An evaluation of the 1994 tax reform in China using a general equilibrium model
In: China economic review, Band 16, Heft 3, S. 246-270
ISSN: 1043-951X
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In: China economic review, Band 16, Heft 3, S. 246-270
ISSN: 1043-951X
In: PBCSF-NIFR Research Paper Forthcoming
SSRN
In: Journal of economic dynamics & control, Band 134, S. 104275
ISSN: 0165-1889
In: Journal of economic dynamics & control, Band 114, S. 103896
ISSN: 0165-1889
SSRN
In: Environmental science and pollution research: ESPR, Band 30, Heft 19, S. 56121-56136
ISSN: 1614-7499
In: Computers and Electronics in Agriculture, Band 173, S. 105452
OBJECTIVES: Community health workers (CHWs) played important roles in supplementing scarce healthcare workforce in Sierra Leone during the Ebola outbreak, causing the government to launch the National Community Health Worker Policy 2016–2020. This study evaluated this ambitious policy and examined CHWs' sustainability through their job satisfaction and the underlying factors to inform new policy recommendations, especially the implication for COVID-19 containment. DESIGN: A mixed-methods approach applying structured questionnaires and semistructured interviews. SETTING AND PARTICIPANTS: 188 CHWs in Bombali District (key Ebola-stricken areas) of Sierra Leone, 184 of them participated in follow-up interviews. PRIMARY AND SECONDARY OUTCOME MEASURES: Quantitative and qualitative elements were triangulated to improve robustness of investigation: job satisfaction was measured by the Minnesota Satisfaction Questionnaire (MSQ), and factors associated with job satisfaction were identified through thematic analysis and multivariable logistic regression. RESULTS: The MSQ score of CHWs in Sierra Leone was 65.09, extremely low even among low-income and middle-income countries. Five themes (grouped from 16 subthemes) emerged through the semistructured interviews and were tested quantitatively. Payment was CHWs' top concern. Low stipend and payment tardiness were significantly associated with dissatisfaction. Those with Ebola experience were 5.20 times (95% CI 1.51 to 17.95, p=0.009) more likely to be dissatisfied. This study also found that working conditions, medical material supplies and career development were far from what the CHW policy promised. CHWs' commitment was the only 'positive' theme, and their intrinsic job satisfaction (mean=3.61) was much higher than the extrinsic job satisfaction (mean=2.72). CONCLUSIONS: Some critical components of the 2016 National Community Health Worker Policy, aiming to promote CHWs and strengthen primary healthcare, have severe shortfalls in practice. The Sierra Leone government should ...
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In: ANINU-D-23-00943
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