Abstract
Introduction: In Cambodia, proper management of the health workforce is one of the major challenges faced by the current health system, particularly the uneven distribution of nurses and midwives at the health center level. This study aimed to explore the current workload of health staff and the skill mix needed at the health center.
Method: We used the data from the study of the Workload Indicators of Staffing Needs (WISN) for Health Centers in Cambodia, 2019 and 2020. There were 24 public health facilities (HCs) in 6 provinces with a total of 214 staff, both health staff and non-health staff. The workload indicator of staffing need (WISN) tool was employed to calculate the workload and the staff requirement for each HC.
Results: Across health centers, midwives and nurses spent 43% and 20% of their working hours, respectively, performing core health service activities, while other 57% and 80% of their working time were used for support activities. These included meetings, training, supervisions, data management, outreach/community activities, finance & administrative tasks, and so on.
Conclusions: Nurses and midwives are mostly occupied with support activities rather than actual core health service activities. Therefore, there is a need for diverse public health skills at the health center level to support this such as management, planning, administrative, finance and community outreach, etc. These public health workforces should be employed to improve work efficiency and consequently giving time to nurses and midwives using their technical skills to improve the performance of the primary health at the grassroots level.