The Main Reasons for Absenteeism in Health Workers in Somaliland

[Deeq A.]

Health worker absenteeism

As we know low health workers or any professional staff absenteeism causes low productivity for that business sub type,

As we are all serving clients whether they are business shops, Drug companies, Supermarkets, the bellow diagrams and points summarized and identified problems that are culprit for low work productivity in general not specific to a country or institution, reasons is to help my study assignments in learning MPH studies In John Hopkins University,(With my experience in working low in come countries as Clinician, Health workers supervisor, coordinator in both governmental and international NGOs/Humanitarians). I witnessed almost all this points for my time working in health sector.

•  Health Facility In inefficiencies.
•   Health Worker Absenteeism or Ghost workers in some countries.
•   Low patient Demand.
•  In sufficient accountability.
•  Low salary or external opportunities.
•  poor work climate, low patient or client demand.
•  In Security for the staff in some areas of the world (where I witnessed during my field worker south central Somalia).

Low health workforce productivity may be due to health worker absenteeism. Absenteeism is the chronic, unexcused absence from work. The definition of absenteeism can be extended to include excused absences—such as for training workshops, sickness, vacation, or scheduled leave for social obligations—which can also result in the interruption of health service delivery.

Absenteeism may vary from working reduced hours each day (i.e., arriving late, leaving early), only regularly working a few days per week, or even taking lengthy excused absences without having another worker fill in (e.g., health worker away at a one-year training program). In some cases, health workers may be assigned to a specific facility and may appear in official human resources for health (HRH) statistics without ever reporting to work.

Absenteeism can result in patients being turned away because the decreased number of health workers cannot attend to all the patients. In some cases, facilities may close for a period of time due to health workers not reporting to work. To compensate for high health worker absenteeism, facilities may hire additional staff to provide health services. The increase in health worker inputs will reduce productivity.

It can also decrease the number of patients seen, impose heavy and demotivating workloads for those health workers who are present, and/or lower the quality of services. Absenteeism can lower quality in a number of ways, including because the remaining health workers may experience the following:

• Have many more patients to attend
• Have to step in and perform tasks that they are not trained to do
• Become demotivated by the absence of their colleagues and their increased workload.

Health worker absenteeism may be a result of one of more underlying causes:

• Insufficient accountability: If accountability mechanisms to keep health workers on the job when they are supposed to be present are weak, then absenteeism may persist. Weak accountability mechanisms may also be related to issues of governance, leadership, and/or poor management.
• Low salary and external income opportunities:An inadequate income can cause absenteeism for multiple reasons. On one level, health workers may become de-motivated by their low salaries and not want to go to work, thus resulting in absenteeism and its respective effects on service quality. To compensate for low salaries, health workers may engage in additional earning arrangements. This may be a clinical job in the private sector, or outside the health sector in agriculture, trade, or other businesses. Where such opportunities are available, health workers may absent themselves from their official work hours at the health facility to instead engage in their other income-generating activities. Delayed remuneration or payroll issues can also encourage health workers to be absent from work.
• Poor work climate: Staff may more frequently be absent when there is an unsafe working environment in terms of occupational safety and health, sexual harassment, violence, or other security issues. The lack of adequate supplies and equipment could also contribute to a poor climate.
• Low patient demand: Absenteeism could also be the result of low demand for services. If there are very few or no patients (maybe due to perceptions of poor quality, access issues, or other reasons), health workers may not come to work because they feel they are not needed. When patients do seek services, there may not be a health worker to attend to their needs. This can lead to a vicious cycle, creating poor perceptions of service quality on behalf of the patients who inform others of their experiences, thus possibly resulting in a further decrease in patients visiting the facility.

• In Security for the staff in some areas of the world( where I witnessed during my field experience around the globe).

By  Dr Essa A Djama MD, MPH