Abstract
BackgroundNigeria faces health workforce challenges and poor population health indices resulting from disparities in health worker densities by geographical locations and levels of health care delivery. Nigeria is constantly reforming its health system with the primary aim of having the right number of health workers in the right place at the right time to meet the population’s health needs. The majority of primary health facilities in the country are staffed using perceived needs. The Workload Indicators of Staffing Need (WISN) tool developed by the World Health Organization is used to determine staffing requirements for facilities.MethodsThe WISN tool was used in assessing the staffing requirements for nurses/midwives and community health practitioners in 26 primary health facilities in Port Harcourt City Local Government Area (PHALGA) and Obio Akpor Local Government Area (OBALGA). Documents were reviewed to obtain information on working conditions and staffing, and interviews conducted with key informants in 12 randomly selected facilities. We supported an expert working group that comprised of nurses/midwives and community health practitioners to identify workload components and activity standards and validate both. We also retrieved workload data from January 1–December 31, 2015 from the national district health information system.ResultsFindings showed varying degrees of shortages and inequitable distribution of health workers. Health facilities in PHALGA had a WISN ratio of 0.63 and a shortage of 31 nurses/midwives. There was also a shortage of 12 community health practitioners with a WISN ratio of 0.85. OBALGA had a shortage of 50 nurses/midwives and 24 community health practitioners; and WISN ratios of 0.60 and 0.79 for nurses/midwives and community health practitioners respectively.ConclusionOur findings provide evidence for policies that will help Nigeria improve the population’s access to quality health services and reduce inequities in distribution of the health workforce. Evidence-based health workforce planning and redistribution using WISN should be institutionalized. Review of scopes of practice of health workforce should be conducted periodically to ensure that the scope of practice matches the training received by the specific cadres and those skills are used to deliver quality services.
Highlights
Nigeria faces health workforce challenges and poor population health indices resulting from disparities in health worker densities by geographical locations and levels of health care delivery
Globally, access to quality health care is affected by numerous human resources for health (HRH) challenges, which are more prominent in developing countries including Nigeria
This indicates that Port Harcourt City Local Government Area (PHALGA) has only 63% of the required nurses/midwives
Summary
Nigeria faces health workforce challenges and poor population health indices resulting from disparities in health worker densities by geographical locations and levels of health care delivery. Access to quality health care is affected by numerous human resources for health (HRH) challenges, which are more prominent in developing countries including Nigeria They include shortages and inequitable distribution of health workforce, poor HRH planning, uninformed policy decisions, inadequate recruitment and retention structures, and inadequate training capacities [1,2,3,4]. The Minimum Standards for Primary Care Delivery by the National Primary Health Care Development Agency (NPHCDA) is a document that indicates the minimum staffing norms for care at the primary health care level [10] This level of care is critical as it is the entry point into the Nigerian health system where preventive, promotive, and curative services for uncomplicated minor ailments and referral services for complicated ailments are provided. These proposed standards are domesticated by the states based on fiscal space
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
