Determination of Actual Human Resources for Health Staffing Requirements Using Workload Indictors for Staffing Needs Methodology

Determination of Actual Human Resources for Health Staffing Requirements Using Workload Indictors for Staffing Needs Methodology A Case Study A Post Graduate Research Dissertation presented to the Institute of Health Policy and Management in Partial Fulfillment of the Requirements for the Award of a Masters Degree in Business Administration- Health Management of International Health Sciences University Patrick, Nalere 2010-MBA-PT-012 December, 2012 1 DECLARATION I Patrick Nalere, declare that the work presented in this study is my own, that all sources used or quoted have been indicated and acknowledged by names of complete references and that it has never been presented anywhere for award of any degree. Candidate: Signed …………………………………………...………………………………..… Patrick Nalere, Date: …………………………………….…………………………………..………. Supervisors: Signed ……………………….……………………………………………………… Okiria John Charles Date: ………………………………..…………………….…………….…………… 2 DEDICATION To my wife and children that endured my absence while concentrating on the study program. 3 DEDICATION.................................................................................3 6.2.1 IMPROVING DISTRIBUTION OF HEALTH WORKERS IN PUBLIC HEALTH FACILITIES…………...55....................................................11 ABSTRACT..................................................................................20 CHAPTER ONE.............................................................................21 INTRODUCTION...........................................................................21 1.0 INTRODUCTION......................................................................21 1.1 BACKGROUND TO THE STUDY.................................................21 1.3 STATEMENT OF THE PROBLEM ...............................................25 1.5 OVERALL OBJECTIVE .............................................................26 1.5.2 Specific Objectives ..................................................................................26 1.5.3 Research Questions ................................................................................26 1.10 OPERATIONAL DEFINITIONS .................................................31 LITERATURE REVIEW...................................................................34 2.1 HEALTH WORKERS’ STAFFING NORMS AND STAFFING REQUIREMENTS ..........................................................................34 2.2 HUMAN RESOURCE FOR HEALTH WORKLOAD...........................35 2.5 TASK SHIFTING AMONG HEALTH WORKERS ............................40 CHAPTER THREE..........................................................................42 RESEARCH METHODOLOGY..........................................................42 4 3.0 INTRODUCTION......................................................................42 3.1 RESEARCH DESIGN................................................................42 3.2.3 Data Analysis and Interpretation .............................................................46 DATA PRESENTATION, ANALYSIS AND INTERPRETATION.....................................49 4.0 INTRODUCTION......................................................................49 4.1.1 The Actual Number and WISN Staffing Recommended for Mityana District. 50 Actual number and WISN Recommended health workers that are required to cope with current workload in public health facilities are calculated below in Table 4.1. Indeed table 4.1 revealed that the district of Mityan in the year 2011 (January – December) had an actual total number of 252 health workers. This comprised of 10 doctors, 26 Clinical Officers, 105 nurses, 83 midwives and 30 Nursing Assistants. Of the 252 health workers in the district, 112 were working at the General Hospital, 37 at Health Centre IVs, 57 at Health Centre IIIs, and 48 at Health Centre IIs. The details of the number of each category of workers are presented in table 4.1 below............................................................................50 4.1.3 The Actual Number and WISN Staffing Recommended for Health Centre IIIs .......................................................................................................................55 4.1.4 The Actual Number and WISN Staffing Recommended for Health Centre IVs .......................................................................................................................58 CHAPTER FIVE.............................................................................62 5.1 SUMMARY OF IMPORTANT FINDINGS ......................................62 5.2.1 Current Staff Status – Over or Understaffing ............................................63 5.2.2 Current Staff and Workload Pressure .......................................................64 5.4 IMPLICATIONS OF UNDERSTAFFING AND OVERSTAFFING IN HEALTH FACILITIES ....................................................................71 CONCLUSION AND RECOMMENDATIONS........................................75 6.0 INTRODUCTION......................................................................75 6.1 CONCLUSIONS ......................................................................75 5 6.2.4 General and Policy Recommendations.......................................................81 6.2.5 Recommendations for Further Research...................................................82 This study research on determining the appropriate number of actual staffing gap, cadre mix and work pressures in all public health facilities in Mityana District focused essentially on numbers of the selected health workers per se for the Public Health Centres to cope with its workload. This only emphasizes effective management of the valuable Health Human Resources, without looking at its quality, motivations, and remunerations among others things. .........................83 REFERENCES....................................................................................................84 APPENDICES...............................................................................89 APPENDIX 1: LETTER OF INTRODUCTION............................................................89 APPENDIX 3: HMIS 105: HEALTH UNIT MONTHLY REPORT ..................................92 APPENDIX 4: HMIS 108: HEALTH UNIT INPATIENT MONTHLY REPORT..................95 1.10 OPERATIONAL DEFINITIONS.......................................................................................................11 DEDICATION.................................................................................3 6.2.1 IMPROVING DISTRIBUTION OF HEALTH WORKERS IN PUBLIC HEALTH FACILITIES…………...55....................................................11 ABSTRACT..................................................................................20 CHAPTER ONE.............................................................................21 INTRODUCTION...........................................................................21 1.0 INTRODUCTION......................................................................21 1.1 BACKGROUND TO THE STUDY.................................................21 6 1.3 STATEMENT OF THE PROBLEM ...............................................25 1.5 OVERALL OBJECTIVE .............................................................26 1.5.2 Specific Objectives ..................................................................................26 1.5.3 Research Questions ................................................................................26 1.10 OPERATIONAL DEFINITIONS .................................................31 LITERATURE REVIEW...................................................................34 2.1 HEALTH WORKERS’ STAFFING NORMS AND STAFFING REQUIREMENTS ..........................................................................34 2.2 HUMAN RESOURCE FOR HEALTH WORKLOAD...........................35 2.5 TASK SHIFTING AMONG HEALTH WORKERS ............................40 CHAPTER THREE..........................................................................42 RESEARCH METHODOLOGY..........................................................42 3.0 INTRODUCTION......................................................................42 3.1 RESEARCH DESIGN................................................................42 3.2.3 Data Analysis and Interpretation .............................................................46 DATA PRESENTATION, ANALYSIS AND INTERPRETATION.....................................49 4.0 INTRODUCTION......................................................................49 4.1.1 The Actual Number and WISN Staffing Recommended for Mityana District. 50 Actual number and WISN Recommended health workers that are required to cope with current workload in public health facilities are calculated below in Table 4.1. Indeed table 4.1 revealed that the district of Mityan in the year 2011 (January – December) had an actual total number of 252 health workers. This comprised of 10 doctors, 26 Clinical Officers, 105 nurses, 83 midwives and 30 Nursing Assistants. Of the 252 health workers in the district, 112 were working at the General Hospital, 37 at Health Centre IVs, 57 at Health Centre IIIs, and 48 at 7 Health Centre IIs. The details of the number of each category of workers are presented in table 4.1 below............................................................................50 4.1.3 The Actual Number and WISN Staffing Recommended for Health Centre IIIs .......................................................................................................................55 4.1.4 The Actual Number and WISN Staffing

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