ABSTRACT
The study examined the Effect of training on the performance of hospital employees under the Ghana Health Service of the Trauma Hospital at Winneba in the Central Region. The case study research design was adopted for the study. Through the use of census sampling and the simple random sampling procedures 60 hospital employees were selected to participate in the study. The questionnaire was used to gather the requisite data for the study. The data were analyzed through the computation of descriptive statistics such as frequencies, percentages, as well as mean of means distributions.
The study among other things found out that training is organized for the employees only once in a while i.e. once in a year. With this, the hospital staffs are mostly offered with both on-the-job and off-the-job training. Job instructional training was the type of on-the-job training that was mostly offered to the employees whereas the off-the-job type of training was offered during workshop to hospital staff. Also, it was found out that, there is lack of interest and committed management; insufficient budget; lack of motivation; lack of recognition of performance of hospital employees; and lack of promotion characterized the kind of environment at the workplace of the hospital employees.
The study recommended that frequent training, on-the-job and off-the-job training, should be organized for the hospital staff both senior and junior staff members so that staff members are abreast with current trends of attending to the health needs of patients. Again, management should show interest, commitment, and active participation towards and during organizing training programmes in order to motivate hospital employees to also take part in training programmes in order for hospital staff members to recognize the need for such training programmes to their development.
CHAPTER ONE
INTRODUCTION
Background to the study
From the World Health Organization’s WHO perspective, health is defined as “a state of physical, mental and social well being and not merely the absence of disease or infirmity’ the organization therefore sees health of an individual or a community as being concerned not only with physical and mental status, but also with social and economic relationships. In (1948), the organization WHO again viewed health from another perspective as a fundamental human right irrespective of race, religion, political belief and economic or social condition. As such, member states are expected to be concerned with equal access and issues of evenhandedness. In this regard, the state is to ensure that health care provided is of adequate quality. In addition health is considered by others as an investment because it has a direct relationship with productivity, the better the health of a country’s workforce, all things being equal, the higher the productivity of the said country. Illness may affect the overall production, either through absenteeism or lack of energy which may result to presenteeism-working while ill. It is in the light of this that governments with different views on health linked to their own ideologies are therefore likely to view their responsibility towards the health sector differently (Green 1996).
Organization of health services by nations are shaped by many factors or elements such as the size and distribution of the population, demography, political structure, politics, decentralization, economic policies and income structure etc.
Demographically it is difficult to organize health in large countries or countries with population sparsely distributed. In Ghana for instance, Northern Region is the largest region but the population is so sparse that it is difficult to locate and reach people for health services compared to a concentrated and heavily populated region like greater Accra, the capital of Ghana. The sex and structure of Ghana is typical of a developing country where the bulk of the population (about 50%) is young (Ghana statistical service, 2003)
The political system of a country can also influence the health service delivery. In socialist state like Cuba, health care provision is in the hands of the state unlike the United State of America where health is seen and considered as business which is essentially privatized.
Ghana Health Service as the main policy implementation machinery for the Ministry of health both at the primary and the secondary levels is responsible for the provision of integrated and comprehensive system of health through preventive, curative and rehabilitative health services. The hospitals under Ghana Health Services are responsible for clinical activities at regional, district and sub-district. The hospitals therefore are set out to: implement approved national health policies for health delivery in the country; increase access to improve health services; improve quality of service; as well as manage prudently resources available for provision health services.
In order that staffs have the necessary skills, knowledge and abilities to effectively implement programs and confront any challenges at the institutional levels, Ghana Health Service incorporates training and capacity development into its activities. This is in recognition of the fact that, health service is dynamic due to the technological advancement and changes that are on going the world over. Under this strategy, training and capacity development are to be based on planned and well coordinated schemes which must be a component of a performance management system. Similarly each management centre is expected to ensure that, their staffs have access to regular in-service training activities.
Problem Statement
For every training program to be more effective, that is, well design and implemented, HRD professionals must pay a very critical attention to “problems associated with training” and try to minimize them if not eliminate them completely. Training is human resource function that involves developing employee’s skills, knowledge and abilities to meet the organizations needs. Training creates competence, motivated and high-performing workforce that is prepared to meet future demands. It also maximizes employee potential, leading to higher productivity. However, this all important exercise comes with its associated problems for the HR department to encounter in implementing training due to inappropriate training, lack of interest and management support, insufficient budget, lack of transfer of training, lack of needs assessment, which is the process of identifying the ‘’gap’’ between the current performance and department or organizational objectives. Problems associated with training hampers and impact on the knowledge, skills and abilities needed by an employee or an organization’s workforce to achieve their objective. Unfortunately all the challenges to training are left to the backdrop at the margin of consciousness. As a result, training activities in the health institution are more often conducted without needs assessment, lack of interest and management support, insufficient budget, lack of transfer of training among others and are often focus on the clinical areas to the neglect of that of management, (Ghana Health Service). This undoubtedly has resulted to lack of capacity to equip hospital staff with the needed skills, knowledge and abilities to effectively perform their duties. (DeSimone & Harris, 1998).
In addition, even though Ghana health Service has training policy guidelines, there is no structured training programmes outlined to equip hospital staff with requisite skills, knowledge and abilities, the study has found. Some institutions attempt to build their own capacity through workshops and seminars. Sometimes some individuals also try to respond to this need by enrolling in management schools but all these are done without any official needs assessments, lack of management support and commitment, insufficient budget and therefore do not necessarily address the management needs holistically and provide the needed skills, knowledge and abilities required to effectively manage the hospitals.
Objective of the Study
The general objective of the study is to examine training and its challenges of hospital staff under Ghana Health Service in the Trauma and Specialist Hospital, Winneba. The following are the specific objectives of the study:
1. Identify the nature of training for hospital staff.
2. Determine the purpose of training designed for employees in the health service.
3. To identify the effect of training on the performance of hospital staff
4. Identify the possible challenges faced by the current hospital staff.
5. Identify policy strategy for resolving the challenges faced by the hospital staff so as to make them more effective.
Research Question
In order to address the above objectives, the following questions were posed:
1. What nature of training is being designed for the hospital staff?
2. What are the purposes of training programs for staff in the health service?
3. What are the effect of training on the performance of hospital staff?
4. What are the challenges of the training program of the hospital staff?
Significance of the Study
The study is very important, since it brings to light the nature, purpose, challenges of staff training and the possible strategies to deal with the identified challenges in the Health Service of Ghana. This can help the health service to develop guidelines for the training of hospital employees to enable them handle clients with all the professionalism they desire.
Delimitations of the Study
The scope of the study will comprised training and its challenges of hospital staff under Ghana Health Service in the Trauma and Specialist Hospital, Winneba. It basically focused on finding out the nature of training designed for the current hospital staff, the purpose of training programmes organized for staff members, the challenges of the training programme, as well as the efforts being put in place to minimize the challenges. Again, it was not possible to examine all the hospitals across the country. Therefore, the study comprised only staff members from the Trauma and Specialist Hospital at Winneba in the Ewutu Effutu District in the Central Region of Ghana.
Limitations of the Study
In every endeavour there are bound to be some imposed restrictions which are inevitable and must be managed. There is the likelihood that certain pieces of vital information would not be relayed to the researcher by the employees due to fear of losing their jobs. Again, since the research would rely mainly on questionnaire, some challenges would emanate from this source. Some of these challenges would be the use of the questionnaire which does not make it possible to understand issues concerning emotions, satisfaction and feelings. Also, there is the possibility of different respondents to read different meanings into a particular statement. There is also the possibility that, some of the items on the questionnaire were left unanswered by some of the respondents. Again, the use of the questionnaire does not give room for the researcher to probe further issues that are raised by respondents in order to get in-depth information about a phenomenon as compared with using interview guides.
Also, the study should have covered all the Hospitals in the Central Region but some of them did not have complete management set up, so findings could not be generalized, hence the selected hospitals. Lack of funding on the part of the researcher as well as space of time was a contributory factor.
Organization of the Study
The study comprises five chapters. Chapter one outlines the background, statement of the problem, objectives, research questions, significance of the study, delimitations of the study, limitations of the study, and the organization of the study. Chapter two focused on the theoretical perspective within which the study was placed. The third chapter outlined the methodological tools that were employed in gathering the data for the study. Chapter four contains the results of and discussion, while chapter five comprises the summarized findings, conclusions and recommendations.
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