Staffing Your Program

To run a successful family planning program, a manager needs a well-qualified and motivated staff. The process through which the manager determines what kinds of workers are needed, obtains the most qualified people, places them in their jobs, and trains them is called "staffing."

Family planning activities fall into three general categories: clinical, administrative, and educational. These different tasks can be carried out by medical, paramedical, and nonmedical personnel. Staff may be specialized so that each person works in only one of these categories, or staff may perform tasks in two or even all three categories. Some staff may work only on family planning. For others, family planning will only be one part of their job.

You can't manage effectively, and your organization can't attain its goals, without the coordinated efforts of the whole staff. If your program is weak in even one of the three essential staffing functions, it can cause your program to be ineffective.

The three essential functions of staffing are:

• Selection of people with the appropriate skills, attitudes, and potential, which will improve organizational performance.
• Orientation of staff to ensure that all staff members know what their roles and duties are and how to perform these duties. This prevents wasted time and costly mistakes.
• Staff development through training and daily interactions to ensure that staff will have knowledge, attitudes, and skills to do their jobs well. This complements and reinforces orientation, builds morale, reduces staff turnover, and creates a work environment where all employees can work productively and strive for improvement.

Staffing can be difficult for managers because they are faced with delivering family planning services in a complex and often highly interdependent environment. Several situations in which family planning managers commonly find themselves are listed below:

• Family planning may have just been added to the existing package of health services. The program manager may have little or no prior experience in choosing the best staffing pattern (that is, how many nurses, aides, or technicians are needed to provide family planning services).
• Training in family planning service delivery may not have been included in the basic professional education of the existing health care staff, and as a result they have not been properly trained to provide family planning services.
• Staff may often be loaned from one organization to another, which can result in confusion concerning roles, responsibilities, and reporting.
• Family planning programs may be controversial. The staff may have unsupportive attitudes toward family planning, or the program's activities may be restricted.
• Limited resources may make it necessary to use volunteers and staff from other departments or organizations. Family planning managers need to know how to recruit, train, motivate, and supervise this type of family planning worker.

The family planning manager is responsible for making sure the tasks are appropriately assigned to competent personnel. As a family planning manager, you should know how to :

• Describe clearly and precisely the work that has to be done so that those who recruit workers will know what skills are needed;
• Orient your staff to the duties and responsibilities of their jobs;
• Train your staff to work effectively;
• Maintain the level of staff competence necessary to achieve both the short- and long-term objectives of the family planning program.

To help in selecting the most appropriate people for the program, the family planning manager prepares job descriptions outlining the work to be done by each staff member. The job description communicates to the person in charge of recruiting the qualifications and skills that the worker must have. A clear job description can reduce political pressure to hire unqualified people by providing objective standards for the job.

To orient staff, the manager can prepare a personnel manual, a manual of Clinical Protocols and procedures, and an orientation checklist. These tools can help introduce new staff to their jobs and familiarize existing staff with new family planning program goals and objectives. In addition, managers can introduce new and existing staff to the program's current or new procedures, rules, and regulations.

To build an effective team, the family planning manager can use supportive supervisory techniques that encourage cooperation, communication, and a frank exchange of ideas. Qualified staff members should be encouraged to develop their abilities further through a variety of staff development techniques.

Selecting Staff

Staff selection may be complicated by the fact that managers may not have much control over selecting staff. The manager may:

• Have to recruit personnel from those already employed in an existing health center or clinic;
• Be limited by civil service and other governmental regulations;
• Be prevented from choosing the best person for the job by social, economic, or political pressures;
• Lose the best candidates due to the inability to offer competitive salaries.

No matter how well-designed or well-funded the family planning program is, family planning services will only be delivered effectively if tasks are properly assigned to the appropriate staff, and if staff have the skills required to do their jobs, are sensitive to the client's needs, and respect the beliefs of the clients.

In many circumstances, your staffing is decided for you. However, when a new program is starting up, or when you feel that modifying the staffing pattern could improve program performance or the quality of care provided, you may need to estimate staffing requirements in order to know how many

employees you need and in what positions. In addition, if you are adding family planning to existing health services, you will need information about the tasks performed and the time that these tasks take.

Projecting or revising staffing requirements involves four steps:

1. Estimating the demand for services

   This step has two parts: an estimate of how many potential clients there are in the community and an estimate of the expected rates of contraceptive use. When combined, these measures can give you an insight into how many people are likely to use family planning services. Information on potential clients and family planning utilization rates is available through national census data, local demographic surveys, and service statistics from ongoing family planning or health programs.

2. Analyzing contraceptive choices

   The analysis of contraceptive choice (what method of contraceptive the family planning acceptors want or would be interested in) will tell you what kinds of services your program should provide. This information is usually available in surveys, existing program data, health service statistics, and data from neighboring countries.

3. Establishing standards for quality of care

   In this step, you must carefully review the kind of services that your program will provide. For each method and service, you will have to develop standards. You can use these standards to determine how many staff members your program will need and what kinds of services each will provide.

4. Projecting staff requirements

   In this step, you estimate the number of staff that you will need to deliver the type, quality, and volume of service that you anticipate.