Personnel management in a district health service -the case of the Sekyere West District
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Date
2001-12-13
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Abstract
In a ministry with about 73 cadres of staff, one would expect that Personnel Management (PM) would have been taken very seriously. However, strategies for managing personnel
have received very little attention in the Ministry of Health (MOH), yet without the right personnel in terms of skills, training, motivation, commitment and high productivity, the MOH cannot achieve her goal.
The Ministry’s mission statement stresses on effective and efficient Personnel
Management (PM), yet it is not given the needed attention it deserves. Personnel are poorly managed. Recruitment and selection is done at Head Office. There are no proper induction procedures and job descriptions are virtually, non-existent. The service level manager seems helpless in terms of PM. The research assessed PM at the Sekyre West District in order to make recommendations to improve them.
The study was a descriptive qualitative type. Self-administered questionnaires, structured interviews and review of existing records using checklist and data compilation forms were tools used to collect data for the study. A sample size of 66, 20% of the total staff strength of the district, was used. The study covered all the four Budget Ma4agement Centres (BMCs) in the district. The sample size of 66 was distributed among the professionals and BMCs as follows: doctors - 4, medical assistants - 3, nurses - 21, ward assistants/maids - 6, paramedics - 32; District Health Administration (DHA) 3, Sub-District Health Administration (SDHA) —15, Midwifery Training School (MT)- 5 and District Hospital (DH) — 43.
Since most of the issues studied were qualitative, data analysis was done manually and the results put in tables and percentages. The results showed that: 60% of the staff was not happy with the appointment process. For those who were satisfied with the process, they were the non-established staffs who were appointed in the district by the district managers. 62% of staff was not given job description on appointment. 59% of staff was not inducted. 52% would refuse transfer to a rural area due to inadequate pay benefits, poor working conditions, inadequate facilities, lack of basic amenities, and lack of good schools. 41% of staff had spent 10 years or more at one station without going on transfer. 90% of staff was not happy with promotions. 87% of staff was not satisfied with wages and salary administration. There were shortfalls in personnel record keeping. In-service
training centred around senior officers especially heads of units and departments with some of the staff who have not had any in-service training since appointment. For further training the major discipline has been post-basic nursing of which midwifery has been dominant (70%). There has not been any post-basic medical training. Heads of BMCs support union activities by providing unions with secretarial services, granting staff permission to be involved in all union activities, allowing unions to use premises and facilities therein for their programmes, payment of T&T and night allowance to staff who travel to take part in union activities, participating fully in union activities (sometimes becoming parents to unions), and promptly attending to resolutions and grievances of unions.
However, the general observation was that BMC heads have very little role t play in personnel functions. These functions continue to be handled and carried out at the headquarters with all the attendant problems like delayed promotion, high labour turnover and imbalance in the distribution of staff (skewed towards urban areas), that lead to low morale, lateness, absenteeism and low productivity. Most staff are not happy as a result and with the unhappiness come lack of commitment to deliver service to the people.
The study therefore recommended that: management capacity at the district be improved with the appointment of BMC heads with management background, training of BMC Heads in management, appointment of personnel officers for the district, personnel functions be decentralized to the district level so that district managers are empowered to handle most of the personnel functions like recruitment, selection and placement, postings and transfers, promotions, wages and salaries administration, trai1ing and development, all staff be given job descriptions on appointment, all staff be inducted, staff be moved about in the district and that incentives be provided in the rural areas to attract staff there, all staff be appraised annually and that workshop on appraisal be organized for reporting officers, personnel record keeping be improved, and that district managers be empowered to manage their personal emolument budget just like administration, service and investment budgets.
Description
A thesis submitted to the Department of Community
Health, School of Medical Sciences, College of Health Sciences,
Kwame Nkrumah University of Science and Technology in partial
fulfilment of the requirements for the award of MSc.degree in Health Services Planning and Management, 2001