Search results

The brain drain challenge has become a cankerworm confronting not only the public health-care sector in Nigeria but almost all sectors of the national economy. This study aims to explore the push factors responsible for brain drain incidence among the migrated, JAPA, physicians to other global work environments. The study investigates the mediating role of capacity development among migrated, JAPA, physicians between the health-care infrastructural deficit and brain drain syndrome.

This study used a survey cross-sectional research design to examine the 214 migrated physicians in four notable perceived countries (UK, USA, Canada and Australia). The study used a probability sampling strategy to survey a self-administered online research instrument. The study adapted a battery of scales from several authors to measure the relevant constructs of this study. Hierarchical multiple regression was used to examine factors that provoke the incidence of brain drain burden among the JAPA Physicians. While Macro Hayes Process was used to investigate the mediating role of capacity development among migrated physicians.

The study revealed from the “JAPA” physicians that working conditions are turbulent and utterly poor which led to the incidence of brain drain. The study indicated that poor remuneration and benefits are the predominant reason for JAPA physicians to European countries and USA/UK. The findings of the study demonstrated that restricted opportunities and poor standard of living in the country were additional factors responsible for the brain drain of Nigerian physicians to other international countries. The outcome of the study also illustrated that inadequate infrastructure and facilities are the dominant variables that pushed physicians to foreign nations. It was revealed that there is a toxic mix of several issues that led to a brain drain albatross among the migrated physicians from Nigeria. The last part of the study indicated that physicians’ capacity development was a game changer that would discourage brain drain incidence and establish motivation for working in Nigeria's public health-care sector.

The study has given a direction for providing succinct solutions to the cankerworm of brain drain that has depleted the Nigerian public health-care industry. It has proffered a possible trajectory that will reverse the JAPA syndrome among the professional health-care workforce. This will not only benefit the public health-care personnel but also be significant for all the human capital across all the sectors of the national economy of Nigeria.

An integrated care system identified quality improvement (QI) capacity as a gap in advancing their integrated quality care priorities and improvement efforts. Here we describe the design and implementation of a QI capacity building program that aimed to (1) build QI capacity amongst diverse integrated care system members and (2) apply QI principles to advance integrated quality care priorities.

The integrated care system leaders, including community members, partnered with the University of Toronto Centre for Quality Improvement and Patient Safety to co-design and deliver the QI capacity building program focused on improving cancer screening rates. An existing acute care capacity building program was adapted. Content included QI tools, data to identify and monitor QI priorities, equity considerations, and empowering participants as change agents.

Participants were satisfied with the content and delivery of the program. Some described using QI tools and strategies in practice following the workshop. Challenges to using the tools included the current pressures facing primary care and the health system, resources, and data availability.

This QI capacity building program was challenging but feasible. Clarifying the target audience, being attentive to co-design, acknowledging post-pandemic system challenges and proactively addressing variable knowledge and barriers to QI work in practice will inform future iterations of this program.

While many examples of QI education programs exist, the majority target a single healthcare sector. We describe a novel QI capacity building model that bridges healthcare sectors and includes patient partners and community members as teachers and participants.

There is growing recognition that transformation of healthcare systems towards health and well-being systems requires a continuous learning process. This explorative study aims to gain insight into the experiences with and investment in these learning processes within regional partnerships for health and in what they need to enhance their learning capacity to use the learning for transformation.

17 interviews were held with programme managers, data scientists, trusted advisors and a citizen representative, all involved in the learning process on a regional level in ten Dutch regional partnerships. The interviews were inductively and thematically analysed, focusing on the experiences and perceptions underlying the learning processes.

Regional partnerships invest in learning processes by organizing interactions between different groups of stakeholders and by reflecting on specific themes or on a region-wide level. Difficulty was found in region-wide reflection and in enhancing the learning capacity within the partnerships. Further enhancing the learning capacity required: (1) Investment in (the use of) expertise for translating learning outcomes into concrete action; (2) Leadership for change, underpinned by a shared sense of urgency to learn for transformation and (3) A facilitative environment for change which is both based on facilitative system structures and a basis of trust and commitment to learn and adapt.

The study highlighted the difficulty of learning on a region-wide level and the struggle to apply this learning for transformation. It provides insights into how learning processes and learning capacity can be further improved.

Decentralization has profound implications for many health systems. This study investigates the effect of health system decentralization in Organization for Economic Co-operation and Development (OECD) countries on public health security capacity and health service satisfaction.

Multiple linear regression analyses were employed for variables related to the level of health security capacity and satisfaction with the healthcare system while controlling for all socio-demographic variables from the European Social Survey, including over 44,000 respondents from 25 OECD countries. The Health Systems in Transition series of countries were used for assessing the decentralization level.

The result of multiple linear regression analyses showed that the level of decentralization in health systems was significantly associated with higher health security capacity (ß-coefficient 3.722, 95% confidence interval (CI) [3.536 3.908]; p=<0.001) and health service satisfaction (ß-coefficient 1.463, 95% CI [1.389 1.536]; p=<0.001) in the study. Countries with a higher level of decentralization in health policy tasks and areas were significantly likely to have higher health services satisfaction, whereas this satisfaction had a significant negative relation with the lower level of decentralization status of secondary/tertiary care services in OECD countries (ß-coefficient −5.250, 95% CI [−5.757–4.743]; p = 0.001).

This study contributes to a better understanding of the extent to which decentralization of health services affects public health safety capacity and satisfaction with health services, whereas the level of decentralization in OECD countries varies considerably. Overall, the findings highlight the importance of public health security and satisfaction with health care delivery in assessing the effects of decentralization in health services.

In an urban environment, different types of actors (individuals, households, community groups, institutions, governmental organizations, nongovernmental organizations (NGO), community-based organizations (CBO) and public and private organizations, etc.) play critical roles in enhancing urban resilience to adapt to the impacts of climate change. To identify and prioritize aspects of climate resilience planning, this study aims to examine the potential impacts of climate change on diverse urban systems and evaluate the capacities of various actors to adapt to climatic stress.

This research selects Mongla, a coastal as well as port town in south-western Bangladesh that faces climate risks including frequent cyclones, storm surges and salinity intrusion due to sea-level and temperature rise, as reported in the National Climate Vulnerability Index 2018. This research uses the methodology proposed by ICLEI South Asia’s Climate Resilient Cities Action Plan and accesses different urban actors’ adaptive capacity for contributing to enhancing climate resilience based on three broad characteristics: the capacity to organize and respond, availability of resources and access to information. The cumulative scores of these characteristics aid in determining the climate adaptive capacity of each urban actor.

The identified 53 actors are grouped into four categories: government (local and national); international/local NGOs, CBOs and associations; community representatives and private sectors and groups and individuals. The group of NGOs, CBOs and associations has a higher overall adaptive potential than all other actor groups, according to the study. When it comes to practicing adaptive capacity, government institutions are in the second-highest position. But, the Khulna development authority, the government agency that is in charge of overseeing all forms of urban development, scored poorly on all fragile urban systems. However, the performance of the fourth group of urban actors is very subpar when it comes to adapting to climatic stress, which emphasizes the need for focused interventions.

Variations in adaptive capacities to climate change across different actors are particularly useful for targeting actors with lower levels of climate adaptive capacities in Mongla town.

This paper particularly addresses the research gap in assessing the adapting capacity of urban actors in Mongla port-town. Policymakers and practitioners can create and carry out targeted interventions that address the particular needs and concerns of vulnerable actors by making use of the insights obtained from this kind of study, thereby assisting in the development of climate resilience in any urban area.

This study aims to identify the critical factors contributing to India-based non-governmental organizations (NGOs) capacity building and value creation for beneficiaries.

A total interpretive structural modeling technique has been used to develop a hierarchical model of critical factors and understand their direct and indirect interrelationships. The driving force and dependence force of these factors were determined by using cross-impact matrix multiplication applied to classification analysis.

This study identifies 12 critical factors influencing NGO capacity building in India’s intellectual disability sector across four dimensions. Internal organizational capabilities include infrastructure, staff qualifications, fundraising, vocational activities and technical resources. Second, coordination and stakeholder engagement highlight government and agency collaboration, dedicated board members and stakeholder involvement. Third, adaptability and responsiveness emphasize adjusting to external trends and seizing opportunities. Finally, impact and value creation emphasis on improving value for persons with disabilities (PWDs).

The findings of this study have practical implications for Indian NGOs working for PWDs. The study provides NGOs with a structural model for improving organizational capacity by identifying and categorizing critical factors into the strategic model.

There is a scarcity of literature on capacity building for disability-focused NGOs in India. This study seeks to identify critical factors and develop a hierarchical model of those factors to assist policymakers in India in building the capacity of NGOs.

Impoverished employee mental health is harmful to employees and organisational performance. There is emerging interest in employee mental health in the human resource management (HRM) field. The majority of these studies mainly focus on the organisational and individual levels from the psychological and managerial perspectives without considering the sectoral characteristics and societal context.

This perspective paper draws on extant literature as well as 10 informal interviews with medical professionals, organisational leaders in the public sector, teachers and HR professionals to shed light on employee mental health research, practice and challenges in the Chinese context.

This paper reveals national, sectoral, occupational and individual factors that shape mental health problems, individual coping mechanisms and organisational interventions. It also shows international influence on employee mental health in the form of institutional pressure and knowledge transfer.

There is limited research on employee mental health and HRM in the Chinese context, which restricts the scope of discussion in this paper, but at the same time presents rich future research opportunities that may be relevant to other national settings.

Managing the mental health of the workforce is part of the mental health management of the population, which means a holistic approach to building a mental health eco-system needs to be adopted. The authors call for more research on employee mental health in the Chinese context to provide evidence to support policy development and organisational efforts to scale up mental health services at the national and organisational levels. The authors also provide practical recommendations for policymakers and employing organisations.

The authors present a multi-level and multi-factor overview related to employee mental health in the Chinese context. The authors argue for a resource-based and multi-stakeholder approach, which will help inform and improve mental health policy and practice. The authors present several avenues for future scholarship and research. The authors extend the research frontiers of employee mental health issues by calling for the inclusion of a broader range of theoretical lenses including institutional theory, cultural and spiritual perspective and critical sociology to understand more fully how employee mental health conditions may be undermined or improved.

Health technologies are advancing rapidly and becoming more expensive, posing a challenge for financing healthcare systems. Health technology assessment (HTA) improves the efficiency of resource allocation by facilitating evidence-informed decisions on the value of health technologies. Our study aims to create a customized HTA roadmap for Oman based on a gap analysis between the current and future status of HTA implementation.

We surveyed participants of an advanced HTA training program to assess the current state of HTA implementation in Oman and explore long-term goals. A list of draft recommendations was developed in areas with room for improvement. The list was then validated for its feasibility in a round table discussion with senior health policy experts to conclude on specific actions for HTA implementation.

Survey results aligned well with expert discussions. The round table discussion concluded with a phasic action plan for HTA implementation. In the short term (1–2 years), efforts will focus on building capacity through training programs. For medium-term actions (3–5 years), plans include expanding the HTA unit and introducing multiple cost-effectiveness thresholds while from 6–10 years, publishing of HTA recommendations, critical appraisal reports, and timelines is recommended.

Although the HTA system in Oman is still in its early stages, strong initiatives are being taken for its advancement. This structured approach ensures a comprehensive integration of HTA into the healthcare system, enhancing decision-making and promoting a sustainable, evidence-based system addressing the population’s needs.

This chapter focuses on the COVID-19 pandemic’s impact on the recognition through discourses of essentiality, of low-status workers and more specifically of care aides as an occupational group that performs society’s ‘dirty work’. The pandemic appears as a privileged moment to challenge the normative hegemony of how work is valued within society. However, public recognition through political discourse is a necessary but insufficient element in producing social change. Based on the theory of performativity, this chapter empirically probes conditions and mechanisms that enable a transition from discourse of essentiality to substantive recognition of the work performed by care aides in healthcare organizations. The authors rely on three main sources of data: scientific-scholarly works, documents from government, various associations and unions, and popular media reports published between February 2020 and 1 July 2022. While discourse of essentiality at the highest level of politics is associated with rapid policy response to value the work of care aides, it is embedded in a system structure and culture that restrains the establishment of substantive policy that recognizes the nature, complexity, and societal importance of care aide work. The chapter contributes to the literature on performativity by demonstrating the importance of the institutionalization of competing logics in contemporary health and social care systems and how it limits the effectiveness of discourse in promulgating new values and norms and engineering social change.

Sustainable development goals (SDGs) designed by the United Nations include ‘universal and equitable access to affordable, reliable and clean energy’ as one of the pathways to achieve a better and more sustainable future by 2030. Universal access to electricity, clean cooking fuel, increasing share of renewable resources and improving energy efficiency are the key components of SDG7. In India, the government has undertaken targeted programmes to ensure full electrification of households and greater use of liquid petroleum gas (LPG) for clean cooking replacing traditional solid biomass fuels in poor households. Installed capacity targets are set to raise the share of renewable resources in total energy mix along with the policies undertaken to make it cost-competitive (SDG India, 2019–2020). However, the economic crisis experienced by India during COVID-19 pandemic is likely to affect this ongoing drive towards clean energy use. Sudden fall in income and loss of employment particularly in the unorganised sector might have made the poor rural households vulnerable to reversion to their traditional cooking fuels. The renewable sector has also faced uncertainties due to halted construction works and disrupted global supply chains during lockdown. The present chapter discusses these pertinent issues crucial for achieving SDGs. It investigates how far the COVID-19-driven economic crisis has delayed India's clean cooking fuel programme for different states. It further examines the impact of COVID-19 lockdown on renewable energy sector, particularly on the solar energy sector. The study suggests some policy measures for a robust recovery, ensuring transition towards clean energy use and sustainable growth to protect the environment.