Clinical workloads had to be adjusted, revised consultant job plans agreed, and concerns about unequal shares of workload among organisations addressed.
Yet, despite these system challenges, this study has shown that integration can have a positive motivating effect on staff and can lead to better sharing of workload - these are important opportunities that deserve to be built on.
While the declines in mean household visits per month could be in part attributed to sharing of workload marked by the successive addition of new CHWs (some of whom went to new villages, others to villages where MNCH CHW had already been deployed), it may too reflect a continuing downward trend in outputs often characteristic of program implementation over time.
Despite these systems challenges, this study has shown that integration of reproductive health and HIV services can have a positive motivating effect on staff and can lead to better sharing of workload – these are important opportunities that deserve to be built on.
And a recent study of African sparrows showed that the hard workers died earlier, or as researcher Dr Andrew Young put it: "Our findings suggest that the unequal sharing of workloads may leave the hardest-working individuals at risk of oxidative stress, which could lead to poor health and accelerated ageing".
I now have a share of his workload too.
One of the most important things a small business manager can do is make sure that everyone is taking on a fair share of the workload.
The effect on work was substantial, with participants reporting having to go home early and feelings of guilt for not carrying a fair share of the workload.
Another expected benefit was team spirit, based on sharing of the workload, ideas and knowledge.
This means they are more vulnerable to early or forced marriage and early pregnancy, and are often left to shoulder a disproportionate share of the domestic workload.
