Workload Indicators Of Staffing Need Method in determining optimal staffing levels at Moi Teaching and Referal Hospital

Background: There is an increasing demand for quality healthcare in the face of limited resources. With the health personnel consuming up to three quarters of recurrent budgets, a need arises to ascertain that a workforce for any health facility is the optimal level needed to produce the desired product. Objective: To highlight the experience and findings of an attempt at establishing the optimal staffing levels for a tertiary health institution using the Workload Indicators of Staffing Need (WISN) method popularised by the World Health Organisation (WHO), Geneva, Switzerland. Design: A descriptive study that captures the activities of a taskforce appointed to establish optimal staffing levels. Setting: Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya, a tertiary hospital in the Rift Valley province of Kenya from September 2005 to May 2006. Main outcome measures: The cadres of workers, working schedules, main activities, time taken to accomplish the activities, available working hours, category and individual allowances, annual workloads from the previous year\'s statistics and optimal departmental establishment of workers. Results: There was initial resentment to the exercise because of the notion that it was aimed at retrenching workers. The team was given autonomy by the hospital management to objectively establish the optimal staffing levels. Very few departments were optimally established with the majority either under or over staffed. There were intradepartmental discrepancies in optimal levels of cadres even though many of them had the right number of total workforce. Conclusion: The WISN method is a very objective way of establishing staffing levels but requires a dedicated team with adequate expertise to make the raw data meaningful for calculations. East African Medical Journla Vol. 85 (5) 2008: pp. 232-23

WORKLOAD INDICATORS OF STAFFING NEED METHOD IN DETERMINING OPTIMAL STAFFING LEVELS AT MOI TEACHING AND REFERRAL HOSPITAL

Background: There is an increasing demand for quality healthcare in the face of limited resources. With the health personnel consuming up to three quarters of recurrent budgets, a need arises to ascertainthat a workforce for any health facility is the optimal level needed to produce the desired product.Objective: To highlight the experience and findings of an attempt at establishing the optimal staffing levels for a tertiary health institution using the Workload Indicators of Staffing Need (WISN) method popularised by the World Health Organisation (WHO), Geneva, Switzerland.Design: A descriptive study that captures the activities of a taskforce appointed to establish optimal staffing levels.Setting: Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya, a tertiary hospital in the Rift Valley province of Kenya from September 2005 to May 2006.Main outcome measures: The cadres of workers, working schedules, main activities, time taken to accomplish the activities, available working hours, category and individual allowances, annual workloads from the previous year’s statistics and optimal departmental establishment ofworkers.Results: There was initial resentment to the exercise because of the notion that it was aimed at retrenching workers. The team was given autonomy by the hospital management to objectively establish the optimal staffing levels. Very few departments were optimally established with themajority either under or over staffed. There were intradepartmental discrepancies in optimal levels of cadres even though many of them had the right number of total workforce.Conclusion: The WISN method is a very objective way of establishing staffing levels but requires a dedicated team with adequate expertise to make the raw data meaningful for calculations

Global status and conservation potential of reef sharks

Fishing has had a profound impact on global reef shark populations, and the absence or presence of sharks is strongly correlated with national socio-economic conditions and reef governance. Decades of overexploitation have devastated shark populations, leaving considerable doubt as to their ecological status(1,2). Yet much of what is known about sharks has been inferred from catch records in industrial fisheries, whereas far less information is available about sharks that live in coastal habitats(3). Here we address this knowledge gap using data from more than 15,000 standardized baited remote underwater video stations that were deployed on 371 reefs in 58 nations to estimate the conservation status of reef sharks globally. Our results reveal the profound impact that fishing has had on reef shark populations: we observed no sharks on almost 20% of the surveyed reefs. Reef sharks were almost completely absent from reefs in several nations, and shark depletion was strongly related to socio-economic conditions such as the size and proximity of the nearest market, poor governance and the density of the human population. However, opportunities for the conservation of reef sharks remain: shark sanctuaries, closed areas, catch limits and an absence of gillnets and longlines were associated with a substantially higher relative abundance of reef sharks. These results reveal several policy pathways for the restoration and management of reef shark populations, from direct top-down management of fishing to indirect improvement of governance conditions. Reef shark populations will only have a high chance of recovery by engaging key socio-economic aspects of tropical fisheries

Directed conservation of the world's reef sharks and rays

Many shark populations are in decline around the world, with severe ecological and economic consequences. Fisheries management and marine protected areas (MPAs) have both been heralded as solutions. However, the effectiveness of MPAs alone is questionable, particularly for globally threatened sharks and rays (‘elasmobranchs’), with little known about how fisheries management and MPAs interact to conserve these species. Here we use a dedicated global survey of coral reef elasmobranchs to assess 66 fully protected areas embedded within a range of fisheries management regimes across 36 countries. We show that conservation benefits were primarily for reef-associated sharks, which were twice as abundant in fully protected areas compared with areas open to fishing. Conservation benefits were greatest in large protected areas that incorporate distinct reefs. However, the same benefits were not evident for rays or wide-ranging sharks that are both economically and ecologically important while also threatened with extinction. We show that conservation benefits from fully protected areas are close to doubled when embedded within areas of effective fisheries management, highlighting the importance of a mixed management approach of both effective fisheries management and well-designed fully protected areas to conserve tropical elasmobranch assemblages globally

Widespread diversity deficits of coral reef sharks and rays

A global survey of coral reefs reveals that overfishing is driving resident shark species toward extinction, causing diversity deficits in reef elasmobranch (shark and ray) assemblages. Our species-level analysis revealed global declines of 60 to 73% for five common resident reef shark species and that individual shark species were not detected at 34 to 47% of surveyed reefs. As reefs become more shark-depleted, rays begin to dominate assemblages. Shark-dominated assemblages persist in wealthy nations with strong governance and in highly protected areas, whereas poverty, weak governance, and a lack of shark management are associated with depauperate assemblages mainly composed of rays. Without action to address these diversity deficits, loss of ecological function and ecosystem services will increasingly affect human communities

Global status and conservation potential of reef sharks

Decades of overexploitation have devastated shark populations, leaving considerable doubt as to their ecological status1,2. Yet much of what is known about sharks has been inferred from catch records in industrial fisheries, whereas far less information is available about sharks that live in coastal habitats3. Here we address this knowledge gap using data from more than 15,000 standardized baited remote underwater video stations that were deployed on 371 reefs in 58 nations to estimate the conservation status of reef sharks globally. Our results reveal the profound impact that fishing has had on reef shark populations: we observed no sharks on almost 20% of the surveyed reefs. Reef sharks were almost completely absent from reefs in several nations, and shark depletion was strongly related to socio-economic conditions such as the size and proximity of the nearest market, poor governance and the density of the human population. However, opportunities for the conservation of reef sharks remain: shark sanctuaries, closed areas, catch limits and an absence of gillnets and longlines were associated with a substantially higher relative abundance of reef sharks. These results reveal several policy pathways for the restoration and management of reef shark populations, from direct top-down management of fishing to indirect improvement of governance conditions. Reef shark populations will only have a high chance of recovery by engaging key socio-economic aspects of tropical fisheries