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Table 1 Indicators for health workers' performance

From: Human resource management interventions to improve health workers' performance in low and middle income countries: a realist review

Factors Examples of indicators*
Impact  
Health status Decline in mortality/morbidity among targeted patients:
Decreased prevalence and incidence
Effects  
Performance Improved service delivery:
Client satisfaction
Re-admission rates and cross-infections
Case fatality rates
Treatment success rates, defaulter rates
Coverage
Service utilisation
Outcomes  
Availability Waiting time, staff ratios, overtime, staff turnover, attendance of health workers
Productivity Occupancy rate, outpatient visits and interventions provided per worker or facility
Patient contacts
Competencies Prescribing practices
Adherence to protocol during diagnosis and communication with patients
Responsiveness Proactive quality service, e.g. decubitus ulcers
Outputs  
Retention Vacancies, posts filled, duration in job
Absence Attendance of health workers, overtime
Being responsible Showing initiative, active participation in audits and meetings
Adherence to rules and Standard Operating Procedures
Skills and knowledge Level of skills and knowledge of practices
Motivation and job satisfaction Level of job satisfaction
Level of staff motivation
Working conditions Availability of infrastructure, medications, supplies
Being aware of and adhering to communication and decision-making procedures:
Number of meetings held with minutes and action list
Confidential procedure for complaints in place and used
Management support offered:
Amount of supportive supervision
  1. * Indicators taken from among others:
  2. • WHO: World health report 2006. Working together for health. Geneva, World Health Organization; 2006
  3. • Buchan J.: Increasing the productivity of an existing "stock" of health workers: review for DFID. London, Department for International Development; 2005.
  4. • Hornby P, Forte P.: Guidelines for introducing human resource indicators to monitor health service performance. Keele, Keele University Centre for Health Planning and Management; 2002.
  5. Adapted from Dieleman M. and Harnmeijer JW.: Improving health worker performance, in search of promising practices. Amsterdam, The Netherlands: KIT; 2006
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