PDF(Pubmed)
Abstract：
UNASSIGNED: Staffing shortages and health inequities are persistent barriers in the Philippines toward achieving universal health care. To ensure an adequate and responsive health workforce, there is a need to evaluate the Human Resources for Health (HRH) status across health facilities, particularly those in underserved communities. Hence, this study aims to determine the staffing requirements and workload pressure among primary care facilities in selected geographically isolated and disadvantaged areas (GIDAs) in the Philippines.
UNASSIGNED: The study utilized the workload indicators of staffing need (WISN) methodology from the World Health Organization to determine the staffing and workload situation among three health worker cadres (physicians, nurses, and midwives) in the study sites. Particularly, six primary care facilities (four rural health units and two community hospitals) located in Surigao del Norte were involved in the study. WISN-related data (health service statistics, available working time, and health professionals\' workload components) were collected through records review, focus group discussions, and key informant interviews. The WISN software was used to analyze the staffing levels and workload pressure in the selected facilities.
UNASSIGNED: A total of 40 health workers, including physicians (n = 5, 13%), nurses (n = 21, 52%), and midwives (n = 14, 35%) participated in the study. The findings noted varying levels of staffing and workload pressures among the three cadres in selected primary care facilities, which were influenced by several factors. Particularly, health facilities with additional human resources obtained from deployment programs indicated adequate staffing and low to normal workload pressures. However, further analysis revealed potential HRH maldistribution and reliance on the temporary nature of the staff augmentation program in delivering primary care services, which need to be addressed to optimize health workforce planning. Service workload may also have been impacted by the temporary closure of health facilities due to disasters. Among the few cadres that reported staffing shortage and high workload pressure, these were due to higher service demands, increased task delegation, and inadequate service coordination. Hence, context-specific challenges and situational factors in GIDAs need to be considered when determining the staffing and workload requirements.
UNASSIGNED: There is a need to improve the capacities of health facilities and local government units (LGUs) to engage in evidence-based HRH planning through the WISN methodology. Doing so could improve staffing and workload distribution among health care facilities in the country. Moreover, interorganizational collaboration (DOH, LGUs, and health facilities) should be strengthened to improve delineation and prevent duplication/omission of health services, rationalize HRH distribution and augmentation, and streamline the priority health services based on the local contextual factors.
UNASSIGNED: The study utilized the workload indicators of staffing need (WISN) methodology from the World Health Organization to determine the staffing and workload situation among three health worker cadres (physicians, nurses, and midwives) in the study sites. Particularly, six primary care facilities (four rural health units and two community hospitals) located in Surigao del Norte were involved in the study. WISN-related data (health service statistics, available working time, and health professionals\' workload components) were collected through records review, focus group discussions, and key informant interviews. The WISN software was used to analyze the staffing levels and workload pressure in the selected facilities.
UNASSIGNED: A total of 40 health workers, including physicians (n = 5, 13%), nurses (n = 21, 52%), and midwives (n = 14, 35%) participated in the study. The findings noted varying levels of staffing and workload pressures among the three cadres in selected primary care facilities, which were influenced by several factors. Particularly, health facilities with additional human resources obtained from deployment programs indicated adequate staffing and low to normal workload pressures. However, further analysis revealed potential HRH maldistribution and reliance on the temporary nature of the staff augmentation program in delivering primary care services, which need to be addressed to optimize health workforce planning. Service workload may also have been impacted by the temporary closure of health facilities due to disasters. Among the few cadres that reported staffing shortage and high workload pressure, these were due to higher service demands, increased task delegation, and inadequate service coordination. Hence, context-specific challenges and situational factors in GIDAs need to be considered when determining the staffing and workload requirements.
UNASSIGNED: There is a need to improve the capacities of health facilities and local government units (LGUs) to engage in evidence-based HRH planning through the WISN methodology. Doing so could improve staffing and workload distribution among health care facilities in the country. Moreover, interorganizational collaboration (DOH, LGUs, and health facilities) should be strengthened to improve delineation and prevent duplication/omission of health services, rationalize HRH distribution and augmentation, and streamline the priority health services based on the local contextual factors.
摘要：
人员短缺和卫生不平等是菲律宾实现全民医疗保健的持续障碍。确保有足够和反应迅速的卫生劳动力，有必要评估各医疗机构的卫生人力资源(HRH)状况，特别是那些服务不足的社区。因此，本研究旨在确定菲律宾选定的地理隔离和弱势地区(GIDA)的初级保健机构的人员配备要求和工作量压力.
■该研究利用世界卫生组织的工作量指标（WISN）方法来确定三名卫生工作者干部（医师，护士,和助产士)在研究地点。特别是,位于北苏里高的6个初级保健机构(4个农村卫生单位和2个社区医院)参与了这项研究.WISN相关数据(卫生服务统计，可用工作时间,和卫生专业人员的工作量构成)通过记录审查收集，焦点小组讨论,和关键线人采访。WISN软件用于分析选定设施的人员配备水平和工作量压力。
■共有40名卫生工作者，包括医生（n=5，13%），护士（n=21，52%），助产士（n=14，35％）参加了这项研究。调查结果指出，选定的初级保健设施中，三名干部的人员配备和工作量压力各不相同，受到几个因素的影响。特别是,从部署计划中获得额外人力资源的卫生设施表明，人员配备充足，工作量压力低到正常水平。然而,进一步的分析显示，在提供初级保健服务时，潜在的HRH分布不均和对员工增加计划的临时性质的依赖。需要解决这些问题，以优化卫生人力规划。服务工作量也可能受到因灾害而暂时关闭保健设施的影响。少数反映人员配备不足,工作量压力大的干部中,这些是由于更高的服务需求，增加任务授权，服务协调不足。因此，在确定人员配备和工作量要求时，需要考虑GIDA中特定环境的挑战和情况因素。
■需要提高医疗机构和地方政府部门（LGU）的能力，以通过WISN方法进行基于证据的HRH计划。这样做可以改善该国医疗机构的人员配备和工作量分配。此外，组织间协作(DOH，LGU,和卫生设施）应加强，以改善划分并防止重复/遗漏卫生服务，合理化HRH分布和增加，并根据当地的环境因素精简优先卫生服务。
■该研究利用世界卫生组织的工作量指标（WISN）方法来确定三名卫生工作者干部（医师，护士,和助产士)在研究地点。特别是,位于北苏里高的6个初级保健机构(4个农村卫生单位和2个社区医院)参与了这项研究.WISN相关数据(卫生服务统计，可用工作时间,和卫生专业人员的工作量构成)通过记录审查收集，焦点小组讨论,和关键线人采访。WISN软件用于分析选定设施的人员配备水平和工作量压力。
■共有40名卫生工作者，包括医生（n=5，13%），护士（n=21，52%），助产士（n=14，35％）参加了这项研究。调查结果指出，选定的初级保健设施中，三名干部的人员配备和工作量压力各不相同，受到几个因素的影响。特别是,从部署计划中获得额外人力资源的卫生设施表明，人员配备充足，工作量压力低到正常水平。然而,进一步的分析显示，在提供初级保健服务时，潜在的HRH分布不均和对员工增加计划的临时性质的依赖。需要解决这些问题，以优化卫生人力规划。服务工作量也可能受到因灾害而暂时关闭保健设施的影响。少数反映人员配备不足,工作量压力大的干部中,这些是由于更高的服务需求，增加任务授权，服务协调不足。因此，在确定人员配备和工作量要求时，需要考虑GIDA中特定环境的挑战和情况因素。
■需要提高医疗机构和地方政府部门（LGU）的能力，以通过WISN方法进行基于证据的HRH计划。这样做可以改善该国医疗机构的人员配备和工作量分配。此外，组织间协作(DOH，LGU,和卫生设施）应加强，以改善划分并防止重复/遗漏卫生服务，合理化HRH分布和增加，并根据当地的环境因素精简优先卫生服务。
