ABSTRACT
The problematic situation of developing
societies to retain their medical personnel given their inability to institute
viable manpower plan and conducive work environment that should be suitable for
the fulfillment of the lofty aspirations of medical personnel is what
necessitate the study. Hence, the study investigated the
relationship between manpower planning, work environment and service delivery
in Ogun State Hospital Management Board (OGHMB). Three hypotheses were
formulated and tested for the study.
The main instrument used for
this study was questionnaire and interview administered medical and non-medical
personals of the board randomly selected from ten hospitals infive zones in
Ogun State. This study adopted both quantitative and qualitative research
designs, while Product Moment Correlation Coefficient (r) and regression to
test the stated hypotheses.
The
finding of this study revealed that in the ten hospitals of the zones in Ogun
State the goal of hospital are clearly stated, they fulfil project requirement
by deploying the required workforce in their area of specialization and
manpower, there is also a positive relationship between manpower and service
delivery in the hospital. It was also revealed that manpower and work
environment have significant effect on service delivery.
Based on these findings, the researcher
therefore recommended that the health sector must embark on radical
reorganization of its objectives and aims which must primarily cater for the
welfare of its personnel which is fundamental to service delivery and therefore
redirect the public perception on the place of government hospitals as not just
death traps but as a reliable solution to all form of health challenges.
CHAPTER ONE
INTRODUCTION
1.1
Background
to the Study
Manpower
planning is an essential cornerstone in the efficient management of personnel
in an organization. Manpower planning for health is not all about number, it
involves distribution, quality and productivity. In essence, man power planning
for health is concerned with getting the right number of staff, in the right
places, at the right time, doing the right job, with the right motivation, at
the right cost. Within many health care systems worldwide, increased attention
is being focused on human resources management (HRM). Specifically, human
resource is one of the three principles of health system inputs, with the other
two major inputs being physical capital and consumables.
Manpower
planning becomes a necessity and a possibility for two reasons; first the
education and training of medical personnel is a time consuming and costly
affair. Medical personnel are highly educated and therefore highly specialized.
Acquiring other skill is difficult, time consuming and signifies a waste of
effort and money. Secondly, medical education and training is very costly,
therefore educational planning and medical planning have to go hand in hand.
Expansion includes the setting up of new medical schools and faculties and at
least the increase of the existing capacity. A reduction of the trend is
possible by imposing a numerous clauses (student stop) in the existing
faculties.
According to Ejumudo (2010),
manpower, when pertaining to health care, can be referred to as the different
kinds of clinical and non-clinical staff responsible for public and individual
health intervention. As arguably the most important of the health system
inputs, the performance and the benefits the system can deliver depend largely
upon the knowledge, skills and motivation of those individuals responsible for
delivering health services.
In the same vein, Erinoso (2008) sees Manpower planning as a process to
measure and compare current manpower with future manpower relative to an
organisation’s strategy and business planning process. Therefore an
organisation operates most effectively when the right people with the right
knowledge, skills and competencies are deployed appropriately. Manpower
planning is expected to focus on the size and composition of manpower, its
deployment across organisation, and the knowledge, skills and competencies
necessary to pursue stated objectives.
It includes all managed movement into, around and out of organisation
including recruitment, promotion, secondment, transfer, redeployment, and
retention. Manpower
planning which is also known as human resource planning consists
of putting right number of people, right kind of people at the right place,
right time, doing the right things for which they are suited for the
achievement of goals of the organization. The manpower planning process
is an ongoing and continuous strategy which is undertaken through a systematic
set of procedures (Oyibo, 2010).
The availability of manpower has been cited as the most
important influence of service delivery in any organization (Clark, 2012).
Institutional effectiveness was not remain unhindered when poor quality work
environment thus cause employee dissatisfaction with job with the usual
resultant high turnover which can force a reduction in job performance. The
work environment can involve the social interactions at the workplace, including
interactions with peers, subordinates, and managers. Generally, and
within limits, employees are entitled to a work environment that is free from
all forms of harassment.
Health care services include all
services dealing with the diagnosis and treatment of disease or the promotion,
maintenance and restoration of health (Oyibo, 2010). They include personal and
non –personal health services. Health care services are the most visible
functions of any health system, both to users and the general public. Service
care provision refers to the way inputs such as money, human resource,
equipment and drugs are combined to allow the delivery of health interventions.
Improving access, coverage and quality of services therefore depends on the
availability of these key resources; on the ways services are organized and
managed and on the incentives influencing providers and users. In the
healthcare delivery, effective planning is needed to ensure that quality
services are provided to those in need. Effective health service delivery is
also concerned with bringing about an acceptable level of coherent programmes
that assist in bringing health care services to populations who would not have
had sufficient or no access to health services.
Doctors
and nurses are reluctant to relocate to remote areas and forest locations that
offer poor communications with the rest of the country and few amenities for
health professionals and their families. Urban areas in Nigeria are more
attractive to health care professionals for their comparative social, cultural
and professional advantages. For instance, medical personnel posted out from
State hospital, Ijaye in Abeokuta are usually reluctant to comply, in some cases,
such staff are queried before they eventually take up the posting. This is as a
result of the fact that metropolitan centers in the country offer more
opportunities for career and educational advancement, better employment
prospects for health professionals and their family, easier access to private
practice and lifestyle-related services and amenities, and better access to
education opportunities for their children. In addition, the low status often
conferred to those working in rural and remote areas further contributes to
health professionals' preference for settling in urban areas, where positions
are perceived as more prestigious. This has significant consequences on the
health of inhabitants of rural areas as unavailability of physicians and nurses
within close proximity often leads to delaying and postponing visits to health
care facilities until the condition becomes unbearable. Transporting the
patient on treacherous roads to urban facilities may take several hours and
this may lead to death.
In
Nigeria, scarce data on the availability, distribution and trends in manpower
for health has been a barrier to effective manpower planning. This situation
couple with lack of conducive work environment usually results to poor service
delivery in the hospitals.
1.2 Statement of the Problem
In
the world over, the unending need for good health care is a primary need of
everyone irrespective of societal placement and social status. This situation
has however increased the need for medical personnel that on a general note is
lacking in Africa and Nigeria in particular. Therefore, it becomes a
problematic situation for developing societies to retain their medical
personnel given their inability to institute viable manpower plan and conducive
work environment that was be suitable for the fulfilment of the lofty
aspirations of medical personnel who for want of greener pastures leave their
home-country for more developed societies thereby compounding the health
challenge of their medically challenged citizens. This problem is fundamentally
a result of failure of the managers of the institution of state to provide an
enabling ground that will be suitable for the actualization of desired
aspiration of workers.
According
to Enebulele, (2013) only one in three registered Nigerian doctor’s practice in
the country, with the other two-thirds migrating abroad. He goes further to
state that, of the 71,740 doctors registered with Medical and Dental Council,
about 27,000 are practicing in Nigeria while others are practicing outside the
shores of this country. According to him, up to 7000 Nigerian doctors combined
work in British and American health sector, while some have left the medical
profession on account of better working condition.The Nigeria's health system
is in a poor state and this is traceable to several factors especially the
gross under-funding of the health sector and shortage of medical personnel at
the primary health care level. However, Nigeria is one of the several major
health-staff-exporting countries in Africa; this fact is however due to poor
manpower planning amongst the personal mangers and poor work environment which
does not give room for self-actualization which is evidence in the number of
health care workers who leave the country after their training for greener
pastures abroad. As a result of inadequate infrastructure and poor compensation
packages, a sizeable number of physicians, nurses and other medical
professionals are lured away to developed countries in search of fulfilling and
lucrative positions Enebulele (2013).
Across Nigeria, there is a national
health manpower crisis marked by critical imbalances. In some states especially
in Ogun State, Nigeria there is shortage of health practitioners, such as doctors,
nurses, pharmacists, physiotherapists and other health workers. Enebulele notes
that medical personnel in Ogun State South-West Nigeria, especially doctors are
over stretched, for instance, a doctor is supposed to attend to about 20-30
patient per day but given the poor work condition that has occasioned mass
exodus of health workers they attend to about 70-120 on a daily basis. This
situation is however compounded by the insecurity situation and poor work
condition that has forced many of them to relocate to places where their safety
is guaranteed.
The ongoing underinvestment in the
health sector, coupled with poor employment conditions and policies (such as
exposure to occupational hazards, discrimination and physical and psychological
violence; insufficient remuneration; unfavourable work-life balances;
unreasonable workloads, limited career development opportunities) have resulted
in a deterioration of working conditions for health professionals in many
states. There is some fear that this may have serious negative impact on the
recruitment and retention of health professionals, the productivity and
performance of health facilities, and, ultimately, on service delivery to
patients. Hence, the
motivation for this study with emphasis on manpower planning, work environment
and service delivery in Ogun state hospital management board.
1.3 Objective of the Study
The general
objective of this study is to investigate the relationship between manpower
planning, work environment and service delivery in Ogun State Hospital
Management Board (OGHMB). The specific objectives are to:
1.
examine the impact of
manpower planning on service delivery in Ogun State Hospital Management Board;
2.
determine the causes of
inadequate work environment on service delivery by hospitals in Ogun State
Hospital Management Board;
3.
appraise the effect of
work environment on service delivery by hospitals in Ogun State Hospital
Management Board;
4.
interrogate the public
perception of service delivery in Ogun State Hospital Management Board and
5.
make solutions that enhance
administrative functions for constructive manpower planning and conducive work
environment for satisfactory service delivery in the health sector.
1.4 Research Questions
Based on the
findings carried out the following questions were:
1.
How does effective
manpower planning affect service delivery in Ogun State Hospital Management
Board?
2.
Why are there
inadequacies in the work environment on service delivery in Ogun State Hospital
Management Board?
3.
How does work
environment affect service delivery by hospitals in Ogun State Hospital
Management Board?
4.
How do people perceive
service delivery in Ogun State Hospital Management Board?
5.
How can there
besolutions that will enhance administrative functions for constructive
manpower planning and conducive work environment for satisfactory service
delivery in the health sector?
1.5 Hypotheses
The following will be tested at 0.05
significance level
H1:
There is a significant relationship between manpower planning and
work
environment in OgunState hospital Management
Board.
H2: There is a significant effect
of manpower planning on service delivery of hospitals
in OgunState hospital management Board.
H3: There is a significant effect of work environment on service
delivery of hospitals in
Ogun State Hospital Management Board.
1.6 Significance of the Study
The significant
of this study is that it may provide useful guidelines for stakeholders in the
health sector towards establishing harmonious relationship among all the health
workers thereby enhancing effective and efficient service delivery,
particularly as it affects Ogun state hospital management board. The study may
also expand the frontier of knowledge on the importance of manpower planning in
relation to service delivery in the health sector generally and Ogun state
hospital management board in particular. The findings may significantly assist
all stakeholders and government to deal with the problem of ensuring an effective
and efficient manpower planning, conducive work environment and service
delivery in Ogun state hospital management board. In conclusion, the study
seeks to fill the gap in the existing studies on the importance of manpower
planning, utilization and good work environment which is a basic perquisite for
passionate service delivery which is the hallmark of medical professional
across the world.
1.7 Scope of the Study
This study
focused on the issues of manpower planning, work environment and service delivery
in Ogun state hospital management board. The study was also cover the periods
between 2010 and 2016.This period was be chosen because it marked the high
point of efflux of medical personnel from the health sector because of
inadequate manpower planning, unconducive work environment which does not
guarantee job and life security. The study was equally be based on some
selected General hospitals under the Ogun State Hospital Management Board. The
Ogun State Hospital Management Board was focused on the study because it over
sees the entire management process and matters in Ogun state. The study was
conducted using members of Medical professionals (Doctors, Nurses, pharmacist,
physiotherapist, Radiologist and medical laboratory Scientist).
1.8 Operational Definition of Terms
Manpower
Planning: This is a process used to measure and compare the
current workforce with the future workforce correlative to the organization’s
strategy and business planning process. An organisation operates most
effectively when the right people with the right knowledge, skills and
competencies are deployed appropriately.
Work
Environment: The term work environment refers to
the surrounding conditions in which an employee operates. The work
environment can be composed of physical conditions, such as office temperature,
or equipment. It can also be related to factors such as work processes or
procedures.
Service
Delivery: Service delivery in any health institution is
concerned with bringing about an acceptable level of coherent programmes that
was assist the institution to provide health care to populations having
insufficient or no access to health services. This refers to the way inputs
such as money, human resource, equipment and drugs are combined to allow the
delivery of health interventions.
Motivation: This
refers to the internal and external factors that stimulates desire and energy
in people to be continually interested and committed to a job, role or subject,
or to make an effort to attain a goal.
Recruitment:
It refers to the overall process of attracting and appointing suitable
candidates for jobs within an organisation.
Promotion:
It is the rising movement of an employee from current job to another i.e higher
pay scale.
1.9 Chapter Outlay of the Study
The study was
divided into five (5) chapters. Chapter one was the General Introduction. The
operational definition of terms, conclude the chapter. Chapter Two was the
Review of relevant related literature and theoretical frame work. Chapter Three
was on the Methodology adopted in the study. It includes the Research Design,
the Population of the Study, Sample Size, Sampling Technique, Research
Instruments, Validity and Reliability of Research Instrument, Methods of Data
Collection, Methods of Data Analysis. Chapter Four is the Presentation and Data
Analysis. Chapter Five of the study is the Conclusion on the Research Questions
and Recommendations.
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