Improving Healthcare Delivery with Strategic Resource Plan  

The need for Nigeria to stem the massive exodus of its healthcare professionals through the development of a strategic human resource plan for effective management of personnel at the various public health facilities, has become a thing of necessity, write Ugo Aliogo and Oluchi Chibuzor 

The ‘JAPA’ syndrome, where Nigerians of different professions leave the country in large numbers in search of greener pasture, has become a crucial human capital dilemma in recent times which has led the gradual loss of the country’s best brains and talented workforce.

This is a serious problem in Nigeria presently as the trend has been on the increase, and created a huge talent gap, thereby imposing a serious challenge to talent sourcing especially in the healthcare industry.

With a deficit of 315,426 medical doctors and over 6,067 Nigerian doctors migrating to the United Kingdom within the last seven years, experts have attributed this to the lack of proper use of the human resource (HR) in the healthcare sector.

Generally, it is known that human resource managers oversee the administrative affairs of a corporate organisation but research has shown that the presence of an HR manager in a healthcare facility is essential in delivering effective services.

Human resources management and development in the healthcare sector are seen as an element that requires less consideration when creating a strategic plan, but it is an essential element in the growth and success of an institution in the healthcare sector. 

Due to the lack of strategic human resources plan and management, a lot of medical facilities especially in the public healthcare sector are failing. 

A strong healthcare system reflects a country’s development level, thus any obstacles in the industry must be solved efficiently and HR leaders in healthcare have been faced with countless challenges in the past decades. Many of these challenges have remained unsolved and the COVID-19 pandemic took a further toll on the country’s healthcare system.

While efforts are being made in addressing most of the challenges facing talent sourcing, HR professionals need to diversify ways to optimise the land and available human resources through engagement and employer participation.

At a stakeholders’ conference, the issue of adopting human resource as a vital element in tackling the issues affecting the healthcare sector, was brought to the front burner of discourse at the Society for Quality in Health in Nigeria (SQHN) event themed: ‘Human Resource in Healthcare: Building an Efficient and Resilient Workforce’.

Brain Drain Case Study 

Speaking during the event, the medical director of Federal Medical Centre (FMC), Dr. Adedamola Dada, highlighted the essence of having a strategic human resource while describing it as the process of attracting talent, retaining them, and ensuring they are appropriately rewarded, and developed in the best interest of both the employers and organisation. 

He hinted that human resource management is the glue that binds everything done in the organisation especially in the medical setting.

He revealed that FMC as a multi-specialist hospital has 288 beds and is a SafeCare Level 4 Hospital in the country. 

He also revealed that the medical center has 1250 workers with 32 percent clinical and 68 percent non-clinical serving low and middle income clients including people in hard-to-reach communities. 

Speaking on the challenges he encountered during implementing HR plans in FMC Ebute Metta, he highlighted staff issues such as over-staff, inadequacy, lack of motivation, attitude, loyalty, and overbearing labour unions.

According to him, “In 2017, I met dilapidated infrastructure and general poor state of the hospital’s internal wards, clinics, lab, pharmacy, kitchen and external environment.  There was also the issue of rationing of electricity supply, leaking roofs, inadequate modern equipment, poor work environment, while adding that lack of work tools demotivates staff. On the issue of brain drain, FMC Ebute Meta has witnessed a total of 152 exits from January 2021 to August 2022. A total of 38 doctors, 42 nurses, 30 Lab/Pharm/Physio and 42 other healthcare professionals have left the country within the period.

Commenting on the issue of funding in the developing healthcare facilities as can be seen in the case of FMC, the board member, SQHN, Dr. Kunke Onakanya, said funding cannot be attributed as the reason responsible for human resources issues in healthcare. 

“I do not think just saying that funding is the reason behind the human resource issues in healthcare, it will be a very simplistic approach. This is because if you look at all that motivates a professional’s funding, finance and money is just one of it; it is by no means all of it,” Onakanya said.

He further explained that funding is one of the problems, but added that if other issues such as the issues of infrastructure, quality in terms of care that is provided, the issues of training and provide mastery to the professionals, “you will remain in the same situation. We have learnt from this conference that there are a lot of things that we still need to address.”

 “As a private medical practitioner, I think what the FMC Ebute Metta story shows and what their MD clearly demonstrated today is that it can be done. It can be done in public and private health practice, that is the example and lesson for this morning,” he said.

Strategic Health Care Plan

In his presentation, human resource management specialist in healthcare, Dr. Obi Obinna, lamented that the issue of brain drain in healthcare has been a crucial HR dilemma in recent times. 

According to him, the trend has been on the increase and in turn created a huge talent gap and imposes a serious challenge to human resourcing especially in the healthcare industry.

He also stated that research has shown that 90 per cent of hospital executives believe that in the next 1 years they would experience a deficiency of specialists, generalists, physicians, nurses and other clinicians, which will hamper their ability to deliver high quality care.

“It is paramount that every organisation should have goals which must entails achieving flexibility, innovation and competitive edge especially in the public health sector; which is an important attribute every organisation must have to survive, inventing a suitable organisational culture and increased efficiency in the run of business in the organisation. Creating solutions in tackling these issues in the medical system through proper strategic human resources plans can help,” Obinna said.

He emphasised that without an effective management of the organisation in the healthcare sectors there would be service failure and clients dissatisfaction, noting that human resource management is the glue that binds everything done in the organisation.

Retaining Healthcare Professionals 

Speaking on the significance of retaining healthcare facilities, Obinna advised that HR officers should offer flexible scheduling to attract and retain health workers.

He maintained that HRM should consider temporary arrangements to attract providers who are training for higher-level jobs and hire them as temporary employees at their current levels while they are working on new certifications. 

Obinna remarked that HR in health facilities must ease burnout to minimise dissatisfaction, and improve work-life balance for their healthcare professionals that are employed at their facilities. 

“With the night tools, they can help employees become more effective and enjoy greater satisfaction at work resulting in increased employee retention, greater capacity and higher performance. HR leaders in healthcare are thus being pushed to be forward-thinking and tech-savvy.

“Facilitating public-private partnership, developing work life balance programmes and mental well-being education and improving communication channels and providing effective and ethical leadership and governance in healthcare institutions. HR and organisations should provide career advancement programmes and opportunities, invest in training, learning and development programmes to keep abreast of new innovations. They must develop and implement enhanced health sector salary/incentives schemes especially in deprived areas.

“The health sector requires diverse and precise application of knowledge to deliver quality services. Changes in the health environment require additional competences with respect to clinical and relational skill sets in order to perform optimally. These skills include having resilience, leadership, emotional intelligence, empathy, quality assurance management and Communication skills will enhance building and sustaining a great organisational culture,” Obinna added. 

Poor Human Resource Planning

Healthcare human resource planning is an important aspect of healthy policies and it ranges from manpower planning and resourcing, recruiting and retention of qualified staff, training and development, HR budgeting and funding, remuneration and allowances, compensation and benefits.

Obinna argued that non-availability of adequate funding would impose a great challenge in attracting, managing and retaining talents in organisation as talent shortage in the healthcare sector can mean either life or death

Obi revealed that these challenges will affect quality of patient care, whether directly or indirectly.

He observed that the required skills for qualitative service delivery are usually scarce and limited within Nigeria, a challenge that should be conquered in a technology-driven healthcare delivery. 

“This requires skills especially as numerous medical equipment and machines have evolved in the recent past. Artificial intelligence, robotics, machine learning, medical coding, telemedicine are taking the lead in the medical and healthcare industry,” Obinna noted.

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