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Perspectives on financing healthcare in Africa
Full text linkWits Business School
University of Witwatersrand
Johannesburg, South Africa
Master in Finance and Investment (2014)Following decades of under-investment, gaps in Africa’s healthcare infrastructure are
becoming disturbingly obvious. The interplay of governments’ fiscal policies of budget
imbalance reduction and other political considerations present a seemingly insurmountable
obstacle to overcoming the backlog in Africa’s healthcare infrastructure. The two main
objectives of this study were to understand the sources of financing and the best way to
structure the financing of healthcare infrastructure in Africa. Looking at financing arrangements
in various industries; and how healthcare sectors in developed countries have been financed,
the report draws on perspectives from the financiers on how the healthcare infrastructure gap
should be filled in Africa.
This study, which utilised survey questionnaires and in-depth interviews, identified
government revenues, regional development banks, private equity and donor financing
numbers as dominant funding sources for the financing of healthcare infrastructure in Africa.
Further, the study explored various ways in which finance could be structured and found that
within those various models of financing, donor financing and government revenue were
statistically significant on structuring the finance, especially within public-private partnership
arrangements. These include sale and lease back arrangements (p=0.0022), complete
ownership of projects by the private sector (p=0.003), management operation contracts
(p=0.00034) and other forms of PPPs.
More perspectives were obtained on enablers and barriers to improving investability of the
healthcare sector. Africa’s economic growth and the improving ease of doing business were
major enablers for healthcare sector’s investability. However, the role played by government as
both a financier and a regulator seemed a barrier. Some structural models that would need
government back-up include subordinated debt; with pricing at marginal cost and matching risk
and return recovered through the taxation system. The latter continues to characterise much of
Africa’s publicly provided healthcare infrastructure.
In conclusion, investments in healthcare may not be separated from a country’s level of
financial deepening. As the sector develops, it then becomes possible to utilise the models
aforementioned. It is recommended that any governments’ investments in healthcare be more
catalytic, to unlock value that allows the private sector to compete, both as financiers and
innovators in healthcare. Furthermore clear strategies on PPPs are urgently needed for
healthcare in Africa including policy consistency in financing and regulating healthcare
Enablers for, and barriers to, implementing environmental sustainability initiatives in hospitals in South Africa
No full textMBA thesisThe global threat of climate change is one of the most crucial environmental
issues facing the world in modern times. Every organisation doing business has
a duty to stem this tide, and the health care industry - hospitals in particular - is
no exception. However, in trying to implement environmental sustainability
initiatives, organisations are faced with a number of challenges, and unless
drivers of and barriers to sustainability are identified, there will likely be a
disconnect between the desired outcomes of policies on environmental
sustainability.
This study, set within the hospital industry, sought to identify what hospitals are
doing to curb this environmental scourge, and in the same vein identify various
enablers of and barriers to the implementation of environmental sustainability
initiatives in South Africa.
Following a literature review identifying some of the initiatives implemented in
other industries and hospitals in other countries, and a review of factors that
enable and hinder the implementation of sustainability initiatives, this thesis
undertook qualitative enquiry among the private and public hospitals in the
Gauteng region of South Africa. Use was made of semi-structured interviews,
where a questionnaire was used to guide the researcher’s interview process. A
total of 17 respondents were interviewed covering ten hospitals of which three
were private institutions.
Data collected was analysed using the coding technique and was compared
and contrasted to the literature in a process of explanation building. It was
possible to identify six categories of initiatives being implemented: policy
initiatives, water conservation, energy conservation, green built environment,
behavioural and organisational structure initiatives. It was also possible to elicit
a total of five enablers and six barriers in the study that were all coded into
themes. The five enablers were: compliance to policy (both internal and external
policy); top management support; availability of suitable equipment; an enabling
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human resource strategy and availability of guidance documents. The six
themes that formed barriers were: lack of demand from stakeholders; lack of a
conducive organisational culture; inadequate resources; infrastructural
challenges; unclear policy guidance and technical and information challenges.
Furthermore, in contrast to some of the literature findings only four enablers
were identified as being relevant to the study and these were organisational
support, clear policy; regulatory enablers and traceability. Of the barriers,
knowledge deficiency, lack of staff motivation and lack of funding emerged as
the most inhibiting.
The main recommendation from this study is the need to develop a policy on
environmental sustainability in hospitals that will, through a consultative
process, guide actions of all parties involved in sustainability. This policy should
take into account the findings from this research on enablers and barriers.
Further, more work needs to be done in understanding the initiatives that would
work in a hospital environment, including creating models to measure the
impact of any initiative or even making an investment case before such
implementation. Internal strategies are needed to maintain any momentum
created on sustainability, such as support from top management, a clearly
communicated organisational strategy, staff motivation and, indeed, allocation
of appropriate resources to the environmental sustainability cause.
It is proposed that the government, especially the National Departments of
Health, of Environmental Affairs and of Public Works, should promulgate
enabling legislation and a framework which would encourage the
implementation, monitoring and evaluation of environmental sustainability
initiatives in South Africa
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
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