Midwifery Manpower in Primary Healthcare Centres of Tehran, Iran: A Cross-sectional Survey

Abstract

Background: It is necessary to use accurate methods of calculating manpower to avoid wasting resources. Given that reproductive health services are an important part of primary health services, it would be useful to apply manpower calculation methods to service providers in related occupational groups. This study calculated the required midwifery manpower in health care centers using the Workload Indicator of Staffing Need method.
 Methods: A cross-sectional study was conducted in 1400 in 276 health centers in Tehran according to the WISN model, in which the list of activities related to reproductive health in the centers under the auspices of the University of Tehran was determined. The available working time, main workload components, and the activity standards (service standards and allowance standards) were determined through a mixed method (direct observation, comments of service providers, and meetings with experts). The volume of services provided over the period of one year prior to the onset of the COVID-19 pandemic was estimated using national statistics. Finally, the required manpower was calculated and compared with the actual workforce.
 Results: The results showed that currently Tehran health centers need 34 more staff to provide reproductive health services. The working pressure was calculated 0.9, and the current allowance factor is 1.31. Based on observations, midwifery capacity is currently not fully and exclusively used.
 Conclusion: To improve the quality of reproductive health services, it is recommended to eliminate the current shortage of midwives, focus more on special midwifery tasks, and reduce the amount of indirect activities of midwives.