Botswana has taken an important step towards evidence-based health workforce planning through the successful implementation of a five-day Workload Indicators of Staffing Need (WISN) technical mission from 15-19 June 2026. Convened by the Ministry of Health, Department of Human Resources and Administration with technical support from the World Health Organization (WHO), the workshop brought together national, district, and facility-level stakeholders to improve the quality, analysis, and use of health workforce data. The technical team from the WHO Regional Office for Africa consisted of Dr. James Asamani, Team Lead for Health Workforce; Mr. Adam Ahmat, Health Workforce Policy and Planning Officer; and Mr. Boris Bediakon, Strategic Information Officer. The Ministry of Health team was led by Ms. Nametso Sephepe, Manager, Human Resources and Administration.
The mission aimed to validate existing WISN data, address information gaps, generate preliminary staffing results, and lay the foundation for developing staffing norms that better reflect actual service delivery demands. Participants included technical teams, health workers, planners, and WHO experts, all working collaboratively to strengthen the country’s capacity for data-driven decision-making. The workshop opened with a refresher on the WISN methodology. Key concepts such as workload components, activity standards, and available working time were revisited, ensuring a common understanding to guide the technical sessions ahead.
Over the course of the week, the focus shifted from theory to practice. A multidisciplinary team comprising officers from Human Resources and Administration, Health Financing, Public Health, the Directorate of Public Service Management (DPSM), and Public Health Medicine residents from the University of Botswana systematically reviewed the completeness and accuracy of the WISN dataset collected from 22 health facilities. Missing data were identified and addressed using source documents, while inconsistencies in facility names, cadres, and workload variables were harmonized. This process significantly improved the reliability of the dataset for analysis.
As the dataset was refined, the team turned to validating key parameters and conducting preliminary analyses. Participants reviewed activity standards and allowance factors and carried out initial WISN calculations. These analyses provided early insights into staffing requirements, workload pressures, and service delivery gaps across facilities and cadres.
A key highlight of the mission was the collaborative interpretation of findings. By examining workload pressures and staffing gaps, participants were able to identify priority areas where staffing adjustments could improve service delivery. These discussions laid the groundwork for developing staffing norms that are responsive to local realities. However, preliminary findings from the assessment highlighted data gaps that needed urgent attention before reliable conclusions could be made. Some facilities has relatively high staffing levels with considerable variation among facilities and occupational groups. Some facilities are experiencing significant workload pressures, while others may offer opportunities for more efficient deployment and redistribution of staff.
The main limitations of the data was its insufficiency in calculation of staffing norms for health posts and clinics, critical in defining staffing needs for the Primary Health Care level. The number of clinics and health posts in the data set was too small and unrepresentative of the total number of clinics and health posts. In addition, the data collection omitted specialist services, similarly missing the opportunity to estimate the staffing requirements for specialist services at the different levels of care. Nevertheless, the emerging trends provided valuable insights that can begin to inform workforce policy discussions and planning decisions.
The mission concluded with a comprehensive debriefing session, during which key findings and recommendations were presented and validated. Participants also agreed on clear next steps, including finalizing the dataset, refining analyses, and integrating WISN results into national planning processes.
As part of the debriefing session, the participants were taken through the foundations of sound health workforce planning and management, how the organization and functions of the health workforce departments can be set up in Ministries of Health drawing from experiences from across the African continent. The Ministry of Health expressed a renewed commitment to establishing a dedicated Human Resources for Health Unit within the Ministry of Health. Participants agreed that stronger institutional capacity for workforce planning, management and policy development is essential for achieving Universal Health Coverage, strengthening health security and building a resilient health system. The proposed HRH Unit will provide leadership in strategic workforce planning and forecasting, workforce intelligence and analytics, staffing norms development, health labour market analysis, workforce deployment, policy development and coordination of workforce reforms linked to National Health Insurance (NHI) and broader health sector transformation. The unit will also support the institutionalization of workforce planning tools such as WISN across the health sector. By enhancing the quality of data and building national capacity for analysis and interpretation, Botswana will be better positioned to make informed decisions that improve efficiency, equity, and service delivery outcomes. As the Ministry of Health advances the next steps, the insights generated during this mission will play a vital role in shaping a resilient and responsive health system for the future.
