Assessing the staffing needs for primary health care centers in Cross River State, Nigeria: a workload indicators of staffing needs study.

Health workforce performance Health workforce planning Primary health care workers Workload indicators of staffing needs

Journal

Human resources for health
ISSN: 1478-4491
Titre abrégé: Hum Resour Health
Pays: England
ID NLM: 101170535

Informations de publication

Date de publication:
28 01 2022
Historique:
received: 20 08 2021
accepted: 24 08 2021
entrez: 29 1 2022
pubmed: 30 1 2022
medline: 17 3 2022
Statut: epublish

Résumé

A major human resources for health challenge for Nigeria is ensuring the availability and retention of adequate competent health workers in the right mix to provide health care particularly at primary health care facilities in remote and rural communities. This study applied the Workload Indicators of Staffing Need (WISN) method to determine the numbers of nurses, midwives, community health officers (CHOs), community health extension workers (CHEWs), and junior community health extension workers (JCHEWs) required to cope with health care service delivery at primary health care facilities in Cross River State; compare workloads of different cadres at selected health facilities, and identify facilities with highest workload pressure. Cross River State in Nigeria has 18 local governments, 196 wards, and an estimated population of over three million people. We used the WISN method to estimate the numbers of nurses/midwives, CHOs/CHEWs, and JCHEWs required to cope with the workload in the 196 ward-level primary health care facilities. Basic services provided by nurses/midwives, and CHOs/CHEWs were typical of the primary health care level. They are antenatal care, routine immunization, child welfare clinic, family planning, treatment of minor ailments, assisted and normal deliveries, postnatal care, emergencies, care of tuberculosis patients, and referrals. Findings show that available nurses/midwives for the 196 PHC facilities were 79, and the calculated requirement was 209, WISN ratio of 0.4 and difference of - 130; the existing number of CHOs/CHEWs was 808, the calculated requirement was 1,258, WISN ratio of 0.6, with a difference of - 450; and the number of existing JCHEWs was 258, the calculated requirement was 203, WISN ratio of 1.3 with a difference of 55. Cross River State had only 40% of required nurses and midwives; and 60% of CHOs/ CHEWs needed to provide health services in the ward-level PHC facilities. The findings from this study indicated marked shortages of needed health workforce particularly nurses and midwives at the primary level of care; and overlap in some of the tasks performed by nurses/midwives, CHO/CHEWs, and JCHEWs.

Sections du résumé

BACKGROUND
A major human resources for health challenge for Nigeria is ensuring the availability and retention of adequate competent health workers in the right mix to provide health care particularly at primary health care facilities in remote and rural communities. This study applied the Workload Indicators of Staffing Need (WISN) method to determine the numbers of nurses, midwives, community health officers (CHOs), community health extension workers (CHEWs), and junior community health extension workers (JCHEWs) required to cope with health care service delivery at primary health care facilities in Cross River State; compare workloads of different cadres at selected health facilities, and identify facilities with highest workload pressure.
METHODS
Cross River State in Nigeria has 18 local governments, 196 wards, and an estimated population of over three million people. We used the WISN method to estimate the numbers of nurses/midwives, CHOs/CHEWs, and JCHEWs required to cope with the workload in the 196 ward-level primary health care facilities.
FINDINGS
Basic services provided by nurses/midwives, and CHOs/CHEWs were typical of the primary health care level. They are antenatal care, routine immunization, child welfare clinic, family planning, treatment of minor ailments, assisted and normal deliveries, postnatal care, emergencies, care of tuberculosis patients, and referrals. Findings show that available nurses/midwives for the 196 PHC facilities were 79, and the calculated requirement was 209, WISN ratio of 0.4 and difference of - 130; the existing number of CHOs/CHEWs was 808, the calculated requirement was 1,258, WISN ratio of 0.6, with a difference of - 450; and the number of existing JCHEWs was 258, the calculated requirement was 203, WISN ratio of 1.3 with a difference of 55. Cross River State had only 40% of required nurses and midwives; and 60% of CHOs/ CHEWs needed to provide health services in the ward-level PHC facilities.
CONCLUSION
The findings from this study indicated marked shortages of needed health workforce particularly nurses and midwives at the primary level of care; and overlap in some of the tasks performed by nurses/midwives, CHO/CHEWs, and JCHEWs.

Identifiants

pubmed: 35090481
doi: 10.1186/s12960-021-00648-2
pii: 10.1186/s12960-021-00648-2
pmc: PMC8796321
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

108

Subventions

Organisme : World Health Organization
ID : 001
Pays : International

Informations de copyright

© 2021. The Author(s).

Références

Bull World Health Organ. 2010 Oct 1;88(10):777-82
pubmed: 20931063
Int J Qual Health Care. 2013 Oct;25(5):497-504
pubmed: 23959955
Hum Resour Health. 2018 Sep 24;16(1):50
pubmed: 30249253
Educ Health (Abingdon). 2006 Nov;19(3):385-7
pubmed: 17178522
Lancet. 2007 Apr 21;369(9570):1373-1378
pubmed: 17448824
Hum Resour Health. 2014 Jun 17;12:35
pubmed: 24938460
Hum Resour Health. 2013 Dec 10;11:64
pubmed: 24325763
Hum Resour Health. 2018 Aug 23;16(1):42
pubmed: 30139364
Glob Health Res Policy. 2019 Dec 6;4:35
pubmed: 31844681

Auteurs

S C Okoroafor (SC)

World Health Organization Country Office for Nigeria, Abuja, Nigeria. okoroafors@who.int.

A Ahmat (A)

World Health Organization Regional Office for Africa, Brazaville, Congo.

M Osubor (M)

Global Affairs Canada, Abuja, Nigeria.

J Nyoni (J)

World Health Organization Regional Office for Africa, Brazaville, Congo.

J Bassey (J)

Cross River State Ministry of Health, Calabar, Nigeria.

W Alemu (W)

World Health Organization Country Office for Nigeria, Abuja, Nigeria.

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