Browsing by Author "Mugisha John Francis"

Now showing 1 - 4 of 4

Application of workload indicators of staffing needs (WISN) in determining health workers' requirements for Mityana general hospital, Uganda
(International Journal of Public Health Research, 2015-08-30) Govule Philip ; Mugisha John Francis ; Katongole Simon Peter ; Bikaitwoha Maniple Evard ; Nanyingi Miisa ; Anguyo DDM Onzima Robert
With reducing number of health workers amidst increasing disease burden, ever increasing population and limited resources, health systems are faced with challenges of providing adequate and quality health care globally. The application of provider-population ratio or fixed staff establishments have overtime, not matched the changing human resource needs of health care organizations. This study aimed to estimate human resource requirements of Mityana hospital basing on workload as an alternative to the existing approaches. Methodology: We employed descriptive cross-sectional design and the Workload Indicator of Staffing Needs (WISN) methodology. We utilized focus group discussion, observation and document review to obtain information from key informants; generated annual service statistics from the hospital’s records. The quantitative data were analyzed using the WISN software and spread sheet. Results: All the cadres studied had the same hours of work in a year (1,664), except nursing assistants whose annual available working time was1,696 hours. All the cadres were experiencing additional workload due to use of their time for activities other than their primary duties. Medical officers used more than 50% of their time for such (non-primary) activities compared to the laboratory staff (15%). As a result, the calculated WISN staff requirements were very high compared to the existing staff levels. Mityana hospital had 44% of the posts filled for the studied cadres. The nurses and midwives had the highest calculated requirements (72 and 45 respectively) and the highest staff positions filled (57% and 84% respectively) making them experience the lowest work pressure (49% each). The highest work pressure was experienced by medical officers and medical clinical officers (82% each). Conclusion: The study reveals shortages in health workforce in Mityana hospital. Non-primary activities contributed to work pressure in different units of the hospital, resulting into long hours of shifts which could have compromised quality of health care. This method (WISN) estimates staffing requirements based on actual service provision. Stakeholders facing human resource challenges and scarcity can employ it in prioritizing health cadres for recruitment and deployment based on existing work pressure.
The Challenges of Managing Government-seconded Health Workers in Private Not-for-profit Health Facilities of Kibaale District, Uganda
(Uganda Martyrs University Press, 2008-12) Bikaitwoha Everd Maniple; Barugahara Peter; Mugisha John Francis
Private health care providers are an important component of pluralistic national health systems. In Uganda, the public-private partnership for health (PPPH) has led to the government assisting the private health sector in various ways, in recognition of and support to their work. Apart from financial assistance, the government deploys civil servants to work in private-not-for-profit (PNFP) health facilities. Such government-seconded health workers are recruited, deployed and paid by the government but they work under the management of the PNFP health units. In the rural and remote district of Kibaale in mid-western Uganda, government-seconded health workers form 48% of the key professional staff in PNFP health services. However, government secondment raises a number of important managerial and human resource challenges. PNFP health care managers have some workers over whom they do not have full authority and control. The seconded workers have to serve two authorities and satisfy them equally. This cross-sectional descriptive study aimed at identifying the problems arising from this kind of relationship in a district where PNFP health units are heavily dependent on governmentseconded personnel, and how such problems may be addressed. It was found that there is unequal treatment of seconded and non-seconded staff, with the former receiving better pay, and having more professional management than the latter. However, they felt there was too much workload in PNFP units compared to government and were not comfortable with the PNFP prohibition of private practice. In addition, they felt that they were not trusted by the PNFP managers and that they had limited or no opportunities for career development and further studies. PNFP managers felt they had no control over seconded staff and felt that they have no possibility to participate in the selection of staff to be seconded to their units. As a result, seconded staff were perceived to have no commitment to work in PNFP units, and to be prone to absenteeism, illegal private practice, demand for big financial allowances, abrupt attrition and pilferage of health care supplies. This paper proposes quick enactment of the PPPH policy to define the relationship between the public and the private sectors. It also proposes that the government gives unconditional funding to the PNFP facilities on a contractual basis, and only demands for accountability on agreed outputs. This would facilitate the PNFP managers to recruit their own staff and endeavour to attain the agreed outputs.
Perceptions of Health Workers and Managers on the Use of Non-Monetary Human Resource Motivation Tools in General Hospitals of Central Uganda
(Open Science, 2015-08-30) Katongole Simon Peter; Mugisha John Francis; Anguyo Robert; Bikaitwoha Everd Maniple; Wampande Lillian Nantume
World over, there is a driving force to create a health care workplace that motivates, maintains and obtains the best out of health workers. In order to achieve this, non-monetary tools can be employed by health managers in hospital settings. Therefore, a study was carried out in six Ugandan general hospitals to establish the perceptions of health workers on the use of non-monetary human resource motivation tools and to examine the contribution of these tools to employees’ motivation. A cross-sectional qualitative study was employed. Key informant interviews with three District Health Officers and 15 top hospital managers were conducted. Six focus group discussions, one in each hospital where also conducted with participating health workers derived from professional groups such as medical officers, enrolled/registered midwives and nurses and allied health professionals. Health workers were interviewed on prevailing practice, adequacy, experience, functioning and views on core non-monetary human resource motivation tools such as training, supervision, performance assessments, and management. Critical incidents were nonmonetary human resource motivation tools had influenced the motivation of some health workers were identified. The use of core non-monetary human resource tools such as continuous medical education, communication between health workers, taking part in decisions of the hospital and organizing social functions were well perceived by the respondents. Promotion of health workers, recognizing best performers, supervision, training and workshops were not well perceived. Health workers were mainly: motivated by the good work relationships and they were mainly demotivated by the poor working conditions. There is a need to have urgent attention on factors which seem to affect the effective use of the non-monetary human resource tools. The factors include; improving working conditions and staffing to reduce workload and avail enough resources to the workers to be motivated carry out their work.
Unrest Over Health Sector Remuneration: What is the Problem?
(Uganda Martyrs University, Department of Health Sciences, 2003-12) Mugisha John Francis
Employee unrest over remuneration in the Ugandan health sector is an old problem. Although salaries have been increasing since 1990, the country has witnessed more strikes in this period than before. In fact, one has the impression of a constantly looming strike by the health workers over poor remuneration. The salary is still meagre when compared to the cost of living. But I will also argue that the cause of pay unrest is associated with lack of pay policy and proper job evaluation. I will demonstrate that government has largely managed salaries by crisis –mainly responding to emerging complaints. Although remuneration refers to all forms of employee reward, here it will simply mean salary because of the notion of “consolidated pay package” in the Uganda public service. And although I am aware of its wide definition, I will use the term “health sector” to mean public departments that are financed and, or regulated by the Ministry of Health, for the purpose of this presentation.