Assessment of challenges facing insurance companies in building competitive advantage in Kenya: A survey of insurance firms

ABSTRACT During the last few years, the insurance industry has undergone a series of changes through financial reforms, advancement of communication and information technologies, globalization of financial services and economic development. Those changes have had a considerable effect on efficiency, productivity change, market structure and performance in the insurance industry. There is an established relationship between business strategy, innovation and organizational performance. This study adopted a descriptive research design.The target population for this study consisted of 44 insurance companies with headquarters in Nairobi. The study targeted the top management specifically the general managers and/or marketing directors due to the role they play in insuring the company builds its competitive advantage. The study collected both primary and secondary data. The study generated both qualitative and quantitative data. Descriptive statistics data analysis method was applied to analyze both quantitative data. Data obtained from the questionnaires were processed through editing and coding and then entering the data into a computer for analysis using descriptive statistics with the help of Statistical Package for Social Sciences (SPSS) version 21.0. The study concludes that the most significant factor is government regulation as a unit change leads to a 2.453 increase in building competitive advantage followed by insurance products at 1.967. The study recommends that insurance companies be monitored/assessed based on their level of risk. This will ensure a stable insurance industry and this will play a major role in increasing the insurance penetration

Outcome Assessment of a Dedicated HIV Positive Health Care Worker Clinic at a Central Hospital in Malawi: A Retrospective Observational Study

BACKGROUND: Malawi has one of the world's lowest densities of Health Care Workers (HCW) per capita. This study evaluates outcomes of a dedicated HCW HIV clinic in Malawi, created at Zomba Central Hospital in January 2007. METHODS AND FINDINGS: Retrospective cohort data was analyzed comparing HCW clinic patient baseline characteristics and treatment outcomes at 18 months after inception, against those attending the general HIV clinic. In-depth interviews and focus group discussions were conducted to explore perceptions of patients and caregivers regarding program value, level of awareness and barriers for uptake amongst HCW. 306 patients were enrolled on antiretroviral therapy (ART) in the HCW HIV clinic, 6784 in the general clinic. Significantly (p<0.01) more HCW clients were initiated on ART on the basis of CD4 as opposed to WHO Stage 3/4 (36% vs.23%). Significantly fewer HCW clients defaulted (6% vs.17%), and died (4% vs.12%). The dedicated HCW HIV clinic was perceived as important and convenient in terms of reduced waiting times, and prompt and high quality care. Improved confidentiality was an appreciated quality of the HCW clinic however barriers included fear of being recognized. CONCLUSIONS/SIGNIFICANCE: Outcomes at the HCW clinic appear better compared to the general HIV clinic. The strategy of dedicated clinics to care for health providers is a means of HIV impact mitigation within human resource constrained health systems in high prevalence settings

Environmental Systems and Local Actors: Decentralizing Environmental Policy in Uganda

In Uganda, environmental and natural resource management is decentralized and has been the responsibility of local districts since 1996. This environmental management arrangement was part of a broader decentralization process and was intended to increase local ownership and improve environmental policy; however, its implementation has encountered several major challenges over the last decade. This article reviews some of the key structural problems facing decentralized environmental policy in this central African country and examines these issues within the wider framework of political decentralization. Tensions have arisen between technical staff and politicians, between various levels of governance, and between environmental and other policy domains. This review offers a critical reflection on the perspectives and limitations of decentralized environmental governance in Uganda. Our conclusions focus on the need to balance administrative staff and local politicians, the mainstreaming of local environmental policy, and the role of international donors

'I believe that the staff have reduced their closeness to patients': an exploratory study on the impact of HIV/AIDS on staff in four rural hospitals in Uganda

<p>Abstract</p> <p>Background</p> <p>Staff shortages could harm the provision and quality of health care in Uganda, so staff retention and motivation are crucial. Understanding the impact of HIV/AIDS on staff contributes to designing appropriate retention and motivation strategies. This research aimed 'to identify the influence of HIV/AIDS on staff working in general hospitals at district level in rural areas and to explore support required and offered to deal with HIV/AIDS in the workplace'. Its results were to inform strategies to mitigate the impact of HIV/AIDS on hospital staff.</p> <p>Methods</p> <p>A cross-sectional study with qualitative and quantitative components was implemented during two weeks in September 2005. Data were collected in two government and two faith-based private not-for-profit hospitals purposively selected in rural districts in Uganda's Central Region. Researchers interviewed 237 people using a structured questionnaire and held four focus group discussions and 44 in-depth interviews.</p> <p>Results</p> <p>HIV/AIDS places both physical and, to some extent, emotional demands on health workers. Eighty-six per cent of respondents reported an increased workload, with 48 per cent regularly working overtime, while 83 per cent feared infection at work, and 36 per cent reported suffering an injury in the previous year. HIV-positive staff remained in hiding, and most staff did not want to get tested as they feared stigmatization. Organizational responses were implemented haphazardly and were limited to providing protective materials and the HIV/AIDS-related services offered to patients. Although most staff felt motivated to work, not being motivated was associated with a lack of daily supervision, a lack of awareness on the availability of HIV/AIDS counselling, using antiretrovirals and working overtime. The specific hospital context influenced staff perceptions and experiences.</p> <p>Conclusion</p> <p>HIV/AIDS is a crucially important contextual factor, impacting on working conditions in various ways. Therefore, organizational responses should be integrated into responses to other problematic working conditions and adapted to the local context. Opportunities already exist, such as better use of supervision, educational sessions and staff meetings. However, exchanges on interventions to improve staff motivation and address HIV/AIDS in the health sector are urgently required, including information on results and details of the context and implementation process.</p

Exploring hybrid HIV/AIDS curriculum development through dialogue with pupils, teachers and community stakeholders

Paper presented at Oxford, University of Cambridge, 13 Septembe

Let's talk about HIV and AIDS

A study of 15 schools in six African countries examined whether a process of dialogue between teachers, community members and Grade 6 learners could help build a participatory curriculum in HIV/AIDS and sex education that takes into account learners' knowledge of sexuality. Duncan Scott, Sharlene Swartz, Colleen McLaughlin and Susan Kiragu report that participants' attitudes towards the curriculum and each other changed over the year, but it involved developing strategies to transcend cultural barriers to learning.

Old enough to know: consulting children about sex and AIDS education in Africa

This compelling study, comprising of a sample of eight schools in three countries in sub-Saharan Africa - Kenya, South Africa and Tanzania - examines the sources, contents and processes of children's community-based sexual knowledges and asks how these knowledges interact with AIDS education programmes in school. Old enough to know showcases the possibilities of consulting pupils using engaging, interactive and visual methods including digital still photography, mini-video documentaries, as well as interviews and observations. These innovative methods allow children to speak freely and openly in contexts where talking about sex to adults are a cultural taboo.