Determining Staffing Levels and Mix of UCMB Affiliated Hospitals

Abstract

Uganda Catholic Medical Bureau (UCMB) affiliated hospitals, like many other health institutions, are stressed by limited resources and increasing costs. This calls for a need to finance the increasing costs through efficiency gains on fixed inputs. Determining optimal staffing levels and skill mix would ensure efficiency gains on personnel whose costs account for 31-65% of UCMB's total recurrent expenditure. It would also match the staffing to the workload. A descriptive cross-sectional study was carried out in four UCMB hospitals with the main objective of setting standard workloads for each staff category. The set standards would then be the basis for setting staffing norms. Results indicated a marked shortage of nursing aides, doctors and dispensers, but minimal shortage of nurses. The shortage of nursing aides resulted in both inappropriate use and increased work pressure on the nurses. Standard workloads per staff cadre per year were set as follows: 9,000 out patients to be seen by a clinician that is 37 patients per day and a dispenser to serve 10,667 out patients. On the wards, the standards were set at 8,000 inpatient days for a medical officer, 2,530 inpatient days for a nurse, 1,808 and 3,639 inpatient days for a midwife and nursing aide respectively.