31 research outputs found
Firm age, collateral value, and access to debt financing in an emerging economy: evidence from South Africa
This paper applies the Blundell and Bond system generalised method of moments (GMM) two-step estimator to examine the impact of age and collateral value on debt financing, using a panel of 177 non-financial companies listed on the Johannesburg Stock Exchange over the period 1999 to 2009. The results show that South African firms have target leverage ratios and adjust their capital structures from time to time to achieve their respective targets, that the relationship between firm age and debt financing is non-monotonic, and that firms with higher collateral value are likely to face fewer constraints on borrowing and therefore have greater access to medium-term and long-term debts. Robustness tests also reveal that during start-up and maturity stages, a firm's access to debt markets is significantly influenced by investments in assets that are acceptable to external creditors as collateral. These findings suggest that debt financing policies could be more critical for firms in the start-up and maturity stages
Firm age, collateral value, and access to debt financing in an emerging economy: evidence from South Africa
This paper applies the Blundell and Bond system generalised method of moments (GMM) two-step estimator to examine the impact of age and collateral value on debt financing, using a panel of 177 non-financial companies listed on the Johannesburg Stock Exchange over the period 1999 to 2009. The results show that South African firms have target leverage ratios and adjust their capital structures from time to time to achieve their respective targets, that the relationship between firm age and debt financing is non-monotonic, and that firms with higher collateral value are likely to face fewer constraints on borrowing and therefore have greater access to medium-term and long-term debts. Robustness tests also reveal that during start-up and maturity stages, a firm's access to debt markets is significantly influenced by investments in assets that are acceptable to external creditors as collateral. These findings suggest that debt financing policies could be more critical for firms in the start-up and maturity stages
Improving Maternal and Child Healthcare Programme Using Community-Participatory Interventions in Ebonyi State Nigeria
In Nigeria, the government is implementing the Free Maternal and Child Health Care Programme (FMCHCP). The policy is premised on the notion that financial barriers are one of the most important constraints to equitable access and use of skilled maternal and child healthcare. In Ebonyi State, Southeastern Nigeria the FMCHCP is experiencing implementation challenges including: inadequate human resource for health, inadequate funding, out of stock syndrome, inadequate infrastructure, and poor staff remuneration. Furthermore, there is less emphasis on community involvement in the programme implementation. In this policy brief, we recommend policy options that emphasize the implementation of community-based participatory interventions to strengthen the government’s FMCHCP as follows: Option 1: Training community women on prenatal care, life-saving skills in case of emergency, reproductive health, care of the newborn and family planning. Option 2: Sensitizing the community women towards behavioural change, to understand what quality services that respond to their needs are but also to seek and demand for such. Option 3: Implementation packages that provide technical skills to women of childbearing age as well as mothers’ groups, and traditional birth attendants for better home-based maternal and child healthcare. The effectiveness of this approach has been demonstrated in a number of community-based participatory interventions, building on the idea that if community members take part in decision-making and bring local knowledge, experiences and problems to the fore, they are more likely to own and sustain solutions to improve their communities’ health
Implementation of a health policy advisory committee as a knowledge translation platform: the Nigeria experience
Background:
In recent times, there has been a growing demand internationally for health policies to be based on
reliable research evidence. Consequently, there is a need to strengthen institutions and mechanisms that can promote
interactions among researchers, policy-makers and other stakeholders who can influence the uptake of research
findings. The Health Policy Advisory Committee (HPAC) is one of such mechanisms that can serve as an excellent
forum for the interaction of policy-makers and researchers. Therefore, the need to have a long term mechanism
that allows for periodic interactions between researchers and policy-makers within the existing government system
necessitated our implementation of a newly established HPAC in Ebonyi State Nigeria, as a Knowledge Translation
(KT) platform. The key study objective was to enhance the capacity of the HPAC and equip its members with the
skills/competence required for the committee to effectively promote evidence informed policy-making and function
as a KT platform.
Methods:
A series of capacity building programmes and KT activities were undertaken including: i) Capacity
building of the HPAC using Evidence-to-Policy Network (EVIPNet) SUPPORT tools; ii) Capacity enhancement
mentorship programme of the HPAC through a three-month executive training programme on health policy/health
systems and KT in Ebonyi State University Abakaliki; iii) Production of a policy brief on strategies to improve the
performance of the Government’s Free Maternal and Child Health Care Programme in Ebonyi State Nigeria; and
iv) Hosting of a multi-stakeholders policy dialogue based on the produced policy brief on the Government’s Free
Maternal and Child Health Care Programme.
Results:
The study findings indicated a noteworthy improvement in knowledge of evidence-to-policy link among
the HPAC members; the elimination of mutual mistrust between policy-makers and researchers; and an increase in
the awareness of importance of HPAC in the Ministry of Health (MoH).
Conclusion:
Findings from this study suggest that a HPAC can function as a KT platform and can introduce a new
dimension towards facilitating evidence-to-policy link into the operation of the
MoH
, and can serve as an excellent
platform to bridge the gap between research and polic
Promoting Researchers and Policy-Makers Collaboration in Evidence-Informed Policy-Making in Nigeria: Outcome of a Two-Way Secondment Model between University and Health Ministry
Background
There is need to strengthen institutions and mechanisms that can more systematically promote interactions between researchers, policy-makers and other stakeholders who can influence the uptake of research findings. In this article, we report the outcome of a two-way secondment model between Ebonyi State University (EBSU) and Ebonyi State Ministry of Health (ESMoH) in Nigeria as an innovative collaborative strategy to promote capacity enhancement for evidence-to-policy-to-action.
Methods
This study was an exploratory design with a quantitative cross-sectional survey technique. A secondment memorandum of understanding (MOU) was signed between heads of EBSU and ESMoH. The secondment program lasted six months with ten researchers and ten policy-makers spending up to two days per week in each other’s organization. The secondee researchers got engaged in policy-making and implementation activities in ESMoH, while the policy-maker secondees got involved in research activities in EBSU. Secondees evidence-to-policy capacity enhancement meetings were held and questionnaires designed in 5-point Likert scale were used to assess their impact.
Results
The secondee policy-makers and researchers admitted having considerable knowledge of secondment with mean ratings (MNRs) of 3.40 and 3.74 respectively on the 5 points scale. Secondment appeared to be more common in the policy-makers’ organization (MNRs: 2.80-3.07) than in the researchers’ institution (MNRs: 2.58-2.84). The secondee policy-makers participated in some academic and research activities including serving in research ethics committee in EBSU and provided policy-making perspective to the activities. The secondee researchers supported the policymaking process in ESMoH through policy advisory roles, and provided capacity enhancement for staff of the ministry on the use of research evidence in policy-making. There was a noteworthy increase on knowledge of policy analysis and contextualization among the secondees ranging from 20.7% to 50.4% and 31.3% to 42.8% respectively following a training session. A Society for Health Policy Research and Knowledge Translation was established by mutual agreement of secondees as a platform to permanently institutionalize the collaboration.
Conclusion
The outcome of this study clearly suggests that secondment has great potential in promoting evidence informed policy-making and merits further consideration
Improving maternal and child healthcare programme using community-participatory interventions in Ebonyi State Nigeria
In Nigeria, the government is implementing the Free Maternal and Child Health Care Programme (FMCHCP).
The policy is premised on the notion that financial barriers are one of the most important constraints to equitable
access and use of skilled maternal and child healthcare. In Ebonyi State, Southeastern Nigeria the FMCHCP is
experiencing implementation challenges including: inadequate human resource for health, inadequate funding,
out of stock syndrome, inadequate infrastructure, and poor staff remuneration. Furthermore, there is less
emphasis on community involvement in the programme implementation. In this policy brief, we recommend
policy options that emphasize the implementation of community-based participatory interventions to strengthen
the government’s FMCHCP as follows: Option 1: Training community women on prenatal care, life-saving skills
in case of emergency, reproductive health, care of the newborn and family planning. Option 2: Sensitizing the
community women towards behavioural change, to understand what quality services that respond to their needs are
but also to seek and demand for such. Option 3: Implementation packages that provide technical skills to women
of childbearing age as well as mothers’ groups, and traditional birth attendants for better home-based maternal
and child healthcare. The effectiveness of this approach has been demonstrated in a number of community-based
participatory interventions, building on the idea that if community members take part in decision-making and
bring local knowledge, experiences and problems to the fore, they are more likely to own and sustain solutions to
improve their communities’ healt
Promoting Researchers and Policy-Makers Collaboration in Evidence-Informed Policy-Making in Nigeria: Outcome of a Two-Way Secondment Model between University and Health Ministry
Abstract
Background: There is need to strengthen institutions and mechanisms that can more systematically promote interactions
between researchers, policy-makers and other stakeholders who can influence the uptake of research findings. In this
article, we report the outcome of a two-way secondment model between Ebonyi State University (EBSU) and Ebonyi
State Ministry of Health (ESMoH) in Nigeria as an innovative collaborative strategy to promote capacity enhancement
for evidence-to-policy-to-action.
Methods: This study was an exploratory design with a quantitative cross-sectional survey technique. A secondment
memorandum of understanding (MOU) was signed between heads of EBSU and ESMoH. The secondment program
lasted six months with ten researchers and ten policy-makers spending up to two days per week in each other’s
organization. The secondee researchers got engaged in policy-making and implementation activities in ESMoH,
while the policy-maker secondees got involved in research activities in EBSU. Secondees evidence-to-policy capacity
enhancement meetings were held and questionnaires designed in 5-point Likert scale were used to assess their impact.
Results: The secondee policy-makers and researchers admitted having considerable knowledge of secondment with
mean ratings (MNRs) of 3.40 and 3.74 respectively on the 5 points scale. Secondment appeared to be more common in
the policy-makers’ organization (MNRs: 2.80-3.07) than in the researchers’ institution (MNRs: 2.58-2.84). The secondee
policy-makers participated in some academic and research activities including serving in research ethics committee
in EBSU and provided policy-making perspective to the activities. The secondee researchers supported the policymaking process in ESMoH through policy advisory roles, and provided capacity enhancement for staff of the ministry
on the use of research evidence in policy-making. There was a noteworthy increase on knowledge of policy analysis
and contextualization among the secondees ranging from 20.7% to 50.4% and 31.3% to 42.8% respectively following a
training session. A Society for Health Policy Research and Knowledge Translation was established by mutual agreement
of secondees as a platform to permanently institutionalize the collaboration.
Conclusion: The outcome of this study clearly suggests that secondment has great potential in promoting evidence
informed policy-making and merits further consideration
Enhancing the Capacity of Policy-Makers to Develop Evidence-Informed Policy Brief on Infectious Diseases of Poverty in Nigeria
Background:
The lack of effective use of research evidence in policy-making is a major challenge in most low- and
middle-income countries (LMICs). There is need to package research data into effective policy tools that will help
policy-makers to make evidence-informed policy regarding infectious diseases of poverty (IDP). The objective of
this study was to assess the usefulness of training workshops and mentoring to enhance the capacity of Nigerian
health policy-makers to develop evidence-informed policy brief on the control of IDP.
Methods:
A modified “before and after” intervention study design was used in which outcomes were measured on
the target participants both before the intervention is implemented and after. A 4-point Likert scale according to the
degree of adequacy; 1
= “grossly inadequate,” 4
= “very adequate” was employed. The main parameter measured was
participants’ perceptions of their own knowledge/understanding. This study was conducted at subnational level and
the participants were the career health policy-makers drawn from Ebonyi State in the South-Eastern Nigeria. A one-
day evidence-to-policy workshop was organized to enhance the participants’ capacity to develop evidence-informed
policy brief on IDP in Ebonyi State. Topics covered included collaborative initiative; preparation and use of policy
briefs; policy dialogue; ethics in health policy-making; and health policy and politics.
Results:
The preworkshop mean of knowledge and capacity ranged from 2.49-3.03, while the postworkshop mean
ranged from 3.42–3.78 on 4-point scale. The percentage increase in mean of knowledge and capacity at the end
of the workshop ranged from 20.10%–45%. Participants were divided into 3 IDP mentorship groups (malaria,
schistosomiasis, lymphatic filariasis [LF]) and were mentored to identify potential policy options/recommendations
for control of the diseases for the policy briefs. These policy options were subjected to research evidence synthesis
by each group to identify the options that have the support of research evidence (mostly systematic reviews) from
PubMed, Cochrane database and Google Scholar. After the evidence synthesis, five policy options were selected out
of 13 for malaria, 3 out of 10 for schistosomiasis and 5 out of 11 for LF.
Conclusion:
The outcome suggests that an evidence-to-policy capacity enhancement workshop combined with a
mentorship programme can improve policy-makers’ capacity for evidence-informed policy-making (EIP
Evaluation of the effect of an educational intervention on knowledge and adherence to HIV guidelines among frontline health workers in Alex-Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria
Background: The aim of this study was to appraise the implementation of
the National HIV guidelines and determine the effect of an educational
intervention on health worker knowledge and practice of the guidelines.
Methods: A before and after study design without control was carried
out using a self-administered questionnaire and key informant
interviews. Data was also collected from client record cards. An
educational intervention was carried out using pamphlets containing
summarized information on the guideline. Data analysis was carried out
using IBM-SPSS version 20. Result: Results showed that 54.5% of the
respondents were males and 76% were medical doctors. Baseline knowledge
level of respondents was high with 97% of respondents having good
knowledge with a mean score of 3.9. This increased to 4.1 out of 5
post-intervention. All respondents had good practice of the guidelines
before and after intervention with a mean score of 4.5 out of 5. Client
records also showed good practice. Barriers to guideline implementation
include: poor knowledge, inadequate training, guideline unavailability,
poor functioning of the laboratory equipment, poor funding. Conclusion:
HIV guidelines are being implemented in the clinic to a large extent;
however, trainings, funding and provision of the guideline in the
clinics are recommended