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Research Article
Doctoring in Europe: The Perspectives of Primary Care Physicians: A Research Note
Randolph Quaye*
Issue:
Volume 10, Issue 2, June 2025
Pages:
30-35
Received:
14 March 2025
Accepted:
25 March 2025
Published:
14 April 2025
Abstract: This paper explores the views of general practitioners (GPs) in Europe attending the World Family Council of Doctors conference in Dublin, Ireland (2024). Specifically, it engages a cross section of WONCA members by inquiring about their role as gatekeepers in health care, their current thinking about health care costs, their work experience and their stewardship in maintaining health care costs while simultaneously, working to improve the health of their patients. Data was collected from the relevant existing literature and a questionnaire distributed randomly to GPs attending the 2024 WONCA conference in Dublin, Ireland. The questionnaires were developed on the basis of a systematic review of the relevant literature on the changing status of GPs and was distributed to 50 GPs attendees with a return rate of 76%. This paper thus utilized a relatively small sample size focused exclusively on GPs. Based on the data collected, this paper contends that European GPs are generally satisfied with their work (92%) and they overwhelmingly see their role as “gatekeepers” in holding down health care costs, GPs were generally opposed to market reforms in health care. This study has wider implications for: (1) how GPs in Europe are meeting the challenges of their gatekeeping role in the face of financial constraints, and (2) how European GPs are working to reduce health inequalities.
Abstract: This paper explores the views of general practitioners (GPs) in Europe attending the World Family Council of Doctors conference in Dublin, Ireland (2024). Specifically, it engages a cross section of WONCA members by inquiring about their role as gatekeepers in health care, their current thinking about health care costs, their work experience and th...
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Review Article
The Nexus of Health Workers’ Incentives, Health Workers’ Migration and Nigeria’s Economic Growth and Development, 1999 – 2023: An Analytical Review
Olumayowa Adeleke Idowu*
Issue:
Volume 10, Issue 2, June 2025
Pages:
36-42
Received:
25 March 2025
Accepted:
2 April 2025
Published:
28 April 2025
Abstract: Like education, investment in healthcare is critical to every economy’s human capital development, because human capital development serves as the bedrock of economic growth and development. This view is supported by theories and empirical studies. Nigeria’s participation in the previous United Nations’ Millenium Development Goals (MDGs) and the current Sustainable Development Goals (SDGs) also attests to this. The attainment of SDGs number 3, ensure healthy lives and promote well-being for all at all ages and number 4, ensure inclusive and equitable quality education and promote lifelong learning opportunities for all, is very important to the attainment of the remaining goals. Despite this obvious importance of investment in health and education to Nigeria’s sustainable economic development, the political leaders have not lived up to electorates’ expectations in terms of their campaign promises, words, actions and policies in providing adequate budgetary allocations for health and education. The purpose of this paper is to conduct an analytical review of investment in health through the lens of health workers’ incentives, the influence of inadequate incentives on health workers’ migration, and the consequences of these on Nigeria’s economic development from 1999, when Nigeria returned to civil rule until 2023 when the last administration handed over power to the incumbent government. A thorough search of Google Scholar for studies, and web search of media reports on Nigeria’s healthcare expenditure, economic growth, health workers’ incentives, strike actions, and migration from 1999 – 2023 was conducted, and available studies and reports were analyzed. The results show that from May 1999 to May 2023, the total number of days that health workers in Nigeria have embarked on industrial strike due to poor incentives was 319 days (about 10 and a half months). The regular health workers’ incentives which are usually responsible for the strike actions include salary structures, payment of arrears, welfare packages, quality of hospital equipment, funding for training programs, working conditions, and other incentive or welfare-related factors. Poor incentives have not only necessitated incessant industrial actions but have also promoted mass migration of Nigeria health workers, and other outcomes, all serving as mediating factors of the relationship between health workers’ incentives and economic development. Overall, Nigeria has lost and is losing certain percent of its productive workforce, and this undermines its economic development.
Abstract: Like education, investment in healthcare is critical to every economy’s human capital development, because human capital development serves as the bedrock of economic growth and development. This view is supported by theories and empirical studies. Nigeria’s participation in the previous United Nations’ Millenium Development Goals (MDGs) and the cu...
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Research Article
The Impact of the Performance-Based Financing Project: An Observational Panel Study on Health Workers' Output in Rural Mezam, Northwest Region, Cameroon
Issue:
Volume 10, Issue 2, June 2025
Pages:
43-59
Received:
21 March 2025
Accepted:
31 March 2025
Published:
29 April 2025
Abstract: Performance-Based Financing (PBF) has been implemented in many countries to improve healthcare access, quality, and outcomes while ensuring the efficient and equitable allocation of resources within the healthcare system. However, little effort has been made to assess its impact. This study evaluates the impact of the PBF project on health workers' performance and healthcare quality in Mezam Division, North West region of Cameroon, between 2012 and 2022. Specifically, the study aims to understand health workers' perceptions of the PBF project, analyze the effect of PBF on health workers' output, and examine the impact of PBF on healthcare quality. A structured questionnaire was used to generate panel data among healthcare workers in six beneficiary health districts in the study site. The perception scores were estimated based on the Net Promoter Score (NPS) methodology, and variability was tested using Analysis of Variance (ANOVA). Health workers' output and performance indicators were analyzed using the chi-square test, assessing the relation between PBF introduction and changes in health workers' output, while healthcare quality metrics were analyzed using the Mann-Whitney U test to compare healthcare quality before and after PBF implementation. The results showed that health workers' perceptions varied but were generally positive, with a Net Promoter Score (NPS) of approximately 48.25. PBF significantly boosted health workers' output (p = 0.002) and healthcare quality (p < 0.05). We concluded that the PBF project in the Mezam Division had positive effects on workers’ output and the quality of healthcare delivered. Given the positive impacts, the study recommends scaling up PBF initiatives in Cameroon and other African countries with precarious health systems. Our study demonstrates the relevance of impact assessments in providing evidence for making informed decisions on efficient resource allocation in the health sector.
Abstract: Performance-Based Financing (PBF) has been implemented in many countries to improve healthcare access, quality, and outcomes while ensuring the efficient and equitable allocation of resources within the healthcare system. However, little effort has been made to assess its impact. This study evaluates the impact of the PBF project on health workers'...
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Research Article
Study of the Clinical and Economic Aspects of Diabetic Patients Hospitalized in Matlaboul Fawzayni National Hospital Center of Touba Senegal
Issue:
Volume 10, Issue 2, June 2025
Pages:
60-66
Received:
23 December 2024
Accepted:
5 February 2025
Published:
6 June 2025
DOI:
10.11648/j.hep.20251002.14
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Abstract: Diabetes mellitus is a chronic hyperglycemia with an enormous human and social cost. The main objective was to evaluate the clinical and economic aspects of patients followed at Matlaboul Fawzayni National Hospital Center in Touba (MFNHCT). Our study was cross-sectional, prospective, descriptive and analytical. It included all consenting patients hospitalized at Touba Hospital from January 1 to December 31, 2022. A questionnaire was administered directly to the patients. The data were entered in Excel and analyzed using SPSS software. Of the 653 diabetic patients consulted, 84 were hospitalized and enrolled. There was a female predominance with a sex ratio of 0.91. The mean age was 53.2±17.83 years. Type 2 diabetes accounted for 94% of the cases. Polyuria-polydipsia syndrome and incidental discovery were the main modes of discovery with 38.10% and 35.71%, respectively. The majority of patients were treated with MHD + ADO + insulin (66.67%). Metformin was the first-line molecule in the treatment of type 2 diabetes with a prevalence of 54.90%. The most common acute complication was ketoacidosis (89.16%). The most common chronic complications were cardiovascular and renal with 30.95% and 21.43%, respectively. Among the working patients, 33.33% had repeated absences from work due to illness or medical visits. The premature death of 9.52% of our patients was due to acute or chronic complications. Catastrophic health care expenditures were found in low and middle income patients. The average cost of hospitalization for type 1 diabetes was 19,088 CFA francs compared to 23,681 CFA francs for type 2 diabetes. This mean difference was statistically significant with a p-value of 0.04 (<0.05). Average hospitalization costs were higher in patients with type 2 diabetes. Diabetes remains a heavy economic burden. Strengthening preventive measures for this disease and promoting universal health coverage will help reduce household expenditures.
Abstract: Diabetes mellitus is a chronic hyperglycemia with an enormous human and social cost. The main objective was to evaluate the clinical and economic aspects of patients followed at Matlaboul Fawzayni National Hospital Center in Touba (MFNHCT). Our study was cross-sectional, prospective, descriptive and analytical. It included all consenting patients h...
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Research Article
Rethinking the Dynamics of Healthcare Funding, Maternal Health Status and Lifespan Inequality Among Women in the ECOWAS Region
Johnbosco Chukwuma Ozigbu,
Christopher Ifeanyi Ezekwe*
Issue:
Volume 10, Issue 2, June 2025
Pages:
67-76
Received:
20 April 2025
Accepted:
3 May 2025
Published:
12 June 2025
DOI:
10.11648/j.hep.20251002.15
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Abstract: Motivated by the widening gap in lifespan within and between countries and across age groups, this study quantifies the implications of public health expenditure, out-of-pocket healthcare payments and maternal health conditions such as the prevalence of obesity and anaemia on lifespan inequality among women in five anglophone countries (Ghana, Liberia, Nigeria, Sierra Leone, and The Gambia) and five francophone countries (Senegal, Niger, Mali, Guinea and Togo) in the ECOWAS region. Heterogeneous panel estimation involving mean group (MG) and pooled mean group (PMG) estimators alongside unit root tests and descriptive statistics formed the basis for the analysis. Findings indicate that public health expenditure does not significantly reduce the disparity in lifespan in both the short and long run. This highlights the need for more effective public healthcare financing that will increase healthcare access and prioritise healthcare in reinvestments of the savings from subsidy removal, while mitigating corruption. Further analysis showed that out-of-pocket healthcare payments significantly reduced inequality in the length of life of women in both the short and long run. This highlights the efficacy of out-of-pocket healthcare payments in promoting uniformity in the ages of death of women. However, the findings showed that the prevalence of obesity and anaemia among women worsened the lifespan inequality during the study period. This explains the need to address underlying health conditions in women through healthy diets and regular physical exercise. Given the findings, this study recommends boosting the purchasing power of women for more independent financial decisions to improve equality in their longevity. Again, targeted conditional cash transfers should be provided to vulnerable women to boost their out-of-pocket healthcare payments for a more equal lifespan.
Abstract: Motivated by the widening gap in lifespan within and between countries and across age groups, this study quantifies the implications of public health expenditure, out-of-pocket healthcare payments and maternal health conditions such as the prevalence of obesity and anaemia on lifespan inequality among women in five anglophone countries (Ghana, Libe...
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