The effect of human resource management on performance in hospitals in Sub-Saharan Africa: a systematic literature review

Abstract

Hospitals in Sub-Saharan Africa (SSA) face major workforce challenges while having to deal with extraordinary high burdens of disease. The effectiveness of human resource management (HRM) is therefore of particular interest for these SSA hospitals. While, in general, the relationship between HRM and hospital performance is extensively investigated, most of the underlying empirical evidence is from western countries and may have limited validity in SSA. Evidence on this relationship for SSA hospitals is scarce and scattered. We present a systematic review of empirical studies investigating the relationship between HRM and performance in SSA hospitals.Following the PRISMA protocol, searching in seven databases (i.e., Embase, MEDLINE, Web of Science, Cochrane, PubMed, CINAHL, Google Scholar) yielded 2252 hits and a total of 111 included studies that represent 19 out of 48 SSA countries.From a HRM perspective, most studies researched HRM bundles that combined practices from motivation-enhancing, skills-enhancing, and empowerment-enhancing domains. Motivation-enhancing practices were most frequently researched, followed by skills-enhancing practices and empowerment-enhancing practices. Few studies focused on single HRM practices (instead of bundles). Training and education were the most researched single practices, followed by task shifting.From a performance perspective, our review reveals that employee outcomes and organizational outcomes are frequently researched, whereas team outcomes and patient outcomes are significantly less researched. Most studies report HRM interventions to have positively impacted performance in one way or another. As researchers have studied a wide variety of (bundled) interventions and outcomes, our analysis does not allow to present a structured set of effective one-to-one relationships between specific HRM interventions and performance measures. Instead, we find that specific outcome improvements can be accomplished by different HRM interventions and conversely that similar HRM interventions are reported to affect different outcome measures.In view of the high burden of disease, our review identified remarkable little evidence on the relationship between HRM and patient outcomes. Moreover, the presented evidence often fails to provide contextual characteristics which are likely to induce variety in the performance effects of HRM interventions. Coordinated research efforts to advance the evidence base are called for.Electronic supplementary materialThe online version of this article (10.1186/s12960-018-0298-4) contains supplementary material, which is available to authorized users.

Perceptions and predictors of organizational justice among healthcare professionals in academic hospitals in South-Eastern Nigeria

“…Keywords: Organizational justice, Health professionals, teaching hospitals, Nigeria Background Skilled and motivated health workforce is an essential input to strengthen hospitals in low and middle-income countries (LMICs) [1]. Nonetheless, perception of unfair treatment of health workers reduce health workforce performance and hospital operational efficiency [1,2].…”

“…Keywords: Organizational justice, Health professionals, teaching hospitals, Nigeria Background Skilled and motivated health workforce is an essential input to strengthen hospitals in low and middle-income countries (LMICs) [1]. Nonetheless, perception of unfair treatment of health workers reduce health workforce performance and hospital operational efficiency [1,2]. Health workers have views about and expect fairness in the distribution of organizational resources and opportunities, wages, decision-making processes, interpersonal behaviors and provision of information within their work environment [3].…”

“…This perception of fairness or unfairness in resource allocation, decision-making and interpersonal interaction refers to organizational justice [3]. Health workers care about justice because fair actions and processes make them feel valued and motivated to perform, thus making organizational justice imperative in improving operational efficiency of hospitals [1].…”

Task shifting of intraocular injections from physicians to nurses: a randomized single‐masked noninferiority study

“…; Gile et al. ). To this end, a randomized controlled single‐masked noninferiority study comparing the change of best‐corrected visual acuity (BCVA) between the participants in the nurse and physician group was designed (Austeng et al.…”

“…However, no randomized controlled trial (RCT) has earlier investigated whether such a task shift can be performed without increased risk to visual function. There are few RCTs on task shifting of surgical procedures and to our knowledge none from high-income settings (Fulton et al 2011;Gile et al 2018). To this end, a randomized controlled single-masked noninferiority study comparing the change of bestcorrected visual acuity (BCVA) between the participants in the nurse and physician group was designed (Austeng et al 2016).…”