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Workloads and activity standards for integrated health service delivery: insights from 12 countries in the WHO African region

Over the past decade, many African countries have made progress not only in recruiting more health workers but also in rationalising their distribution and establishing evidence-based staffing norms and standards. Still, staffing of health facilities remains inadequate, unrelated to needs and the ac...

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Autores principales: Ahmat, Adam, Millogo, Jean Jacques Salvador, Illou, Mourtala Mahaman Abdou, Maritza, Titus, Bamogo, Francis, Okoroafor, Sunny C, Nyoni, Jennifer, Asamani, James Avoka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9109045/
https://www.ncbi.nlm.nih.gov/pubmed/35589143
http://dx.doi.org/10.1136/bmjgh-2022-008456
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author Ahmat, Adam
Millogo, Jean Jacques Salvador
Illou, Mourtala Mahaman Abdou
Maritza, Titus
Bamogo, Francis
Okoroafor, Sunny C
Nyoni, Jennifer
Asamani, James Avoka
author_facet Ahmat, Adam
Millogo, Jean Jacques Salvador
Illou, Mourtala Mahaman Abdou
Maritza, Titus
Bamogo, Francis
Okoroafor, Sunny C
Nyoni, Jennifer
Asamani, James Avoka
author_sort Ahmat, Adam
collection PubMed
description Over the past decade, many African countries have made progress not only in recruiting more health workers but also in rationalising their distribution and establishing evidence-based staffing norms and standards. Still, staffing of health facilities remains inadequate, unrelated to needs and the actual workloads of health facilities. Several countries in Africa applied the workload indicators of staffing need (WISN) method to address these issues. The WISN method is a facility and cadre-oriented human resource planning and management tool that enables health managers to determine the appropriate number of health workers required to deliver quality health services based on workload. In this paper, we synthesised and presented the workload components and activity standards of the health service activities for general medical practitioners, nurses and midwives in primary healthcare settings based on WISN studies conducted in 12 African countries. The workload components and activity standards were synthesised based on the time taken for each health service activity, with the minimum and maximum unit of time and the mean and median of the number of observations established. For general medical practitioners, minimal variations in the country estimations for discharging patients, referrals and emergency management presented large variations in recorded admissions, minor operations and ward rounds. The variations in service standards for nurses were minimal for 8 of 11 activities while the time spent on counselling, patient referral activities, review consultation varied greatly. For the midwives, the mean values and the median values for 10 of 14 activities were similar for the countries with wide variations observed for admission for pregnant mothers, monitoring of labour, family planning (insertion), postnatal care, normal delivery and immediate postnatal care. We also shared experiences in workload component and activity standard setting processes and considerations for practice. The findings of this synthesis are helpful to countries in defining health service activities and service standards for general medical practitioners, nurses and midwives in the primary level of care, which is relevant in essential service package delivery towards improved access to quality health services.
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spelling pubmed-91090452022-05-27 Workloads and activity standards for integrated health service delivery: insights from 12 countries in the WHO African region Ahmat, Adam Millogo, Jean Jacques Salvador Illou, Mourtala Mahaman Abdou Maritza, Titus Bamogo, Francis Okoroafor, Sunny C Nyoni, Jennifer Asamani, James Avoka BMJ Glob Health Practice Over the past decade, many African countries have made progress not only in recruiting more health workers but also in rationalising their distribution and establishing evidence-based staffing norms and standards. Still, staffing of health facilities remains inadequate, unrelated to needs and the actual workloads of health facilities. Several countries in Africa applied the workload indicators of staffing need (WISN) method to address these issues. The WISN method is a facility and cadre-oriented human resource planning and management tool that enables health managers to determine the appropriate number of health workers required to deliver quality health services based on workload. In this paper, we synthesised and presented the workload components and activity standards of the health service activities for general medical practitioners, nurses and midwives in primary healthcare settings based on WISN studies conducted in 12 African countries. The workload components and activity standards were synthesised based on the time taken for each health service activity, with the minimum and maximum unit of time and the mean and median of the number of observations established. For general medical practitioners, minimal variations in the country estimations for discharging patients, referrals and emergency management presented large variations in recorded admissions, minor operations and ward rounds. The variations in service standards for nurses were minimal for 8 of 11 activities while the time spent on counselling, patient referral activities, review consultation varied greatly. For the midwives, the mean values and the median values for 10 of 14 activities were similar for the countries with wide variations observed for admission for pregnant mothers, monitoring of labour, family planning (insertion), postnatal care, normal delivery and immediate postnatal care. We also shared experiences in workload component and activity standard setting processes and considerations for practice. The findings of this synthesis are helpful to countries in defining health service activities and service standards for general medical practitioners, nurses and midwives in the primary level of care, which is relevant in essential service package delivery towards improved access to quality health services. BMJ Publishing Group 2022-05-13 /pmc/articles/PMC9109045/ /pubmed/35589143 http://dx.doi.org/10.1136/bmjgh-2022-008456 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Practice
Ahmat, Adam
Millogo, Jean Jacques Salvador
Illou, Mourtala Mahaman Abdou
Maritza, Titus
Bamogo, Francis
Okoroafor, Sunny C
Nyoni, Jennifer
Asamani, James Avoka
Workloads and activity standards for integrated health service delivery: insights from 12 countries in the WHO African region
title Workloads and activity standards for integrated health service delivery: insights from 12 countries in the WHO African region
title_full Workloads and activity standards for integrated health service delivery: insights from 12 countries in the WHO African region
title_fullStr Workloads and activity standards for integrated health service delivery: insights from 12 countries in the WHO African region
title_full_unstemmed Workloads and activity standards for integrated health service delivery: insights from 12 countries in the WHO African region
title_short Workloads and activity standards for integrated health service delivery: insights from 12 countries in the WHO African region
title_sort workloads and activity standards for integrated health service delivery: insights from 12 countries in the who african region
topic Practice
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9109045/
https://www.ncbi.nlm.nih.gov/pubmed/35589143
http://dx.doi.org/10.1136/bmjgh-2022-008456
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