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Lessons Learnt during the Implementation of WISN for Comprehensive Primary Health Care in India, South Africa and Peru

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  • Sikhumbuzo A. Mabunda

    (The George Institute for Global Health, University of New South Wales, Sydney 2042, Australia
    School of Population Health, University of New South Wales, Sydney 2033, Australia)

  • Mona Gupta

    (National Health Systems Resource Centre, Ministry of Health and Family Welfare, New Delhi 110067, India)

  • Wezile W. Chitha

    (Health Systems Enablement & Innovation Unit, University of the Witwatersrand, Johannesburg 2000, South Africa)

  • Ntombifikile G. Mtshali

    (School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa)

  • Claudia Ugarte

    (General Directorate of Health Personnel, Ministry of Health, Lima 15072, Peru
    Department of Medical Clinics, Universidad Peruana Cayetano Heredia (UPCH), Lima 15102, Peru)

  • Ciro Echegaray

    (General Directorate of Health Personnel, Ministry of Health, Lima 15072, Peru)

  • María Cuzco

    (General Directorate of Health Personnel, Ministry of Health, Lima 15072, Peru)

  • Javier Loayza

    (General Directorate of Health Personnel, Ministry of Health, Lima 15072, Peru)

  • Felipe Peralta

    (General Directorate of Health Personnel, Ministry of Health, Lima 15072, Peru
    Department of Preventive Medicine and Public Health, Universidad Nacional Mayor de San Marcos (UNMSM), Lima 15081, Peru)

  • Seimer Escobedo

    (Health Systems, Peruvian Society of Health Administration, Lima 15046, Peru)

  • Veronica Bustos

    (Human Resources for Health, Independent Consultant, Lima 15074, Peru)

  • Onke R. Mnyaka

    (Health Systems Enablement & Innovation Unit, University of the Witwatersrand, Johannesburg 2000, South Africa)

  • Buyiswa Swaartbooi

    (Health Systems Enablement & Innovation Unit, University of the Witwatersrand, Johannesburg 2000, South Africa)

  • Natasha Williams

    (Health Systems Enablement & Innovation Unit, University of the Witwatersrand, Johannesburg 2000, South Africa)

  • Rohina Joshi

    (The George Institute for Global Health, University of New South Wales, Sydney 2042, Australia
    School of Population Health, University of New South Wales, Sydney 2033, Australia
    The George Institute for Global Health, New Delhi 110025, India)

Abstract

Introduction: The World Health Organization introduced the workload indicators of staffing needs (WISN) in 1998 to improve country-level health workforce planning. This study presents the primary care health workforce planning experiences of India, South Africa and Peru. Methods: A case study approach was used to explore the lessons learnt in the implementation of WISN in India and South Africa. It also describes the methods developed and implemented to estimate health workforce in Peru. We identify the barriers and facilitators faced by countries during the implementation phase through the triangulation of literature, government reports and accounts of involved health planners in the three countries. Results: India implemented WISN in a referral pathway of three district health facilities, including a primary health centre, community health centre and district hospital. Implementation was impeded by limited technical support, poor stakeholder consultation and information systems challenges. South Africa implemented WISN for health workforce planning in primary care and found the skills mix and staff determinations to be unaffordable. The Peruvian Ministry of Health considered using WISN but decided to develop a context-specific tool to estimate the health workforce needed using its available resources such as the National Register of Health Personnel. The main challenge in using WISN was the insufficient information on its inputs. Conclusion: While India and South Africa had unique experiences with the integration of WISN in their health system, none of the countries has yet benefited from the implementation of WISN due to financial, infrastructure and technical challenges. Since the methodology developed by the Peruvian Ministry of Health is context-specific, its implementation has been promising for health workforce planning. The learnings from these countries’ experiences will prove useful in bringing future changes for the health workforce.

Suggested Citation

  • Sikhumbuzo A. Mabunda & Mona Gupta & Wezile W. Chitha & Ntombifikile G. Mtshali & Claudia Ugarte & Ciro Echegaray & María Cuzco & Javier Loayza & Felipe Peralta & Seimer Escobedo & Veronica Bustos & O, 2021. "Lessons Learnt during the Implementation of WISN for Comprehensive Primary Health Care in India, South Africa and Peru," IJERPH, MDPI, vol. 18(23), pages 1-14, November.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:23:p:12541-:d:690205
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    References listed on IDEAS

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    1. Besuthu Hlafa & Kin Sibanda & Dumisani MacDonald Hompashe, 2019. "The Impact of Public Health Expenditure on Health Outcomes in South Africa," IJERPH, MDPI, vol. 16(16), pages 1-13, August.
    2. Tania Dmytraczenko & Gisele Almeida, 2015. "Toward Universal Health Coverage and Equity in Latin America and the Caribbean," World Bank Publications - Books, The World Bank Group, number 22026, December.
    3. Sanggon Na & Soonman Kwon, 2015. "Building Systems for Universal Health Coverage in South Korea," Health, Nutrition and Population (HNP) Discussion Paper Series 98266, The World Bank.
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    2. Sutton, Claire & Prowse, Julie & McVey, Lynn & Elshehaly, Mai & Neagu, Daniel & Montague, Jane & Alvarado, Natasha & Tissiman, Chris & O'Connell, Kate & Eyers, Emma & Faisal, Muhammad & Randell, Rebec, 2023. "Strategic workforce planning in health and social care – an international perspective: A scoping review," Health Policy, Elsevier, vol. 132(C).

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