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Case Report

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

1
The George Institute for Global Health, University of New South Wales, Sydney 2042, Australia
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School of Population Health, University of New South Wales, Sydney 2033, Australia
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National Health Systems Resource Centre, Ministry of Health and Family Welfare, New Delhi 110067, India
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Health Systems Enablement & Innovation Unit, University of the Witwatersrand, Johannesburg 2000, South Africa
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School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
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General Directorate of Health Personnel, Ministry of Health, Lima 15072, Peru
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Department of Medical Clinics, Universidad Peruana Cayetano Heredia (UPCH), Lima 15102, Peru
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Department of Preventive Medicine and Public Health, Universidad Nacional Mayor de San Marcos (UNMSM), Lima 15081, Peru
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Health Systems, Peruvian Society of Health Administration, Lima 15046, Peru
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Human Resources for Health, Independent Consultant, Lima 15074, Peru
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The George Institute for Global Health, New Delhi 110025, India
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Int. J. Environ. Res. Public Health 2021, 18(23), 12541; https://doi.org/10.3390/ijerph182312541
Received: 29 October 2021 / Revised: 25 November 2021 / Accepted: 27 November 2021 / Published: 28 November 2021
(This article belongs to the Special Issue Decision Making in Public Health)
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.
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Keywords: WISN; decision making; health workforce; planning; health systems; health policy WISN; decision making; health workforce; planning; health systems; health policy
MDPI and ACS Style

Mabunda, S.A.; Gupta, M.; Chitha, W.W.; Mtshali, N.G.; Ugarte, C.; Echegaray, C.; Cuzco, M.; Loayza, J.; Peralta, F.; Escobedo, S.; Bustos, V.; Mnyaka, O.R.; Swaartbooi, B.; Williams, N.; Joshi, R. Lessons Learnt during the Implementation of WISN for Comprehensive Primary Health Care in India, South Africa and Peru. Int. J. Environ. Res. Public Health 2021, 18, 12541. https://doi.org/10.3390/ijerph182312541

AMA Style

Mabunda SA, Gupta M, Chitha WW, Mtshali NG, Ugarte C, Echegaray C, Cuzco M, Loayza J, Peralta F, Escobedo S, Bustos V, Mnyaka OR, Swaartbooi B, Williams N, Joshi R. 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. 2021; 18(23):12541. https://doi.org/10.3390/ijerph182312541

Chicago/Turabian Style

Mabunda, Sikhumbuzo A., Mona Gupta, Wezile W. Chitha, Ntombifikile G. Mtshali, Claudia Ugarte, Ciro Echegaray, María Cuzco, Javier Loayza, Felipe Peralta, Seimer Escobedo, Veronica Bustos, Onke R. Mnyaka, Buyiswa Swaartbooi, Natasha Williams, and Rohina Joshi. 2021. "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 18, no. 23: 12541. https://doi.org/10.3390/ijerph182312541

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