CHAPTER
ONE
INTRODUCTION
Manpower planning is an essential
cornerstone in the efficient management of personnel in an organization.
Manpower planning for health is not all about number, it involves distribution,
quality and productivity. In essence, man power planning for health is
concerned with getting the right number of staff, in the right places, at the
right time, doing the right job, with the right motivation, at the right cost.
Within many health care systems worldwide, increased attention is being focused
on human resources management (HRM). Specifically, human resource is one of the
three principles of health system inputs, with the other two major inputs being
physical capital and consumables.
Manpower planning becomes a necessity
and a possibility for two reasons; first the education and training of medical
personnel is a time consuming and costly affair. Medical personnel are highly
educated and therefore highly specialized. Acquiring other skill is difficult,
time consuming and signifies a waste of effort and money. Secondly, medical
education and training is very costly, therefore educational planning and medical
planning have to go hand in hand. Expansion includes the setting up of new
medical schools and faculties and at least the increase of the existing
capacity. A reduction of the trend is possible by imposing a numerous clauses
(student stop) in the existing faculties.
According to Ejumudo (2010),
manpower, when pertaining to health care, can be referred to as the different
kinds of clinical and non-clinical staff responsible for public and individual
health intervention. As arguably the most important of the health system
inputs, the performance and the benefits the system can deliver depend largely
upon the knowledge, skills and motivation of those individuals responsible for
delivering health services.
In the same vein, Erinoso (2008) sees Manpower planning as a process to
measure and compare current manpower with future manpower relative to an
organisation’s strategy and business planning process. Therefore an
organisation operates most effectively when the right people with the right
knowledge, skills and competencies are deployed appropriately. Manpower
planning is expected to focus on the size and composition of manpower, its
deployment across organisation, and the knowledge, skills and competencies
necessary to pursue stated objectives.
It includes all managed movement into, around and out of organisation
including recruitment, promotion, secondment, transfer, redeployment, and
retention. Manpower
planning which is also known as human resource planning consists
of putting right number of people, right kind of people at the right place,
right time, doing the right things for which they are suited for the
achievement of goals of the organization. The manpower planning process
is an ongoing and continuous strategy which is undertaken through a systematic
set of procedures (Oyibo, 2010).
The availability of manpower has
been cited as the most important influence of service delivery in any
organization (Clark, 2012). Institutional effectiveness was not remain unhindered
when poor quality work environment thus cause employee dissatisfaction with job
with the usual resultant high turnover which can force a reduction in job
performance. The work environment can involve the social
interactions at the workplace, including interactions with peers, subordinates,
and managers. Generally, and within limits, employees are entitled to a
work environment that is free from all forms of harassment.
Health
care services include all services dealing with the diagnosis and treatment of
disease or the promotion, maintenance and restoration of health (Oyibo, 2010).
They include personal and non –personal health services. Health care services
are the most visible functions of any health system, both to users and the
general public. Service care provision refers to the way inputs such as money,
human resource, equipment and drugs are combined to allow the delivery of
health interventions. Improving access, coverage and quality of services
therefore depends on the availability of these key resources; on the ways
services are organized and managed and on the incentives influencing providers
and users. In the healthcare delivery, effective planning is needed to ensure
that quality services are provided to those in need. Effective health service
delivery is also concerned with bringing about an acceptable level of coherent
programmes that assist in bringing health care services to populations who
would not have had sufficient or no access to health services.
Doctors and nurses are reluctant to relocate to remote areas
and forest locations that offer poor communications with the rest of the
country and few amenities for health professionals and their families. Urban
areas in Nigeria are more attractive to health care professionals for their
comparative social, cultural and professional advantages. For instance, medical
personnel posted out from State hospital, Ijaye in Abeokuta are usually
reluctant to comply, in some cases, such staff are queried before they
eventually take up the posting. This is as a result of the fact that
metropolitan centers in the country offer more opportunities for career and
educational advancement, better employment prospects for health professionals
and their family, easier access to private practice and lifestyle-related
services and amenities, and better access to education opportunities for their
children. In addition, the low status often conferred to those working in rural
and remote areas further contributes to health professionals’ preference for
settling in urban areas, where positions are perceived as more prestigious.
This has significant consequences on the health of inhabitants of rural areas
as unavailability of physicians and nurses within close proximity often leads
to delaying and postponing visits to health care facilities until the condition
becomes unbearable. Transporting the patient on treacherous roads to urban
facilities may take several hours and this may lead to death.
In Nigeria, scarce data on the availability, distribution
and trends in manpower for health has been a barrier to effective manpower
planning. This situation couple with lack of conducive work environment usually
results to poor service delivery in the hospitals.
1.2 Statement of the Problem
In the world over, the unending need
for good health care is a primary need of everyone irrespective of societal
placement and social status. This situation has however increased the need for
medical personnel that on a general note is lacking in Africa and Nigeria in
particular. Therefore, it becomes a problematic situation for developing
societies to retain their medical personnel given their inability to institute
viable manpower plan and conducive work environment that was be suitable for
the fulfilment of the lofty aspirations of medical personnel who for want of
greener pastures leave their home-country for more developed societies thereby
compounding the health challenge of their medically challenged citizens. This
problem is fundamentally a result of failure of the managers of the institution
of state to provide an enabling ground that will be suitable for the
actualization of desired aspiration of workers.
According to Enebulele, (2013) only
one in three registered Nigerian doctor’s practice in the country, with the
other two-thirds migrating abroad. He goes further to state that, of the 71,740
doctors registered with Medical and Dental Council, about 27,000 are practicing
in Nigeria while others are practicing outside the shores of this country. According
to him, up to 7000 Nigerian doctors combined work in British and American
health sector, while some have left the medical profession on account of better
working condition.The Nigeria’s health system is in a poor state and this is
traceable to several factors especially the gross under-funding of the health
sector and shortage of medical personnel at the primary health care level.
However, Nigeria is one of the several major health-staff-exporting countries
in Africa; this fact is however due to poor manpower planning amongst the personal
mangers and poor work environment which does not give room for
self-actualization which is evidence in the number of health care workers who
leave the country after their training for greener pastures abroad. As a result
of inadequate infrastructure and poor compensation packages, a sizeable number
of physicians, nurses and other medical professionals are lured away to
developed countries in search of fulfilling and lucrative positions Enebulele
(2013).
Across
Nigeria, there is a national health manpower crisis marked by critical
imbalances. In some states especially in Ogun State, Nigeria there is shortage
of health practitioners, such as doctors, nurses, pharmacists, physiotherapists
and other health workers. Enebulele notes that medical personnel in Ogun State
South-West Nigeria, especially doctors are over stretched, for instance, a
doctor is supposed to attend to about 20-30 patient per day but given the poor
work condition that has occasioned mass exodus of health workers they attend to
about 70-120 on a daily basis. This situation is however compounded by the
insecurity situation and poor work condition that has forced many of them to
relocate to places where their safety is guaranteed.
The
ongoing underinvestment in the health sector, coupled with poor employment
conditions and policies (such as exposure to occupational hazards,
discrimination and physical and psychological violence; insufficient
remuneration; unfavourable work-life balances; unreasonable workloads, limited
career development opportunities) have resulted in a deterioration of working
conditions for health professionals in many states. There is some fear that
this may have serious negative impact on the recruitment and retention of
health professionals, the productivity and performance of health facilities,
and, ultimately, on service delivery to patients. Hence, the motivation for this study
with emphasis on manpower planning, work environment and service delivery in
Ogun state hospital management board.
1.3 Objective of the Study
The general objective of this study is
to investigate the relationship between manpower planning, work environment and
service delivery in Ogun State Hospital Management Board (OGHMB). The specific
objectives are to:
- examine the impact of
manpower planning on service delivery in Ogun State Hospital Management Board;
- determine the causes of
inadequate work environment on service delivery by hospitals in Ogun State
Hospital Management Board;
- appraise the effect of
work environment on service delivery by hospitals in Ogun State Hospital
Management Board;
- interrogate the public
perception of service delivery in Ogun State Hospital Management Board and
- make solutions that enhance
administrative functions for constructive manpower planning and conducive work
environment for satisfactory service delivery in the health sector.
1.4 Research Questions
Based on the findings carried out the
following questions were:
- How does effective
manpower planning affect service delivery in Ogun State Hospital Management
Board?
- Why are there
inadequacies in the work environment on service delivery in Ogun State Hospital
Management Board?
- How does work
environment affect service delivery by hospitals in Ogun State Hospital
Management Board?
- How do people perceive
service delivery in Ogun State Hospital Management Board?
- How can there
besolutions that will enhance administrative functions for constructive
manpower planning and conducive work environment for satisfactory service
delivery in the health sector?
1.5 Hypotheses
MANPOWER PLANNING, WORK ENVIRONMENT AND SERVICE DELIVERY IN OGUN STATE HOSPITAL MANAGEMENT BOARD
