Determining Healthcare Workforce Requirements for Kuluva Hospital in West Nile-Uganda, using the Workload Indicators of Staffing Need (WISN)

Abstract

Health workforce shortage is a major threat to global public health with a greater implication for low resourced countries. The right placement of the available staff in many health facilities remains a challenge due to inadequate information on exact workload and work pressure that staff undergo in course of work. This study aimed to determine the need for key health workforce cadre in Kuluva hospital using Workload Indicators of Staffing Need (WISN) methodology.

The study followed a predominantly quantitative approach of Workload Indicator Staffing Needs (WISN) methodology. We held a meeting with hospital management to understand policy issues and procedures. The key staff were interviewed in departments, available records reviewed, practices observed to establish the available working time, activity standards and time taken to perform other supportive activities. Service statistics was generated from HMIS data of 2016/17. Data was analyzed manually using calculator and Microsoft Excel spreadsheet.

All cadre categories had the same available working time of 1,504 hours in a year with 105 staff of the studied cadres required to perform all activities in Kuluva hospital based on WISN calculation. Although overall work pressure was 30%, 5 out of 7 staff cadre categories experienced work pressure of varying degrees – medical officers (70%), laboratory staff (70%) and clinical officers (60%) were most affected compared to nurses (30%) and midwives (10%). There was perfect number of anesthetists but surplus nursing assistants than needed by the hospital. Amidst shortage, the critical cadres still spent significant time on non-professional activities; medical officers (24%) and midwives (25%).

These findings can provide insight into the management of Kuluva hospital to address the current disparities in the health workforce in terms of numbers and skill mix for continuous improvement of health service delivery to the population it serves.