Exodus of Clinicians from Public Sector to Non-Clinical Practice in Private Sector in Dar es Salaam Tanzania; Exploring the Drivers

2020 ◽  
Vol 31 (2) ◽  
pp. 45-58
Author(s):  
Elice Temu ◽  
Gasto Frumence ◽  
Nathanael Sirili
Keyword(s):  
Public Health ◽  
Clinical Practice ◽  
Public Sector ◽  
Private Sector ◽  
Work Environment ◽  
Health Workforce ◽  
Health Sector ◽  
Dar Es Salaam ◽  
Medical Doctors ◽  
The Public

Background: Globally, shortage of clinicians health workforce is among the major challenges facing the health systems of many countries including Tanzania. Migration of medical doctors from clinical practice to non-clinical practice partly contributes to this challenge. This study aimed to explore factors influencing Medical Doctors’ decision to migrate from clinical practice in the public sector to non-clinical practice in the private sector in Dar es Salaam Tanzania.Methods: An exploratory qualitative study was conducted using 12 in-depth interviews with medical doctors working in the private sector but formerly worked in the public health sector. Interviews were digitally recorded, transcribed verbatim and thematically analyzed.Results: Three main themes emerged; health system-level drivers that has three sub-themes, namely poor work environment, heavy workload due to shortage of clinicians and underfunded public health sector; individual-level drivers, which include four sub-themes: Age, area of specialization, marital status and empathy to patients; and external environment drivers consisting of two sub-themes: peer pressure and community culture.Conclusion: Improving the work environment through increased funding will partly address the main health system drivers underlying migration from the clinical practice. Furthermore, nurturing junior doctors to be enthusiastic and adapting to cultural shocks can partly help to address the individual and external drivers. Keywords: Shortage, Medical Doctors, Clinicians, Physicians, migration, health workforce, Tanzania Clinical Practice, Non-Clinical Practice.

Comprehensive cancer control-research & development: knowing what we do and doing what we know

2009 ◽  
Vol 95 (5) ◽  
pp. 610-622 ◽  
Author(s):  
Jon F Kerner ◽  
Eduardo Cazap ◽  
Derek Yach ◽  
Marco A Pierotti ◽  
Maria Grazia Daidone ◽  
...  
Keyword(s):  
Public Health ◽  
Public Sector ◽  
Private Sector ◽  
Knowledge Exchange ◽  
Health Sector ◽  
Cancer Control ◽  
Lessons Learned ◽  
Comprehensive Cancer Control ◽  
The Public ◽  
Control Research

Comprehensive cancer control is defined as an integrated and coordinated approach to reducing cancer incidence, morbidity, and mortality across the cancer control continuum from primary prevention to end-of-life care. This approach assumes that when the public sector, non-governmental organizations, academia, and the private sector share with each other their skills, knowledge, and resources, a country can take advantage of all its talents and resources to more quickly reduce the burden of cancer for all its population. One critical issue for comprehensive cancer control is the extent to which the private sector can contribute to cancer prevention and control programs and policies that have historically been lead by the public health sector, and similarly how can the public sector increase its investment and involvement in clinical research and practice issues that are largely driven by the private sector worldwide? In addition, building capacity to integrate research that is appropriate to the culture and context of the population will be important in different settings, in particular research related to cancer control interventions that have the capacity to influence outcomes. To whatever extent cancer control research is ultimately funded through the private and public sectors, if investments in research discoveries are ultimately to benefit the populations that bear the greatest burden of disease, then new approaches to integrating the lessons learned from science with the lessons learned from service (public health, clinical, and public policy) must be found to close the gap between what we know and what we do. Communities of practice for international cancer control, like the ones fostered by the first three International Cancer Control Congresses, represent an important forum for knowledge exchange opportunities to accelerate the translation of new knowledge into action to reduce the burden of cancer worldwide.

scholarly journals Reasons for Ethical Problems in the Health Sector

2012 ◽  
Author(s):  
Filiz Tepecik ◽  
Ayla Yazıcı
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Health Sector ◽  
Efficient Production ◽  
Health Care Market ◽  
Unequal Distribution ◽  
Ethical Problems ◽  
The Public ◽  
Private Entrepreneurs ◽  
Effective Use

There are two main reasons of public interventions in the health market. First, the health care market cannot make efficient production on market conditions because of its attributes such as the unequal distribution of knowledge, being a public good, the presence of positive and negative externalities. Second, the public authority has also the aim to achieve justice. These qualities are also the source of ethical problems in the health sector, whether the service is generated, by the public or the private sector. Almost in all countries the health sector is usually provided by the public sector because of externalities. But because the side effects of the production of health services by the public sector emerged in recent years, the participation of the private sector was ensured to minimize these effects. For developing countries such as Turkey and Eurasian countries, a more effective use of the funds used for the health sector is recommended, and the space these expenditures cover in the budget are said can be scaled down with the opening of some areas for private entrepreneurs. However, the unique characteristics of the health sector seem to cause problems regardless whether it is produced by the public or the private sector. In this study it is attempted to give the attributes of the health sector in detail and to establish a relationship with ethical problems in the light of experiences in Turkey.

scholarly journals Knowledge Management in the Public Sector

2019 ◽  
pp. 484-497 ◽  
Author(s):  
Yousif Abdullatif Albastaki ◽  
Adel Ismail Al-Alawi ◽  
Sara Abdulrahman Al-Bassam
Keyword(s):  
Knowledge Management ◽  
Public Sector ◽  
Private Sector ◽  
Work Environment ◽  
Public Services ◽  
Continuous Change ◽  
The Public ◽  
Government Organizations ◽  
The World ◽  
The Government

Although knowledge is recognized as a very important element of any business, the public sector does not fully explore the depth of the knowledge management (KM) as compared to private sector business. As days are passing by, public sector business has also started to realize the importance of KM. The public sector is a business that is run by the government. This sector includes organizations like government cooperation, enterprises, militaries, education, health, and related departments public services. In the public sector, the managers have started to adopt and develop practices of KM. Government organizations are facing many challenges to adapt and engage themselves in an electronic work environment. Over the years KM has grown and has been in continuous change in the public sector and has become essential to any organization in the world. Managers have been looking for a more futuristic approach for the past years. The purpose of this chapter examines the ongoing change in KM in the public sector and tackles the gap in the literature.

scholarly journals Work Features that Influence the Retention of Professional Nurses in the Public Health Sector in Windhoek, Namibia

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Frieda N. Washeya ◽  
Laetitia N. Fürst
Keyword(s):  
Public Health ◽  
Career Development ◽  
Patient Care ◽  
Work Environment ◽  
Health Sector ◽  
Healthcare Sector ◽  
Professional Nurse ◽  
The Public ◽  
Public Health Sector ◽  
Professional Nurses

The retention of professional nurses in the public health sector is essential for maintaining quality nursing care. Effective retention strategies enhance nurses’ job satisfaction, promote professionalism, decrease organisational costs and improve patients’ care. The Namibian public health sector has, for a long time, experienced challenges in retaining professional nurses and this has affected patient care, students’ clinical practice and the facilities’ status. A qualitative descriptive design was used in this study to explore professional nurses’ perceptions of factors influencing the retention of professional nurses at a health facility in Windhoek, Namibia. Semi-structured, face-to-face interviews were conducted with 11 professional nurses. Tesch’s eight steps for data analysis generated two themes, namely: 1) Satisfaction with remuneration varied; the work environment was non-conducive and management was inadequate; and 2) Dissatisfaction resulted from negative psychological effects of the work environment and lack of career development opportunities. Remuneration packages in the public healthcare sector were regarded as inadequate compared to the private healthcare sector, which was deemed as greener pastures. The physical work environment is non-conducive and under-resourced, which has an effect on the physiological work environment when staff develop feelings of guilt, frustration, stress, feeling unsafe and uncared for—all potential catalysts for the loss of the professional nurse workforce due to resignations. In addition, career development opportunities were experienced as biased and unfair. Strategies are recommended to improve the remuneration packages and provide a well-resourced and conducive work environment, which supports the professional nurse to ensure quality patient care.

Delivery of rural and remote health care via a broadband Internet Protocol network – views of potential users

2005 ◽  
Vol 11 (8) ◽  
pp. 419-424 ◽  
Author(s):  
P Jennett ◽  
M Yeo ◽  
R Scott ◽  
M Hebert ◽  
W Teo
Keyword(s):  
Health Care ◽  
Public Sector ◽  
Rural Communities ◽  
Private Sector ◽  
Internet Protocol ◽  
Health Sector ◽  
Health Service Delivery ◽  
Broadband Internet ◽  
The Public ◽  
User Groups

summary We asked the views of potential users of a proposed Canadian broadband Internet Protocol (IP) network for health, the Alberta SuperNet. The three user groups were drawn from the public, provider and private sectors. In all, 35 health-sector participants were selected (17 government, nine health-care organizations, five providers/ practitioners and four private sector). The questionnaire was Web-based, semistructured and self-administered. It consisted of four major areas: value, readiness, effect on usual care and limitations. A total of 28 (80%) individuals responded to the questionnaire: 21 (81%) were from the public sector (three provincial, nine regional and nine organizational), three (60%) were from the provider sector and four (100%) were from the private sector. Overall, the items related to health services and health human resources were considered to be the most valuable to rural communities. Respondents identified the expansion of telehealth services as the most important, except those from the private sector, who ranked this a close second. The health system's move to the use of electronic health records was ranked second in importance by all respondents. The private-sector respondents viewed all user groups to be generally less ready (mean score 2.5 on a seven-point scale from 1 = not ready to 7 = ready), while the public-sector respondents were the most optimistic (mean score 4.0). Specific socioeconomic impact data were limited. The top-ranked disadvantage of the 10 suggested was that ‘Changes in health-service delivery practices and/or processes will be required’.

scholarly journals An Alzheimer’s Curriculum to Educate the Current and Future Public Health Workforce

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 9-10
Author(s):  
Taylor Kennedy ◽  
Molly French ◽  
Linelle Blais ◽  
Nia Reed
Keyword(s):  
Public Health ◽  
Health Workforce ◽  
Adult Population ◽  
Health Sector ◽  
The United States ◽  
Public Health Workforce ◽  
Public Health Approach ◽  
Health Crisis ◽  
The Public ◽  
Schools Of Public Health

Abstract Alzheimer’s disease is the 6th leading cause of death among adults in the United States and the 5th leading cause for those aged 65 and older. Nearly 14 million Americans will be diagnosed with Alzheimer’s dementia by 2060, but the public health workforce is struggling to meet current demands. As the older adult population continues to grow, the public health sector will need to ensure a sizable and competent workforce is prepared to meet the needs of those living with dementia as well as their caregivers. In support of national efforts to promote and ensure a competent workforce, the Alzheimer’s Association, Centers for Disease Control and Prevention, and Emory University developed “A Public Health Approach to Alzheimer’s and Other Dementias” (ADOD) curriculum. The free, introductory curricular resource was first piloted by faculty and students at undergraduate schools of public health across the country; however, due to its broad applicability the curriculum has since been updated and expanded to educate graduate students in schools of public health, students in related disciplines, and practicing public health professionals. The curriculum provides an introduction to ADOD as a public health crisis, basics of dementia, the role of public health in addressing the epidemic, and the creation of dementia-friendly communities. The purpose of the curriculum is to educate future public health workforces about ADOD; encourage the current public health workforce to apply knowledge to practice; and seek to improve health outcomes for those living with dementia, as well as their caregivers.

scholarly journals Measuring and Assessing the Wealth Influence on the Efficiency of the Health System through the Private Sector

2020 ◽  
Vol 31 (4) ◽  
pp. 437-449
Author(s):  
Mina Fanea-Ivanovici ◽  
Marius-Cristian Pană ◽  
Mihail Dumitru Sacală ◽  
Cristina Voicu
Keyword(s):  
Public Health ◽  
Private Sector ◽  
Health Sector ◽  
Public Hospitals ◽  
Quality Of Services ◽  
Private Hospitals ◽  
The Public ◽  
Public Health Sector ◽  
Private Health Sector

The aim of the paper is to provide an analysis of the dynamics of the public and private health sectors in Romania. Using descriptive statistics, it first investigates whether the public health sector follows the reformation trends suggested by official strategies and reports, and to what extent the private health sector is a viable alternative to the public one, by analysing the demand for private inpatient services. We look into the reduction in the occupancy degree in public hospitals as a means to increase the efficiency of public health expenditures, which represents one way to reform the public health sector. We also find that the increase in the occupancy degree in private hospitals is negatively correlated with the quality of services provided by public hospitals, but positively correlated with population wealth. Increase in the occupancy degree in private hospitals is an indicator of poor quality of services in public hospitals. It can also be explained by increasing expectations and requirements of beneficiaries as a reflection of increase in wealth and of their will to preserve their health capital. Using regression models, the paper then proposes the Wealth-Health Index, a composite indicator to explore the connection between wealth and health and the dynamics of the private health sector. Investment in physical infrastructure and the size of medical staff in the private sector is positively correlated with wealth increase.

Does Economic Freedom Influence Major Health Indicators in India? Cross-state Panel Estimation Results

2016 ◽  
Vol 1 (2) ◽  
pp. 203-221 ◽  
Author(s):  
Saleema Razvi ◽  
Debashis Chakraborty
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Economic Freedom ◽  
Health Sector ◽  
Health Indicators ◽  
Healthcare Outcomes ◽  
Best Interest ◽  
Indian States ◽  
The Public ◽  
The Impact

It is widely acknowledged that inadequacies in public sector health systems can only be overcome by substantial structural and institutional reforms. In India, the need for reforms in the health sector has been highlighted and stressed upon in recent period. While there is a growing belief that public and private sectors in health can potentially gain from one another, there is also recognition that, given their respective strengths and weaknesses, neither the public sector nor the private sector alone can operate in the best interest of the health system. The current study attempts to analyse the impact of enabling environments measured by the economic freedom index in 20 Indian states on select healthcare outcomes, through a panel data model. The empirical results confirm that rise in economic freedom lowers maternal mortality and infant mortality, as the resulting conducive environment enables greater private sector participation. However, the crucial role to be played by the public sector is also underlined in no uncertain terms. The obtained results strongly indicate that the health scenario in India can improve only through closer co-ordination between the public and the private sectors.

scholarly journals Human resources for health talent management contribution: A case for health systems strengthening in the public health sector

2021 ◽  
Vol 9 (2) ◽  
pp. 192-201
Author(s):  
Bernard Nkala ◽  
Charles Mudimu ◽  
Angelbert Mbengwa Mbengwa
Keyword(s):  
Public Health ◽  
Human Resources ◽  
Performance Management ◽  
Health Systems ◽  
Health Workforce ◽  
Health Sector ◽  
Talent Management ◽  
The Public ◽  
Public Health Sector ◽  
Workforce Engagement

Talent Management is an essential component in transforming health systems if carefully implemented for the public sector especially in low income countries. In Zimbabwe public health sector, talent retention and engagement are viewed as amongst the challenges affecting the realisation of effective performance and productivity from the existing Health workforce. Largely, modern health care systems lack robust strategies to identify and utilize employee talent essential to help attain organisational citizenship. The study reviewed the relevancy and effectiveness of talent management practices in the public health sector using a case study of Parirenyatwa Group of Hospitals, one of the major referral hospitals in Zimbabwe. The study aimed at closing the talent pipe-line gaps as part of the Health Systems Strengthening initiative towards bringing about talent retention and engagement amongst the health workforce in public sector settings. The study assessed the impact of the existing talent management initiatives focusing on variables; recruitment and attraction perspective, compensation and rewarding component, health workforce succession management and implemented performance management system. The study obtained cross sectional data collected through a designed tool following a purposive (non-probability) sampling technique from a sample of n=200 existing health management team to assess the perception of implemented talent management approaches. The study further used responses from n=450 randomly selected health professionals recruited in the last 3 years prior to the survey to analyse the association between the variables on talent management practices namely (recruitment and selection, compensation and rewarding, succession management and performance management system) and the age of health workforce to employee engagement. The data on recruited cadres was obtained from the existing Hospital Human Resources for Health Recruitment Database. The research revealed that talent management in public health sector currently suffers from theoretical problems since the existing Human Resources for Health literature concentrates on anecdotal information. The human resource practitioners need to come up with more involving workplace activities to demystify the theory that millennials are generally finding it difficult to engage. In addition, the public sector succession planning strategies would need to be in place for the millennials well in time to adequately replace the considerable number of those at retiring stages. The Logistic regression analysis revealed recruitment and attraction perspective, and succession management positively influence health workforce engagement while adherence to implementing performance management system negatively affected employee engagement. Compensation and rewarding practices in a public health set up proved an insignificant variable to health workforce engagement hence study concluded further analysis on the impact on wider target group. The study revealed as the age increases, the health workforce become more engaged and self-motivated to develop their personal talent, thus theory suggests such are ‘Baby Boomers’ age group that do not need much push and are prepared to perfect their work talent for the benefit of the health system. The role of performance management system must be equally elevated within health system initiatives in order to achieve ultimate health workforce engagement. The study recommended the public health sector to incorporate in its human resources policy, a strategy for managing and utilisation of talent from the different health workforce generations within the health system. In improving the performance of public health systems, talent management need to be put forward in the health systems strengthening agenda in order to build highly engaged health teams. Talent management practices become essential and if carefully implemented, are likely to help public health systems retain rare skills especially in highly specialised functions. Furthermore, the organisations need to synchronise its strategic plan with the talent management strategy. There must be continuous capacity building of human resources departments to firstly own policies that influence talent management so as to ensure ultimate health workforce engagement.

Sign in / Sign up

Export Citation Format

Share Document