Does the perceived healthcare quality provided by full-time government employee doctors in the public system differ from the perceived care quality in their own privately managed facilities in Nigeria?

Objective: Although the differences in the quality levels between the public and private sectors have been identified in literature not much is known about the level of quality differences that exist when full time government employee doctors offer the same clinical services in their own privately managed facilities. The objective of this study was to compare service user perceived quality of care provided by full-time government employee doctors in the public system and in their own privately managed facilities in Nigeria.Methods: A cross-sectional multistage sampling design was used to elicit service user views on process, structure and outcome elements of quality identified in the Donabedian’s care quality model. The software for population surveys in EPI Info 7 was used to calculate the required sample. A total of 407 questionnaires were administered and completed after a pre-test.Results: Respondents reported better health outcomes in private practice than in the public system and a majority would recommend visiting a dual physician’s private practice than the public system where they work full-time. Process aspects of quality, including better rapport with doctors, greater perceived confidentiality, shorter wait times, and absence of bureaucratic impediments were said to be better in privately managed facilities of government doctors. However, respondents said that the public sector was superior in respect of the structure element of quality as reflected in better infrastructure, equipment, and availability of drugs.Conclusions: Despite the relatively lower cost of care in government hospitals the outcome and process elements are still crucial in determining which sector patients prefer. These two elements seem to have influenced patronage for private practices of dual practitioners.

THE CONSTITUTIONAL RIGHT OF ACCESS TO PUBLIC SERVICE ON THE SAME TERMS AND THE ISSUE OF EMPLOYING A LOCAL GOVERNMENT EMPLOYEE FOR THE PERIOD OF REPLACEMENT – REFLECTIONS ON THE TOPIC

The study attempts to analyse the legal regulation concerning the employment of a local government employee for a replacement period from the point of view of the constitutional right of access to public service on equal terms. The study refers jurisprudence (in particular to the decisions of the Constitutional Tribunal). This solution is an exception to the general rule of competitive and open recruitment. It should be emphasised that the right resulting from Article 60 of the Constitution of the Republic of Poland is not absolute. Hence the introduction of „exceptions” is permissible. However, this should be supported by another constitutional value. The analysed statutory regulation is only temporary (for the period of excused absence of an employee). It is based on the principle of efficiency and reliability of public institutions resulting from the preamble to the Constitution of the Republic of Poland. The purpose of this solution is to ensure the effective performance of tasks by the local government.

Dilema Kepemimpinan Kristen, Tuhan atau atasan?

This paper aims to examine and describe the nature of dedicated Christian leadership and to explore the essential elements of servanthood leadership. To serve is one of the most basic substances of Jesus' work. The problem of Christian leadership today is when leaders lose the character of Christ and are trapped in manipulating the name of Christianity or the church for the sake of his/her power. Methodically, this research refers to the leadership patterns of figures in the Old and New Testaments, with the support of literature studies that discuss Christian leadership discourse. Jesus displaying his leadership as a critique towards the misgovern leader who can only tells order, same as the authoritarian leadership, those who reigning over the official or government employee by own wish or merely by his/her desire. If so, it means that the leader's character humiliates even corrupts his/her own leadership. In all conscience, the leader is a minister to his/her follower's needs; to serve with love, humility, and forgiveness. The result of this study emphasizes that Christian leaders who want to grow up should simply be like Jesus, great leaders originally ought to serve others first, thus in plain reality, the core of his/her leadership will be visible in greatness. Tulisan ini hendak mengkaji dan menguraikan hakikat kepemimpinan Kristen yang mengabdi, dan mencari tahu unsur esensial dari kepemimpinan yang mengabdi. Mengabdi/melayani adalah sebuah unsur yang sangat mendasar dalam kepemimpinan Yesus. Problem kepemimpinan Kristen masa kini adalah ketika pemimpin kehilangan karakter Kristus, dan justru terjebak mengatasnamakan kekristenan dan gereja untuk kepentingan kekuasaan. Secara metodik, penelitian ini merujuk pola kepemimpinan tokoh dalam Perjanjian Lama dan Perjanjian Baru, dengan dukungan studi kepustakaan yang membahas wacana kepemimpinan Kristen. Yesus memberikan kritik pada kepemimpinan yang bersifat memerintah pengikut, menempatkan pimpinan sebagai bos yang harus selalu diikuti perkataan dan kehendaknya dan tidak memberikan teladan benar. Karakter pemimpin yang demikian merusak dan merendahkan wibawa eksistensi dari kepemimpinan. Seorang pemimpin adalah pelayan bagi pengikutnya. Melayani dgn kasih dan pengampunan. Hasil pengkajian ini menandaskan bahwa seharusnya pemimpin Kristen yang mau besar, mula-mula harus melayani orang lain, dan bahwa kenyataan yg sederhana ini merupakan inti kebesaran-Nya sebagai seorang pemimpin

Exploring the Existence of Innovative Work Behavior among Government Employee: Have Been There?

Introduction/Main Objectives: This study aims to determine the existence of innovative work behavior ecosystems for Indonesia’s government employees Background problems: The quality of individual employees partially determines the quality of the organization. The abilities of the different employees who work in the same system will undoubtedly deliver the government employee and possibly produce results which are less than were expected. Novelty: The previous studies have examined innovative work behavior, focusing on the external factors and ignoring the internal factors of individual traits. This study focused on investigating the interrelationship among the factors that will be affected by innovative behavior, especially in government employees in Indonesia. Methods: This study examines the relationship among these variables using structural equation modeling (SEM) with LISREL 8.8 as the statistical tool. Finding/Result: This study found that transforma­tional leadership and work engagement positively influence innovative work behavior. Unexpectedly, this research indicates an insignificant relationship between organizational justice and innovative work behavior among government employees. Besides, this study also found that transformational leadership and organizational justice have an impact on work engagement. Conclusion: These findings provide managerial implications about the need to strengthen employees’ innovative work behavior to ensure the organization’s continuity. Additionally, the results prove that innovative work behavior by government employees is supported by government’s role such as the style of leadership and work engagement.

Availability, pricing and affordability of essential medicines in Eastern Ethiopia: a comprehensive analysis using WHO/HAI methodology

Background Access to essential medicines is a universal human right and availability and affordability are the preconditions for it. In line with the sustainable development goals, World Health Organization (WHO) has outlined a framework that assists the policy makers to improve access to essential medicines for universal health coverage by 2030. However, the availability and affordability of essential medicines remains suboptimal in several low-income countries. Therefore, this study was designed to investigate the availability, pricing and affordability of essential medicines in eastern Ethiopia. Methods A cross-sectional study design was employed to conduct this study. Public and private health facilities found in Eastern Ethiopia and which fulfilled criteria set forth by WHO/Health Action International (HAI) guideline and essential medicines listed on WHO/HAI guideline and essential medicine list of Ethiopia were included. Accordingly, 60 medicine outlets were selected based on the WHO/HAI standardized sampling methodology. A standardized data collection tools developed by WHO/HAI, with necessary modifications, was employed to collect the data. Median Price Ratio (MPR) was computed as a ratio of median local buyers’ price to international buyers’ reference price. The Mann–Whitney U test was employed to compare the median buyers’ price between public and private health facilities. Kruskal–Wallis test was also run to explore the median price difference among all facilities. Treatment affordability was calculated based on the number of days of wage of the lowest-paid government employee of Ethiopia required to purchase the prescribed regimen. Results The overall percent availability of originator brand (OB) versions of essential medicines was found to be 3.6% (range: 0.0–31.7%), with the public and private sectors contributing 1.43% and 5.50%, respectively. The overall percent availability of lowest price generics (LPGs) was 46.97% (range: 1.7–93.3%) (Public: 42.5%; private: 50.8%). Only eight LPGs (16.0%) met the WHO target of 80%. The Mann–Whitney U test indicated that 64% drugs showed statistically significant median price difference between public and private settings (p < 0.05). The MPR value indicated that the median buyers’ price of drugs in private sector were more than four times the international reference price in 30% of drugs. The percentage of unaffordable medicine were 72.09 and 91.84% for public and private facilities, respectively, with 79.17% of the medicines were unaffordable when both settings were combined. Conclusion Only 16% of the surveyed medicines surpassed the WHO cut-off point of 80%. Nearly one-third of drugs in the private sector had a price of more than four times compared to the international reference prices. Moreover, four out of five drugs were found unaffordable when both settings were combined, demanded several days of wage of lowest paid government employee. This finding calls a prompt action from stakeholders to devise a strategy that help promote the access of essential medicines and rescue the struggling healthcare system of Ethiopia.

Predictors of community acquired childhood pneumonia among 2–59 months old children in the Amhara Region, Ethiopia

Background Worldwide, pneumonia is the third leading cause of death in under 5 years children. Ethiopia is ranked 4th out of 15 countries having the highest burdens of the death rate among under-five children due to pneumonia. Regardless of this fact, efforts to identify determinants of pneumonia have been limited yet in Amhara region. This study was aimed to identify predictors of community-acquired childhood pneumonia among 2–59 months old children in the Amhara region, Ethiopia. Methods Facility-based case–control study was conducted in the Amhara region from June 4 to July 15, 2018, among 28 health centers distributed across the region. The total sample size used was 888 (296 cases and 592 controls) children whose age were 2–59 months. At first, multistage sampling technique was employed. Data were collected on a face-to-face interview. Epi data v. 4.6 for data entry and statistical packages for social sciences version 23 for data analysis were used. Multivariable logistic regression analyses were used to test the associations between the study variables at P-value < 0.05 with 95% CI. As a result, determinants were identified for CAP. Results Among 888 enrolled children (296 cases and 592 controls), who experienced a community-acquired pneumonia had an increased risk of maternal age of 18–24 years (AOR 0.03, at 95%CI (0.01, 0.14), Government employee (AOR 0.19, at 95% CI (0.07,0.54), lack of separate kitchen (AOR 5.37; at 95% CI (1.65, 17.43), history of diarrhea in the past two weeks (AOR 10.2; at 95% CI (5.13, 20.18), previous respiratory tract infections (AOR 8.3, at 95% CI (3.32, 20.55) and history of parental asthma (AOR 4.9, at 95% CI (2.42, 10.18). Conclusion Maternal age of 18–24 years and government employee, lack of separate kitchen, history of diarrhea in the past two weeks; previous respiratory tract infection and history of parental asthma were found statistically significant. Health personnel’s needs to focus on creating awareness to the community on the merit of the separate kitchen for reduction of Community-acquired childhood pneumonia, and focus on prevention and management of childhood diarrheal and acute respiratory tract infections.

Putting a price on tenure

Government employees in Brazil are granted tenure after three years on the job. Firing a tenured government employee is all but impossible, so tenure is a big employee benefit. But exactly how big is it? In other words: how much money is tenure worth to a government employee in Brazil? No one has ever attempted to answer that question. I do that in this paper. I use a modified version of the Sharpe ratio to estimate what the risk-adjusted salaries of government workers should be. The difference between actual salary and risk-adjusted salary gives us an estimate of how much tenure is worth to each employee. I find that in the 2005-2019 period the monthly value of tenure was R$ 3980 to the median federal government employee, R$ 1971 to the median state government employee, and R$ 500 to the median municipal government employee.