ArticleBMJ open2020
Assessment of staffing needs for physicians and nurses at Upazila health complexes in Bangladesh using WHO workload indicators of staffing need (WISN) method.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 19 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 52 citations in OpenAlex.
- Article
- Technical efficiency of sub-district level hospitals in Bangladesh: a comparative frontier analysis.Health economics review · 2026Article
- Workplace bullying and turnover intentions among male nurses in Bangladesh: a cross-sectional study.Annals of medicine and surgery (2012) · 2026Article
- Survey protocol: implementing Workload Indicators of Staffing Need in Iranian primary healthcare services.Primary health care research & development · 2025Article
- The implementation of the Workforce Indicators of Staffing Needs (WISN) method to improve access to health workforce in selected South-East Asian countries.PLOS global public health · 2025Article
- Intensity of nursing work in a primary healthcare center: An observational study.International journal of nursing sciences · 2024Article
- Workload Indicators of Staffing Need (WISN) Method for Midwives Planning and Estimation at Asrade Zewude Memorial Primary Hospital, North west Ethiopia.Discover health systems · 2023Article
- A qualitative assessment of facility readiness and barriers to the facility-based management of childhood severe acute malnutrition in the public healthcare settings in Bangladesh.Public health nutrition · 2022Article
- Measuring coverage and quality of supportive care for inpatient neonatal infections: EN-BIRTH multi-country validation study.Journal of global health · 2022Article
- How to make the best use of the workload indicators of staffing needs method in determining the proportion of time spent in each of the workload components and its implication in decision making: the experience of the Sultanate of Oman.Human resources for health · 2022Article
- Determining staffing standards for primary care services using workload indicators of staffing needs in the Philippines.Human resources for health · 2022Article
- Adopting workload-based staffing norms at public sector health facilities in Bangladesh: evidence from two districts.Human resources for health · 2022Article
- Assessment of Staffing Needs for Frontline Health Workers in Selected Maternal and Child Health Services in 3 Countries of Sub-Saharan West Africa: Cote d'Ivoire, Burkina Faso, and Niger.Health services insights · 2022Article
- Study on the Rehabilitation Therapist Estimation Under Institutional Perspective by Applying the Workload Indicators of Staffing Needs in the Aging Context.Frontiers in public health · 2022Article
- Determining staffing needs for improving primary health care service delivery in Kaduna State, Nigeria.F1000Research · 2022Article
- Patient satisfaction level and its determinants after admission in public and private tertiary care hospitals in Bangladesh.Frontiers in health services · 2022Article
- Observational
- Lessons Learnt during the Implementation of WISN for Comprehensive Primary Health Care in India, South Africa and Peru.International journal of environmental research and public health · 2021Article
- Article
Corrections and comments
- Erratum issued
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
objectiveThis study aimed to assess the current workload and staffing need of physicians and nurses for delivering optimum healthcare services at the Upazila Health Complexes (UpHCs) in Bangladesh.
designMixed-methods, combining qualitative (eg, document reviews, key informant interviews, in-depth interviews, observations) and quantitative methods (time-motion survey).
settingStudy was conducted in 24 health facilities of Bangladesh. However, UpHCs being the nucleus of primary healthcare in Bangladesh, this manuscript limits itself to reporting the findings from the providers at four UpHCs under this project.
participants18 physicians and 51 nurses, males and females. PRIMARY OUTCOME MEASURES: Workload components were defined based on inputs from five experts, refined by nine service providers. Using WHO Workload Indicator of Staffing Need (WISN) software, standard workload, category allowance factor, individual allowance factor, total required number of staff, WISN difference and WISN ratio were calculated.
resultsPhysicians have very high (WISN ratio 0.43) and nurse high (WISN ratio 0.69) workload pressure. 50% of nurses' time are occupied with support activities, instead of nursing care. There are different workloads among the same staff category in different health facilities. If only the vacant posts are filled, the workload is reduced. In fact, sanctioned number of physicians and nurses is more than actual need.
conclusionsIt is evident that high workload pressures prevail for physicians and nurses at the UpHCs. This reveals high demand for these health workforces in the respective subdistricts. WISN method can aid the policy-makers in optimising utilisation of existing human resources. Therefore, the government should adopt flexible health workforce planning and recruitment policy to manage the patient load and disease burden. WISN should, thus, be incorporated as a planning tool for health managers. There should be a regular review of health workforce management decisions, and these should be amended based on periodic reviews.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.