Skip to main content
Top
Published in: Human Resources for Health 1/2018

Open Access 01-12-2018 | Research

Comparing time and motion methods to study personnel time in the context of a family planning supply chain intervention in Senegal

Authors: Elizabeth McElwee, Jenny A. Cresswell, Christian Yao, Macaire Bakeu, Francesca L. Cavallaro, Diane Duclos, Caroline A. Lynch, Lucy Paintain

Published in: Human Resources for Health | Issue 1/2018

Login to get access

Abstract

Background

A family planning (FP) supply chain intervention was introduced in Senegal in 2012 to reduce contraceptive stock-outs. Labour is the highest cost in low- and middle-income country supply chains. In this paper, we (1) understand time use of personnel working in the FP supply chain at health facilities in Senegal, (2) estimate the validity of self-administered timesheets (STs) relative to continuous observations (COs), and (3) describe the cost of data collection for each method.

Methods

We collected time use data for seven stockroom managers in six facilities using both ST and CO. Activities were categorized as follows: stock management associated with FP, non-FP stock management, other productive activities, non-productive activities, and waiting time. Paired t tests were used to compare the mean differences between the two methods in all categories and in productive time alone.

Results

Among all activities, the absolute and relative time spent on productive activities was higher when estimated by ST compared to CO. Conversely, waiting time was underestimated by STs. There was no difference in the relative time spent on non-productive activities. When comparing the distribution of the three productive activity categories, we found no evidence of a difference in relative time percentage estimates between CO and ST (FP stockroom management − 3.0%, 95% CI − 7.4 to 1.4%; non-FP stockroom management 3.4%, 95% CI − 2.8 to 9.6%; and other productive activities − 0.1%, 95% CI − 6.3 to 6.0%). Data collection costs for CO are 140% more than ST.

Conclusion

STs were not a reliable method for measuring absolute labour time at health facilities in Senegal due to considerable underestimates of time waiting for clients. However, ST had acceptable reliability when examining distribution of productive time. Although CO provides more accurate absolute time estimates, the unit costs for data collection using this method are more than triple those for STs in Senegal.
Literature
1.
go back to reference Daff BM, Seck C, Belkhayat H, Sutton P. Informed push distribution of contraceptives in Senegal reduces stockouts and improves quality of family planning services. Glob Health Sci Pract. 2014;2:245–52.CrossRef Daff BM, Seck C, Belkhayat H, Sutton P. Informed push distribution of contraceptives in Senegal reduces stockouts and improves quality of family planning services. Glob Health Sci Pract. 2014;2:245–52.CrossRef
3.
go back to reference Shretta R, Johnson B, Smith L, Doumbia S, de Savigny D, Anupindi R. Costing the supply chain for delivery of ACT and RDTs in the public sector in Benin and Kenya. Malar J. 2015;14:57.CrossRef Shretta R, Johnson B, Smith L, Doumbia S, de Savigny D, Anupindi R. Costing the supply chain for delivery of ACT and RDTs in the public sector in Benin and Kenya. Malar J. 2015;14:57.CrossRef
6.
go back to reference Routh S, Thwin AA, Barb N, Begum A. Cost efficiency in maternal and child health and family planning service delivery in Bangladesh: implications for NGOs. Health Policy Plan. 2004;19:11–21.CrossRef Routh S, Thwin AA, Barb N, Begum A. Cost efficiency in maternal and child health and family planning service delivery in Bangladesh: implications for NGOs. Health Policy Plan. 2004;19:11–21.CrossRef
7.
go back to reference Bratt JH, Foreit J, Chen PL, West C, Janowitz B, de Vargas T. A comparison of four approaches for measuring clinician time use. Health Policy Plan. 1999;14:374–81.CrossRef Bratt JH, Foreit J, Chen PL, West C, Janowitz B, de Vargas T. A comparison of four approaches for measuring clinician time use. Health Policy Plan. 1999;14:374–81.CrossRef
8.
go back to reference Manzi F, Schellenberg JA, Hutton G, Wyss K, Mbuya C, Shirima K, et al. Human resources for health care delivery in Tanzania: a multifaceted problem. Hum Resour Health. 2012;10:3.CrossRef Manzi F, Schellenberg JA, Hutton G, Wyss K, Mbuya C, Shirima K, et al. Human resources for health care delivery in Tanzania: a multifaceted problem. Hum Resour Health. 2012;10:3.CrossRef
9.
go back to reference Adam T, Amorim DG, Edwards SJ, Amaral J, Evans DB. Capacity constraints to the adoption of new interventions: consultation time and the integrated management of childhood illness in Brazil. Health Policy Plan. 2005;20:i49–57.CrossRef Adam T, Amorim DG, Edwards SJ, Amaral J, Evans DB. Capacity constraints to the adoption of new interventions: consultation time and the integrated management of childhood illness in Brazil. Health Policy Plan. 2005;20:i49–57.CrossRef
10.
go back to reference Mangham-Jefferies L, Mathewos B, Russell J, Bekele A. How do health extension workers in Ethiopia allocate their time? Hum Resour Health. 2014;12:61.CrossRef Mangham-Jefferies L, Mathewos B, Russell J, Bekele A. How do health extension workers in Ethiopia allocate their time? Hum Resour Health. 2014;12:61.CrossRef
11.
go back to reference Were MC, Sutherland JM, Bwana M, Ssali J, Emenyonu N, Tierney WM. Patterns of care in two HIV continuity clinics in Uganda, Africa: a time-motion study. AIDS Care. 2008;20:677–82.CrossRef Were MC, Sutherland JM, Bwana M, Ssali J, Emenyonu N, Tierney WM. Patterns of care in two HIV continuity clinics in Uganda, Africa: a time-motion study. AIDS Care. 2008;20:677–82.CrossRef
12.
go back to reference Lopetegui M, Yen P-Y, Lai A, Jeffries J, Embi P, Payne P. Time motion studies in healthcare: what are we talking about? J Biomed Inform. 2014;49:292–9.CrossRef Lopetegui M, Yen P-Y, Lai A, Jeffries J, Embi P, Payne P. Time motion studies in healthcare: what are we talking about? J Biomed Inform. 2014;49:292–9.CrossRef
13.
go back to reference Tilahun H, Fekadu B, Abdisa H, Canavan M, Linnander E, Bradley EH, et al. Ethiopia’s health extension workers use of work time on duty: time and motion study. Health Policy Plan. 2017;32:320–8.PubMed Tilahun H, Fekadu B, Abdisa H, Canavan M, Linnander E, Bradley EH, et al. Ethiopia’s health extension workers use of work time on duty: time and motion study. Health Policy Plan. 2017;32:320–8.PubMed
14.
go back to reference Wirth P, Kahn L, Perkoff GT. Comparability of two methods of time and motion study used in a clinical setting: work sampling and continuous observation. Med Care. 1977;15:953–60.CrossRef Wirth P, Kahn L, Perkoff GT. Comparability of two methods of time and motion study used in a clinical setting: work sampling and continuous observation. Med Care. 1977;15:953–60.CrossRef
15.
go back to reference Finkler SA, Knickman JR, Hendrickson G, Lipkin M Jr, Thompson WG. A comparison of work-sampling and time-and-motion techniques for studies in health services research. Health Serv Res. 1993;28:577–97.PubMedPubMedCentral Finkler SA, Knickman JR, Hendrickson G, Lipkin M Jr, Thompson WG. A comparison of work-sampling and time-and-motion techniques for studies in health services research. Health Serv Res. 1993;28:577–97.PubMedPubMedCentral
16.
go back to reference Bonenberger M, Aikins M, Akweongo P, Bosch-Capblanch X, Wyss K. What do district health managers in Ghana use their working time for? A case study of three districts. PLoS One. 2015;10:6.CrossRef Bonenberger M, Aikins M, Akweongo P, Bosch-Capblanch X, Wyss K. What do district health managers in Ghana use their working time for? A case study of three districts. PLoS One. 2015;10:6.CrossRef
17.
go back to reference Burke TA, McKee JR, Wilson HC, Donahue RMJ, Batenhorst AS, Pathak DS. A comparison of time-and-motion and self-reporting methods of work measurement. J Nurs Adm. 2000;30:118–25.CrossRef Burke TA, McKee JR, Wilson HC, Donahue RMJ, Batenhorst AS, Pathak DS. A comparison of time-and-motion and self-reporting methods of work measurement. J Nurs Adm. 2000;30:118–25.CrossRef
18.
go back to reference Ampt A, Westbrook J, Creswick N, Mallock N. A comparison of self-reported and observational work sampling techniques for measuring time in nursing tasks. J Health Serv Res Policy. 2007;12:18–24.CrossRef Ampt A, Westbrook J, Creswick N, Mallock N. A comparison of self-reported and observational work sampling techniques for measuring time in nursing tasks. J Health Serv Res Policy. 2007;12:18–24.CrossRef
19.
go back to reference Fernald DH, Coombs L, DeAlleaume L, West D, Parnes B. An assessment of the Hawthorne effect in practice-based research. J Am Board Fam Med. 2012;25:83–6.CrossRef Fernald DH, Coombs L, DeAlleaume L, West D, Parnes B. An assessment of the Hawthorne effect in practice-based research. J Am Board Fam Med. 2012;25:83–6.CrossRef
20.
go back to reference Cavallaro FL, Duclos D, Faye S, Faye A, Cresswell J, Lynch C. Understanding “missed appointments” for women’s refills of pills and injectables in Senegal: a mixed methods study. IUSSP; 29 October - 4 November; Capetown, SA; 2017. Cavallaro FL, Duclos D, Faye S, Faye A, Cresswell J, Lynch C. Understanding “missed appointments” for women’s refills of pills and injectables in Senegal: a mixed methods study. IUSSP; 29 October - 4 November; Capetown, SA; 2017.
22.
go back to reference Naburi H, Ekström AM, Mujinja P, Kilewo C, Manji K, Biberfeld G, et al. The potential of task-shifting in scaling up services for prevention of mother-to-child transmission of HIV: a time and motion study in Dar es Salaam, Tanzania. Hum Resour Health. 2017;15:35.CrossRef Naburi H, Ekström AM, Mujinja P, Kilewo C, Manji K, Biberfeld G, et al. The potential of task-shifting in scaling up services for prevention of mother-to-child transmission of HIV: a time and motion study in Dar es Salaam, Tanzania. Hum Resour Health. 2017;15:35.CrossRef
23.
go back to reference Chin-Quee D, Bratt J, Malkin M, Nduna MM, Otterness C, Jumbe L, et al. Building on safety, feasibility, and acceptability: the impact and cost of community health worker provision of injectable contraception. Glob Health: Sci Pract. 2013;1:316–27. Chin-Quee D, Bratt J, Malkin M, Nduna MM, Otterness C, Jumbe L, et al. Building on safety, feasibility, and acceptability: the impact and cost of community health worker provision of injectable contraception. Glob Health: Sci Pract. 2013;1:316–27.
Metadata
Title
Comparing time and motion methods to study personnel time in the context of a family planning supply chain intervention in Senegal
Authors
Elizabeth McElwee
Jenny A. Cresswell
Christian Yao
Macaire Bakeu
Francesca L. Cavallaro
Diane Duclos
Caroline A. Lynch
Lucy Paintain
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Human Resources for Health / Issue 1/2018
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/s12960-018-0328-2

Other articles of this Issue 1/2018

Human Resources for Health 1/2018 Go to the issue