Understanding Health Workforce Productivity at the Facility Level: A New eLearning Course

Rachel DeussomPeople drive health systems. In the words of Vujicic and colleagues, health workers are “gatekeepers and navigators for the effective or wasteful application of all other resources.”

The global health community recognizes that there is “no health without a workforce.” Efforts have been made to train, deploy, and retain more health workers in areas where they are most needed. But beyond this, we need those health workers that are already at their jobs to be productive.

What does this mean? Well, imagine that you are a district health manager.

Clients and health worker in GuatemalaOne clinic within your district is a busy facility in an ever-expanding provincial capital, situated in a bustling neighborhood near several private clinics and shops. The staff complained that they were overwhelmed and could not keep up. So last year, you hired several new doctors, nurses, and an additional lab technician. But when you visited the clinic last month, the waiting room was still overflowing with patients late into the afternoon.

Why hadn’t patient waiting times at the clinic improved since the deployment of those new health workers?

What could be done to prevent patients from being turned away at the end of the day?

eLearning courseA new eLearning course on USAID’s Global Health eLearning Center managed by K4Health called Health Workforce Productivity: An Approach for Measurement, Analysis, and Improvement is designed to help managers and supervisors understand these types of questions.

Wanda Jaskiewicz and I developed this course to introduce learners to a specific approach to assess health workforce productivity problems at the facility level. Could productivity be low due to inefficient processes at a clinic? Or because health workers aren’t showing up to work? Or maybe because communities are not accessing services? Or some combination of these problems?     

The course helps learners to think about what underlying causes may be driving down health workforce productivity levels, and how to analyze them by presenting a package of analytical tools or methodologies. Finally, the course shares suggestions for what types of interventions could help improve health workforce productivity. We tried to make the course’s approach as practical as possible, with plenty of references to toolkits, resources, and country examples.

Health worker and client in KenyaFor those interested in digging deeper on the health workforce productivity issue within their own context, consider using the Health Workforce Productivity Analysis and Improvement Toolkit, an online platform that describes a step-wise process to measure and analyze the productivity of facility-based health workers, while also allowing users to enter their own data and analyze it over time.   

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Author photo courtesy of Rachel Deussom; health worker photos by Trevor Snapp, courtesy of IntraHealth International