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Previous research has demonstrated that social-relational factors are instrumental to employee voice. An essential aspect of this relates to notions of respect or disrespect. Although nurses commonly report experiencing professional disrespect in their interaction with doctors, earlier studies have focused on how the professional status hierarchy and power imbalance between doctors and nurses hinder speaking up without considering the role of professional disrespect. Addressing this gap, we explore how professional disrespect in the doctor–nurse relationship in surgical teams influences the willingness of nurses to voice legitimate concerns about threats to patient safety.

Fifty-seven semi-structured interviews with nurses drawn from a range of specialities, ranks and surgical teams in three hospitals in a West African Country. In addition, two interviews with senior representatives from the National Registered Nurses and Midwifery Association (NRNMA) of the country were undertaken and analysed thematically with the aid of NVivo.

Disrespect is expressed in doctors’ condescending attitude towards nurses and under-valuing their contribution to care. This leads to safety concerns raised by nurses being ignored, downplayed or dismissed, with deleterious consequences for patient safety. Feeling disrespected further motivates nurses to consciously disguise silence amidst speech and engage in punitive silence aimed at making clinical practice difficult for doctors.

We draw attention to the detrimental effect of professional disrespect on patient safety in surgical environments. We contribute to employee voice and silence by showing how professional disrespect affects voice independently of hierarchy and conceptualise the notion of punitive silence.

The purpose of this paper is to examine the trend of return migration of health professionals to Ghana and how it is impacting the delivery of health services in the country. It also highlights the challenges facing returnees to the country.

A qualitative exploratory case study approach was employed in the study. Data gathered were analysed using the sequential model of qualitative content analysis.

It was found that while push factors dominantly influence out-migration, pull factors rather dominated reasons for return migration. Other determinants of return migration include social and financial benefits to the home country, achieving goals for travelling, skills’ improvement and spousal consideration. The paper also highlights some of the challenges returnees usually encounter in the home country.

This paper makes reasonable recommendations regarding how return migration of Ghanaian health professionals might be smoother.

The study brings to the fore, the necessity for the government to plan for health professionals, who returned to Ghana to contribute to the health system.

This study seeks to undertake a systematic review to consolidate existing empirical evidence on the impact of financial and non‐financial incentives on motivation and retention of health workers in Ghana's district hospitals.

The study employed a purely quantitative design with a sample of 285 health workers from ten district hospitals in four regions of Ghana. A stepwise regression model was used in the analysis.

The study found that financial incentives significantly influence motivation and intention to remain in the district hospital. Further, of the four factor model of the non‐financial incentives, only three (leadership skill and supervision, opportunities for continuing professional development and availability of infrastructure and resources) were predictors of motivation and retention.

A major limitation of the study is that the sample of health workers was biased towards nurses (n=160; 56.1 percent). This is explained by their large presence in remote districts in Ghana. A qualitative approach could enrich the findings by bringing out the many complex views of health workers regarding issues of motivation and retention, since quantitative studies are better applied to establish causal relationships.

The findings suggest that appropriate legislations backing salary supplements, commitment‐based bonus payments with a set of internal regulations and leadership with sound managerial qualities are required to pursue workforce retention in district hospitals.

This paper aims to examine empirically the ways in which workforce knowledge and organisational factors of an implementing agency affected the implementation of health sector administration decentralisation in Ghana with insights from the Nkwanta district health administration.

This is a qualitative study using data from individual and group interviews through purposive selection of health officials, who were directly involved in the work of actual implementation of the programme. Specifically, participants included senior management, middle management and junior workers, who had worked at least for the past three months in the district.

The study found that most of the interviewees involved in the implementation process are knowledgeable of the objectives of the decentralisation process. Also, major factors that are militating against effective decentralisation in the district include inadequate funds, lack of qualified personnel, inadequate logistics and equipment, poor interpersonal relationships, lack of transparency and a good operational system, lack of incentives to motivate the staff, political interference, poor infrastructure and high rate of illiteracy.

The findings of this study will help improve the implementation of decentralisation within the health sector in Ghana. The paper provides recommendations, which, if considered for implementation, will help improve the decentralisation process.

Hospital and health system managers are facing several problems following the introduction of Ghana's national health insurance policy. This study aims to investigate the opinions of health managers about the problems emanating from the national health insurance policy for hospital managers in regard to reimbursement, claims management, service delivery and waiting time.

The study involved key informants from 12 National Health Insurance Scheme (NHIS) accredited district hospitals, which were purposively selected from five regions in Ghana. Data were collected using in‐depth personal interviews with managers of pharmacy, supply/procurement, accounts and insurance scheme units of the hospitals. Data analysis was guided by the major themes that emerged during the interviews. A framework approach to analysis was used, grouping and incorporating themes and sub‐themes that emerged from the interview data.

The major findings identified by interviewees with regards to problems confronting hospital management were: cash flow delays from the health insurance authority; lack of capacity to procure essential drug and non‐drug consumables; and the inability to take initiatives and carry on effective administrative work. Other problems identified by the interviewee included inadequate logistics and human resources, limited space within the hospitals to cope with the increasing number of service users and “moral hazard” on the part of policy holders.

The NHIS has brought many organizational and service management challenges to hospitals. To overcome these challenges, services under the health insurance authority need to be streamlined to remove cash flow bottlenecks. Also, accredited hospitals need to adopt and use new technology, especially computerization and automation of the health insurance service delivery system. This would enable the authority to cope with the huge management problems confronting hospitals and the national insurance scheme. Above all, appropriate fund management systems would have to be established in the hospitals to reduce moral hazards.

This paper aims to emphasize the need for a strategic approach to employee retention beyond financial benefits. This is directly proportional to employee retention. Bringing out the retention measures preferred by employees, depicting the relationship of demographic profile with employee retention tendency and exploring implications giving importance to beyond paycheque factors are the objectives of the study.

This study uses applied qualitative approach with a realistic view to collect the details of retention measures and practices from purposively selected 36 health-care experts by the conduct of interview using a one-to-one discussion with written notes. With quantitative approach, opinion survey was administered to receive the perceived opinion of randomly selected 350 health-care employees on paycheque and on beyond paycheque factors boosting their intention to stay. Bhattacharya and Ramachandran’s health-care study framework on retention was applied for the identification of the factors.

Both paycheque and beyond paycheque benefits are important for retention. Most respondents prefer beyond paycheque factors practiced at sampled hospital. Age, marital status and residence of employees are significantly associated with retention. The strategic initiatives of the sampled hospital to retention concerning motivational needs of employees in the workplace are thank you board, camp head, ad act camp, success corner and so forth.

Addressing health-care work and relationship-related issues in terms of employee retention giving importance to beyond paycheque benefits – remedy for compassion fatigue health-care employees face in routine works, meeting promises made by management regarding paycheque or beyond paycheque benefits, employees participative in decisions in medical, clinical and in functional areas, reducing workload and role stress by the conduct of role analysis.

Many research studies are emphasizing the contribution of financial benefits to employee retention. Only a few studies have been carried out exploring and emphasizing the importance of beyond financial benefits motivating employee retention. This is the study of evidence from a hospital that gives strategic importance to beyond paycheque elements as well as paycheque elements.