Browsing by Author "Namaganda Grace"

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Determining Staffing Levels and Mix of UCMB Affiliated Hospitals
(Uganda Martyrs University, Department of Health Sciences, 2004-12) Namaganda Grace
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.
Making the transition to workload-based staffing:
(BioMed Central, 2015) Namaganda Grace; Oketcho Vincent; Bakaitwoha Everd Maniple; Viadro Claire
Background: Uganda’s health workforce is characterized by shortages and inequitable distribution of qualified health workers. To ascertain staffing levels, Uganda uses fixed government-approved norms determined by facility type. This approach cannot distinguish between facilities of the same type that have different staffing needs. The Workload Indicators of Staffing Need (WISN) method uses workload to determine number and type of staff required in a given facility. The national WISN assessment sought to demonstrate the limitations of the existing norms and generate evidence to influence health unit staffing and staff deployment for efficient utilization of available scarce human resources. Methods: A national WISN assessment (September 2012) used purposive sampling to select 136 public health facilities in 33/112 districts. The study examined staffing requirements for five cadres (nursing assistants, nurses, midwives, clinical officers, doctors) at health centres II (n= 59), III (n= 53) and IV (n= 13) and hospitals (n= 11). Using health management information system workload data (1 July 2010 – 30 June 2011), the study compared current and required staff, assessed workload pressure and evaluated the adequacy of the existing staffing norms. Results: By the WISN method, all three types of health centres had fewer nurses (42 – 70%) and midwives (53 – 67%) than required and consequently exhibited high workload pressure (30 –58%) for those cadres. Health centres IV and hospitals lacked doctors (39 – 42%) but were adequately staffed with clinical officers. All facilities displayed overstaffing of nursing assistants. For all cadres at health centres III and IV other than nursing assistants, the fixed norms or existing staffing or both fell short of the WISN staffing requirements, with, for example, only half as many nurses and midwives as required. Conclusions: The WISN results demonstrate the inadequacies of existing staffing norms, particularly for health centres III and IV. The results provide an evidence base to reshape policy, adopt workload-based norms, review scopes of practice and target human resource investments. In the near term, the government could redistribute existing health workers to improve staffing equity in line with the WISN results. Longer term revision of staffing norms and investments to effectively reflect actual workloads and ensure provision of quality services at all levels is needed.
Using the workload indicator of staffing needs (WISN) methodology to assess work pressure among the nursing staff of Lacor hospital.
(Uganda Martyrs University Press, 2008-04-01) Mugisha F. John; Namaganda Grace
In their effort to provide adequate and quality health services, health systems in both developed and the developing countries have to confront the challenges of an ever increasing population with limited or diminishing resources. This includes the human resource which constitutes a major input in health care delivery and a key determinant of the cost and quality of care. There is an increasing need therefore for health organizations to identify the most appropriate staffing levels and skill mix to ensure efficient use of the limited health personnel. This paper demonstrates the use of the workload indicator of staffing needs (WISN) methodology in determining staffing requirements for the nursing staff in a hospital setting. It shows how the results can be used to assess overstaffing and understaffing as well as determine the work pressure among the different categories of nurses thus providing a basis for effective nurse redistribution to exploit efficiency gains without compromising the quality of services.