MGT 425(Manpower Planning and Forecasting)

Term Paper
On
“A Study on shortage of Human Resources in Health Care Industry of
Bangladesh”

Submitted by:
Labiba Sharmin Hossain ID# 15104145
Ahana Alam ID# 15204034
Sanjana Hossen ID# 16104088
Rezwana Tasnim ID# 16104018
Ibna Shad Anik ID# 16304083

Section: 02

Submitted to
Mr. Zaheed Husein Mohammad Al-Din
Senior Lecturer
BRAC Business School
BRAC University

Semester: Spring 2019

 Date of Submission: March 24, 2019
Letter of Transmittal

March 24, 2019

Mr. Zaheed Husein Mohammad Al-Din

Manpower Planning and Forecasting (MGT 425),
BRAC Business School,
BRAC University,
66, Mohakhali, Dhaka 1212, Bangladesh.

Subject: Letter of Transmittal for shortage of Human Resources in Health Industry of

Bangladesh.

Our Sir,

It is indeed a great pleasure for us to be able to hand over the result of our hardship of the HRM
report on shortage of Human Resources in Health Industry of Bangladesh. This report is the
result of the knowledge, which has been acquired from the respective course.
We tried our level best for preparing this report. The information of this report is mainly based
on your help towards Internet information and us. Some other details were gathered from the
HR personnel of the industry. All of us gave our hundred percent for making this report come
together.
We, passionately hope that you will find this plan worth reading. Please feel free for any query
or clarification that you would like us to explain. Hope you will appreciate our hard work and
excuse the minor errors. Thanking you for your cooperation.

Sincerely,

----------------------
Sanjana Hossen
ID# 16104088
On behalf of the group members
 Table of Content
Topic Page NO.

Introduction 1

Origin of the Report 1

Purpose Statement 1

Objectives 1

Scope 1

Limitations 1

Methodology 1

Overview of the Industry 2

Type of Human Resource Required 3

HR Planning Processes Used in the Industry 4-5

Evaluation for the Status of HR Requirement and Availability 5-6

Reason for the Shortage of HR 6-7

Impact of the Shortage in Health Industry 7

Steps Taken to deal with the shortage of HR 7-8

Benefits Derived from the Steps Taken 8

Recommendation for Dealing Shortage 9

Key Findings 9

Conclusion and Recommendation 10

Appendix 11-12

Figure (01 and 02) 11,12

Table (01) 11
References 13

Executive Summary

Health industry is one of the most important industry that government is giving their utmost
consideration. In this term paper, we have designed a structure of human resource required in
health industry. We will design what type of HR planning process in the health industry. After
finding out the HR planning process, we need to find out the status of HR requirement and
availability in the health industry. Moreover, currently Health Industry in Bangladesh facing
so many problems due to lack of management, lack of hiring expertise workers, lack of proper
training etc. Moreover, there is lack of skilled manpower such as Doctors, Nurses,
administrative workers who can run the industry efficiently and effectively. In our project, we
have shown several aspects behind why Health Industry in Bangladesh were in decline.
Moreover, our project also shows the potential impact of those aspects in the Health Industry.
We also had discussed about the existing steps and measures that the government took in order
to tackle the situation. Finally, we have discovered some potential solution to tackle the issues
and run the Health Industry effectively and efficiently. By making proper implementation of
those steps, we firmly believe that, we can improve a lot on the management, recruiting and
training potential human resources needed for Health Industry and the other aspects related to
Health Industry.
Introduction

Origin of the Report: The origin of this report is for human resource of health sector. In
here, we discuss about the shortages of Human Resources of health care industry in Bangladesh
and we proposed solutions of the problems. Hence, human resource is an important part of
every industry and company, without this resource an industry cannot cope up with its activity
and purpose. Therefore, it is important for the industry to find out where is the problem in
resource. So, for this report, we went to the industry, talk with them, gather the information of
shortage, we find out our solutions based on the human resource of this industry and analysis
the shortage and then mention the solutions.

Purpose Statement: The purpose of the statement is finding the shortage of human resource
in health care industry and the solutions to overcome of this shortage problem.

Objective: From this report, we can elicit the current condition of human resource in health
care industry. We find out where the main problem is occurring and in which stage this problem
is. Then we will analyze these shortages carefully and reveal it to the industry management. As
a result, they will come to know about their issues and can take necessary steps to overcome
these shortages. Like shortage of nurse and physician a lot in government hospitals. There has
a shortage on skillful people for this. Therefore, we tried to find out why there is shortage and
what we can do about it.

Scope: Our main target is finding the problem from it and help the industry to recover it by
giving solutions. We cannot find all the problem of this massive industry because there have
lot of sectors under it. In addition, it is impossible to track down all of it. However, we tried to
find out the big one that is keeping huge impact on its human resource sector. We came to learn
that there have shortage of skill full nurse and physician and our scope is finding out why there
is this lack in these governmental hospital.

Limitations: This report has some limitation, as if we do not have that enough time to go
through in depth data. Go to the industries, finding out respective people who have knowledge
about this issue & can talk with us. It took a lot of time to present our report. In addition, some
information was confidential. Therefore, we have to shape it in positive and legal way.

Methodology: For this report, we used primary data and secondary data. We made some
questionnaire from secondary data & then we went for survey. The survey was conducted in
industry with its respective worker. We went to the industry and gathered this information by
talking with them. Entire questionnaire was filled out in industry. And at first, some
information we collected from newspaper, journal, books, online-articles. And we related the
data with our course material. And this is how we made this report by using secondary data.

The data was collected in 10 March 2019.

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 1. Overview on Health Industry:

The healthcare industry can be termed as one of the most important sectors of the economy,
since medication counts as a basic need for living and has a strong stable demand. Growth in
living standards and the aging population are likely to ensure that this industry grows much
faster than the country’s economy. This reveals a strong correlation between income and
healthcare spending – this is mainly because the demand rises in response to a proportional rise
in the income.

Healthcare sector in Bangladesh is provided in three major categories. The type of service a
patient need is determined by the medical necessity. The service categories are defined as
follows.

 The primary care is given to people in need of general health care. This type of care is
commonly provided by family practice, pediatrics, internal medicine, and sometimes
gynecologist.

 The secondary care is more intensive in nature than the previous one. Certified
physicians upon requests provide it from the primary physicians with help from firms
like the Maryland Health Insurance. Hospitals like Dhaka Medical College Hospitals,
BIRDEM treat people needing secondary care.

 Tertiary health care, the specialized consultative care, is facilitated by specialists

working in a center that has personnel and facilities for investigation and treatment of
special health problems.

There is a growing popularity of getting into the medical profession in Bangladesh. Albeit that
trend, the country remains among the 57 countries recognized by WHO in 2006 for having a
severe scarcity of trained medical professionals.

According to reports of MOHFW published in 2012 and 2013, there are currently 64,434
registered doctors, 6,034 registered dentists, and 27,000 midwives. The figures indicate a
physician density of 0.036%.

There is a total of 128 public medical intuitions that provide secondary and tertiary level health
care to both in and outpatients. Of these 128 institutions, 53 are district hospitals, 11 general
hospitals, a medical university in Dhaka (BSMMU), and 63 other types of hospitals.

Asia-Pacific Observatory on Public Health Systems and Policies reports that there are 2,983
registered private hospitals around the country, which provide 45,485 functional beds as of
2013. The bed-density in the private sectors then stands at 0.031%.

Another significant aspect of the health care industry is the new trend of startups. This type of
startups is initiated by a new breed of entrepreneurs, who want to bring affordability and
speediness in the health care system by introducing technology. Doctorola, the partner of this

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report, is such a startup that helps people get doctor’s appointment through website and mobile
phones.

2. Discussion of the Type of Human Resource Required in the Industry:

A hospital industry is a microcosmic community that operates like a small city, presenting the
same issues with a stronger dynamic due to the human interaction factor. With functions that
cover everything from performance management to safety, Human Resources of this industries
plays a vital role in the health care workplace in ensuring the delivery of health care services
and facilitating optimal patient outcomes. In any health care setting, the Human Resource
department fills a variety of personnel needs that both employers and employees encounter.
The role of this department is to manage all aspects of operations that are personnel related.

Doctors: In a hospital industry, doctor is the main resource. Without doctor, there will be no
treatment. There are different types of expertise doctors exist in a health industry. There is a
specific type of doctor for almost every major system located in the human body. Like –
Neurologists(human brain), Oncologists(focus on the treatment and prevention of cancer),
Ophthalmologists(eye), Otolaryngologists(ear, nose, sinuses), Pathologists(lab doctors),
Physiatrists(neck or back pain and sports or spinal cord injuries), Plastic Surgeons(repair your
skin, face, hands, body), Psychiatrists(work with people with mental, emotional, or addictive
disorders), Radiologists(X-rays, ultrasound, and other imaging tests to diagnose diseases),
Medicine Specialists, Urologists(who care for men and women for problems in the urinary
tract, like a leaky bladder), Cardiologists(experts on the heart and blood vessels),
Gastroenterologists(specialists in digestive organs, including the stomach, bowels, pancreas,
liver, and gallbladder), Anesthesiologist(doctors give you drugs to numb your pain or to put
you under during surgery, childbirth, or other procedures), Immunologists(doctors give you
drugs to numb your pain or to put you under during surgery, childbirth, or other procedures),
Pediatrician(care for children from birth to young adulthood) etc. Doctor’s must be skilled in
science, diagnosis and treatment. During medical school and the doctor's undergraduate career,
he or she should focus on the human sciences, such as biology, human anatomy and
biochemistry, all of which are necessary to understand the job requirements of being a doctor.
The skills learned in these sciences are the core to understanding diagnosis and treatment. In
addition, communication may be another important skill for a doctor. This communication skill
includes confidence, empathy, being humane, respectfulness and thoroughness. While it is
important that the doctor understands how to treat his or her patient. Moreover, the most
important one is Becoming a doctor requires a minimum of four years of medical schooling
beyond completion of a bachelor's degree program. Upon graduation, the doctor may spend 3-
8 years interning and in residency choosing his or her specialty.

 And the types of human resource need in this industry are:

–Physician
–Counseling
–Nurse
–Work place Safety and Sanitation manager
– Labor Mediation

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 Health care industry also need qualified person for this position because doctor cannot do the
entire job in a hospital. They also need help from other qualified person. So, only experienced
and graduated from respective place like medical college, or training institution are applicable
for those posts.

3. HR Planning Processes Used in the Industry:

Human resource planning is the process in which organizations regulate the staffing support;
they will need to meet business needs and customer demands. The process of human resource
planning involves assessing the already existing workforce by analyzing individual employee's
skills to see if they are a valuable part of the company future. Human resource planning is often
a part of a company business plan. It is important to develop strategies that will continue with
the organization in all environments. An effective human resource planning strategy will be set
up to address hard economic times. For any successful organization, it is important to follow
the Human Planning processes, which are given below:

In our country some processes are maintained, some are not, which are described below:

 Objectives of Human Resource Planning: It is important that the human resource planning
must be matched with overall organizational plans like filling future vacancies rather than
matching existing employees with existing jobs. Previously Bangladesh was not able to move
with the modern trend of healthcare but now days they are focusing on a comprehensive HRH
strategy, which is currently being developed by the Human Resource Development Unit of
Ministry of Health & Family Welfare, Bangladesh Secretariat (MOHFW).

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 Current Manpower Stock: It talks about the Current manpower stock must be continuously
maintained by every department. Manpower inventory must have the detailed bio data of each
individual, this record not only help in employee development but also in the finding of the
surplus or shortage of manpower. In our country there is a robust lack for qualified doctors and
nurses, as well as seats for the patients is also lacking.

 Demand/ Supply Forecasting: For this, the organization must check the demand of
manpower after every one year, two-year so on. For this, the health care industry of Bangladesh
is trying to fulfil the requirement but they are not capable of doing this. Because there are not
enough qualified doctors and nurses to serve the large population of the country.

 Determining net Requirement: Human resource manager must check the demand and
supply of the manpower before deriving at any conclusion. In previous period there was a huge
number of lacking about the management systems in the health care industry but now days it is
well managed as there are many private hospitals like Labaid, Apollo, ICDDRB and so on.
These hospitals are very well managed with their well-developed management team

 Redeployment and Redundancy: In redeployment, the surplus employees in one

department can be transferred to another department where deficit of employees estimated and
in case of redundancy where surplus employees cannot be redeployed them can be offered
voluntary retirement scheme. In our country, the healthcare industry gives these services
because they have lack of well qualified doctors and nurses.

 Employment Programme: Here it is required to prepare programmes of recruitment,

selection, transfer and promotion to achieve organization goal. In Bangladesh, this session is
well maintained but there is a little injustice for the employment programme which should be
taken care of by the authority.

 Training and Development: It is very necessary for the employees to keep them updated in
the job they are doing. In our country it is well maintained, all the health care’s private and
government take special care to train their employees.

 Evaluation of Human Resource Planning: After doing, all the steps it is necessary to
evaluate the effectiveness of human resource planning so that the output can be measured.
Currently the 57th largest economy in the world, Bangladesh has been making significant socio-
economic developments in recent years. GDP has been growing at an average rate of 6-7% over
the past decade. However, improving healthcare indicators such as decline in mortality rates and
increase in average life expectancy, the health sector of the country is yet to reach its full
potential. Total healthcare expenditure stands at only 3.7% of total GDP of the economy.

4. Evaluation for the Status of HR Requirement and Availability in the

Industry
Bangladesh is suffering from severe shortage of doctors, nurses and midwives along with a
mismanagement of related technicians to facilitate the service delivery. In other words, there

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is severe shortage of health workforce. The country currently has one registered physician per
1,847 people while the ratio for a government physician is 1: 6,579. To meet the need for the
people the requirements are:

For Doctors:
 MBBS from any reputed medical college
 Original Internship training certificate
 Provisional registration certificate
 Full registration
 For officially settle as a doctor need other degrees (MCPS, FCPS, PHD etc)

For Nurses:
 Need to complete nursing degree from any nursing college
 Know primary things to help doctors while operating
 B.SC in nursing (optional)

These two professions are directly related with health care but there are other posts, which are
required to run any health care like the management team, chemist, receptionist etc.

Availability in the Industry:

To meet the growing population of our country both doctors and nurses are in shortage
situation. Bangladesh Health Care Industry is trying to fulfill the requirement but it is tough
for them because the growth rate is too high than the serving persons.

For example, few days ago there were a large number of people affected by Chikunguni, but
in our country the only treatment for this disease was possible in Dhaka city. For this reason,
the hospitals became out of services as they don’t have enough capability to meet up the large
number of people.

Moreover, the doctors and nurses also need proper training and regularly acknowledged to
serve the patients to move with the new technologies and trends.

Bangladesh suffers from both a shortage of and geographic mal-distribution of HRH. There are
an estimated 3.05 physicians per 10,000 populations and 1.07 nurses per 10,000 populations
(estimates based on MoHFW HRD 2011). There is a severe gap between sanctioned and filled
health worker positions. 36% vacancy in sanctioned health worker positions and only 32% of
facilities have 75% or more of the sanctioned staff working in the facilities.

5. Reason for the Shortage of HR:

Health workers are concentrated in urban secondary and tertiary hospitals, although 70% of the
population lives in rural areas. For that reason, there is a shortage of health workers in rural
areas of Bangladesh.

a) Lack of proper demand and supply focusing. The demand and supply of health worker
is not same in both urban and rural areas. Most of the population lives outside Dhaka.
There is a huge demand of doctors, nurses and health worker in rural areas but the

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 supply of qualified doctors and nurses is not enough to serve the large population of the
country.

b) One of reason of shortage of health worker in health industry is lack of proper

management
System. Now a day it is well managed in some renowned privet hospitals but there is
lack of good management system in both private and governmental hospitals.

c) Lack of training and development. Hospitals need to help staff develop the skills
necessary to work effectively in teams. If there is lack training and development
process, then there will be a shortage of efficient health workers.

d) Failure of HR planning process is one of the main reason of shortage. The HR planning
process Human resources planning ensures the best fit between employees and jobs
while avoiding manpower shortages or surpluses. Doctors and nurses, nurses and
auxiliaries, dentists and dental assistants, surgeons and anesthetists, and in these cases
planning will be important to ensure a proper balance. The relative balance between the
supply of medical generalists and specialists is also important and argues for not relying
too much on market forces to guide specialty training. For that reason, a proper HR
planning is essential.

6. Impact of the Shortage in Health Industry:

Firstly, Clinician shortage continues to be a problem in rural areas. It is also unaffordable by
low income rural people to get proper treatment from urban areas. For that reason, they are
facing many health problem and they are not getting proper treatment. Secondly, a poor
functional distribution and poor geographic distribution of the workforce is an impact of
shortage. Our country has far higher health worker-to-population ratios in the large urban
centers than in small towns and rural areas, despite a wide variety of programs to reduce the
geographic imbalance. Thirdly, Shortages of health care workers lead to burnout for
overworked physicians and nurses, as well as decreased health outcomes for patients. A few
amount of doctors is attending large amount of patients. For that reason, patients are not getting
proper treatment from the doctors. Fourthly, Physicians, advanced-practice nurses, registered
nurses and other allied health professionals each provide individualized health care services.
Many hospitals are struggling with a nurse shortage. For that reason, proper patient care is not
given in many hospitals. Lastly, there are shortage of Health Professional surgeons in many
hospitals especially in rural areas. Proportionately fewer surgeons practice in rural and many
hospitals do not have a surgeon. For that reason, people are not getting proper surgery. Low
income people cannot effort high cost surgery. Many people are dying because of the shortage
of surgeons.

7. Steps Taken to deal with the shortage of HR

a. During a tight marketplace, the keys to maintaining connect enough personnel by variety and
talent are:
 Redesigning work processes and introducing new technologies to extend strength,
effectiveness, and worker satisfaction,

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  Retentive existing employees, as well as those able to retire
 Attracting the new generation of employees.

b. The employees challenges and methods facing hospitals need leaders who:

 Have combine appetence for leading change,

 Actively cultivate associate engaged employees,
 Welcome the new generations to their organizations.

c. Hospitals have to develop new work models that increase effectiveness, work force
satisfaction, and patient outcomes. Established improvement methods developed by
corporations outside of health care might speed up efforts to boost performance.
d. Hospitals should give its employees proper training and development. A strong training gives
work efficiency. Hospitals have to facilitate employees develop the talents necessary to figure
effectively in groups.
e. To deal with HR shortage HR planning process is must. Planning helps reduce, and even
eliminate uncertainty, improve efficiency of operations, and find smarter ways to complete
project tasks and deliverables. To accommodate the preferences of the multiple work force
generations, hospitals have to be bound to replace early human resources policies, that were
applied equally, to all or any employees with policies and programs that embody flexibility
and decisions.

8. Benefits Derived from the Steps Taken

Enterprise Leadership: Set the proper performance metrics that support addition and
personality to drive higher outcomes across the organization.
Workforce Representation: produce a broad culture to draw in prime talent and strengthen
your leader whole.
Patient Experience: Build relationship and trust with customers by permitting them to share
their feedback and develop systems to act on it feedback.
Preventive Care: Be proactive in progressing to catch and addressing the individual health
desires of our workers, customers and their communities – to assist use drive growth.

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 9. Recommendation for Dealing Shortage:

 Health worker should provide in both rural and urban areas. As most of the people in
Bangladesh live in rural areas. So if health worker equally provided in both areas equally
in that case rural areas people can be benefited as well. It helps to create more concern
about health among rural areas people.

 In rural areas, there should be provided more qualified doctors and nurses. In a research,
we found that there is less amount of qualified doctors and nurses provide services to the
rural people which is not enough. In that case, providing more and more qualified doctors
and nurses is needed for the rural areas people.

 Management system should maintain properly and the rule of management system should
strict in both private and government sectors. As in private sector, the management system
maintains very well. In that case. Management system should be stronger in government
sector as well.

 Hospitals authority should arrange more training session for their workers. It helps them to
develop the skills which is necessary to work effectively.
 Rewards can be provided to the workers as well in order to gain more attention on their
work.
 Health Professional surgeons should provide in many hospitals especially in rural areas. It
helps to get proper surgery and treatment. Moreover, the surgery cost should low so that
the rural areas people can afford to do surgery. It helps to minimize the shortage of HR.

10. Key Findings:

Health care is the foremost necessary industry that government is giving their utmost thought.
During this term paper, we have considered a structure of human resource needed in health
care. We will style what variety of unit of time coming up with method within the health
profession. While checking out the unit of time we want to seek out the standing of unit of time
demand and accessibility within the health care. Moreover, presently Health industry in
Bangladesh is facing numerous issues because of lack of management, lack of hiring
experience employees, lack of correct coaching etc. Moreover, there is lack of complete work
force like Doctors, Nurses, body employees World Health Organization will run the trade with
efficiency and effectively. In our project, we have been shown many aspects behind why Health
care in our country were in decline. Finally, we have been discovered some potential resolution
to tackle the problems and run the Health trade effectively and with efficiency. By creating
correct implementation of these steps, we have a tendency to believe that, we are able to

9
improve plenty on the management, recruiting and coaching potential human resources
required for Health trade and additionally the opposite aspects associated with Health trade.

11. Conclusion and Recommendation:

Health Industry always have a crucial role in the economy in the economy of our country.
Countries like Bangladesh facing so many problems in the health industry. Not only taking
proper steps can solve the situation, we also need co-operation of government. Without having
proper co- operation of government, we cannot take proper measures to solve the problems that
we have in the health industry. That is why, friendly Government policies regarding health
Industry is very essential for us in order to implement those steps practically. To conclude, we
can say that, friendly government policies with proper steps can surely help our Health Industry
to solve those issues and take the industry into a new height.

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 12.Appendix:

As the situation is improving day by day, the rate of fertility and morality is going down.

Figure: 01

Distribution of beds Secondary and Tertiary Public Health Organizations whereas the
population is too high –
Table: 01

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Figure: 02

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 13.References:

1. Population Reference Bureau. 2012. World Population Data Sheet. Available from: http://
www.prb.org / Data Finder Geography/ Data.aspx? loc=378.
2. Health bulletin 2013. Management Information System. Directorate General of Health
Services. Ministry of Health and Family Welfare. Government of the People’s Republic.
3. World Health Organization (WHO). World Health Report 2006: Working together for
health. Geneva: WHO, 2006. Available from: http:// www. who. int/whr/
2006/whr06_en.pdf.
4. AMR Chowdhury, A Bhuiya, ME Chowdhury, S Rasheed, Z Hussain, LC Chen.
Bangladesh paradox: exceptional health achievement despite economic poverty. Lancet.
2013; 23;382 (9906) : 1734-45.
5. Bangladesh Health Watch. Health workforce in Bangladesh: Who constitutes the health
care system? State of health in Bangladesh 2007. BRAC University, Dhaka (2008).
Available from: http:// sph.bracu.ac.bd/ images/ reports/bhw/ 2007/
Full_Report_2007_Final.pdf.
6. The Daily Star. Child deaths halved. UN award for Bangladesh. Daily Star, Sept 21, 2010.
Available from: http: //www. thedailystar.net / new Design / news-details.php?nid.
7. Bangladesh Bureau of Statistics (BBS). 2011. Statistical pocketbook of Bangladesh
2010.Dhaka: BBS.

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