Search

Background: Quality nutrition services are dependent upon the accessibility and availability of nutrition professionals. In this study, we used the World Health Organization’s Workload Indicators of Staffing Need (WISN) methodology to develop a dietetic staffing norm framework and implementation tool for South African central and tertiary public hospitals. Methods: We followed the eight step WISN methodology as a basis for this developmental study. National data on permanently employed dietitians in public hospitals were used to determine the facility type. Available working time (AWT) was determined using WISN calculations and SA labour regulations. Consensus on workload components (WC) and activity standards (AS) was achieved through a Delphi exercise. Steps 5 to 8 ended in determination of dietitian requirements based on WISN software. Similar steps were used to develop the framework and tool. The tool’s calculated outputs were compared against the WISN software. Results: Central and tertiary public hospitals were identified as the target facilities. Dietitians AWT at these facilities was calculated as 1528 h per year. A final list of 45 WC and aligned AS was obtained and provided the necessary contextualization. A WISN based framework, and a Microsoft Excel tool (calculator) resulted. Calculated average dietitians’ requirements were 24.59 and 24.23 for WISN software and the excel tool respectively. Conclusion: The WISN methodology is a versatile tool that allows for the development of context and cadre specific staffing norm implementation frameworks and tools. The developed tool is valid and contextualized to determine the specific need for dietitians at SA central and tertiary public hospitals. These results will help policy makers to plan and forecast dietetic staffing needs at a macro level. [ABSTRACT FROM AUTHOR]

South Africa faces both under- and over-nutrition, highlighting the need for prioritizing nutrition services. Registered dietitians are crucial for delivering appropriate and quality nutrition services. Consequently, this case study employs the World Health Organization evidence-based Workload Indicators of Staffing Need to ascertain the requisite dietetic workforce needed at central and tertiary public hospitals in South Africa. Head dietitians from 21 of 22 central and tertiary public hospitals participated in an online survey to provide data and consensus on workload components and activity standards via Delphi technique. Data were analyzed using the World Health Organisation Workload Indicators of Staffing Need software. Dietetic staffing needs were determined based on the difference between existing and required numbers of dietitians. WISN ratio was used as a metric to gauge dietitians' workload pressure. Majority (95%) of hospitals experienced dietetic staff shortages and few (14%) had requisite staff to cover basic health services. Majority (76%) exhibited a WISN ratio below 0.5, indicating fullfilment of less than 50% of staff requirements. Based on the Workload Indicators of Staffing Need, dietitians in South African central and tertiary public hospitals experience high workload pressures due to extreme understaffing. The results can guide future profession workforce planning to facilitate enhanced nutrition outcomes in South Africa. [ABSTRACT FROM AUTHOR]