The Relationship Between Staffing Sufficiently by the Workload Indicator of Staffing Needs and HIV Outcomes in Namibia

Abstract Background: No study in inpatient or outpatient nurse staffing research have examined nurse staffing using the measure of the World Health Organization’s Workload Indicator of Staffing Needs, despite this being a commonly used tool to make staffing decisions across various healthcare settings around the world. This study aimed to understand the relationship between nurse staffing in HIV clinics and the patient outcomes of viral load documentation and viral load suppression in order to better understand the best ways of staffing nurses to provide the best HIV services to clients. Methods: This study modeled nurse staffing measured as the Workload Indicator of Staffing Needs, with two HIV outcomes of viral load documentation and viral load suppression in remotely located 66 hospitals, health centers and clinics in Northern Namibia. Various control variables were taken into account. Results: Sufficient nurse staffing based on the Workload Indicator of Staffing Needs was associated with better viral load documentation, however overly sufficient staffing made no difference on viral load documentation. There was no association between sufficient staffing by the Workload Indicator of Staffing Needs and viral load suppression. Conclusions: Our findings suggest that staffing sufficiently by the Workload Indicator of Staffing Needs was associated with better HIV outcomes of viral load documentation and viral load suppression at the facility level. This suggests that policy makers should continue using the Workload Indicator of Staffing Needs tool to staff their clients in order to have the best HIV outcomes possible at their facilities.