Indicators of High Performance and Strategies to Achieve Optimum Performance for Health Workers

Human resource is one of the very important aspects of management within an organisation. An organisation exists because of the people in it and organization’s productivity merely depends on the workers optimal performance. In health care system, the World Health Organisation (WHO,2006) defines performance of health workers in terms of four dimensions and that include availability, productivity, responsiveness, and competency. In Papua New Guinea, health workers deliver services in line with the government policy framework and standard as authorised by the National Health Administrative Act 1997 and these four dimensions defined by WHO is applicable for health workers to achieve optimal performance. Thus, this paper will discuss these four dimensions as indicators of high performances and will also outline possible strategies to achieve optimal performance of health worker.

 

First and foremost is the availability of staff. Health workers presence at the health facility determines the performance of the health workers with in the health system. The number of qualified staff being available at the health facility will determine the quality of task being performed and would reduce the waiting time for the client or the patient to be treated. If a health facility is understaffed, then there is high possibility of workload and overtime work which would eventually develop low feelings for others thus creating high absenteeism at the workplace (WHO, 2006). The WHO also supports that health workers may leave the health facility for another health care provider and this may cause high turnover of staff which would directly affect the health service being provided.

 

Studies have shown that health workers have various “push and pull” factors that cause that cause them to stay put or move to other location (Padarath et al., 2003 & Zurn et al., 2004).Factors like, low salaries, difficult working and living conditions and limited career opportunities are some examples of pushing factors while pulling factors can include higher remuneration, improved living conditions, a better working environment (WHO, 2006; various authors cited in Buchan et al., 2005).

 

Therefore, in order to retained health workers, the pulling factors must be addressed.          

·        Higher remuneration must be provided for health workers,

·        Living conditions for the health workers must be improved and,

·        The working conditions must also be improved to suit the workers interest to be committed and stable in order to deliver quality health service.

 

Another factor that can be used to assess performance improvement of workers is increase productivity. This specifically refers to the occupancy rate, the outpatient visit and the type of interventions provided per worker or facility and also the number of patient contacts made by the health workers (WHO, 2006). These are the main indicators which can improve productivity and show that there is improvement in workers performance.

 

In order for that to happened, these are some strategies that can be executed for an optimal performance.

·        Certain benefits and allowances must be provided for the health worker,

·        Workers must be socially recognised for their efforts made and,

·        Regular and appropriate management and supervision must be provided for the health workers.

This is to ensure the health workers are happy and treats a lot of patient effectively and efficiently. In that way, the health workers are productive thus achieving the optimal performance.

 

 Health workers responsiveness is another common indicator that can demonstrate that there is improvement in the performance of the health worker. Clients seeking health care at a health facility appreciates the health workers who are responsiveness to them thus creating a sense of satisfaction because their demands are being met. A study in Uganda on the performance of workforce shows that most of the health workers (89.9%) agreed that their clients are always satisfied with their services while the majority of the respondents (79.7%) indicated that they get professional support to improve their performances. The study also revealed that some of the clients are not satisfied with the services because the health workers are not meeting both the clinical and emotional needs of them and services is not timely. This can be attributed to organisational constraint such as the low staffing level, heavy workload, poor work flow structures and probably lack of some essential drugs and equipment necessary for performance (Nzinga et, 2009).

 

Therefore, in order for the health worker to response timely meeting the emotional and clinical need of the client, the management must ensure;

·        The level of the staff is increased to reduce work load,

·        Relevant and sufficient drugs and equipment are made available for the health workers to use and,

·        A good work flow structure for the health workers must also be in place. This work structure must include the workers duty statement and roster as well as the appraisal clearly spelt out for tangible outcome in the workplace.

This is to ensure the health workers must be responsive to the patient thus achieving the optimal performance as expected.

 

Another factor that can determine the performance of the health worker is competency. Competency include the skills necessary for the health workers to their work with confident while prescribing the right type of the treatment for the client (WHO, 1993). The WHO also supports that competency may also include health workers attitude towards the patient care taking into effective consideration of the need for timely referral for the patient who needs further treatment and care. Communication skills is also one of the very important aspect of health worker for patient support and care as listening, guidance, clear expectations and prerequisites for better performance. (Huang et, 2006).It was seen that health workers competency covers some wide aspect of areas which needs to be considered for optimal performance.

 

In order for the health workers to achieve optimum performance, they need to possess certain knowledge, skills and abilities. High level of knowledge, skills and abilities among health workers are necessary for effective performance. (Liu, 2007).A good example is from a study done in India, where there is considerable improvement in the outcome of maternal health as a result of good skills in identifying obstetric cases, good counselling and communication skills. (Iyengar, 2009).Therefore, the main strategy to be taken now is to,

·        Send the health workers for continuous education so that they can use their knowledge and skills to improve the safety of the client ,

This is to ensure optimal performance is achieved by the health workers.

 To conclude, this essay have describe the key indicators of health workers performance which are recommended by the WHO and they are workers availability, productivity, responsiveness and competencies. The essay has also outlined some possible strategies which can be used to enable workers to achieve the optimal performance based on the performance indicators as described.

 

List of References

 

Buchan J, Kingma M, Elegardo-Lorenzo FM. (2005). International migration of nurses: trends and policy implications. International Council of Nursing (http://www.icn.ch/global/Issue5migration.pdf, accessed 12 June 2006

 

Huang, L., Chen, L.Tsai, H.C., & Lin, C.J. (2006).Development of an instrument for assessing factors related to nurses’ organisation commitment. Mid Taiwan of Medicine, 11, 9-11.

 

Iyengar, K. & Iyengar, S.D. (2009).Emergency obstetric care and referral: experience

of two midwife-led health centres in rural Rajasthan, India. Reproductive Health

Matter, 17, 9–20.             

 

 

Liu, Y., Combs, J.G., Ketchen, D.J. (Jr), & Ireland, R.D.(2007). The Value of human resource management for organisational performance. Bus Horiz , 50,503–511.

 

 

 Nzinga, J., Mbindyo, P., Mbaabu, L., Warira, A., & English, M. (2009). Documenting the experiences of health workers expected to implement guidelines during an intervention study in Kenyan Hospitals. Implementation Science, 4, 44.Retrieved from http://www.implementationscience.com/content/4/1/44.

 

 

Padarath. A., Chamberlain, C., McCoy, D., Ntuli, A., Rowson, M. & Loewenson, R. (2003). Health personnel in Southern Africa: confronting misdistribution and brain drain. EQUINET Discussion Paper no. 3.Harare, EQUINET.

 

World Health Organization. (1993).Training manual on management of human resources for health. Geneva, WHO.

 

World Health Organization. (2006).World health report 2006: Working together for health. Geneva. World Health Organization. (http://www.who.int/whr/2006/en/, accessed 25 April 2006).

 

Zurn, P., Dal Poz, M.R., Stilwell, B. & Adams, O. (2004). Imbalance in the health workforce. Human Resources for Health, 2, 13.

 

 

 

Pictures of Some Potential Health Workers.