埃塞俄比亚西北部阿斯拉德·泽武德纪念医院助产士规划与评估的人员需求工作量指标（WISN）方法
Workload Indicators of Staffing Need (WISN) Method for Midwives Planning and Estimation at Asrade Zewude Memorial Primary Hospital, North west Ethiopia.
作者信息
Asres Gizew Dessie
机构信息
Hospital Performance Monitoring and Evaluation Team Leader, Asrade Zewude Memorial Primary Hospital, Bure, Amhara Region Ethiopia.
Licensed Consultant on Health and Health Helated Issues, Gizew Pharmacy, Bure, Amhara Region Ethiopia.
出版信息
Discov Health Syst. 2023;2(1):1. doi: 10.1007/s44250-022-00013-7. Epub 2023 Jan 10.
BACKGROUND
Workforce is a crucial component of the health service delivery system. Ethiopia faces health workforce challenges when it comes to evidence based health workforce planning.Workforce planning was initially determined by comparing the health worker ratio to the general population number. Later, it was determined by standard staffing schedules for each health facility level. However, neither of these methods addressed the evidence based workload variation issue among the same level facilities all around the country. A workload indicator of staff needs (WISN) method can address these variations. Therefore this research was carried on to determine workload pressure excess or gap in midwives, thereby to promote the WISN use in health facilities, based on WISN results of midwives at Asrade Zewude memorial Hospital.
METHODS
A cross sectional study using WISN model was used to determine the workload excess and gap pressure in midwives at Asrade Zewude Memorial primary hospital, North West Ethiopia. Midwives were selected based on a priority point scale as outlined in the WISN method.
RESULTS
According to the data obtained, midwives worked five days a week and 1030 h per year. This working time was spent on health service activities (58.4%), additional activities (36.6%) and support activities (5%). WISN calculations demonstrated a shortage of five midwives with WISN ratio of 0.8 at Asrade Zewude Memorial primary hospital North West Ethiopia.
CONCLUSION
Midwives at the study area were carrying on their routine tasks even though there was a staff gap of 5: thus, the midwives had a workload excess of 20%. Under these conditions, it may be hard for the facility to achieve universal health service goals. Therefore the hospital should institutionalize WISN method planning to objectively employ midwifery professionals. This study had limitations too as it used retrospective annual service statistics and small sample size which affects generalization of the results to other health facilities and other health worker cadres within the study hospital.
背景
劳动力是卫生服务提供系统的关键组成部分。埃塞俄比亚在基于证据的卫生人力规划方面面临卫生人力挑战。卫生人力规划最初是通过比较卫生工作者与总人口数量的比例来确定的。后来，它是由每个卫生设施级别的标准人员配置表来确定的。然而，这两种方法都没有解决全国同一级别设施之间基于证据的工作量差异问题。工作人员需求工作量指标（WISN）方法可以解决这些差异。因此，本研究基于阿斯拉德·泽武德纪念医院助产士的WISN结果进行，以确定助产士的工作量压力过剩或差距，从而促进WISN方法在卫生设施中的应用。
方法
采用横断面研究，使用WISN模型来确定埃塞俄比亚西北部阿斯拉德·泽武德纪念医院助产士的工作量过剩和差距压力。助产士是根据WISN方法中概述的优先点量表选择的。
结果
根据获得的数据，助产士每周工作五天，每年工作1030小时。这些工作时间用于卫生服务活动（58.4%）、额外活动（36.6%）和支持活动（5%）。WISN计算表明，埃塞俄比亚西北部阿斯拉德·泽武德纪念医院短缺五名助产士，WISN比率为0.8。
结论
尽管存在5名工作人员的差距，但研究区域的助产士仍在执行日常任务；因此，助产士的工作量过剩20%。在这些情况下，该设施可能难以实现全民健康服务目标。因此，医院应将WISN方法规划制度化，以客观地聘用助产专业人员。本研究也有局限性，因为它使用了回顾性年度服务统计数据和小样本量，这影响了将结果推广到其他卫生设施以及研究医院内的其他卫生工作者类别。
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