Percent of key positions filled
The effectiveness of the organization’s human resource management system to fill key positions
The definition of “key” varies considerably by organization. For health service delivery organizations, clinical standards and organizational norms will dictate the definitions of key staff at the clinic level. The total number of required key staff is often determined as a ratio of physicians, nurses, auxiliary nurses, midwives, and other clinical staff to the catchment population. At the headquarters level of an organization, “key” may include department or unit heads, and critical technical support staff. In some countries, in large health organizations, more complex algorithms that include staff time available, type of patient load (inpatient, outpatient, deliveries, community visits, among others) and administration time are used to determine appropriate staffing levels.
Accurate count of key positions in the organization that are actually filled at the period under review and total number of key positions available in the organization.
Personnel management information systems; personnel records; organization’s organigram; facility survey; accurate payroll system; personnel policy manual.
The purpose of the indicator is to measure the effectiveness of the organization’s human resource management system to fill key positions and thus to ensure organizational capacity to perform and achieve its objectives. The indicator measures actual performance against the ideal scenario in which all key positions are filled. Most reproductive health organizations spend the majority of their resources on staff; an incomplete complement of key staff can compromise quality of care.
Calculation of this indicator requires an organization to have a clearly defined and agreed-upon definition of “filled.” Payroll systems may fail to provide accurate information if staff remain on a payroll (with or without pay) when they are on extended or permanent leave; hence the position is “filled,” but no one is performing the functions of that staff member.
Because of inadequacies of personnel information systems, some organizations (especially public sector) rely on an annual count of employees as part of their management information system reports to provide the data for this indicator.
Where payroll and annual reporting systems are inaccurate, including questions about human resources on periodic facility assessments is common. A frequently used indicator is, Percent of facilities that have the full complement of staff on duty on the day of a site visit.
An important limitation of this indicator is that it does not measure the competency of the staff filling key positions. Assessing competency requires a more timeconsuming, qualitative analysis of job descriptions, qualifications of staff in positions, and performance reviews.