Orientador: Maria Alejandra Caporale Madi / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Economia / Made available in DSpace on 2018-08-16T06:48:10Z (GMT). No. of bitstreams: 1 Goliati_TiyamikeHarold_M.pdf: 2154779 bytes, checksum: 95f480693dbcaaee8d66a7adb606380c (MD5) Previous issue date: 2010 / Resumo: A falta de enfermeiras do setor público de saúde de Malaui está afetando a habilidade das enfermeiras remanescentes para executarem seus deveres eficientemente. Essa escassez tem sido exacerbada pela existência de migração de enfermeiras e outros profissionais ligados à saúde. A deterioração do setor público de saúde combinada ao ambiente pobre de trabalho e salários reais em queda repele a migração de enfermeiras do setor público de saúde do país para organizações privadas e países desenvolvidos ao perceberem que têm uma boa remuneração e um ambiente de trabalho ideal para seus funcionários. A implementação de políticas neoliberais no país contribuiu com o declínio dos gastos sociais com a saúde e com outros serviços sociais que tem uma implicação direta no desenvolvimento social. Metodologia: A pesquisa visou entender a migração e a falta de enfermeiras no setor público de saúde no contexto de desafios contemporâneos para os profissionais de saúde em Malaui sob as políticas neoliberais. Ele empregou uma abordagem mista de desenho. Os dados foram analisados usando o pacote de estatísticas para ciências sociais (SPSS) versão 15.0 para Windows. Dados qualitativos foram feitos por análise de conteúdo e então, analisados posteriormente pelo SPSS. Resultados: As enfermeiras de Malaui encontram desafios multilaterais. Eles incluem baixos salários, baixos benefícios de aposentadoria, acomodação inadequada, nenhum acesso aos empréstimos do governo para enfermeiras de cabeceira, recursos/enfermeiras insuficientes, a sobrecarga de trabalho, as condições precárias de trabalho, as escassas oportunidades de treinamento, ambiente inseguro de trabalho. Conclusão: A situação, no entanto, está mudando lentamente devido ao crescente comprometimento do governo com relação ao setor de saúde, juntamente com medidas Keynesianas na economia. O desgaste das enfermeiras tem estado sob uma tendência descendente; as saídas de enfermeiras de instituições de treinamento têm aumentado; indicadores econômicos e sociais têm sido positivos; e o pacote de remuneração, as condições de trabalho e o ambiente de trabalho têm melhorado. Salários em termos reais têm subido em uma tentativa de reverter os salários reais em queda que balançaram o Mercado de trabalho desde que as políticas neoliberais encontraram seu espaço na política de Malaui / Abstract: Shortage of nurses in Malawian public health sector is affecting the ability of the remaining nurses to discharge their duties effectively. This scarcity has been exacerbated by existence of migration of nurses and other health-care personnel. Deterioration of the public health sector combined with the poor working environment and decreasing real wages repel the out-migration of nurses from the country?s public health sector to private organisations and developed countries perceived to have good remuneration package and ideal working environment for their employees. The implementation of neoliberal policies in the country contributed to decreasing social spending for health and other social services that have a direct implication on social development. Methodology: The research was aimed at understanding the migration and shortage of nurses in the public health sector in the context of contemporary challenges for health-care professionals in Malawi under neoliberal policies. It employed a mixed design approach. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 15.0 for Windows. Qualitative data were done by content analysis and then analysed further by SPSS. Results: Malawian nurses face multilayered challenges. These include, low salaries, low retirement benefits, Inadequate accommodation, No access to Government loans for bedside nurses, insufficient resources/nurses, Work overload, Poor working conditions, scarce training opportunities, unsafe working environment. Conclusion: the situation, however, is slightly changing due to increased government commitment towards health sector coupled with Keynesian measures in the economy. Nurses? attrition has been on a downward trend; outputs of nurses from training institutions have been rising; social and economic indicators have been positive; and remuneration package, working conditions and working environment have been improving. Salaries in real terms have been rising in an attempt to reverse the decreasing real wages that rocked the labour market since neoliberal policies found its space in the Malawian policymaking / Mestrado / Economia Social e do Trabalho / Mestre em Desenvolvimento Econômico

The assessment of the motivational value of rewards in the world of work is interesting but difficult to understand. Variations in research reports and inadequate comprehension of the efficiency and motivational value of rewards have brought about confusions, controversies and contradictions among authors, researchers, consultants and practitioners in the field of Industrial and Organisational Psychology (Mangham, 2007; Muula, 2006; Muula & Maseko, 2005; Palmer, 2006; World Bank, 2004). As a consequence, organisations are applying theories and models of motivation selectively depending on their beliefs, ideological framework of values and assumptions (Dzimbiri, 2009). The study was therefore carried out as a positive contribution to the existing knowledge and debate on the motivational value of rewards for health professionals in the public health sectors of the developing countries. Through a systematic sampling method, 571 health professionals were sampled for the study. Data were collected through the use of a self-administered questionnaire which was composed based on the data collected from desk research/literature review, focus group discussions and interviews. The findings of the study revealed that the Malawi‟s Ministry of Health (MoH) is failing to attract, motivate and retain health professionals; there is perception of inequity of the rewards among the health professionals; health professionals develop coping strategies to supplement their monthly financial rewards; health professionals engage in corrupt practices to supplement their monthly financial rewards; and there is erosion of industrial democracy in the Malawi‟s Public Health Sector. While the statistical testing of the hypothesized model proved a lack of fit between the variables, the statistical testing of the re-specified model suggests that there is a positive relationship between financial rewards and reward-related problems being faced by health professionals in the Malawi‟s MoH. Through the Structural Equation Modeling (SEM) exercise, an inverse (negative) relationship between financial and non-financial rewards was deduced, and scientifically and graphically demonstrated. Both the re-specified and graphical models symbolize a pragmatic departure from the theoretical model whose authors (Franco, Bennett, Kanfer & Stubblebine, 2004) are largely inclined to the use of non-financial rewards and suggest that financial rewards should be used with caution. These findings also reject the Herzberg‟s two factor theory (Herzberg, 1960) which claims that financial rewards (salaries) are not a motivator. The major recommendations of the study are that the Franco et al.‟s (2004) model should be adopted and adapted in the Malawi‟s MoH with the view that the value of both financial and non-financial rewards (as motivators) varies from individual to individual due to individual differences and prevailing factors/forces in both the work environment and wider society in which the MoH operates; a hybrid reward system combining the strengths of time-based, performance-based and competence-based reward systems should be developed and implemented; the results of scientifically testing the re-specified model and the inverse (causal) relationship established between financial and non-financial rewards (as demonstrated in a graphic model) should be re-tested with other samples in the public health sectors of the developing countries; and the motivational value of non-financial rewards should be scientifically established and compared with the motivational value of financial rewards used independent of each other in business organisations to make an objective conclusion on the rewards-motivation debate.

Development aid in most of the developing countries can sometimes compromise the principles of public service broadcasting (PSB). This may be true when reflected against the tension between donor financed programmes in Malawi and the mandate of Television Malawi (TVM). Although the donor intentions are noble, the strings attached to the funding are sometimes retrogressive to the role of PSBs. A case in point is how donors dictate terms on the HIV/Aids communication strategies at TVM. Producers receive money from donors with strings attached on how the money should be used and accounted for. If producers deviate they are sanctioned through withholding funding, shifting schedules and reducing the funding frequency. The donors also dictate who to interview on what subject, how to conduct capacity building. Some scholars have researched much on the impact of commercialisation of the media. This study is a departure from these traditional interferences; it interrogates the interest of philanthropy tendencies by international donors in the three chosen HIV/Aids programmes broadcast by TVM. The study investigates the extent of pressure exerted by donors on the producers of HIV/Aids programmes in Malawi. Thus, the study seeks to illicit specifics in the power relationship between the donor and the producer hence the study employs the political economy of development aid as applied to the public service broadcasting and communication for development. The study employed qualitative research methods and techniques (in-depth interviews, case study and document analysis). The study reveals how donor ideologies dominate the Aids messages-content output of the texts constructed. The study argues that cultural alienation of the Malawian audiences retards efforts of donors in combating HIV infection rate.

The purpose of the study was to evaluate the impact of implementing capacity building strategies on the provision of health services in the central region of Malawi. The study intended to determine why a lack of quality services is still prevailing in the health services in the central region despite implementing capacity building strategies aimed at improving the delivery of health services. In addition to this, to come up with recommendations to improve the implementation of the existing capacity building strategies so that the implementation results in the intended impact, that is efficient and effective provision of health services in the central region of Malawi. The studies reviewed what various scholars have written on capacity building in order to ground capacity building in Public Administration and provide the study with a conceptual, theoretical and legislative framework. This enabled the researcher to describe the nature and place of capacity building in Public Administration. It was evident from the review that the implementation of capacity building strategies is a systematic process which requires that chief officials follow all the steps in order to effectively and efficiently implement the capacity building strategies so that the intended impact is achieved. In this regard, capacity building is a management function which requires that chief officials play an enabling role by providing the necessary resources (both human and financial) and policies that support the implementation of capacity building strategies. The study used both quantitative and qualitative research methods whereby thirty-five respondents composed of political office-bearers and chief officials from Lilongwe, Dedza, Mchinji and Dowa districts and Ministry of Health Headquarters in the central region of Malawi were given self-administered questionnaires to complete. Face-to-face interviews and document analysis were also used as research methods. The intention was to determine the problems that are being experienced in the implementation of the existing capacity building strategies and find out if the strategies are resulting in the intended impact. The study findings confirmed that there are indeed problems being experienced in the implementation of the existing capacity building strategies, namely: inadequate human and financial resources, corruption, political interference, lack of consultation with stakeholders and lack of political will to make sure that the implementation of the capacity building strategies is effectively and efficiently done. It was also revealed that the implementation of the existing capacity building strategies is impacting negatively on the provision of health services in the central region of Malawi, hence indicating a need to change in approach. The study concludes that in order for the capacity building strategies to achieve the intended impact there is a need to broaden the scope of the legal framework on health capacity building strategies in Malawi, enforce the use of performance standards and improve the operational framework to gain efficiencies and effectiveness from current investments in capacity building.