High workload prevails in Public Sector Health Facilities in Bangladesh as revealed in a policy dialogue

WHO Bangladesh/ M. Rahmat Ali

Workload Indicators of Staffing Need (WISN) findings highlighted human resource shortages and large number of vacant positions at all levels of facilities at the public sector health services in Bangladesh.

This information was revealed during a policy dialogue on workload of the health workforce in public sector health facilities in Bangladesh on 30 April 2019, organized by Ministry of Health and Family Welfare (MOHFW), USAID Bangladesh, Save the Children and WHO Bangladesh.

The workload pressure is calculated through determination of the WISN ratio (WHO human resource management tool) which shows high workload at most of the facilities, at district and sub district level, including community facilities. This is valid for a wide range of staff, including physicians, nurses and support services staff, such as cleaning, laundry, attendant, kitchen staff, security etc. Even if all the vacant positions were filled in and number of staff would improve in certain areas, high workload will still prevail in most of facilities because the actual need is much higher than the number of sanctioned posts.

These findings come after Health Services Division through Human Resource Branch, with technical support from WHO, undertook the initiative of applying the WISN method in different health facilities in Bangladesh.

WHO Bangladesh/ M. Rahmat Ali

In this regard, two studies have been conducted in four districts of the country.

The first study was funded by USAID’s MaMoni project and conducted by the Bangladesh University of Health Sciences (BUHS) at Kushtia and Brahmanbaria districts.

The second study was technically and financially supported by WHO Bangladesh and was conducted by the BRAC James P Grant School of Public Health, BRAC University at Jhenaidah and Moulvibazar districts.

Both studies aimed to assess the current staffing need for delivering optimum health services, including the Essential Service Package (ESP). A joint technical brief based on the key results was developed, as attached.

Participants in the policy dialogue urged to reduce high vacancy rates of different categories of health workforce especially nurses, physicians and all supporting staff. They also focused on formulation of a need based health workforce plan with projection up to 2030 so that an evidence-based recruitment and deployment strategy could be adopted. Participants recommended to set health service activity standards and organize WISN training for the district level managers so that workload can be measured and appropriate deployment could be made.

WHO remains committed in supporting the Ministry of Health and Family Welfare to improve health Human Resources in Bangladesh a key component on the road of achieving Universal Health Coverage and Health for All.