The cost of health-related brain drain to the WHO African Region

The African Region continues to experience loss of a sizeable number of highly skilled health professionals (physicians, nurses, dentists and pharmacists) to Australia, North America and European Union. Past attempts to estimate cost of migration were limited to education cost only and did not include the lost returns from investment. The objective of this study was to estimate the social cost of emigration of doctors and nurses from the African Region to the developed countries. The cost information used in this study was obtained from one nonprofit primary and secondary school and one public university in Kenya. The cost estimates represent unsubsidized cost. The loss incurred by African countries through emigration is obtained by compounding the cost of educating a medical doctor and a nurse over the period between the age of emigration and the retirement age in recipient countries. The main findings were as follows: total cost of educating a single medical doctor from primary school to university is US$65,997; for every doctor that emigrates, a country loses about US$1,854,677 returns from investment; total cost of educating one nurse from primary school to college of health sciences is US$43,180; for every nurse that emigrates, a country loses about US$1,213,463 returns from investment. Developed countries continue to deprive African countries of billions of dollars worth of invaluable investments embodied in their human resources. If the current trend of poaching of scarce human resources for health (and other professionals) from African countries is not curtailed, the chances of achieving the Millennium Development Goals would remain dismal. Such continued plunder of investments embodied in human resources contributes to further underdevelopment of Africa and to keeping majority of her people in the vicious circle of poverty. Therefore, both developed and developing countries need to urgently develop and implement strategies for addressing this issue. African Journal of Health Sciences Vol. 13 (3-4) 2006: pp. 1-1

A study of factors that impact on executive network marketing in financial institutions in LDCs. An examination of factors that impact on executive network marketing in the finacial services sector in less developed countries: The case of Ghana.

This research study provides a view of the relationship between organizational leaders and relationship executives of financial institutions and their exchange partners. It does so by analyzing data on the networking efforts of 20 executive directors in qualitative interviews and 124 relationship executives in research questionnaires. Network marketing within the financial services sector is becoming increasingly important. We proposed a model that seeks to offer an explanation of Executive network marketing in financial institutions in LDCs where the market system is underdeveloped. The proposed model identified four categories being: firm characteristics, Executives’ personal contact groups, Executives’ business contact groups and issues of commitment and trust in exchange relationships. Multiple factor analysis established the regression model as significant in establishing a formal relationship between the dependent variable (network marketing) and the independent variables (firm characteristics, business contact, personal contact and commitment and trust). It was confirmed that there are differences in Executives’ level of network marketing among the different age groups. Also there were significant differences in the network marketing of the Executives with regard to their level of education. It was observed that there were significant differences in the network marketing of the Executives with respect of their fields of study. Finally it was observed that owner managers were more involved in network marketing than the professional managers and those in partnerships. Not only did the study confirm the research model, but it also revealed that, to a considerable extent, network marketing is practiced by the Executives in the financial services sector in Ghana. The study concluded that business contact networks are the most effective of the Executives’ network marketing in financial services sector in Ghana. It is therefore important that state policies are directed towards enhancing the business environment within the financial services sector. Government should desist from being a regulator and a player in the same market

Benefit-cost analysis of electronic claims processing under Ghana's National Health Insurance Scheme.

OBJECTIVE: The aim of this study was to evaluate the benefit-cost of E-claims. A benefit-cost analysis was used to evaluate the efficiency of E-claims from the perspective of the providers and the purchaser. DESIGN: A benefit-cost analysis approach was taken for this economic evaluation. Furthermore, we estimated the incremental benefit-cost ratio (IBCR) of the intervention under assessment. PARTICIPANTS: Purchasers and healthcare providers of the National Health Insurance Scheme (NHIS) of Ghana were the study population. RESULTS: The analysis was stratified according to providers and purchaser. Cost incurred in processing claims electronically and manually were estimated by assessing the resource use and their corresponding costs. Sensitivity analysis was conducted to assess the robustness of the results to variations in discount rate and proportions of claims processed under E-claims compared with paper claims. The combined sample of providers and purchaser made incremental gains from processing claims electronically. The IBCR was -19.75, 25.56 and 5.10 for all (sample) providers, purchaser and both providers and purchaser, respectively. When projected for the 330 facilities submitting claims to the NHIS claims processing centre (CPC) as at December 2014, the IBCR were -35.20, 25.56 and 90.06 for all providers, purchaser and both providers and purchaser. The results were sensitive to the discount rate used and proportions of E-claims compared with paper claims. CONCLUSION: Electronic processing of claims is more efficient compared with manual processing, hence provide an economic case for scaling it up to cover many more healthcare facilities and NHIS CPCs in the Ghana

Effect of Performance Appraisal System on Employee Productivity;(Selected Public Senior High Schools, Ho Municipality, Ghana)

Performance appraisals improve the work performance of employees by helping them realize their full potentials in carrying out their firm's mission and also, to provide information to employees and managers for use in making work-related decisions. They, also, provide feedback to employees and thereby serve as a vehicle for personal and career development. Performance appraisals, however, are beset with difficulties as a result of their complex nature. The general objective of the study, therefore, was to evaluate the performance appraisal system and its effect on employee productivity (performance) at the Ghana Education Service (GES). The research design used in the study was the descriptive study because it was appropriate for the achievement of the research objectives. The population for the study was 153 and a sample size of 108 respondents was selected using the probability and non-probability sampling method. Interview and questionnaires were used as instruments for the study and out of 106 questionnaires distributed, all of them were retrieved from respondents and interview conducted for two respondents. The data was analyzed with tables, bar charts. Among the main findings of the study was that the GES only carried out performance appraisal when teachers were due for promotion. The finding indicated a negative relationship between performance appraisal and productivity of teachers. It means that performance appraisal has no link with the WASSCE results. The study recommends that the Ghana Education Service should adopt performance apprnaisal that is tailored to the job description and the job analysis, that is, there should be a clear cut policy on the conduct of performance appraisal in the GES in order to improve on its conduct. Keywords: High School, Productivity, Appraisal, Performance, Employee DOI: 10.7176/JESD/12-2-01 Publication date: January 31st 202

Phosphates du Protérozoïque supérieur dans la chaîne des Dahomeyides (circa 600 Ma) de la région de Bassar (Nord-Togo, Afrique de l'Ouest)

Les phosphates de Bassar (nord du Togo) sont situés dans la partie tectonisée de la couverture du craton ouest-africain, et plus précisément dans les schistes de l'unité structurale de l'Atacora de la chaîne des Dahomeyides. Les roches phosphatées se présentent comme des intercalations d'épaisseur variables (< 30 m). Elles sont généralement constituées de pellets d'apatite plus ou moins pure et recristallisée enrobés dans une matrice essentiellement phosphatée. Ce gisement s'ajoute notamment aux indices d'Aloub Djouana et de Pagala et démontre ainsi une extension fort intéressante des phosphates précambriens dans les unités tectonisées au front des Dahomeyide

The Cost of Health-related Brain Drain to the WHO African Region

The African Region continues to experience loss of a sizeable number of highly skilled health professionals (physicians, nurses, dentists and pharmacists) to Australia, North America and European Union. Past attempts to estimate cost of migration were limited to education cost only and did not include the lost returns from investment. The objective of this study was to estimate the social cost of emigration of doctors and nurses from the African Region to the developed countries. The cost information used in this study was obtained from one nonprofit primary and secondary school and one public university in Kenya. The cost estimates represent unsubsidized cost. The loss incurred by African countries through emigration is obtained by compounding the cost of educating a medical doctor and a nurse over the period between the age of emigration and the retirement age in recipient countries. The main findings were as follows: total cost of educating a single medical doctor from primary school to university is US$65,997; for every doctor that emigrates, a country loses about US$1,854,677 returns from investment; total cost of educating one nurse from primary school to college of health sciences is US$43,180; for every nurse that emigrates, a country loses about US$1,213,463 returns from investment. Developed countries continue to deprive African countries of billions of dollars worth of invaluable investments embodied in their human resources. If the current trend of poaching of scarce human resources for health (and other professionals) from African countries is not curtailed, the chances of achieving the Millennium Development Goals would remain dismal. Such continued plunder of investments embodied in human resources contributes to further underdevelopment of Africa and to keeping majority of her people in the vicious circle of poverty. Therefore, both developed and developing countries need to urgently develop and implement strategies for addressing this issue

E-health: Determinants, opportunities, challenges and the way forward for countries in the WHO African Region

BACKGROUND: The implementation of the 58(th )World Health Assembly resolution on e-health will pose a major challenge for the Member States of the World Health Organization (WHO) African Region due to lack of information and communications technology (ICT) and mass Internet connectivity, compounded by a paucity of ICT-related knowledge and skills. The key objectives of this article are to: (i) explore the key determinants of personal computers (PCs), telephone mainline and cellular and Internet penetration/connectivity in the African Region; and (ii) to propose actions needed to create an enabling environment for e-health services growth and utilization in the Region. METHODS: The effects of school enrolment, per capita income and governance variables on the number of PCs, telephone mainlines, cellular phone subscribers and Internet users were estimated using a double-log regression model and cross-sectional data on various Member States in the African Region. The analysis was based on 45 of the 46 countries that comprise the Region. The data were obtained from the United Nations Development Programme (UNDP), the World Bank and the International Telecommunications Union (ITU) sources. RESULTS: There were a number of main findings: (i) the adult literacy and total number of Internet users had a statistically significant (at 5% level in a t-distribution test) positive effect on the number of PCs in a country; (ii) the combined school enrolment rate and per capita income had a statistically significant direct effect on the number of telephone mainlines and cellular telephone subscribers; (iii) the regulatory quality had statistically significant negative effect on the number of telephone mainlines; (iv) similarly, the combined school enrolment ratio and the number of telephone mainlines had a statistically significant positive relationship with Internet usage; and (v) there were major inequalities in ICT connectivity between upper-middle, lower-middle and low income countries in the Region. By focusing on the adoption of specific technologies we attempted to interpret correlates in terms of relationships instead of absolute "causals". CONCLUSION: In order to improve access to health care, especially for the majority of Africans living in remote rural areas, there is need to boost the availability and utilization of e-health services. Thus, universal access to e-health ought to be a vision for all countries in the African Region. Each country ought to develop a road map in a strategic e-health plan that will, over time, enable its citizens to realize that vision

Temporal Control in Apraxia of Speech: An Acoustic Investigation of Token-to-Token Variability

TB

The Neurocognition of Prosody

Prosody is one of the most undervalued components of language, despite its fulfillment of manifold purposes. It can, for instance, help assign the correct meaning to compounds such as “white house” (linguistic function), or help a listener understand how a speaker feels (emotional function). However, brain-based models that take into account the role prosody plays in dynamic speech comprehension are still rare. This is probably due to the fact that it has proven difficult to fully denote the neurocognitive architecture underlying prosody. This review discusses clinical and neuroscientific evidence regarding both linguistic and emotional prosody. It will become obvious that prosody processing is a multistage operation and that its temporally and functionally distinct processing steps are anchored in a functionally differentiated brain network