Identifying and addressing human resources requirements for sustainable and high quality HIV/AIDS care and treatment in Uganda

Accurate information on staffing requirements for HIV/AIDS care is central to sustaining high quality service delivery. A USAID-funded project supports, in collaboration with Uganda's MOH, rapid scale-up of HIV/AIDS services at eleven regional and seven district hospitals. Among other support, the project seconds staff to compensate for shortages in the civil service workforce.

In 2011 the project conducted an HR assessment. Record reviews, time-task analysis, and time-utilization observations were used to document the existing workforce and workload at the hospitals' HIV clinics and identify staffing requirements.

Among the findings:

- Given current service structures, providing care to 1000 HIV+ clients annually requires 0.7 full-time clinical staff, 1.9 full-time counselors, 1.0 full-time lab staff and 0.4 full-time pharmacy dispensers. - Some participating hospitals were adequately staffed for the moment, but all would require additional staff as the number of clients expanded. - The greatest shortages were among dispensing and counseling staff. - Staff time could be used more efficiently.

The assessment findings were used to develop staffing plans for each site.

Facility-level staffing analyses help clinic managers understand staffing needs. They can be used to advocate for adequate workforce and to develop strategies to fill gaps (such as expanding the use of volunteers for selected tasks, rotating staff, or adapting the organization of services).

RECOMMENDATIONS: HR management can be used in some cases to improve service delivery. However, to meet national targets, the government and its partners must plan to both increase the health workforce and utilize the existing workforce efficiently.