Human Resource Challenges in Egypt Egypts Health reforms in hospitals and the Family Health Model require changes in staff skills and mix. Workforce distribution poorly allocated: Between urban and rural areas Between primary, secondary, and tertiary care Among different specialties New management skills due to increasing complexity of health systems. The need for linking training programs to actual staffing needs. 5
Development and Application of Workforce Planning Model in Egypt
Objectives of our Work Identify a good methodology to plan the number and type of staff needed Build MOHP capacity in workforce planning Develop Egyptian standards for Health Workforce Develop a strategy report on long-term MOHP workforce plan 7
What is the Workload Indicators of Staffing Need (WISN) Model? The Health Systems 20/20 adapted the World Health Organizations Workload Indicators of Staffing Need (WISN) methodology to the Egyptian context. The method uses expert-generated activity standards and the observed volume of services at a hospital to estimate numbers of workers needed. 8
11 WISN Results in two Fifty-bed Hospitals Source: S. Ozcan et al. 1998. Determining hospital workforce requirements: a case study. Human Resources for Health Development Journal (HRDJ) Vol. 3 No. 3
Workforce Planning Model Determines staff requirements based on actual Workload or Service Volume 12
13 Expert Opinion Panel Local Labor/HR Laws Facility Records 1. Clinical & nonclinical activities of heath workers (e.g., Outpatient exam., admin., training) 1. Clinical & nonclinical activities of heath workers (e.g., Outpatient exam., admin., training) 2. Activity standards (Time per activity) 2. Activity standards (Time per activity) 3. Total available working hours 3. Total available working hours 5. Actual workload or annual service volume (e.g., no. of patients, surgeries, admission,..) 5. Actual workload or annual service volume (e.g., no. of patients, surgeries, admission,..) 4. Standard workload 6. Staffing Needs or Number of Workers Required (R) 6. Staffing Needs or Number of Workers Required (R) 8. Workforce Ratio 7. Workforce Gap Workforce Planning Model in Egypt
Activity Standards What are Activity Standards? Time it takes a trained and well-motivated staff member to perform the action to acceptable professional standards in the circumstances of the country. 14
Challenges with ROUTINE DATA MOHP lacks personnel database Patient registration and records are incomplete Lack of activity standards for health services Inconsistencies between reported and actual workload Data on severity and case mix are absent or inaccurate Necessary to do: Data collection Special studies Estimates 27
Challenges with POLICIES & ORGANIZATION Top-down assignment of staff Current policies E.g. minimum staff required even if workload is zero! To maximize benefit of workforce planning need: HR strategy Institutional home Steering committee to engage policy makers 28
Results of Workforce Assessment in one of the Pilot Governorates 29 Example of Egypt Workforce Analysis Results
Other Staff Requirements Staff TypeCurrentRequiredGAPRatio Dentists9245472.0 Pharmacists2871171702.5 Admin Staff170711285791.5 Medical Technicians Dentistry7310637.3 Lab.10749582.2 Radiology2211620513.8 40
41 Next Steps Application in primary health care facilities (PHCs), other type of hospitals and other sectors. Designing training programs in response to actual staffing needs. Using results of workforce assessment as a basis for developing workforce plans. The workforce standards should be officially adopted by the MOHP.
42 Conclusions An effective, valid workforce planning model was developed for the Egyptian context. The model quantified the magnitude of staff imbalances by governorate, specialty, and staff category. Implications Policies are needed to close the gaps observed between the need for and supply of health workers for all levels of service provision.