Abstract
This descriptive mixed method study aimed to 1) investigate workload and factors associated with productivity of health personnel in District Health promotion Hospitals 2) describe relationship between workload and existing staffs and 3) formulate policy recommendations for health workforce planning and development. Stratified random sampling was applied to select samples for quantitative data collection. 48 District Health promotion Hospitals (DHPH) of 5 sizes (S,M,L,Extra and special size) were selected from 12 provinces in 12 health regions of Ministry of Public Health. All 336 health personnel in 48 selected DHPH were requested to record their daily time spent and productivity in electronic forms for 3 months. Purposive sampling was applied to select 8 outstanding DHPHs from 4 geographic regions across country. Focus Group Discussions were conducted, all health personnel who working in selected settings were participated. Descriptive statistic and content analysis were applied for data analysis. The main findings from this study indicated that 1) Health personnel in DHPH spent their working hours for curative activity 60%-70% more than health promotion and prevention activities which were their major responsibility 2) Comparing with staffing standard and current workload, there was shortage of health personnel in DHPH. In average each staff provided 1.2 FTE to complete their jobs. They also complaint about not balancing between their effort and reward, they did not get overtime payment and career advancement. 3) Health personnel had to share 30% of their working hours for administrative and clerical jobs which led to decrease time to provide health services. These jobs consisted of performance reporting associated with MOPH mandatory indicators, financial and accounting report, supply and inventory document and input data into management information system for various public agencies etc. These finding suggested that, MOPH should improve staffing standard and allocation, improve morale and optimize resources utilization. Moreover, development of administrative competency for directors of DHPH and re-orientation of mandatory reporting system need to be concerned as well.
