An estimation of staffing requirements in primary care in Oman using the Workload Indicators of Staffing Needs method

Background: Oman is a high-income country having a relatively small population scattered over large sparsely populated areas. This presents challenges to the provision of health services. It is important to ensure that all health facilities at all levels of care have the right number and skills mix of health workers to deliver quality health care. Aims: The main aim was to develop national staffing norms to ensure adequate numbers, appropriate skills mix and equitable distribution of health professionals in primary health care (PHC) using the workload indicators of staffing needs (WISN) method. Methods: All types of PHC services were itemized (promotive, preventive, curative, and rehabilitative and support services). We used 2014 data from the health information system and the human resources management information system to develop staffing norms using the WISN method. First we set the norms based on the national average for the activity standards, then simulated the norms in Muscat governorate, which has 32% of the population. Results: We calculated the required numbers of GPs and specialists for PHC centres providing core as well as core and supplementary services and the expected annual outpatient attendance. The simulation showed that doctors were less workload stressed (WISN ratio 1.02) than nurses (WISN ratio 0.66) on average, although some variations between health centres were noted. Conclusions: Additional parameters (e.g. planned new services; local disease profile; change in health policies) may be added in future to re-adjust the calculation method once the health services mapping and human resources for health profiles for each governorate is completed.