Health worker motivation in Africa: the role of non-financial incentives and human resource management tools

BACKGROUND: There is a serious human resource crisis in the health sector in developing countries, particularly in Africa. One of the challenges is the low motivation of health workers. Experience and the evidence suggest that any comprehensive strategy to maximize health worker motivation in a developing country context has to involve a mix of financial and non-financial incentives. This study assesses the role of non-financial incentives for motivation in two cases, in Benin and Kenya. METHODS: The study design entailed semi-structured qualitative interviews with doctors and nurses from public, private and NGO facilities in rural areas. The selection of health professionals was the result of a layered sampling process. In Benin 62 interviews with health professionals were carried out; in Kenya 37 were obtained. Results from individual interviews were backed up with information from focus group discussions. For further contextual information, interviews with civil servants in the Ministry of Health and at the district level were carried out. The interview material was coded and quantitative data was analysed with SPSS software. RESULTS AND DISCUSSION: The study shows that health workers overall are strongly guided by their professional conscience and similar aspects related to professional ethos. In fact, many health workers are demotivated and frustrated precisely because they are unable to satisfy their professional conscience and impeded in pursuing their vocation due to lack of means and supplies and due to inadequate or inappropriately applied human resources management (HRM) tools. The paper also indicates that even some HRM tools that are applied may adversely affect the motivation of health workers. CONCLUSION: The findings confirm the starting hypothesis that non-financial incentives and HRM tools play an important role with respect to increasing motivation of health professionals. Adequate HRM tools can uphold and strengthen the professional ethos of doctors and nurses. This entails acknowledging their professionalism and addressing professional goals such as recognition, career development and further qualification. It must be the aim of human resources management/quality management (HRM/QM) to develop the work environment so that health workers are enabled to meet their personal and the organizational goals

Scalability of a task-sharing psychological intervention for refugees: A qualitative study in the Netherlands

Mental health systems across the world struggle to meet the needs of present and future populations. People affected by war and forced displacement, such as refugees, have especially high unmet psychological needs. Shifting tasks from mental health specialists to less specialised providers is increasingly opted as an innovative solution to overcome the mental health care gap. Yet little is known about how task-sharing interventions for refugees can be implemented on a larger scale and integrated in existing systems. In this article, we use a system innovation perspective to examine the factors influencing the potential for scaling up a task-sharing psychological intervention for refugees called ‘Problem Management Plus’ (PM+) in the Netherlands. Semi-structured interviews were conducted with individuals (n=42) knowledgeable about PM+ and the Dutch mental health system for refugees. Findings suggest that the feasibility of wider implementation largely depends on whether barriers like stigma, attrition, fragmentation, competition, legal, and financial challenges can be overcome. Formalising the roles of new non-specialist workers will be important, including developing structures for their accreditation and supervision. There are various possibilities for institutional anchoring of the innovation: in asylum centres, formal health care, and communities. The integration scenarios identified in this study need to be tested, evaluated, refined, and reported in future implementation research

Variabilidade espacial de plantas daninhas em dois sistemas de manejo de solo Spatial variability of weeds in two soil management systems

Estudos sobre a distribuição espacial das plantas daninhas são importantes no contexto agronômico e ambiental. O objetivo deste trabalho foi descrever a distribuição espacial de plantas daninhas em dois sistemas de manejo de solo. O estudo foi realizado em um Latossolo Vermelho distroférrico, em Campo Mourão, PR, utilizado em sistema de plantio direto (PD) e preparo convencional do solo (PC). Estabeleceu-se uma malha referenciada em coordenadas x e y, totalizando 128 pontos amostrais. Avaliou-se a biomassa da parte aérea das plantas, a densidade de plantas, a densidade de Commelina benghalensis e a densidade de Bidens pilosa. Os dados foram submetidos à análise exploratória e à análise variográfica. A variabilidade espacial foi estudada através da geoestatística, mediante a análise de semivariogramas, interpolação por krigagem e construção de mapas de isolinhas. O alcance das variáveis biomassa e densidade de B. pilosa é maior no PD que no PC; para a variável densidade de plantas, o alcance é maior no PC. A distribuição espacial descrita por técnicas geoestatísticas, mostra seu potencial no mapeamento de plantas daninhas o que permite estratégias de manejo localizado e o estabelecimento de critérios para experimentos futuros.<br>Studies of spatial distribution of weeds are important in the agronomic and environmental context. The objective of this research was to describe the spatial distribution of weeds in two soil management systems. This study was accomplished in a Distroferric Red Latosol (Oxisol), located in Campo Mourão, Parana State, Brazil, in no-tillage (NT) and conventional tillage of soil (CT). A grid was established in coordinated x and y, with 128 sampling points. The studied variables were biomass of shoot weeds, density of weeds, Commelina benghalensis density and Bidens pilosa density. Exploratory data analysis was used to evaluate distribution of variables as well as to adapt them for the spatial analysis. The spatial variability was studied using geostatistics by analysis of semivariograms, kriging interpolation and constructions of maps. The ranges of biomass and density of Bidens pilosa, were larger in NT than in the CT. For plant density range was larger in the PC. The spatial distribution described by geostatistics allowed weed mapping and its site specific management and the establishment of criteria for future experiments

Theoretical foundations of emerging economy business research

In “Probing Theoretically into Central and Eastern Europe: Transactions, Resources, and Institutions,” we outlined the contributions of research in Central and Eastern Europe (CEE) to theoretical debates in business research. In this retrospective, we reflect upon the evolution of the field over the past decade. With the fading impact of CEE’s distinct shared history, we suggest that CEE best be analyzed as emerging economies, rather than as a distinct geographic entity. Emerging economy business research is converging on common themes and shared theoretical ideas, while identifying critical variations that constrain generalizations among and beyond emerging economies. This research thus highlights the need to develop a better understanding of the boundary conditions of scholarly theories of business knowledge. Over the past decade, the institution-based view has emerged from distinct intellectual traditions in institutional economics, organizational theory, and the analysis of business–government bargaining. Research in these converging lines of theorizing places contextual variations at the center of explanations of business phenomena around the world. We suggest that the institution-based view is evolving toward a paradigm, and offer suggestions on how to advance this research agenda further, in particular by exploring how firms engage with different sets of potentially conflicting institutions at multiple levels and locations