The implementation process of the Workload Indicators Staffing Need (WISN) method by WHO in determining midwifery staff requirements in Greek Hospitals

INTRODUCTION One of the greatest challenges in the healthcare field is planning the health workforce under limited financial resources while being fully capable of responding to an affordable, fair and efficient healthcare system. This study aimed to demonstrate the implementation process of the health workforce planning tool ‘Workload Indicators of Staffing Needs’ introduced by the World Health Organization. METHODS A descriptive and cross-sectional study was carried out at four (two public and two private) hospitals in Greece, to estimate midwifery staff requirements at ward level during 2015–2016, using the WISN software tool. Focus group discussions, structured interviews and annual service statistics from the hospitals’ records were used to obtain data. RESULTS Results for both private hospitals showed a shortage in the number of midwives. However, after combining the interpretation of the results, as indicated by the WISN methodology and the structured interviews, current and required staffing is in balance in both. On the other hand, both public hospitals indicate a surplus of midwives (1.83 and 1.33 ratios for the General hospitals in Korinthos and Kalamata, respectively). CONCLUSIONS This study demonstrated the implementation process of the WISN methodology through its application in midwifery staff at four hospitals in Greece and confirmed its usefulness in estimating staffing requirements. The application of the WISN methodology should be viewed as a vital tool in assessing overstaffing and understaffing through the estimation of workload pressure among different categories of health staff, thus providing the basis for effective health workforce redistribution in Greece. INTRODUCTION Throughout the world countries are trying to regulate and adapt their health systems in order to ensure real and sustainable improvements in their populations’ health status as set forth in the United Nation’s Millennium Development Goals1. One of the most important components for the sustainability, functioning and performance of the labourintensive health sector is the health workforce (or human resources for health) and the way it is planned and managed under limited financial resources while being fully capable of responding to an affordable, fair and efficient healthcare system2,3. Consequently, the process of health workforce planning that according to Hall and Mejia4 is ‘the process of estimating the number of persons and the kind of knowledge, skills and attitudes they need to achieve predetermined health targets and ultimately health status objectives’, is fundamental in ensuring good quality healthcare, influencing a population’s health status and ensuring the sustainability of healthcare systems across the world. Nonetheless, planning the health workforce is a challenging process. On the one hand, the changes in the sociodemographic, epidemiological cultural and social profiles of the population affect the need for health services, and on the other hand, they affect the health workforce’s AFFILIATION 1 Department of Social and Educational Policy, University of Peloponnese, Corinth, Greece 2 Department of Nursing, University of Peloponnese, Sparti, Greece 3 Department of Economics, University of Piraeus, Athens, Greece 4 Department of Public Administration, Panteion University, Athens, Greece CORRESPONDENCE TO Fotini Gialama. Department of Social and Educational Policy, University of Peloponnese, Corinth, Greece. Email: fgialama@gmail.com