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Determining the right number and skill mix of health professionals is one of the critical components for successful and efficient health care delivery. However, in many developing countries including Ethiopia the staffing norms are established by using institutional size with no consideration to variation in workload among facilities which might result from location and accessibility of the facility, health seeking behavior, morbidity pattern, quality of services and other related factors.
Analysis Design and Methods
The approach that has been adopted to replace the existing institution based staffing norm to more efficient method of setting staffing standard is the use of Workload Indicators for Staffing Need (WISN) method. The conceptual approach behind WISN method is developed by Shipp (Shipp, 1998). The major conceptual framework adopted in this approach involves setting up Work load data and current staffing levels, setting activity standard, determining workload based requirement and finally calculating WISN ratio.
Results
For the selected HRH categories, the staffing requirement at primary and secondary facility for the health sector of Ethiopia was determined. The WISN ratio is found to be less than one for all major categories indicating staff shortage and increased burden on the existing health workforce. Marked difference in staffing requirement for similar types of facilities but located in different geographic area was observed, demonstrating the traditional staffing norm based on institution type is not efficient.
Conclusion and Recommendation
This study has demonstrated that the traditional institution based staffing norm is not efficient and countries need to adopt more efficient method for developing staffing standard. WISN is one of such tool that potentially improve efficiency in estimating the requirement and deployment of health workforce at facility level by avoiding staff overload and under-utilization of key health staff.
Learning Objectives: Discuss the approach that has been adopted to replace the existing institution based staffing norm to more efficient method of setting staffing standard is the use of Workload Indicators for Staffing Need (WISN) method.