ABSTRACT
INTRODUCTION: The shortage and poor distribution of the Health Workforce in Ivory Coast remains a major challenge for government authorities. The aim of this study was to identify factors related to healthcare workers' preferences for job posting in underserved areas. METHODS: The Discrete Choice Experiment method was used. The survey was conducted during the months of August and September 2015 among 490 students in healthcare worker training programmes and 574 in-service healthcare workers randomly selected from 8 health regions of Ivory Coast. The mixed logit model was used for data analysis. RESULTS: Availability of safe drinking water, electricity, phone network, and internet connexion (p = 0.001), availability of regular transportation (p < 0.001), family proximity (p < 0.001) were the most important job attributes for accepting job posting in underserved areas for in-service medical officers, nursing officers, and midwives.The main factors for accepting job posting in underserved areas by students in medical training programmes (medical school, nursing and midwifery school) were the availability of a scholarship after 5 years of employment (p = 0.009), the availability of safe drinking water, electricity, phone network, and internet connexion (p = 0.001), and availability of regular transportation (p < 0.001). Various combinations of these attributes with a financial bonus of 20% of the current salary would increase the proportion of health workers willing to work in underserved areas. CONCLUSION: These results could help to elaborate effective strategies for the attraction and maintenance of healthcare workers in underserved areas in Ivory Coast.
Subject(s)
Health Personnel/psychology , Medically Underserved Area , Motivation , Professional Practice Location/statistics & numerical data , Students, Health Occupations/psychology , Cote d'Ivoire , HumansSubject(s)
Asthma/epidemiology , Adolescent , Adult , Age Factors , Age of Onset , Aged , Asthma/physiopathology , Benin/epidemiology , Child , Cross-Sectional Studies , Female , Humans , Logistic Models , Male , Middle Aged , Risk Factors , Severity of Illness Index , Socioeconomic Factors , Surveys and Questionnaires , Young AdultABSTRACT
The 2008 cholera outbreak in Benin was characterized by a low case fatality rate (0.39 p.100) in the Littoral department, where 502 cases were recorded between July and December. The aim of this study was to identify the key factors associated with the low case fatality rate within the department. The cross-sectional, descriptive and analytical study conducted as part of this research used 404 patient records, focus group discussions with ten former patients, in-depth interviews with 8 health authorities involved in the response and structured face-to-face interviews with 12 health personnel involved in the treatment of patients. The data were analyzed using qualitative and quantitative content analysis based on EPIINFO 3.3.2 and EXCEL 2007 software. The results from several sources were cross-checked through triangulation. The mean age of patients was 23.72 ± 14.8 years. 39.35% patients were admitted with severe dehydration. Oral rehydration, intravenous rehydration and antibiotic therapy were given to 99.5%, 85% and 97.77% of patients, respectively. Only one hospital death was noted. The low case fatality rate was mainly due to the following factors: the high quality of care provided in a center with qualified personnel and available and free of charge treatment kits, protocols based on massive rehydration and appropriate hygiene measures, and patient compliance with the treatment plan. The response was also characterized by good coordination, wide mass and local health promotion, and selective antibiotic prophylaxis, which contributed significantly to reducing the spread of the infection.
Subject(s)
Cholera/mortality , Cholera/therapy , Disease Outbreaks , Adolescent , Adult , Benin/epidemiology , Child , Clinical Competence , Cross-Sectional Studies , Female , Humans , Male , Patient Compliance , Rehydration Solutions , Retrospective Studies , Young AdultABSTRACT
Introduction: la presente etude vise a determiner la frequence de l'asthme severe chez les patients asthmatiques suivis au Centre National Hospitalier de Pneumo-Phtisiologie (CNHPP) de Cotonou et identifier les facteurs de risque qui lui sont associes. Methodes: l'etude transversale; descriptive et analytique a porte sur 213 patients asthmatiques de la file active 2013 du CNHPP. Les donnees ont ete collectees par l'exploitation des dossiers et l'entretien individuel avec les patients. Elles ont ete traitees et analysees a l'aide des logiciels EPIINFO7 et STATA11. Le test Chi2 de Pearson; la regression logistique uni variee et multi variee ont ete utilises au seuil de signification de 0;05. Resultats: au total; 154 patients asthmatiques soit 72;7% ont repondu au questionnaire. Parmi eux 20;8% (IC95% :(14;67 ; 28;05)) souffraient d'asthme severe. L'age des patients s'etendait de 10 a 76 ans avec une mediane de 41 ans; 51;3% etaient de sexe feminin; 79;9% avaient des antecedents d'allergie; 61;7% ont commence leur asthme apres l'age de 12 ans et seuls 11% ont consomme ou consommaient du tabac. Les facteurs associes a la survenue de l'asthme severe etaient : l'age de 46 a 55 ans (p = 0;04) ; les troisieme et quatrieme quintiles du bien-etre economique (p = 0;01) et le debut de l'asthme apres l'age de 12 ans (p 0;001). Conclusion: l'etude a montre une frequence elevee de l'asthme severe au Benin et permettra d'ameliorer sa prise en charge au CNHPP
Subject(s)
Asthma , Asthma/epidemiology , Risk FactorsABSTRACT
BACKGROUND: Past attempts to estimate the cost of migration were limited to education costs only and did not include the lost returns from investment. The objectives of this study were: (i) to estimate the financial cost of emigration of Kenyan doctors to the United Kingdom (UK) and the United States of America (USA); (ii) to estimate the financial cost of emigration of nurses to seven OECD countries (Canada, Denmark, Finland, Ireland, Portugal, UK, USA); and (iii) to describe other losses from brain drain. METHODS: The costs of primary, secondary, medical and nursing schools were estimated in 2005. The cost information used in this study was obtained from one non-profit primary and secondary school and one public university in Kenya. The cost estimates represent unsubsidized cost. The loss incurred by Kenya through emigration was obtained by compounding the cost of educating a medical doctor and a nurse over the period between the average age of emigration (30 years) and the age of retirement (62 years) in recipient countries. RESULTS: The total cost of educating a single medical doctor from primary school to university is 65,997 US dollars; and for every doctor who emigrates, a country loses about 517,931 US dollars worth of returns from investment. The total cost of educating one nurse from primary school to college of health sciences is 43,180 US dollars; and for every nurse that emigrates, a country loses about 338,868 US dollars worth of returns from investment. CONCLUSION: Developed countries continue to deprive Kenya of millions of dollars worth of investments embodied in her human resources for health. If the current trend of poaching of scarce human resources for health (and other professionals) from Kenya is not curtailed, the chances of achieving the Millennium Development Goals would remain bleak. Such continued plunder of investments embodied in human resources contributes to further underdevelopment of Kenya and to keeping a majority of her people in the vicious circle of ill-health and poverty. Therefore, both developed and developing countries need to urgently develop and implement strategies for addressing the health human resource crisis.
