Applying the workload indicators of staffing need (WISN) method in Namibia: challenges and implications for human resources for health policy

Abstract

IntroductionAs part of ongoing efforts to restructure the health sector and improve health care quality, the Ministry of Health and Social Services (MoHSS) in Namibia sought to update staffing norms for health facilities. To establish an evidence base for the new norms, the MoHSS supported the first-ever national application of the Workload Indicators of Staffing Need (WISN) method, a human resource management tool developed by the World Health Organization.ApplicationThe WISN method calculates the number of health workers per cadre, based on health facility workload. It provides two indicators to assess staffing: (1) the gap/excess between current and required number of staff, and (2) the WISN ratio, a measure of workload pressure. Namibian WISN calculations focused on four cadres (doctors, nurses, pharmacists, pharmacy assistants) and all four levels of public facilities (clinics, health centers, district hospitals, intermediate hospitals). WISN steps included establishing a task force; conducting a regional pilot; holding a national validation workshop; field verifying data; collecting, uploading, processing, and analyzing data; and providing feedback to policy-makers.ChallengesThe task force faced two challenges requiring time and effort to solve: WISN software-related challenges and unavailability of some data at the national level.FindingsWISN findings highlighted health worker shortages and inequities in their distribution. Overall, staff shortages are most profound for doctors and pharmacists. Although the country has an appropriate number of nurses, the nurse workforce is skewed towards hospitals, which are adequately or slightly overstaffed relative to nurses’ workloads. Health centers and, in particular, clinics both have gaps between current and required number of nurses. Inequities in nursing staff also exist between and within regions. Finally, the requirement for nurses varies greatly between less and more busy clinics (range = 1 to 7) and health centers (range = 2 to 57).Policy implicationsThe utility of the WISN health workforce findings has prompted the MoHSS to seek approval for use of WISN in human resources for health policy decisions and practices. The MoHSS will focus on revising staffing norms; improving staffing equity across regions and facility types; ensuring an appropriate skill mix at each level; and estimating workforce requirements for new cadres.

Perencanaan Tenaga Teknis Kefarmasian Berdasarkan Analisis Beban Kerja Menggunakan Metode WISN di RSIA KM

“…Metode Workload Indicators of Staffi ng Need (WISN) diyakini bersifat dinamis dan berguna untuk mendukung manajer dan pengambil keputusan untuk meningkatkan kualitas Sumber Daya Manusia dan keseimbangan tenaga kerja. (McQuide et al, 2013). Pengelolaan sumber daya manusia diperlukan guna mencapai tujuan organisasi serta untuk memperoleh jenis dan jumlah tenaga kerja sesuai dengan kebutuhan organisasi (Dessler, 2003).…”

“…Stres sebagai akibat ketidakserasian emosi, hubungan manusia dalam pekerjaan yang kurang baik, rangsangan atau hambatan psikologis, sosial, dan lainnya yang dapat menyebabkan terjadinya gangguan kesehatan dan tidak produktifnya tenaga kerja (Yudatama & Haksama, 2014). Proses Workload Indicators of Staffing Need (WISN) mengukur serangkaian aktivitas pegawai, dilaksanakan secara fl eksibel dan didesain agar sesuai dengan tujuan (McQuide et al, 2013).…”

“…Metode Workload Indicators of Staffi ng Need (WISN) dapat digunakan untuk meningkatkan kualitas data beban kerja, sehingga metode tersebut mendukung pembuat kebijakan untuk dapat mempertimbangkan dampak dari keputusan kebutuhan pegawai (McQuide et al, 2013). Berdasarkan hasil perhitungan Workload Indicators of Staffing Need (WISN), untuk mencapai nilai maksimal dan pemenuhan tenaga kerja sesuai dengan beban kerja, maka diperlukan rekrutmen tenaga baru sejumlah 4 orang.…”

An economic-research-based approach to calculate community health-staffing requirements in Xicheng District, Beijing

“…The method has previously been used in Tanzania, Namibia, and elsewhere. The problem with the WISN approach is the static and narrowly focused model underlying the WHO approach [20, 25]. …”

Workload assessment on foundry SME to enhance productivity using full time equivalent

“…Meanwhile, the study of physical workload for laundry worker using cardio vascular load method has been discussed by Sari [9]. Research regarding workload using workload indicators of staffing need (WISN) in Namibia [10], WISN in staffing nurse [11], also WISN Method for staffing in family health care [12] . Furthermore, research related workload and foundry has been conducted by Sharma & Singh [13], regarding work-related musculoskeletal disorders, job stressors and gender responses in foundry industry.…”