RESUMO
The primary health-care system in Jamaica offers extensive preventive and curative services to the public through a system of health centres, ranging from small centres with basic services to large centres with more sophiticated services. At a time of severe constraints in terms of financial and human resources, it is important to have a management system which will make the best use of these resources. The present survey was undertaken as part of a management exercise initiated by the Ministry of Health, Jamaica. The aim of the study was to describe what proportion of their working day was spent productively by various categories of personnel. A random sample of 96 was taken from approximately 400 health centres in Jamaica. At each health centre selected, 1 of each type of staff category was randomly chosen and observed during 1 day. About 500 days' observations were so made. The most being done by the staff member was recorded and classified as 'productive', 'other essential' or 'unproductive'. It was found that productive time ranged from over 60 percent to under 40 percent according to category of worker. It varied very little between large and small health centres. It has been proposed that 25 percent unproductive time would be suitable norm. The results therefore indicate that there is much scope for improvement of time and staff management in the primary in the primary health care services. At present, based on findings report here and on a model developed in a collaborative project, a new system of scheduling of clinics and of staff allocation to these clinics is being tried in two districts in Western Jamaica, the results of which will be available soon (AU)
