Human Resources

Workload indicators of staffing need method in determining optimal staffing levels at Moi Teaching and Referral Hospital
Musua P, Nyongesa P, Shikhule A, Birech E, Kirui D, Njenga M, Mbiti D, Bett A, Lagat L, Kiilu K: East African Medical Journal 85(5):232-239, 2008

This study aimed to highlight the experience and findings of an attempt at establishing the optimal staffing levels for a tertiary health institution using the Workload Indicators of Staffing Need (WISN) method popularised by the World Health Organisation (WHO), Geneva, Switzerland. The descriptive study captures the activities of a taskforce appointed to establish optimal staffing levels. The cadres of workers, working schedules, main activities, time taken to accomplish the activities, available working hours, category and individual allowances, annual workloads from the previous year's statistics and optimal departmental establishment of workers were examined. There was initial resentment to the exercise because of the notion that it was aimed at retrenching workers. The team was given autonomy by the hospital management to objectively establish the optimal staffing levels. Very few departments were optimally established with most either understaffed or overstaffed. There were intradepartmental discrepancies in optimal levels of cadres even though many of them had the right number of total workforce. The WISN method is a very objective way of establishing staffing levels but requires a dedicated team with adequate expertise to make the raw data meaningful for calculations.

Workplace violence and gender discrimination in Rwanda's health workforce: increasing safety and gender equality
Newman CJ, de Vries DH, Kanakuze J and Ngendahimana G: Human Resources for Health 9(19), 19 July 2011

The authors of this article examined the influence of gender on workplace violence, and synthesised their findings with other research from Rwanda, before they examined the subsequent impact of the study on Rwanda's policy environment. Fifteen out of 30 districts were selected at random. Forty-four facilities at all levels were randomly selected in these districts. From these facilities, 297 health workers were selected at random, of whom 205 were women and 92 were men. Researchers administered health worker survey, facility audits, key informant and health facility manager interviews and focus groups to collect data in 2007. They found that 39% of health workers had experienced some form of workplace violence in year prior to the study. The study identified gender-related patterns of perpetration, victimisation and reactions to violence. Negative stereotypes of women, discrimination based on pregnancy, maternity and family responsibilities and the 'glass ceiling' affected female health workers' experiences and career paths and contributed to a context of violence. Addressing gender discrimination and violence simultaneously should be a priority for workplace and violence research, workforce policies, strategies, laws and human resources management training, the authors conclude.

World AIDS Day: Medical professionals speak out for their colleagues in Africa
Physicians for Human Rights

On World AIDS Day, Physicians for Human Rights sent a letter to President Bush urging the US government to address the massive health worker shortage in Africa. An estimated one million additional health workers are needed in sub-Saharan Africa alone to fight AIDS and other diseases. The letter was signed by over 100 prominent US health professionals, including 33 deans of medical, nursing, and public health schools, representing some of the country's most influential health leaders. Many of these health experts have seen first-hand the devastation caused by the lack of health workers, medicines, and supplies in many African countries struggling with the AIDS pandemic.

World Health Day: Chronic deficit of health workers
Inter Press Service News Agency: Capdevila G

There is a critical shortage of health workers - doctors, nurses and lab technicians - in poor countries, which most desperately need them. This was the warning given by the World Health Organisation warned in its annual report on global health problems.

World Health Day: Kenyan medics deplore low pay, scarce incentives
IPS News Agency: Mulama J

As the international community prepared to commemorate this year’s World Health Day on April 7, the issue of poor remuneration for health workers in Kenya were being debated. The pay for doctors and other health care givers in the public service is so low that many of these people could not devote their full time to public service. This forms the basis of the argument for improving remuneration packages for Kenyan doctors.

World Health Day: Mozambican nurses to the fore with ARV distribution
Inter Press Service News Agency: Ayisi RA. 3 April 2006

As World Health Day (Apr. 7) was rapidly approaching, public attention that week was being directed to the widespread shortage of health workers. The theme for World Health Day 2006, 'Working together for health', was chosen to add momentum to efforts at resolving the crisis -- something that is nowhere more evident than in Mozambique.

World Health Report 2005 policy brief two: rehabilitating the workforce
World Health Organization (WHO), 2005

This policy brief from the World Health Report argues that it will not be possible to effectively scale up Maternal, Newborn and Child Health (MNCH) care without confronting the global health workforce crisis. It argues that the low number of health professionals is one of the main factors in the exclusion from care and high mortality rates for mothers and newborns. It highlights how lack of managerial autonomy, gender discrimination and violence in the workplace, dwindling salaries, poor working conditions and some donor interventions have all contributed to a lack of productivity, as well as the rural to urban, public to private and poor to rich country brain drain and migration.

Wrong schools or wrong students? The potential role of medical education in regional imbalances of the health workforce in the United Republic of Tanzania
Leon BK and Kolstad JR: Human Resources for Health 8(3), 26 February 2010

This paper is based on the premise that medical schools can play an important role in solving the problem of geographical imbalance of doctors in the United Republic of Tanzania. It reviews available research evidence that links medical students' characteristics with human resource imbalances and the contribution of medical schools in perpetuating an inequitable distribution of the health workforce. Structured questionnaires were also administered to 130 fifth-year medical students at the medical faculties of MUCHS (University of Dar es Salaam), HKMU (Dar es Salaam) and KCMC (Tumaini University, Moshi campus) in Tanzania. The study found a lack of a primary interest in medicine among medical school entrants, biases in recruitment, the absence of rural-related clinical curricula in medical schools, and a preference for specialisation not available in rural areas. These were considered the main obstacles for building a motivated health workforce to help correct the inequitable distribution of doctors in the Tanzania. The study suggests that there is a need to re-examine medical school admission policies and practices.

Wrong schools or wrong students? The potential role of medical education in regional imbalances of the health workforce in the United Republic of Tanzania
Leon BK and Kolstad JR: Human Resources for Health 8(3), July 2010

This paper reviews available research evidence that links medical students’ characteristics with human resource imbalances and the contribution of medical schools in perpetuating an inequitable distribution of the health workforce. Existing literature on the determinants of the geographical imbalance of clinicians, with a special focus on the role of medical schools, is reviewed. Structured questionnaires collecting data on demographics, rural experience, working preferences and motivational aspects were administered to 130 fifth-year medical students at the medical faculties of MUCHS (University of Dar es Salaam), HKMU (Dar es Salaam) and KCMC (Tumaini University, Moshi campus) in the United Republic of Tanzania. The 130 students represented 95.6% of the Tanzanian finalists in 2005. The paper found that the lack of a primary interest in medicine among medical school entrants, biases in recruitment, the absence of rural related clinical curricula in medical schools, and a preference for specialisation not available in rural areas are among the main obstacles for building a motivated health workforce that could help correct the inequitable distribution of doctors in the United Republic of Tanzania. The paper suggests that there is a need to re-examine medical school admission policies and practices.

Zambia paralysed by by workers' strike

Some 80000 striking state workers in Zambia vowed yesterday to pursue a work stoppage which has paralysed operations in ministries and hospitals if their pay demands were not met, a trade union leader said. Zambia Congress of Trade Unions (ZCTU) deputy president Japhet Moonde said union leaders presented their demands for a 100 percent pay hike to Vice President Enos Kavindele yesterday, as the strike entered its second week.

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