Workforce Planning Method Introduced to Provincial Leaders in Viet Nam

By Sara Wilhelmsen, Senior Project Officer and Thien Nga Nguyen, Acting Project Director LMG-TSP

Viet Nam recently achieved low-middle income status, which has led to an anticipated reduction in external donor funding. Also recently, in 2012, the Government of Viet Nam issued Decree 41/2012/ NĐ-CP (Decree 41) mandating the use of workload indicators to define civil service staffing requirements across all ministries, including health. In this context, Hai Phong, as with other provinces, faced challenges in identifying the staffing needs to maintain HIV services, and to develop a human resource (HR) plan based on evidence and workload analysis as required by Decree 41.

The Leadership, Management & Governance - Transition Support Program (LMG-TSP) supported by USAID, assisted health leaders in Hai Phong to pilot the WHO’s Workforce Indicator of Staffing Needs (WISN) method to determine how many health workers of a particular type would be required to deliver the HIV treatment services that were currently offered. The 2010 WISN method uses a bottom up approach and applies simple principles to determine staff requirements based on actual workload. The WISN method sets activity (time) standards for health professionals and translates these into workloads as a rational method of setting staffing levels in health facilities. The WISN method provides clear targets for budgeting and resource allocation.

Training on WISN, Hai Phong 28 February - 1 March 2014. Photo by Management Sciences for HealthThe WISN pilot was implemented from December 2013 to May 2014 and involved 74 full time and part time staff who were providing HIV treatment and HTC services in all 12 outpatient clinics (OPCs) in Hai Phong. They were taught how to calculate WISN results and then consulted with experts who were included in the pilot who validated results and helped bring the teams to consensus.

The result of the pilot was the establishment of the estimated amount of time each health worker required to deliver HIV treatment services in relation to their other services based on actual workload. The WISN method helped support workforce planning and management through the effective use of scarce human resources. It also helped improve communication among staff and managers about their workloads, including identifying duplication of staff work that can be reduced. Prior to WISN implementation, many staff perceived that they were overloaded. However, WISN outcomes showed that, in most cases, the current workload for both HIV and other health services could be accomplished with fewer staff through more efficient use of staff resources.  Results were reliable and accepted by stakeholders involved in the process. They provided valuable information to guide managers in appropriate work allocation and staffing levels as HIV/AIDS services integrate into health system. 

WISN results are the only source of evidence currently available in Viet Nam on staffing need based on workload. In the transition context, the application of WISN in a vertical HIV program have shown to be useful in determining the staffing necessary to maintain services as they are integrated into the mainstream health system. WISN is especially relevant as it is compatible with the requirements of Decree 41.

A “bottom up” approach helps improve ownership of workforce planning. Health cadres now have a feeling of ownership of the process, as together they have clarified their main health service and support activities.  In addition, the data inputs and outputs of WISN are transparent – anyone can review them, helping to increase confidence and ownership of the results.

Having demonstrated a successful model, LMG-TSP was requested to provide WISN training to the national human resources technical working group in the Vietnam Administration for AIDS Control. Six members of Hai Phong WISN Technical Working Group were also trained and mentored by the project. They now have the capacity to serve as trainers for future WISN exercises and strengthen workforce planning and management for a smoother transition to a more integrated health system.