it turned out that district officials were not making payments despite the fact that funds had been allocated for this purpose. We took this to the Chief Secretary, requesting urgent action to be taken with districts as unused funds were about to be reallocated for some other purpose within a month and these payments would be delayed indefinitely. As the stocktake was looming close, all parties worked together and, as a result, more than 75% of the payments were made in time. Following this, and with Chief Minister’s approval, we have now devised a system of centralized payments in order to avoid such occurrences in future. The stocktake routines not only help uncover such issues; they enable fast policy change to facilitate improvements in the delivery system. They are also a tool to measure my own performance.

I now have my own set of routines to ensure sufficient progress is made between stocktakes. I hold weekly reviews with my team to ensure implementation activities or “traffic lights” are on track. Stocktakes drive accountability; they keep us focused and result oriented. The visible commitment and continued interest shown by the Chief Minister inspires us all to drive change and deliver results for the betterment of health of the people of Punjab.

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