The Influence of Medical Staffing Levels on the Management of Patients :
Abstract
The study was about the influence of medical staffing levels on the management of patients: A case study of HC IIIs in Moyo district. The specific objectives were: to determine the capability of the medical staff to manage the number of patients that turns up on a day to day basis, to investigate the ability of medical staff in utilizing available equipment in HC IIIs of Moyo district, to establish the capacity of the medical staff in managing cases of illness mandated to HC IIIs. A cross sectional study was conducted which involved quantitative and qualitative data collection methods. Out of 72 target population of medical workers, a sample size of 61 was studied and focus group discussions were also conducted to patients who have been attended in these health facilities. The data was analyzed using SPSS version 16.0 software and excel and was presented in narrative summary, tables, bar charts and pie charts.
The key findings of the study indicated that attending to all patients, minimizing waiting time, providing appropriate treatment, provision of patient counseling and minimizing number of deaths at health facility were all compromised by the inadequate number of medical staff. On average, all the eight HC IIIs in Moyo District had 9 trained health staffs each, which is less than the required 15 trained health staff (HSSP I, 1999).
In the study, majority of the respondents agreed that all the five components of patient management were affected by low level of qualification of medical staff, majority of the respondents 33 (54.1%) commented that qualifications of the medical staff of HC IIIs in Moyo District were inadequate and greater numbers of the medical staff in HC IIIs of Moyo 12 (16.7%) were nursing assistants who mainly do the work of nurses and midwives.
Majority of the respondents also said that all components of patient management were affected by cadres (skill mix) of medical staff in HC IIIs of Moyo District with greater number 46 (75.4%) further reporting that skill mix of the medical staff was inadequate. Level of experience was also reported by majority of the respondents to affect all the components of patient management with most of them 44 (72.1%) further stating that level of experience of the medical staffs in HC IIIs of Moyo District was adequate.
Further findings indicated that majority of the health workers were able to utilize most of the equipments in HC IIIs of Moyo except manual vacuum aspirator, implant inserter, manual vacuum extractor and ophthalmoscope. There was also evidence that the medical staffs had gaps in managing conditions and diseases mandated to HC III facilities.
Basing on the above findings, it is recommended that the MoH, Public Service Commission, MoFPED and other stake holders should recruit and retain skilled medical staffs to meet the staffing norm of Uganda Local Government, create opportunities and offer sponsorship for further education and training of middle health care workers to manage cases beyond their original capacity and finally to prioritize and support training of laboratory technicians, midwives, clinical officers, nurses and recruit them to fill the existing gaps in HC III facilities of Moyo and other districts with the same staffing gaps.