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Objective To determine how specific job attributes influenced fourth year medical students' stated preference for hypothetical rural job postings in Ghana. Methods Based on discussions with medical student focus groups and physicians in practice and in the Ministry of Health, we created a discrete choice experiment (DCE) that assessed how students' stated preference for certain rural postings was influenced by various job attributes: a higher salary, free superior housing, an educational allowance for children, improved equipment, supportive management, shorter contracts before study leave and a car. We conducted the DCE among all fourth year medical students in Ghana using a brief structured questionnaire and used mixed legit models to estimate the utility of each job attribute. Findings Complete data for DCE analysis were available for 302 of 310 (97%) students. All attribute parameter estimates differed significantly from zero and had the expected signs. In the main effects mixed logit model, improved equipment and supportive management were most strongly associated with job preference (/3 = 1.42; 95% confidence interval, Ch 1.17 to 1.66, and [beta] = 1.17; 95% CI: 0.96 to 1.39, respectively), although shorter contracts and salary bonuses were also associated. Discontinuing the provision of basic housing had a large negative influence ([beta]= -1.59; 95% Ch-1.88 to -1.31). In models including gender interaction terms, women's preferences were more influenced by supportive management and men's preferences by superior housing. Conclusion Better working conditions were strongly associated with the stated choice of hypothetical rural postings among fourth year Ghanaian medical students. Studies are needed to find out whether job attributes determine the actual uptake of rural jobs by graduating physicians. Objectif Determiner comment les preferences d'etudiants en quatrieme annee de medecine pour des postes de travail hypothetiques en milieu rural au Ghana ont ete influencees par les caracteristiques specifiques de ces postes. Methodes A partir de discussions avec des groupes thematiques d'etudiants en medecine, des medecins en exercice et des employes du Ministere de la sante, nous avons mis sur pied une experience a choix discrets (DCE), qui a permis d'evaluer comment les preferences exprimees par les etudiants pour certains postes en milieu rural etaient influencees par les diverses caracteristiques de ces postes : salaire plus eleve, logement confortable gratuit et indemnite pour l'education des enfants, equipement perfectionne, encadrement cooperatif, contrats plus courts avant la fin des etudes et vehicule de fonction. Nous avons applique cette DCE a l'ensemble des etudiants ghaneens en quatrieme annee de medecine a l'aide d'un bref questionnaire structure, puis employe des modeles logit a effets mixtes pour estimer l'utilite de chaque caracteristique des postes. Resultats Nous disposions de donnees completes se pretant a une analyse de la DCE pour 302 etudiants sur 310 (97%). Toutes les estimations des parametres lies aux caracteristiques differaient significativement de zero et presentaient les signes attendus. La modelisation logit des effets mixtes principaux faisait apparaitre une forte association entre la presence d'un equipement perfectionne ou d'un encadrement cooperatif et la preference pour le poste ([beta] = 1,42; intervalle de confiance a 95%, IC: 1,17a 1,66, et [beta] = 1,17; IC a 95% : 0,96 a 1,39, respectivement), meme si la possibilite de contrats plus courts et l'existence de primes salariales etaient aussi associees a cette preference. Ne pas mettre a disposition un logement de base avait une forte influence negative (p = -1,59; IC a 95%: -1,88 a -1,31). Les modeles integrant les termes d'interaction entre les sexes indiquaient que les preferences des femmes etaient plus influencees par la presence d'un encadrement cooperatif et celles des hommes par la mise a disposition d'un logement confortable. Conclusion II existait une forte association entre de meilleures conditions de travail et le choix declare par les etudiants ghaneens en quatrieme annee de medecine d'un poste rural hypothetique. Des etudes sont necessaires pour determiner si les caracteristiques des postes conditionnent l'acceptation reelle des postes en milieu rural par des medecins ayant obtenu leur diplome. Objetivo Determinar que condiciones especificas de empleo influyen en la preferencia declarada de alumnos de cuarto ano de medicina por puestos de trabajo hipoteticos en zonas rurales en Ghana. Metodos Basandonos en conversaciones mantenidas con grupos de discusion de estudiantes de medicina y medicos en ejercicio en el Ministerio de Salud, creamos un modelo de eleccion discreta (MED) para evaluar el efecto de diversas condiciones de empleo en la preferencia declarada de los estudiantes por determinados destinos rurales; a saber: sueldos mas altos, alojamiento gratuito de mayor calidad, subsidios de educacion para los ninos, mejores equipos, gestion de apoyo, contratos mas cortos antes de la licencia de estudios, y entrega de un coche. Ensayamos sobre el terreno el MED y un breve cuestionario estructurado entre todos los estudiantes de cuarto ano de medicina en Ghana, y usamos modelos logit mixtos para estimar la utilidad de cada caracteristica del trabajo. Resultados Se consiguio usar en el analisis MED los datos completos de 302 de un total de 310 estudiantes (97%). Todas las estimaciones de los parametros de las condiciones estudiadas fueron significativamente distintas de cero y tuvieron el signo previsto. En el modelo logit mixto de efectos principales, un mejor equipo y la gestion de apoyo fueron los factores mas estrechamente relacionados con la preferencia por el trabajo ([beta] = 1,42, intervalo de confianza del 95%: 1,1 7-1,66, [beta] = 1,1 7, IC95%: 0,96-1,39, respectivamente), si bien se observo tambien una asociacion con los contratos mas cortos y las bonificaciones salariales. La interrupcion de la prestacion de alojamiento basico tuvo una enorme influencia negativa (6 = 1,59, IC95%: 1,88-1,31). En los modelos que incluian la interaccion del factor genero, las preferencias de las mujeres respondian en mayor medida a la gestion de apoyo y las de los hombres, a una vivienda mejor. Conclusion Se observo una solida relacion entre unas condiciones de empleo mejores y la eleccion declarada de puestos de trabajo rurales hipoteticos entre estudiantes de cuarto ano de medicina de Ghana. Es necesario realizar nuevos estudios para averiguar si las condiciones de empleo determinan la ocupacion real de puestos de trabajo rurales por los medicos que acaban la carrera., Introduction In many low-income countries, health worker shortages hamper progress towards meeting the health-related Millennium Development Goals. (1) Africa is the region of the World Health Organization (WHO) with the [...]

Background: The government of Sierra Leone introduced Social Health Insurance Scheme as a measure to remove financial barriers that beset the people in accessing health to ensure universal coverage. Under this policy, the citizens were encouraged to subscribe to the scheme to avoid out of pocket payment for healthcare at the point of use. This study was conducted to find out the predictors of willingness among the people to pay for health insurance premium. Methods: A cross-sectional study design was employed in six selected districts in Sierra Leone. Quantitative data was collected for this study through the use of semi-structured questionnaire with a sample size of 1185 respondents. Data was analysed into descriptive and inferential statistics using the contingent valuation model. Statistical analysis was run at 5% significant level using Stata version 14.0 software. Results: The results showed that majority of the respondent are willing to join and pay a monthly premium of Le 10 000 (US$1.03) with an estimated mean contribution of about Le 14 089 (US$1.44) and the top five predictors of willingness to pay (WTP) were household monthly income, age, district of resident, gender, and educational qualification. Conclusion: The findings on predictors of WTP premium of Sierra Leone National Social Health Insurance (SLeNSHI), suggests that the socio-demographic characteristics of the population are important in premium design and payment. Efforts at improving the socio-economic statuses of the population could be helpful in premium design and payment. [ABSTRACT FROM AUTHOR]

Healthcare provider attitudes and perceptions of disability may influence the delivery of comprehensive quality care to patients with disabilities. The study was conducted to ascertain healthcare providers' perspectives on access to healthcare by disabled people in a peri‐urban district of Ghana. We employed a qualitative approach and selected participants using the purposive sampling technique. Qualitative data were collected from 28 healthcare providers through face‐to‐face interviews using an interview guide. Data let thematic an alysis was employed to tease out the findings through categorisation and the main themes have been presented as findings with specific quotations to support them. We found that people with disabilities who visited healthcare facilities were perceived as individuals who are stressed up, selfish and inconsiderate, violent, having low self‐esteem and also difficult to communicate with. This could affect the interactions between healthcare providers and people with disabilities who visit the facility and subsequently the quality of service provided. It is recommended that the Ministry of Education, Ministry of Health and the Ghana Health Service work closely with the various educational institutions to train healthcare professionals to improve their knowledge on disability issues to improve service delivery. [ABSTRACT FROM AUTHOR]