Workload Indicators of Staffing Need Method

  • Published Date: September 2015
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Context: The onset of the HIV epidemic in Viet Nam in the 1990s evoked an emergency response. Extensive external funding was invested to bring the epidemic under control. Viet Nam recently achieved low-middle income status, which has led to an anticipated reduction in external donor funding. The objective of the Leadership, Management and Governance - Transition Support Program (LMG-TSP) is to support Viet Nam’s HIV response in transitioning to greater country ownership and sustainability in the health system. In 2012, the Government of Viet Nam (GVN) issued Decree 41/2012/NĐ-CP (Decree 41) which mandated the use of workload indicators to define civil service staffing requirements across all ministries. It was stipulated that this analysis of workload should also define activities and produce detailed job descriptions. However, guidance on specific methodologies to use was not provided. Currently, the health sector needs a tool that can provide evidence-based human resource planning using workload analysis as required by the Decree 41.

Approach: The Workload Indicators of Staffing Need (WISN) method was initially developed in 1998 by the World Health Organization (WHO), and used a “top down” approach that led to many challenges and ultimately the rejection of results by health professionals. It has been extensively revised and the current WISN Toolkit finalized in 2010 uses a “bottom up” approach, meaning that the method now involves the staff that do the work. It is increasingly being used internationally1 because it addresses workload-based Human Resources for Health (HRH) planning. The WISN method uses simple principles to determine staff requirements based on actual workload, not on the number of beds or on population ratio. 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 results provide clear targets for budgeting and resource allocation.

Conclusion: 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 program such as HIV is essential to determine the staffing need to secure services as they are integrated into the mainstream health system. WISN is relevant Viet Nam because it is compatible with the requirements of Decree 41; it provides a detailed analysis of workload and workload components, and can be used to develop job descriptions. This tool brief provides a valuable resource for Viet Nam and other countries undergoing similar vertical health program transition.