Staffing Needs for Quality Perinatal Care in Tanzania
), Urassa D.P(2), Massawe S(3), Massawe A(4), Lindmark G(5), Van Roosmalen J(6),
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(2)
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(6)
Corresponding Author
Abstract
In Tanzania maternal and perinatal mortalities and morbidities are problems of public health importance, and have been linked to the shortage of skilled staff. We quantified the available workforce and the required nursing staff for perinatal care in 16 health institutions in Dar es Salaam. WHO safe motherhood needs assessment instruments were used to assess the availability of human resources, WHO designed Workload Indicators for Staffing Need (WISN) and Tanzanian standard activities and components of the workload for labour ward nursing were used to calculate nurse staffing requirements and WISN ratios. There was a severe shortage of essential categories of health staff for perinatal care in all institutions. The ranges of WISN ratios for nursing staff working in the municipal hospitals’ labour wards were; nurse officers 0.5 – 1, trained nurses/midwives 0.2 - 0.4 and nurse assistants 0.1. These findings reflect extremely huge perinatal care workload pressure and suggest the urgent need for more staff in order to achieve the global millennium development goals set for maternal and infant survival (Afr J Reprod Health 2008; 12[3]:113-124).
RĖSUMĖ
L’importance des dotations en personnel de soin périnatal en Tanzanie En Tanzanie, les mortalités maternelles et périnatales et les morbidités sont des problèmes de santé publique importants qui sont liées au manque de personnel qualifié. Nous avons quantifié la main d’œuvre disponible et les infirmiers requis pour les soins périnatals dans 16 établissements sanitaires à Dar es Salam. Les instruments de d’évaluation de la maternité sans danger de l’OMS ont été utilisés pour évaluer la disponibilité des ressources humaines. Les indicateurs de la répartition du travail pour la dotation en personnel (IRDP) conçus par l’OMS et les activités standards tanzaniennes et des composants de la répartition des infirmiers des salles d’accouchement ont été utilisés pour calculer les besoins d’infirmiers requis et la proportion de l’IRDP. Il y avait un manque sévère des catégories du personnel sanitaire pour des soins périnatals dans tous les établissements. Les gammes des proportions de l’IRDP pour des personnels infirmiers travaillant dans les salles d’accouchement des hôpitaux municipaux étaient : des officiers infirmiers 0,5 – 1, infirmiers/sages femmes qualifiées 0,2 – 0,4 et les aides - infirmiers 0,1. Ces résultats reflètent extrêmement la pression énorme de la répartition du travail et suggèrent le besoin urgent de la dotation en personnel afin de réaliser le but du développement mondial millénial mis pour la survivance maternelle et infantile (Afr J Reprod Health 2008; 12[3]:113-124).
KEY WORDS: Perinatal care, Standard workload, Activity standard, WISN ratio
References
National Bureau of Statistics. Tanzania Demographic Health Survey 2004- 2005:
Carlveton, Maryland: ORC Macro., 2005; 129, 160-1
Kilonzo A, Kouletio M, Whitehead SJ, Curtis
KM and McCarthy BJ. Improving surveillance of maternal and perinatal health in 2 districts of rural Tanzania. Am J Public Health. 2001; 91:1636-1640
Campbell OM and Graham WJ. Strategies for reducing maternal mortality: getting on with what works. Lancet 2006; 368: 1284-99.
Bour D and Bream K. An analysis of the determinants of maternal mortality in subSaharan Africa. J Womens Health 2004; 13: 926-38.
Aiken LH, Clarke SP, Sloane DM, Sochalski J and Silber HJ. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. Jama 2002; 288: 1987-93.
Needleman J, Buerhaus P, Mattke S, Stewart M and Zelevinsky K. Nurse-staffing levels and the quality of care in hospitals. N Engl J Med 2002; 346: 1715-22.
Kwast B and Bergström S. Training of professionals for safer motherhood, in Lawson J, Harrison K, Bergström S. Maternity care in developing countries. RCOG press, London. 2001: 45-62.
Mbaruku G, van Roosmalen J, Kamugisha C, Nturugelegwa E and Bergström S.
Perceptions of obstetric risk among health staff, traditional birth attendants and community members in rural Tanzania. Submitted.
Wyss K. An approach to classifying human resources constraints to attaining healthrelated Millennium Development Goals. Hum Resour Health 2004; 2: 11.
Shipp J. Workload indicators of staffing need (WISN): A manual for implementation. World Health Organization, Geneva. 1998
National Bureau of Statistics. Tanzania population and housing census results.
[cited 2006 30 June]; Available from: http://www.tanzania.go.tz/Statistics.html.
Nyamtema AS, Mgaya HN and Hamudu NS. A survey on obstetric care, factors affecting provision of care and pregnancy outcome in Dar es Salaam district hospitals. Tanz Med J 2003; 18: 36-9.
Kielmann A, Janovsky J and Annett H. Assessing district health needs services and systems; protocols for rapid data collection and analysis. London: Macmillan, 1995.
UNICEF/WHO/UNFPA. Guidelines for monitoring the availability and use of obstetric services. UNICEF, New York. 1991.
WHO. Safe Motherhood Needs Assessment version 1.1, Maternal and Newborn Health/Safe Motherhood, Division of
Reproductive Health, Family and Reproductive Health. World Health
Organization, Geneva. 2001.
Rogo KO, Aloo-Obunga C, Ombaka C, Oguttu M, Orero S, Oyoo C and Odera J. Maternal mortality in Kenya: the state of health facilities in a rural district. East Afr Med J 2001; 78: 468-72.
Steinbrook R. Nursing in the crossfire. N Engl J Med 2002; 346: 1757-66.
Zanzibar safe motherhood programme. An assessment of maternal health and maternal care in Unguja and Pemba. 2000.
Lankshear AJ, Sheldon TA and Maynard A. Nurse staffing and healthcare outcomes: a systematic review of the international research evidence. Adv Nurs Sci 2005; 28: 163-74.
Tourangeau AE, Cranley LA and Jeffs L. Impact of nursing on hospital patient mortality: a focused review and related policy implications. Qual Saf Health Care 2006; 15: 4-8.
Maine D, Akalin MZ, Ward VM and Kamara A. The design and evaluation of maternal mortality programs. Center for population and family health, School of public health, Columbia University. 1997.
Kurowski C, Wyss K, Abdulla S and Mills A. Scaling up priority health interventions in Tanzania: the human resources challenges. Health Policy Plan 2007; 22:113-127.
Bloom B. The Toxonomy of Educational Objectives. Pitman Learning, California. 1979.
Islam MT, Haque YA, Waxman R and Bhuiyan, AB. Implementation of emergency obstetric care training in Bangladesh: lessons learned. Reprod Health Matters 2006; 14: 6172.
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