TABLE OF CONTENTS
Title Page i
Table of Contents vi
List of Tables ix
List of Figures x
List of Appendices xi
CHAPTER ONE: INTRODUCTION
- Background to the Study 1
1.2 Statement of the Problem 3
1.3 Objective of the Study 5
1.4 Research Questions 5
1.5 Hypotheses 6
1.6 Significance of the Study 6
1.7 Scope of the Study 7
1.8 Operational Definition of Terms 7
1.9 Chapter Outlay of the Study 8
CHAPTER TWO: REVIEW OF LITERATURE
2.0. Introduction 9
2.1 Conceptual Model 9
2.1.1 Manpower Planning 9
2.1.2 Work Environment 12
2.1.3 Service Delivery and Health Care provision in Nigeria 21
2.1.4. Gap in Literature 24
2.2 Theoretical Framework 24
2.2.1 Herzberg’s Two-Factor Theory 24
2.2.2. Human Capital Theory 27
2.3 Research Model 30
- Review of Related Studies 31
2.5 Ogun State in Brief 38
CHAPTER THREE: METHODOLOGY
3.0 Introduction 40
3.1 Research Design 40
3.2 Population 40
3.3 Sample size and sampling Technique 41
- . Research Instrument 42
3.5. Secondary Data 45
3.6. Method of Data Collection 45
3.7 Method of Data Analysis 46
3.8 Ethical Consideration 47
CHAPTER FOUR: DATA ANALYSIS, RESULTS AND
DISCUSSION OF FINDINGS
4.0 Introduction 48
4.1 Presentation of Data 48
4.2 Section A: Analysis of Demographic Data 49
4.2.1 Inferences from Respondents Characteristics 52
4.3 Analyses of the collected Data 61
4.4. Test of Hypotheses 61
4.5 Discussion of Findings 65
4.5.1 Research Question One: How does effective manpower planning affect service
delivery in Ogun state hospital management board? 65
4.5.2 Research Question Two: To what extent does work environment affect service
delivery by hospitals in Ogun state hospital management board? 66
4.5.3 Research Question Three: What are the causes of inadequate work environment
on service delivery in ogun state hospital management board? Research Question
Four: What is the public perception of service delivery in Ogun 66
- State hospital management board? 67
CHAPTER FIVE: SUMMARY, CONCLUSION
- Introduction 69
5.1 Summary 69
5.2 Conclusion 70
5.3 Recommendations 70
5.4 Contribution to Knowledge 72
5.5 Suggestion for Further Research 73
LIST OF TABLES
3.1: List of sampled Hospitals in Ogun State 41
3.2: List of selected Hospitals in each zones in Ogun State 42
3.3 Reliability Test 45
4.1: Respondent Age group 49
- 2: Marital status of respondent 50
4.3: Length of service of the respondent with the hospital 50
4.4: Qualification of respondent 51
4.5: Respondent indication to the extent they agree to question on manpower planning 53
- 6: Respondent indication to the extent they agree to question on work environment 55
4.7: Respondent indication to the extent they agree to question on service delivery 57
4.8: Public perception of service delivery in Ogun state medical board 59
4.9: Plan for budget of human resources 60
4.10: The extent to which work environment affects service delivery 60
4.11: The extent effective manpower affects service delivery 61
4.12: Correlation analyses between Manpower Planning, Work Environment and
service delivery 62
4.13: Frequency table of public perception of service delivery 64
4.14: ANOVA 64
LIST OF FIGURE
2.1 Researcher (2016): Relationship between manpower planning, work
environment and service delivery. 30
LIST OF APPENDICES
1 Pilot Test 79
2 Questionnaire 81
3 Interview Schedule 85
- Background to the Study
Manpower planning is an essential cornerstone in the efficient management of personnel in an organization. Manpower planning for health is not all about number, it involves distribution, quality and productivity. In essence, man power planning for health is concerned with getting the right number of staff, in the right places, at the right time, doing the right job, with the right motivation, at the right cost. Within many health care systems worldwide, increased attention is being focused on human resources management (HRM). Specifically, human resource is one of the three principles of health system inputs, with the other two major inputs being physical capital and consumables.
Manpower planning becomes a necessity and a possibility for two reasons; first the education and training of medical personnel is a time consuming and costly affair. Medical personnel are highly educated and therefore highly specialized. Acquiring other skill is difficult, time consuming and signifies a waste of effort and money. Secondly, medical education and training is very costly, therefore educational planning and medical planning have to go hand in hand. Expansion includes the setting up of new medical schools and faculties and at least the increase of the existing capacity. A reduction of the trend is possible by imposing a numerous clauses (student stop) in the existing faculties.
According to Ejumudo (2010), manpower, when pertaining to health care, can be referred to as the different kinds of clinical and non-clinical staff responsible for public and individual health intervention. As arguably the most important of the health system inputs, the performance and the benefits the system can deliver depend largely upon the knowledge, skills and motivation of those individuals responsible for delivering health services. In the same vein, Erinoso (2008) sees Manpower planning as a process to measure and compare current manpower with future manpower relative to an organisation’s strategy and business planning process. Therefore an organisation operates most effectively when the right people with the right knowledge, skills and competencies are deployed appropriately. Manpower planning is expected to focus on the size and composition of manpower, its deployment across organisation, and the knowledge, skills and competencies necessary to pursue stated objectives. It includes all managed movement into, around and out of organisation including recruitment, promotion, secondment, transfer, redeployment, and retention. Manpower planning which is also known as human resource planning consists of putting right number of people, right kind of people at the right place, right time, doing the right things for which they are suited for the achievement of goals of the organization. The manpower planning process is an ongoing and continuous strategy which is undertaken through a systematic set of procedures (Oyibo, 2010).
The availability of manpower has been cited as the most important influence of service delivery in any organization (Clark, 2012). Institutional effectiveness was not remain unhindered when poor quality work environment thus cause employee dissatisfaction with job with the usual resultant high turnover which can force a reduction in job performance. The work environment can involve the social interactions at the workplace, including interactions with peers, subordinates, and managers. Generally, and within limits, employees are entitled to a work environment that is free from all forms of harassment.
Health care services include all services dealing with the diagnosis and treatment of disease or the promotion, maintenance and restoration of health (Oyibo, 2010). They include personal and non –personal health services. Health care services are the most visible functions of any health system, both to users and the general public. Service care provision refers to the way inputs such as money, human resource, equipment and drugs are combined to allow the delivery of health interventions. Improving access, coverage and quality of services therefore depends on the availability of these key resources; on the ways services are organized and managed and on the incentives influencing providers and users. In the healthcare delivery, effective planning is needed to ensure that quality services are provided to those in need. Effective health service delivery is also concerned with bringing about an acceptable level of coherent programmes that assist in bringing health care services to populations who would not have had sufficient or no access to health services.
Doctors and nurses are reluctant to relocate to remote areas and forest locations that offer poor communications with the rest of the country and few amenities for health professionals and their families. Urban areas in Nigeria are more attractive to health care professionals for their comparative social, cultural and professional advantages. For instance, medical personnel posted out from State hospital, Ijaye in Abeokuta are usually reluctant to comply, in some cases, such staff are queried before they eventually take up the posting. This is as a result of the fact that metropolitan centers in the country offer more opportunities for career and educational advancement, better employment prospects for health professionals and their family, easier access to private practice and lifestyle-related services and amenities, and better access to education opportunities for their children. In addition, the low status often conferred to those working in rural and remote areas further contributes to health professionals’ preference for settling in urban areas, where positions are perceived as more prestigious. This has significant consequences on the health of inhabitants of rural areas as unavailability of physicians and nurses within close proximity often leads to delaying and postponing visits to health care facilities until the condition becomes unbearable. Transporting the patient on treacherous roads to urban facilities may take several hours and this may lead to death.
In Nigeria, scarce data on the availability, distribution and trends in manpower for health has been a barrier to effective manpower planning. This situation couple with lack of conducive work environment usually results to poor service delivery in the hospitals.
1.2 Statement of the Problem
In the world over, the unending need for good health care is a primary need of everyone irrespective of societal placement and social status. This situation has however increased the need for medical personnel that on a general note is lacking in Africa and Nigeria in particular. Therefore, it becomes a problematic situation for developing societies to retain their medical personnel given their inability to institute viable manpower plan and conducive work environment that was be suitable for the fulfilment of the lofty aspirations of medical personnel who for want of greener pastures leave their home-country for more developed societies thereby compounding the health challenge of their medically challenged citizens. This problem is fundamentally a result of failure of the managers of the institution of state to provide an enabling ground that will be suitable for the actualization of desired aspiration of workers.
According to Enebulele, (2013) only one in three registered Nigerian doctor’s practice in the country, with the other two-thirds migrating abroad. He goes further to state that, of the 71,740 doctors registered with Medical and Dental Council, about 27,000 are practicing in Nigeria while others are practicing outside the shores of this country. According to him, up to 7000 Nigerian doctors combined work in British and American health sector, while some have left the medical profession on account of better working condition. The Nigeria’s health system is in a poor state and this is traceable to several factors especially the gross under-funding of the health sector and shortage of medical personnel at the primary health care level. However, Nigeria is one of the several major health-staff-exporting countries in Africa; this fact is however due to poor manpower planning amongst the personal mangers and poor work environment which does not give room for self-actualization which is evidence in the number of health care workers who leave the country after their training for greener pastures abroad. As a result of inadequate infrastructure and poor compensation packages, a sizeable number of physicians, nurses and other medical professionals are lured away to developed countries in search of fulfilling and lucrative positions Enebulele (2013).
Across Nigeria, there is a national health manpower crisis marked by critical imbalances. In some states especially in Ogun State, Nigeria there is shortage of health practitioners, such as doctors, nurses, pharmacists, physiotherapists and other health workers. Enebulele notes that medical personnel in Ogun State South-West Nigeria, especially doctors are over stretched, for instance, a doctor is supposed to attend to about 20-30 patient per day but given the poor work condition that has occasioned mass exodus of health workers they attend to about 70-120 on a daily basis. This situation is however compounded by the insecurity situation and poor work condition that has forced many of them to relocate to places where their safety is guaranteed.
The ongoing underinvestment in the health sector, coupled with poor employment conditions and policies (such as exposure to occupational hazards, discrimination and physical and psychological violence; insufficient remuneration; unfavourable work-life balances; unreasonable workloads, limited career development opportunities) have resulted in a deterioration of working conditions for health professionals in many states. There is some fear that this may have serious negative impact on the recruitment and retention of health professionals, the productivity and performance of health facilities, and, ultimately, on service delivery to patients. Hence, the motivation for this study with emphasis on manpower planning, work environment and service delivery in Ogun state hospital management board.
1.3 Objective of the Study
The general objective of this study is to investigate the relationship between manpower planning, work environment and service delivery in Ogun State Hospital Management Board (OGHMB). The specific objectives are to:
- examine the impact of manpower planning on service delivery in Ogun State Hospital Management Board;
- determine the causes of inadequate work environment on service delivery by hospitals in Ogun State Hospital Management Board;
- appraise the effect of work environment on service delivery by hospitals in Ogun State Hospital Management Board;
- interrogate the public perception of service delivery in Ogun State Hospital Management Board and
- make solutions that enhance administrative functions for constructive manpower planning and conducive work environment for satisfactory service delivery in the health sector.
1.4 Research Questions
Based on the findings carried out the following questions were:
- How does effective manpower planning affect service delivery in Ogun State Hospital Management Board?
- Why are there inadequacies in the work environment on service delivery in Ogun State Hospital Management Board?
- How does work environment affect service delivery by hospitals in Ogun State Hospital Management Board?
- How do people perceive service delivery in Ogun State Hospital Management Board?
- How can there be solutions that will enhance administrative functions for constructive manpower planning and conducive work environment for satisfactory service delivery in the health sector?
The following will be tested at 0.05 significance level
H1: There is a significant relationship between manpower planning and work
environment in Ogun State hospital Management Board.
H2: There is a significant effect of manpower planning on service delivery of hospitals
in Ogun State hospital management Board.
H3: There is a significant effect of work environment on service delivery of hospitals in
Ogun State Hospital Management Board.
1.6 Significance of the Study
The significant of this study is that it may provide useful guidelines for stakeholders in the health sector towards establishing harmonious relationship among all the health workers thereby enhancing effective and efficient service delivery, particularly as it affects Ogun state hospital management board. The study may also expand the frontier of knowledge on the importance of manpower planning in relation to service delivery in the health sector generally and Ogun state hospital management board in particular. The findings may significantly assist all stakeholders and government to deal with the problem of ensuring an effective and efficient manpower planning, conducive work environment and service delivery in Ogun state hospital management board. In conclusion, the study seeks to fill the gap in the existing studies on the importance of manpower planning, utilization and good work environment which is a basic perquisite for passionate service delivery which is the hallmark of medical professional across the world.
1.7 Scope of the Study
This study focused on the issues of manpower planning, work environment and service delivery in Ogun state hospital management board. The study was also cover the periods between 2010 and 2016.This period was be chosen because it marked the high point of efflux of medical personnel from the health sector because of inadequate manpower planning, unconducive work environment which does not guarantee job and life security. The study was equally be based on some selected General hospitals under the Ogun State Hospital Management Board. The Ogun State Hospital Management Board was focused on the study because it over sees the entire management process and matters in Ogun state. The study was conducted using members of Medical professionals (Doctors, Nurses, pharmacist, physiotherapist, Radiologist and medical laboratory Scientist).
1.8 Operational Definition of Terms
Manpower Planning: This is a process used to measure and compare the current workforce with the future workforce correlative to the organization’s strategy and business planning process. An organisation operates most effectively when the right people with the right knowledge, skills and competencies are deployed appropriately.
Work Environment: The term work environment refers to the surrounding conditions in which an employee operates. The work environment can be composed of physical conditions, such as office temperature, or equipment. It can also be related to factors such as work processes or procedures.
Service Delivery: Service delivery in any health institution is concerned with bringing about an acceptable level of coherent programmes that was assist the institution to provide health care to populations having insufficient or no access to health services. This refers to the way inputs such as money, human resource, equipment and drugs are combined to allow the delivery of health interventions.
Motivation: This refers to the internal and external factors that stimulates desire and energy in people to be continually interested and committed to a job, role or subject, or to make an effort to attain a goal.
Recruitment: It refers to the overall process of attracting and appointing suitable candidates for jobs within an organisation.
Promotion: It is the rising movement of an employee from current job to another i.e higher pay scale.
1.9 Chapter Outlay of the Study
The study was divided into five (5) chapters. Chapter one was the General Introduction. The operational definition of terms, conclude the chapter. Chapter Two was the Review of relevant related literature and theoretical frame work. Chapter Three was on the Methodology adopted in the study. It includes the Research Design, the Population of the Study, Sample Size, Sampling Technique, Research Instruments, Validity and Reliability of Research Instrument, Methods of Data Collection, Methods of Data Analysis. Chapter Four is the Presentation and Data Analysis. Chapter Five of the study is the Conclusion on the Research Questions and Recommendations.
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