INTRODUCTION TO WORKFORCE
PLANNING
HR Planning
Gains
Training
Schools
In-migration
Transfers
from other
sectors
Health
Workforce
Change
profession
Retirement
Death
Disablement
Out
Migration
Transfer to
Other sectors
Losses
AIDS
2
HR Planning Methodology
Ratios –limited broad application
Health Facility Staffing- define number and type of staff per facility
serving a defined population
Dewdney Model – practical in places where information is limited.
Uses simple spreadsheets
Hall Model – complex computer model, required intensive training. Can
only be used in countries where there is easily obtainable national data
and statistics
Workload Indicators for Staffing Needs (WISN) – useful
and can be used to identify requirements for individual
facilities
3
Forecasting to improve performance
• What factors determine workload?
• How can staff performance be measured?
• How to forecast numbers of posts required in
the future
5
Take into Account the prevailing External
Labour Market
•
•
•
•
Unemployment Levels
Competition with other employers
Output from training
Local living conditions/cost of living
6
Recruitment and Selection
• Job descriptions
• Objective recruitment and selection process
• Ensuring the most appropriately trained and
experienced person is selected
7
Other Methods of Filling Posts
•
•
•
•
•
Reallocation of duties
Transfer of posts
Redeployment
Outsourcing
Appointment of a previously identified
successor
8
The 3 Dangers in Personnel
Management!!!
Discrimination
Nepotism
Corruption
9
Practical Approach to Planning your
Workforce
1. Find out what you have
•
Survey - a snapshot only is not useful for dynamic
planning and management
•
Registration of Health workers and development of
a personnel records system that contains ALL the
data required for all purposes in the health system
Who Needs HR Data
• Health Management Information System - only requires
3 or 4 quantitative data fields (e.g. Profession, place of work, facility
where working)
• Personnel Administration/Civil Service – requires data for
personnel administration only (e.g. Name, age, profession, post,
grade/ eschelon, salary grade and incremental level etc.)
• HRD Planning and Management – requires both quantitative
and qualitative data (all the above data + details of educational
level , professional qualifications, in-service training, work history
etc)
• Professional Associations – Membership data
• Survey of different HR information
systems in Indonesia
Managing the HR Data
• Data can be maintained in manual personnel record files
• Can be maintained in a computerised system (e.g. Access
Database or SQL) which is set up to export certain fields
as required by particular users (e.g. The 3 or 4 data fields
for Health MIS; data to civil service database)
• HR Information systems are completely
useless if they are not updated and
maintained.
Putting it all together – NATIONAL
AND REGIONAL WORKFORCE
PLANNING
Dewdney Workforce Planning Methodology
• Uses Spreadsheets
• Incorporates all aspects required for planning
• Can start with limited data and as clearer data is
available it can be entered and data modified
• Can generate workforce projections
• Can estimate costs of what is planned
• Is a Rolling plan
Facility Based Workforce Planning
Workload Indicators for Staffing Needs (WISN)
is a practical method to assess staffing needs
based on the actual work that health workers
do (their workload)
Can be applied to all personnel categories
-medical staff
-paramedical staff
- non medical staff
Steps of WISN
Step 1. Decide WISN target Group
HRH category
Type of Facility
Geographic Area
e.g. Nurse at health centre level in a particular region
- Cont WISN Steps
Step 2.
Estimate Working Time
Count annual working days.
Estimate days for vacation, public holidays, other
annual leave and absence days per year
Deduct days off from annual working days.
e.g.
There are 260 working days in a year.
A health centre nurse has 40 days off, so she works 220
days in a year.
-cont WISN Steps
Step 3. Define Components of Work
Define the main activities of the HRH category
E.g.
Health Centre nurse has the following main activities:
In-patients
Out Patients
Out reach to health posts
-cont WISN STEPS
Step 4. Activity Standards
Activity Standard:
The time it takes a well trained well-motivated
member of a particular staff category to perform the
action to acceptable professional standards in the
circumstances of the country.
- Cont WISN steps
Two Types of Activity Standards
- Service Standards
- Allowance Standards
- These are used differently in calculating the
final HRH requirements
Service Standards
For activities that are reported in annual service
statistics
Eg.
- Inpatients
- Outpatients
Shown as a unit time or rate of working
Eg.
- 15 minutes per patient or
- 30 patients per day
Allowance Standards
For activities that are NOT reported in annual
statistics
e.g.
- Recording and reporting
- Attending meetings
- Attending training courses
- Providing training
Shown as % of working time or actual working time
e.g.
- 10% of working time
- One hour per day
Step 5. Calculate Standard workloads
Standard workload:
Amount of work (within one activity) that one
person could do in a year
Step 5 Calculate Standard Workloads -continued
• I expressed as a unit of time for the activity:
Std workload = Available working time in a year
Unit time for the activity
• If expressed as rate of working:
Std workload = Rate x Available working time in a year
Step 6: Calculate Allowance Factors
Two types calculated from Allowance Standards
Category Allowance Factor
Applies to all workers in a particular category
e.g.
all nurses in a health centre
Individual Allowance Factor
Applies to a fixed number of workers in a particular
category
e.g.
Only the nurse in charge
Step 7: Calculate the required HRH
Divide annual service statistic by the Standard workload (for each activity)
Add together HRH requirements of all activities
Apply Category Allowance Factor (formula)
Add Individual Allowance Factor(s) (whole time equivalent)
Using WISN Results
Two kinds of comparisons:
Difference between actual and required number of HRH
Shows level of shortage or surplus of HRH
Ratio of actual to required number of HRH (WISN ratio)
Shows the amount of pressure which HRH category works under
WISN ratio = 1: HRH sufficient
WISN ratio less than 1: HRH NOT sufficient
WISN ratio greater than 1: More than enoughtstaff
Example from Indonesia
WISN calculation for TTS district
Health
centre
Current Req. Diff Problem WISN Pres
MW
ratio sure
MW
OverBatu purih
8
7
+1
1.1
No
staffed
Fatumnasi
5
5
0
Nulle
16
10
+6
Niki-niki
13
16
-3
Ayotupas
2
5
-3
Overstaffed
Understaffed
Understaffed
1.0
No
1.6
No
0.8
Low
0.4
Very
high
28
Requirements to Implement WISN
• Steering Committee (SC)of decision makers
who review Activity and Allowance Standards
and consider WISN results for management
action.
• Task Force (TF) of experienced competent
professionals from the category, facility and
level being addressed by WISN who
implement and can train in the methodology
Questions for SC to raise with the TF
• If a facility is overstaffed:
• Why ? Is it underused?
• How does it engage with the community?
• Are there other services which can be offered
for which excess staff can be used?
Questions for SC to raise with the TF
• If a facility is understaffed
•
•
•
•
Why is this happening?
Is it under pressure?
Will it affect service quality?
Can main and supporting activities be made more
proportional?
• Is there duplication of work between the different categories
of professions?
• Is there any category of health worker undertaking work for
which they have not been trained?
ESSENTIAL LINKAGES
• Health system defined Essential Package of
Health Services (EHPS)S through a
decentralised health delivery system
• What kind of health workers are required and
how many?
• Are the training institutions producing the
product and numbers required for the EPHS?
• A CHW or an auxillary nurse may be
considered by isolated communities to be
“doctors” and are better trusted by that
community than a doctor or a registered
nurse posted from the capital.
• How do health workers serve nomadic
populations as well as fixed populations?
• Is the role of HWs to “sit and wait” in the
health facility or to do outreach?
• What is the scope of practice of a
nurse/midwife working in an area where no
doctor will go?
• What is the scope of practice of an auxillary
working in a community where no nurse or
doctor will go?
• If the scope of practice is defined -- have they
been trained to undertake this role??