Publication:
Good Governance and the Role of the Hospital in Health Worker Education in Africa

No Thumbnail Available
Date
2010
ISSN
1029-0540 (Print) 1029-0540 (Linking)
Published
2010
Editor(s)
Abstract
This article reviews the need to strengthen good governance in hospitals for them to contribute effectively to production of adequate numbers of quality health workers in the Africa region. It examines this in the context of the global crisis in human resources for health (HRH) and the challenges that confront the Africa region in meeting HRH standards. Using governance models for health educational institutions, the article recommends a shift to a hospital management system with a governance structure that would address not only service delivery but also human resource development.
Link to Data Set
Associated content
Report Series
Other publications in this report series
Journal
Journal Volume
Journal Issue
Citations

Related items

Showing items related by metadata.

  • Publication
    Health Worker Attitudes toward Rural Service in Liberia : Results from Qualitative Research
    (World Bank, Washington, DC, 2010-11) Attah, Ramlatu; Lievens, Tomas; Vujicic, Marko; Brown-Annan, Julie
    In Liberia, the maldistribution of health workers is particularly pronounced as 14 years of civil war exacerbated the concentration of experienced health workers in urban areas. The government has identified this challenge as a priority area for policy intervention. The objective of this study was to explore the drivers of health workforce choice including job location. It presents the results from preparatory qualitative research that fed into the design of a discrete choice experiment (DCE). The qualitative study interviewed 26 registered nurses, midwives, and physician assistants about their current working conditions, their job location preference, and priority areas for change in working conditions. Content analysis was used to analyze the data. The study shed light on health worker job preferences and their working conditions, and identified six job attributes that health workers consider to be important when choosing a job. These were pay, transport, availability of medical materials and infrastructure, housing, workload, and further training opportunities. These attributes were chosen because they reflect the frequency to which they were cited during the interviews and the extent to which they were amenable to policy intervention. Associated attribute levels were chosen for each attribute to reflect current work conditions and the levels of change that will be necessary to trigger changes in job choice. The relative weight of each of these attributes in location choice has been quantitatively determined through the follow-up DCE. Although the main aim of this study was to feed into the DCE design, it incidentally throws light on a wider variety of issues with regard to health worker career choice, motivation, and performance.
  • Publication
    Fixing the Public Hospital System in China
    (Washington, DC, 2010) World Bank
    In recent years, Chinese health care has improved rapidly, especially in the areas of equity and accessibility of services, as well as the movement toward universal coverage. A new round of health care reform, which was announced in April 2009, began implementation in 2010, with reform pilots in 16 urban areas. This paper analyzes a key pillar of this ongoing reform process, public hospital management. First, the paper reviews the history of public hospital reform, discusses hospital functions and responsibilities, and describes the structure and supply of health services. Second, it describes the main policy issues facing public hospitals, including financing sources and the hospital market environment. Third, it examines organizational arrangements in public hospitals, focusing on decision rights and governance. Fourth, the paper offers an international perspective and framework for assessing hospital reform. Finally, it summarizes the main policy issues and suggests next steps for policy reform. The paper draws on recent publications, grey literature, media reports, and interviews with key stakeholders.
  • Publication
    Healthy Partnerships : How Governments Can Engage the Private Sector to Improve Health in Africa
    (World Bank, 2011) International Finance Corporation
    Health systems across Africa are in urgent need of improvement. The public sector should not be expected to shoulder the burden of directly providing the needed services alone, nor can it, given the current realities of African health systems. Therefore to achieve necessary improvements, governments will need to rely more heavily on the private health sector. Indeed, private providers already play a significant role in the health sector in Africa and are expected to continue to play a key role, and private providers serve all income levels across sub- Saharan Africa's health systems. The World Health Organization (WHO) and others have identified improvements in the way governments interact with and make use of their private health sectors as one of the key ingredients to health systems improvements. Across the African region, many ministries of health are actively seeking to increase the contributions of the private health sector. However, relatively little is known about the details of engagement; that is, the roles and responsibilities of the players, and what works and what does not. A better understanding of the ways that governments and the private health sector work together and can work together more effectively is needed. This Report assesses and compares the ways in which African governments are engaging with their private health sectors. Engagement is defined, for the purposes of this report, to mean the deliberate, systematic collaboration of the government and the private health sector according to national health priorities, beyond individual interventions and programs. With effective engagement, one of the main constraints to better private sector contributions can be addressed, which in turn should improve the performance of health systems overall.
  • Publication
    Leakage of Public Resources in the Health Sector : An Empirical Investigation of Chad
    (2007-09) Gauthier, Bernard; Wane, Waly
    In the public sector in developing countries, leakage of public resources could prove detrimental to users and affect the well-being of the population. This paper empirically examines the importance of leakage of government resources in the health sector in Chad, and its effects on the prices of drugs. The analysis uses data collected in Chad as part of a Health Facilities Survey organized by the World Bank in 2004. The survey covered 281 primary health care centers and contained information on the provision of medical material, financial resources, and medicines allocated by the Ministry of Health to the regional administration and primary health centers. Although the regional administration is officially allocated 60 percent of the ministry's non-wage recurrent expenditures, the share of the resources that actually reach the regions is estimated to be only 18 percent. The health centers, which are the frontline providers and the entry point for the population, receive less than 1 percent of the ministry's non-wage recurrent expenditures. Accounting for the endogeneity of the level of competition among health centers, the leakage of government resources has a significant and negative impact on the price mark-up that health centers charge patients for drugs.
  • Publication
    Brazil - Governance in Brazil's Unified Health System : Raising the Quality of Public Spending and Resource Management
    (Washington, DC, 2007-02) World Bank
    This report on governance in Brazil's unified health system assesses resource allocation and management, planning and budgeting functions, and budget execution at different levels of government for public expenditures on health services. The emphasis is on understanding the incentives generated for service providers, and the overall soundness of the accountabilities established in the public health services expenditure system. The analysis seeks to identify weaknesses of accountabilities for service provision that stem from the structure and process of intergovernmental and provider funding flows and related managerial practices. The paper draws on and enhances an accepted governance tool, public expenditure tracking, in both tracking funding and analyzing the governance and corresponding managerial challenges that impede effective public sector financing. The tracking instrument was applied to a sample of states, municipalities and healthcare facilities in the country in 2004.

Users also downloaded

Showing related downloaded files

No results found.