Needs assessment for performance improvement of personnel in charge of epidemiological surveillance in Morocco

Abstract

Background: In line with the International Health Regulations (IHR 2005), the Morocco health surveillance system has been reinforced via infrastructure strengthening and decentralization in its regions. To plan for personnel capacity reinforcement actions, a national workforce needs assessment was conducted by the National Epidemiological Surveillance Service and the World Health Organization.

Methods: The assessment used an ad-hoc method comprising two stages: (1) A survey via a standardized electronic questionnaire, administered to all staff in regional and provincial surveillance teams. Data collected included demographics, basic qualification, complementary training, perceived training needs, and preferred training modalities. Individuals were asked to grade, on a nine-point scale, their perception of importance of a given list of tasks and of their capacity to perform them. The gap between perceptions was quantified and described. (2) Field visits to national, regional and provincial sites for direct observation and opinion gathering on broader issues such as motivators, barriers, and training needs from the local perspective.

Results: Questionnaire respondents were 122/158 agents at 78 surveillance units countrywide. Mean age was 43.6 years and job longevity 5.7 years. Only 53% (65/122) had epidemiology training, posted in 62% (48/78) of the structures. Self-assessed capacity varied by basic qualification and by structure level (regional vs. provincial). The gap between the importance granted to a task and the perceived capacity to perform it was sizable, showing an uneven distribution across competency domains, regions, surveillance level and staff's basic qualification. From the opinions gathered, a problem of staff demotivation and high turnover emerged clearly.

Conclusions: Our method was successful in revealing specific details of the training needs countrywide. A national strategy is needed to ensure rational planning of training, personnel motivation and long-term sustainability. In terms of training, an innovative program should target the specific needs per group and per region.

Figure 1. Importance attributed to surveillance tasks (grouped in 10 domains), by basic qualification, Morocco 2011.

Figure 2. Level of self-estimated competence in each area, by basic qualification, Morocco 2011.

Figure 3. Competence gap (self-rated), by basic qualification.

Gap between the importance given to surveillance tasks (grouped in 10 broad areas) and the self- estimated competence (rated by each participant using a scale of 1 to 9), by basic qualification categories.