scholarly journals Through service providers’ eyes: health systems factors affecting implementation of tuberculosis control in Enugu State, South-Eastern Nigeria

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Daniel Chukwuemeka Ogbuabor
2020 ◽  
Author(s):  
Daniel Chukwuemeka Ogbuabor

Abstract Background Well-functioning health systems are essential to achieving global and national tuberculosis (TB) control targets. This study examined health system factors affecting implementation of TB control programme from the perspectives of service providers. Methods The study was conducted in Enugu State, South-eastern Nigeria using qualitative, cross-sectional design involving 23 TB service providers (13 district TB supervisors and 10 facility TB focal persons). Data were collected through in-depth, semi-structured interviews using a health system dynamic framework and analysed thematically. Results Stewardship from National TB Control Programme (NTP) improved governance of TB control, but stewardship from local government was weak. Government spending on TB control was inadequate, whereas donors fund TB control. Poor human resources management practices hindered TB service delivery. TB service providers have poor capacity for data management because changes in recording and reporting tools were not matched with training of service providers. Drugs and other supplies to TB treatment centres were interrupted despite the use of a logistics agency. Poor integration of TB into general health services, weak laboratory capacity, withdrawal of subsidies to community volunteers and patent medicine vendors, poorly funded patient tracking systems, and ineffectual TB/HIV collaboration resulted in weak organisation of TB service delivery. Conclusion Health systems strengthening for TB control service must focus on effective oversight from NTP and local health system; predictable domestic resource mobilisation through budgets and social health insurance; training and incentives to attract and retain TB service providers; effective supply and TB drug management; and improvements in organization of service delivery.


2019 ◽  
Author(s):  
Daniel Chukwuemeka Ogbuabor

Abstract Background Well-functioning health systems are essential to achieving global and national tuberculosis (TB) control targets. This study examined health system factors affecting implementation of TB control programme from the perspectives of service providers. Methods The study was conducted in Enugu State, South-eastern Nigeria using qualitative, cross-sectional design involving 23 TB service providers (13 district TB supervisors and 10 facility TB focal persons). Data were collected through in-depth, semi-structured interviews using a health system dynamic framework and analysed thematically. Results Stewardship from National TB Control Programme (NTP) improved governance of TB control, but stewardship from local government was weak. Government spending on TB control was inadequate, whereas donors fund TB control. Poor human resources management practices hindered TB service delivery. TB service providers have poor capacity for data management because changes in recording and reporting tools were not matched with training of service providers. Drugs and other supplies to TB treatment centres were interrupted despite the use of a logistics agency. Poor integration of TB into general health services, weak laboratory capacity, withdrawal of subsidies to community volunteers and patent medicine vendors, poorly funded patient tracking systems, and ineffectual TB/HIV collaboration resulted in weak organisation of TB service delivery. Conclusion Health systems strengthening for TB control service must focus on effective oversight from NTP and local health system; predictable domestic resource mobilisation through budgets and social health insurance; training and incentives to attract and retain TB service providers; effective supply and TB drug management; and improvements in organization of service delivery.


2021 ◽  
Vol 32 (1) ◽  
pp. 565-581
Author(s):  
Wilson Chukwukasi Kassy ◽  
Anne C Ndu ◽  
Chinyere Cecilia Okeke ◽  
Elisa Chwike Aniwada

Ergonomics ◽  
2015 ◽  
Vol 58 (6) ◽  
pp. 1032-1044 ◽  
Author(s):  
Okey Francis Obi ◽  
Boniface O. Ugwuishiwu ◽  
Busayo S. Adeboye

2016 ◽  
Vol 38 (3) ◽  
pp. 310-331 ◽  
Author(s):  
Alexandros Psychogios ◽  
Leslie Thomas Szamosi ◽  
Rea Prouska ◽  
Christopher Brewster

Purpose – The purpose of this paper is to study particular structural and organisational factors affecting the formality of human resource management (HRM) practices in small and medium-sized enterprises (SMEs) in South-Eastern European (SEE) post-communist countries, in particular Serbia, Romania, Bulgaria and the Former Yugoslav Republic of Macedonia in order to understand the antecedents of formalization in such settings. Design/methodology/approach – Adopting a quantitative approach, this study analyses data gathered through a survey of 168 managers of SMEs from throughout the region. Findings – The results show that HRM in SMEs in the SEE region can be understood through a threefold framework which includes: degree of internationalisation of SMEs, sector of SMEs and organisational size of SMEs. These three factors positively affect the level of HRM formalisation in SEE SMEs. These findings are further attributed to the particular political and economic context of the post-communist SEE region. Research limitations/implications – Although specific criteria were set for SME selection, the authors do not suggest that the study reflects a representative picture of the SEE region because the authors used a purposive sampling methodology. Practical implications – This paper provides useful insights into the factors which influence HRM in SMEs in a particular context. The findings can help business owners and managers understand how HRM can be applied in smaller organisations, particularly in post-communist SEE business contexts. Originality/value – HRM in SMEs in this region has hardly been studied at all despite their importance. Therefore, this exploratory research seeks to expand knowledge relating to the application of HRM in SMEs in SEE countries which have their business environments dominated by different dynamics in comparison to Western European ones.


2021 ◽  
pp. 178359172110553
Author(s):  
Ishani Patharia ◽  
Anjana Pandey ◽  
Sanjay Gupta

Technological developments have a major impact on user behavior. The rapidly evolving communication system and technology have provided numerous choices for people. The ever-shifting changes in the generation of communication networks have posed challenges for mobile network service providers to attract and retain customers. This study aims to prioritize the determinants of the adoption of mobile network service providers using the unified theory of acceptance and use of technology (UTAUT-2). In this study, data were collected from 660 mobile phone users in Haryana, India. A fuzzy analytical hierarchy process (F-AHP) was applied to arrange the priority or rank the factors based on the significance of the factors in explaining the adoption of mobile network service providers. Results of the study reveal that efforts expectancy is the highest-ranked and prioritized factor for the adoption of mobile network service providers followed by performance expectancy and facilitating conditions. However, social influence emerged as the least important factor. The present study provides theoretical implications for future researchers by synthesizing and prioritizing the important factors affecting technology acceptance. The practical implications offer a clearer insight to marketers for developing focused pragmatic strategies to retain customer loyalty. The study has considered only UTAUT-2 model constructs and used the F-AHP technique. Other factors may be considered in future studies. Other priority analysis techniques can also be used such as ISM and MICMAC analysis for further study. The research has been conducted in Haryana, India, and therefore, it needs to be tested in other areas/countries for generalizability. JEL Classification: O1, O2, O4


2015 ◽  
Vol 6 (3) ◽  
pp. 206-222 ◽  
Author(s):  
Kanda Sorn-in ◽  
Kulthida Tuamsuk ◽  
Wasu Chaopanon

Purpose – The purpose of this paper is to study the factors affecting the development of e-government by using a citizen-centric approach. Design/methodology/approach – This paper is a mixed-methods study consisting of qualitative and quantitative research. Data were collected from government agencies using a structured interview and questionnaire about e-government services. The research was collected from the people responsible for the management of an e-government project in 75 government agencies. In addition, the researcher collected data from 1,400 citizens by using an e-Survey questionnaire that grouped participants by age. Findings – By using a citizen-centric approach, the paper identified the factors affecting the development of e-government. There were five factors from the viewpoint of government agencies and citizen groups: quality of e-government services, policy and governance, information technology infrastructure, organization and economy and society. Research limitations/implications – The research covered the development patterns of e-government for services from government to citizens only. Practical implications – Seeing the importance of environmental factors for both service providers and service users would facilitate continuous improvement of e-government service provision by government agencies. Social implications – The results reflect citizens’ need for e-government services; quality is their priority. Hence, government agencies must consider the quality of the delivery of information and e-government services as they relate to the lifestyles and needs of citizens. Originality/value – The creation of knowledge from merging e-government concepts with citizen-centric principles is a modern government sector management theory. This research stresses the need for the government sector to see the need for e-government and to recognize the factors for its successful development. This means the design and development of e-government services should respond to the increasing needs of the citizens.


2017 ◽  
Vol 246 ◽  
pp. 19-24
Author(s):  
Krzysztof Tomczuk ◽  
Maciej Grzybek ◽  
Klaudiusz Szczepaniak ◽  
Maria Studzińska ◽  
Marta Demkowska-Kutrzepa ◽  
...  

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