Some traditional ways to determine staffing requirements include calculating population-to-staff ratios (for example, X number of nurses per 10 000 population) and facility-based staffing standards (for example, X number of nurses and Y number of doctors for a health centre). These methods, however, have serious disadvantages. They fail to take into account both the wide local variations in the demand for services and the actual work that health workers do. Health managers need a better, systematic way to make staffing decisions, if they are to manage their valuable human resources well.
On 16 – 17 August 2012, WHO introduced the Workload Indicators of Staffing Need (WISN) method to the province of Iloilo. A good mix of rural health physicians, municipal health officers and rural health nurses from different municipalities of Iloilo attended the two day training.
The WISN method is a human resource management tool that determines how many health workers of a particular type are required to cope with the workload of a given health facility. The method also include ways on how to assess the workload pressure of the health workers in the facility.
After the training, the participants can use the results of WISN to make many and yet different types of decisions, as follows:
- WISN results can help determine how best to improve current staffing situation in a health facility. You can set better priorities for allocating new staff or transferring existing staff, if you first use WISN to identify inequities in current staffing of health facilities or areas. The analysis of the workload pressure will further help you decide which health facilities should receive the highest priority. WISN can help determine the best way to allocate new functions and transfer existing functions to different health worker categories. You can decide whether the number of existing cadres should be reduced, a new staff category created or tasks shifted between cadres. You do this by reviewing the range of functions and any possible overlap in work done by the different staff categories for which the WISN results have been calculated. WISN calculations are based on current professional standards for performing a particular component of work. Thus, they allow you to see the facilities that have low professional performance currently, compared with other facilities. By using improved professional standards in the WISN calculations, you can calculate how many extra staff you would require in a particular cadre to achieve these new standards. Yyou can use WISN to plan future staffing of health facilities. Instead of current workload data, in the WISN calculations you can use data on anticipated workloads of planned future services. This allows you to calculate how many health workers of a particular type you would require to deliver such future services. You can use WISN to examine the impact of different conditions of employment on staff requirements.