Abstract:
Background: There is an increasing demand for quality health care in the face of limited resources. With
the health personnel consuming up to three quarters of recurrent budgets, a need arises to ascertain
that a workforce for any health facility is the optimal level needed to produce the desired product.
Objective: To highlight the experience and findings of an attempt at establishing the optimal staffing
levels for a tertiary health institution using the Workload Indicators of Staffing Need (WISN)
method popularised by the World Health Organisation (WHO), Geneva, Switzerland.
Design: A descriptive study that captures the activities of a taskforce appointed to establish optimal
staffing levels.
Setting: Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya, a tertiary hospital in the Rift
Valley province of Kenya from September 2005 to May 2006.
Main outcome measures: The cadres of workers, working schedules, main activities, time taken
to accomplish the activities, available working hours, category and individual allowances,
annual workloads from the previous year’s statistics and optimal departmental establishment of
workers.
Results: There was initial resentment to the exercise because of the notion that it was aimed at
retrenching workers. The team was given autonomy by the hospital management to objectively
establish the optimal staffing levels. Very few departments were optimally established with the
majority either under or over staffed. There were intra departmental discrepancies in optimal levels
of cadres even though many of them had the right number of total workforce.
Conclusion: The WISN method is a very objective way of establishing staffing levels but requires
a dedicated team with adequate expertise to make the raw data meaningful for calculations.