Workload and Performance of Auxiliary Nurse and Midwives at Selected Health Care Settings in North India
Keywords:ANMs - health care settings - workload.
Auxiliary Nurse Midwives (ANMs) are the back bone of primary health care services in India. The horizontal integration of various national health programmes has increased their responsibility and workload. So a need was felt to conduct a study to assess the workload and performance of ANMs. The objective of the study was to explore the workload and performance of ANMs in selected health care settings in North India. An exploratory cross-sectional study was conducted in two selected health care settings of North India.
The study was conducted on all the 7 ANMs working in the selected health care settings. Data was collected by observing the activities of ANMs using time activity record sheet. The nursing care procedures performed were observed and scored by using performance check list. T-test was used to compare actual time against standard time for performing procedures.
ANMs spent 2/3rd of their time in indirect care activities. Direct care and personal activities accounted for 19 % of their time. Their performance was rated as good.
Majority of the time spent by ANMs was utilized in performing indirect care activities. This study recommends that more time is needed to be devoted to direct care by ANMs.
Indian Public Health Standards (IPHS) Guidelines for Sub-Centres Revised 2012.New Delhi: Directorate General of Health Services. 2012.64p.[Internet]. 2013[cited 2013 Mar 18 ] Available from: http://health.bih.nic.in/Docs/Guidelines/Guidelines-Sub-Centers-(Revised)-2012.pdf
Malik G. Role of Auxiliary nurse midwife in national rural health mission. The Nursing Journal of India [Internet]. 2009 [cited 2013 Jan 22]; 3(3):1-2. Available from: http://www.tnaionline.org/thenursing.htm
Kannan S, Sarma S. Study on workload of public health nurses and other women health workers. MPRA[Internet].2012 Jun 19 [cited 2014 Feb 10]. Available from: http://mpra.ub.uni-muenchen.de/39520/
Maji D, Hutin Y, Ramakrishnan R, Hossain S, De S. Strategies to improve the performance of female health workers in West Bengal: a cross-sectional survey. Natl Med J India [Internet]. 2010 May-Jun [cited 2013 Dec 2]; 23(3):137-42. Available from: http://www.nie.gov.in/images/publication/Maji._Strategies_to_improve_the_performance_of_female_health_2010_336.pdf
Brunicardi FC, Hobson FL. Time management: a review for physicians. Journal of the National Medical Association[Internet]. 1996 Sep[cited 2013 Jan 22]; 88(9):581-7. PubMed PMID: 8855650. Pubmed Central PMCID: 2608106.Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2608106/
Ellwood M. How Sales Reps Spend Their Time [Internet]. http://www.paceproductivity.com. [10 March 2014]2014[cited 2013 Jan 22]. Available from: http://www.paceproductivity.com/files/How_Sales_Reps_Spend_Their_Time.pdf
Weigl M, MÃ¼ller A, Zupanc A, Angerer P. Participant observation of time allocation, direct patient contact and simultaneous activities in hospital physicians. BMC health services research[Internet]. 2009; 9(1):110.Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2709110/
FÃ¼chtbauer LM, NÃ¸rgaard B, Mogensen C. Emergency department physicians spend only 25% of their working time on direct patient care. Danish medical journal[Internet]. 2013; 60(1):4558-4558.Available from: http://www.danmedj.dk/portal/pls/portal/!PORTAL.wwpob_page.show?_docname=9484974.PDF
Kim C, Lovejoy W, Paulsen M, Chang R, Flanders S. Hospitalist time usage and cyclicality: opportunities to improve efficiency. Journal of Hospital Medicine[Internet]. 2010; 5(6):329-334.Available from: http://www.danmedj.dk/portal/page/portal/danmedj.dk/dmj_forside/PAST_ISSUE/2013/DMJ_2013_01/A4558
Ammenwerth E, SpÃ¶tlHP. The time needed for clinical documentation versus direct patient care. Methods Inf Med. 2009;48(1):84-91[cited 2013 Mar 15].Available from: http://www.schattauer.de/en/magazine/subject-areas/journals-a-z/methods/contents/archivestandard/issue/661/manuscript/10818.html
Domenech M, Payton O, Hill J, Shukla R. Utilization of Physical Therapy Personnel in One Hospital A Work Sampling Study. Physical therapy[Internet]. 1983;63(7):1108-1112[cited 2013 Feb 12].Available from: http://ptjournal.apta.org/content/63/7/1108.long
Sharma B, Roy S, Mavalankar D, Ranjan P, Trivedi P. The Role of the District Public Health Nurses: A Study from Gujarat[Internet]. 2010[cited 2013 Feb 12].Available from: http://www.iimahd.ernet.in/publications/data/2010-02-04Sharma.pdf
National Rural Health Mission. Defining roles and responsibilities of second auxiliary nurse midwife (ANM) under NRHM in 'C' districts of Karnataka. Karnataka State Health Report system [Internet]. 2012 [cited 2013 Feb 12]. Available from: http://stg2.kar.nic.in/healthnew/KSHRC%20web/KSHSRC/2nd%20role%20ANM%20Study%20Final%20Report.pdf
Duft K. Agribussiness Management-The management of time [Internet]. 1st ed. Washington: Washington State University and US department of agriculture cooperating; [cited 20 July 2014]. Available from: http://www.agribusiness mgmt.wsu.edu/Extension Newsletters/mgmt/MgmtTime.pdf
Immunization strengthening project- Training Module for Mid-level Managers, Government of India, Ministry of Health and Family Welfare, New Delhi, 2001.
Singh A, Grover A. Knowledge of health workers on blood pressure and its measurement. PGI Bulletin. 1992; 26: 131-3.
District level household and facility survey 2007-08. India: International Institute for Population Sciences [Internet]. 2010 Apr [cited 2013 Jan 4]. Available from: http://www.rchiips.org/prch-3.html
Ahad Baba T, Kaul R, Humaira H. An Epidemiological study to assess the utilization of maternal and child health care services at Sub-center level by the target population in Northern India, Kashmir valley. Int J Med Sci Public Health. 2013; 2:679-87. doi: 10.5455/ijmsph.2013.010520131Available from:http://www.scopemed.org/fulltextpdf.php?mno=36850
Bhatia J, Cleland J. Determinants of maternal care in a region of South India. Health transition review. 1995;127-142.Available from:https://digitalcollections.anu.edu.au/bitstream/1885/41182/2/Bhati1_1.pdf
National Family Health Survey-3. India: International Institute for Population Sciences [Internet]. 2014 [cited 2014 Mar 20]. Available from: http://www.rchiips.org/nfhs
Kranti S. Vora, Dileep V. Mavalankar, K.V. Ramani, MuditaUpadhyaya, Bharati Sharma, SharadIyengar, Vikram Gupta, KirtiIyengar J Health PopulNutr. 2009 April; 27(2): 184-201.