MANPOWER (HUMAN RESOURCES)

Several questions need to be answered with regard

to the provision of health personnel. How many are
required and can be employed? What is the role of
each category of staff and what tasks are they
expected to perform? What training do they require
to enable them to fulfil their respective roles? For a
fuller discussion of these questions, see 'Health
personnel'.

MANAGEMENT
The resources available to the health authorities
should be skilfully managed at all levels, from the
most peripheral unit to the central office at the
headquarters of the Ministry of Health. Training in
management is essential for health workers,
especially those who are placed in positions of
authority and supervision. In small units, the health
workers would need to devote some of their time to
dealing with administrative and other managerial
issues. In large units such as large tertiary hospitals,
trained administrators can make
a useful contribution to the management of the
services.

HEALTH PERSONNEL
The terminology used in classifying health personnel
is wide and varied, reflecting differences in local
practices and in organization. Often, different titles
are given to personnel who perform essentially the
same function and in other cases the same title is
used for workers who perform different functions.
Terms such as medical personnel, health personnel,
professionals, paramedical personnel,
subprofessionals and auxiliaries have been subject to
varied interpretations. However, important general
principles can be widely applied:
What tasks need to be performed?
What types or categories of personnel should
perform the tasks?
What training and supervision do they require to
function effectively?

Tasks
The tasks to be performed include:
leadership in health matters;
health promotion within the community;
education of the public;
specific interventions especially those requiring
knowledge and skill, e.g. prophylaxis, diagnosis,
treatment including surgery and rehabilitation;
monitoring and evaluation to assess performance
of the services, outcomes and eventually, impact.
There is a tendency to overlook the first three tasks

and to think of the function of the health personnel

solely in terms of the performance of technical
interventions.

Types of health personnel

Each component of the health services requires a

team of personnel with different skills who are
working together in pursuance of common goals.
Some members of the team are usually described as
professionals, whilst others are variously described
as subprofessional or auxiliary personnel. It is not
possible to provide rigid criteria for separating these
categories.
At one end of the spectrum, the auxiliary health
worker is trained to perform a number of specific
tasks, of limited scope under supervision. This may
either be as a monovalent worker in a special
programme, for example a vaccinator, a yaws scout,
etc., or as a multipurpose health auxiliary who can
perform a list of specific tasks in accordance with
clearly defined guidelines. At the other extreme, the
professional worker is expected to have acquired
sufficient basic knowledge and skills to be able to
identify and analyse problems and arrive at
independent judgements of situations, for example
doctors, dentists, nurses, mid-wives, and so on.
Regardless of the nomenclature and classification,
the important issue is to recognize the need for team
effort with allocation of tasks on the basis of skill
and experience.
In order to meet special needs, some health practitioners
take bold innovative uses of health personnel.
For example, in some remote communities,
where no doctors are available, nurses have been
trained to perform emergency caesarean sections and
other life-saving obstetric procedures.
Supervision
One important aspect of the management of health
services is the appropriate supervision of staff. This
is an essential function to be performed by the leader
of each group or subgroup. To be effective, the
leader must know what tasks need to be performed
and what skills the workers under supervision
possess.
Experience has shown that the best results are
obtained if feedback is positive, not only blaming
when things go wrong but also praising and
rewarding good performance. The supervisor's role
also includes teaching colleagues as well as learning
from them. Spot checks of performance should be
carried out regularly to prevent slackness in
procedures.