Hierarchical cluster analysis of labour market regulations and population health: a taxonomy of low- and middle-income countries

<p>Abstract</p> <p>Background</p> <p>An important contribution of the social determinants of health perspective has been to inquire about non-medical determinants of population health. Among these, labour market regulations are of vital significance. In this study, we investigate the labour market regulations among low- and middle-income countries (LMICs) and propose a labour market taxonomy to further understand population health in a global context.</p> <p>Methods</p> <p>Using Gross National Product per capita, we classify 113 countries into either low-income (n = 71) or middle-income (n = 42) strata. Principal component analysis of three standardized indicators of labour market inequality and poverty is used to construct 2 factor scores. Factor score reliability is evaluated with Cronbach's alpha. Using these scores, we conduct a hierarchical cluster analysis to produce a labour market taxonomy, conduct zero-order correlations, and create box plots to test their associations with adult mortality, healthy life expectancy, infant mortality, maternal mortality, neonatal mortality, under-5 mortality, and years of life lost to communicable and non-communicable diseases. Labour market and health data are retrieved from the International Labour Organization's Key Indicators of Labour Markets and World Health Organization's Statistical Information System.</p> <p>Results</p> <p>Six labour market clusters emerged: Residual (n = 16), Emerging (n = 16), Informal (n = 10), Post-Communist (n = 18), Less Successful Informal (n = 22), and Insecure (n = 31). Primary findings indicate: (i) labour market poverty and population health is correlated in both LMICs; (ii) association between labour market inequality and health indicators is significant only in low-income countries; (iii) Emerging (e.g., East Asian and Eastern European countries) and Insecure (e.g., sub-Saharan African nations) clusters are the most advantaged and disadvantaged, respectively, with the remaining clusters experiencing levels of population health consistent with their labour market characteristics.</p> <p>Conclusions</p> <p>The labour market regulations of LMICs appear to be important social determinant of population health. This study demonstrates the heuristic value of understanding the labour markets of LMICs and their health effects using exploratory taxonomy approaches.</p

Is it me or us? The impact of individual and collective participation on work engagement and burnout in a cluster-randomized organisational intervention

Participation is generally recommended when implementing organisational interventions, however, understanding how participation works remains understudied. In a cluster-randomised, controlled intervention employing a wait-list control design, we explore whether perceptions of individual or collective participation had the greatest impact on a participatory organisational intervention’s outcomes; work engagement and burnout. We conducted the study in the Danish postal service (N = 330). Using multi-level analyses, we found that perceptions of individual participation predicted improvements in work engagement and reductions in burnout post-intervention, however, these relationships became non-significant after including perceptions of being part of a collective participatory process in the model. Our findings add to the understanding of the role participation and in particular, perceptions of a collective participatory intervention process, plays in ensuring interventions achieve their intended outcomes

How to design, implement and evaluate organizational interventions for maximum impact : the Sigtuna Principles

Research on organizational interventions needs to meet the objectives of both researchers and participating organizations. This duality means that real-world impact has to be considered throughout the research process, simultaneously addressing both scientific rigor and practical relevance. This discussion paper aims to offer a set of principles, grounded in knowledge from various disciplines that can guide researchers in designing, implementing, and evaluating organizational interventions. Inspired by Mode 2 knowledge production, the principles were developed through a transdisciplinary, participatory and iterative process where practitioners and academics were invited to develop, refine and validate the principles. The process resulted in 10 principles: 1) Ensure active engagement and participation among key stakeholders; 2) Understand the situation (starting points and objectives); 3) Align the intervention with existing organizational objectives; 4) Explicate the program logic; 5) Prioritize intervention activities based on effort-gain balance; 6) Work with existing practices, processes, and mindsets; 7) Iteratively observe, reflect, and adapt; 8) Develop organizational learning capabilities; 9) Evaluate the interaction between intervention, process, and context; and 10) Transfer knowledge beyond the specific organization. The principles suggest how the design, implementation, and evaluation of organizational interventions can be researched in a way that maximises both practical and scientific impact

The developing world and state education: neoliberal depredation and egalitarian alternatives.

Neoliberalism has had a major impact on schooling and education in the Developing World, with social repercussions that have affected the salaries of teachers, the number and type of potential students, the availability of education, the cost of education, and more. This edited collection argues that the privatization of public services and the capitalization and commodification of education have resulted in the establishment of competitive markets that are marked by selection, exclusion and inequality. The contributors - academics and organization/social movement activists - examine aspects of neoliberal arguments focusing on low- and middle-income countries (including Chile, Mexico, Argentina, Venezuela, China, Pakistan, India, Turkey, Burkina Faso, Mozambique and South Africa), and suggest where they fall short. Their arguments center around the assumption that education is not a commodity to be bought and sold, as education and the capitalist market hold opposing goals, motivations, methods, and standards of excellence

Strengthening human resources for health through multisectoral approaches and leadership: the case of Cameroon

Problem Cameroon has a severe shortage of human resources for health (HRH) and those that are available are concentrated in urban areas. Approach As the result of a national emergency plan for the years 2006–2008, innovative strategies and a multisectoral partnership – led by the Ministry of Public Health and supported by diverse national and international organizations – were developed to address the shortages and maldistribution of HRH in Cameroon. Local setting At the time that the emergency plan was developed, Cameroon had health services of poor quality, an imbalance between HRH training and employment, a maldistribution of HRH between urban and rural areas and a poor allocation of financial resources for HRH. It also lacked an accreditation system for use in the training of health workers. Relevant changes Between 2007 and 2009, the number of active health workers in Cameroon increased by 36%, several new institutions for higher education in health care and training schools for paramedical staff and midwives were opened, and a national strategy for universal health coverage was developed. Lessons learnt In the improvement of HRH, strong leadership is needed to ensure effective coordination and communication between the many different stakeholders. A national process of coordination and facilitation can produce a consensus-based view of the main HRH challenges. Once these challenges have been identified, the stakeholders can plan appropriate interventions that are coordinated, evidence-based and coherent