Modified Workload Indicators of Staffing Need to Estimate Human Resources at a Health Facility

Document Type: Letter to the editor


Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran


Human resources planning is known as the most essential limitation in achieving health care quality in the world. The main component of health human resource planning is to determine the required staff. There are several methods for determining required staff in a health facility. In this regard, one of the most widely used methods is the workload indicator of staffing need (WISN) method. In 1998, the World Health Organization announced the WISN as a human resource planning tool for the rational distribution of staff at health centers at all levels. It has been used in some countries since then. There is a recommendation on the division of the workload components. According to the modified workload indicator of staffing need (MWISN), there are four kinds of workload component. The first one is common main activity accomplished by all employees of the job category and for which periodic statistics are regularly collected. Uncommon main activity is the second one performed by a limited number of employees of the job category and for which periodic statistics are regularly collected. Moreover, support activities performed by all employees of the job category but for which periodic statistics are not regularly collected. The last one is additional activities performed only by some employees of the job category and for which periodic statistics are not regularly collected. Following the new division of the workload components, the final formula for the estimation of required workforce requirements is modified. Therefore, the MWISN can increase the accuracy and precision of the measurement of the workload and determine the number of workforces required.


1.                   Bahadori M.  Arab M, Sadeghifar J, Ahmadi B, Salimi M, Yghoubi M. (2013) ‘Estimation of nursing staff in selected hospitals of Ilam and Ahvaz Provinces, Western Iran’, Nursing and Midwifery Studies, 2(2), p. 217.
2.                   Govule P, Mugisha JF, Katongole SP, Maniple E, Nanyingi M, Onzima RA. (2015) ‘Application of workload indicators of staffing needs (WISN) in determining health workers’ requirements for Mityana general hospital, Uganda’, International Journal of Public Health Research, 3(5), pp.254-63.
3.                   McQuide PA, Kolehmainen-Aitken RL, Forster N. (2013) ‘Applying the workload indicators of staffing need (WISN) method in Namibia: challenges and implications for human resources for health policy’, Human Resources for Health, 11(1), p. 1.
  1. Mobaraki H, Hassani A, Kashkalani T, Khalilnejad R, Chimeh EE. (2013) ‘Equality in distribution of human resources: the case of Iran’s Ministry of Health and Medical Education’, Iranian journal of public health, 42(1), p. 161.
  2. Mugisha JF, Namaganda G. (2008) ‘Using the Workload Indicator of Staffing Needs (WISN) methodology to assess work pressure among the nursing staff of Lacor Hospital’, 6(1), pp. 1–15.
  3. Namaganda G. et al. (2015) ‘Making the transition to workload-based staffing: using the Workload Indicators of Staffing Need method in Uganda’, Human Resources for Health,13(1), p. 89.
  4. Ozcan S, Hornby P. (1999) ‘Determining hospital workforce requirements: a case study’, Hum Resour Dev J, 3(3).
  5. Russo G, Fronteira I, Jesus TS, Buchan J. (2018) ‘Understanding nurses’ dual practice: a scoping review of what we know and what we still need to ask on nurses holding multiple jobs.’, Human resources for health. England, 16(1), p.14. doi:10.1186/s12960-018-0276-x.
  6. Shipp PJ. (2010) Workload indicators of staffing need (WISN) a manual for Implementation, World Health Organization Division of Human Resources Development and Capacity Building, Geneva, Switzerland.
  7. Tabatabaee SS, Nekoie-Moghadam M, Vafaee-Najar A, Amiresmaili MR. (2016) ‘Barriers against required nurse estimation models applying in Iran hospitals from health system experts’ point of view’, Electronic Physician. The Electronic Physician, 8(12), p. 3348.
  8. Tabatabaee SS, Vafaee-Najar A, Amiresmaili MR, Nekoie-Moghadam M. (2017) ‘Nurse staffing norm in Iran Hospitals: What features should be included for success?’, International Journal of Preventive Medicine. Medknow Publications, 8.
  9. Vafaee-Najar A, Amiresmaeili M, Nekoei-Moghadam M, Tabatabaee SS. (2018) ‘The design of an estimation norm to assess nurses required for educational and non-educational hospitals using workload indicators of staffing need in Iran’,

Human resources for health. BioMed Central, 16(1), p. 42.

  1. WHO (2006) ‘Working together for health. the world report 2006.Policy briefs.’, Evidence and Information for Policy, p. 27.