Public Service Motivation and Determining Factors to Attract and Retain Health Professionals in the Public Sector: A Systematic Review

A Qualitative Study to Explore Global Trends in Clinical Pharmacy Practice

RATIONALE

Pharmacists' clinical responsibilities have been on a progressive rise, adopting a more person-centered approach, and experiencing increased involvement in healthcare teams across all settings. The development and evolution of clinical pharmacy practice in each country depends on the existing facilitators and barriers, which are variable and highly context-related.

AIMS AND OBJECTIVES

To investigate the perspectives of global experts regarding the advancement of clinical pharmacy practice, with a specific focus on examining the factors contributing to success and their outlook on the future of clinical pharmacy.

METHODS

Semi-structured interviews were conducted with academia and practice experts from 13 countries. Each expert was asked what they considered to be the future of clinical pharmacy education and practice, as well as what should be improved in the clinical pharmacy learning path to ensure that it keeps pace with the evolution of pharmacists' clinical responsibilities in practice. Success factors for change in clinical pharmacy practice were also explored. Interviews were transcribed verbatim and analyzed thematically.

RESULTS

Success factors for advancing clinical pharmacy practice included elements related to the healthcare and political landscape, such as remuneration, leadership, as well as willingness and readiness for change. Other success factors identified are directly related to the pharmacist, such as the use of reflective practice or the pharmacist's motivation. Perceived future directions include the existence of a multidisciplinary approach in practice, the expansion of clinical pharmacy services, as well as the delivery of clinical pharmacy services at the primary care level.

CONCLUSION

The development of clinical pharmacy practice relies on a wide range of factors. The analysis carried out in this study of the success factors as well as the potential future directions of clinical pharmacy can serve as catalysts for the development of this pharmacy field at the country, regional, and global levels.

The Public Service Motivation's Impact on Turnover Intention in Korean Public Organizations: Do Perceived Organizational Politics Matter?

Increasing turnover intention among public employees in Korean public sector organizations endangers both organizational sustainability and public service quality. Although prior research highlights job stress, compensation systems, and organizational culture as key drivers of turnover, scholars in limited empirical studies directly examine the role of public service motivation. In this study, we address this gap by investigating whether public service motivation reduces turnover intention and how perceived organizational politics may moderate this relationship. Using survey data from the 2023 Korean Public Employee Viewpoints Survey-conducted by the Korea Institute of Public Administration and including responses from central and local government employees-we employ stereotype logistic regression for analysis. Results show that public service motivation significantly lowers turnover intention, but its positive effect diminishes when employees perceive high levels of organizational politics. When employees believe that power and resources are distributed based on political interests rather than merit, they experience diminished reciprocity toward their organization. As a result, their intention to leave the organization increases. These findings underscore the need to sustain and enhance public service motivation while mitigating perceived organizational politics. Enhancing fairness, transparency, and trust-while reducing political interference-can preserve public service motivation's positive impact and reduce turnover intention within public sector organizations.

Job incentives influencing health professionals working in rural and remote areas in Thailand: finding from discrete choice experiment to policy recommendation

BACKGROUND

This research aims to understand job incentives of health professionals who work in rural and remote areas, which could lead to the further development of policy proposals.

METHODS

The study design has been applied discrete choice experiment (DCE) to determine attribute preferences of: 1) doctors, dentists, and pharmacists, and 2) nurses and interdisciplinary teams. Four areas in northern Thailand were purposively selected. To determine the attributes and levels, a qualitative method was employed. An orthogonal array was adopted to produce 16 options for categorizing the employment preferences of each person. Conditional and mixed logit regressions were used to examine the major incentives influencing health workforce decision-making. In addition, willingness to pay (WTP) analysis according to beta coefficients from the regression models was performed.

RESULTS

The total number of participants in the first group was 34, and the latter group included 160 participants. Financial incentives, suitable accommodation, workload and job post in hometown were all significant criteria for both groups. Surprisingly, opportunity to continue study was not a significant consideration for doctors, dentists, or pharmacists to work in remote areas. When getting a 40% higher income than counterparts working in public hospitals in urban regions, the decision-making level among doctors, dentists and pharmacists influenced decisions by 4.2 times, while nurses and interdisciplinary teams were influenced twice as much. Regarding the WTP analysis, doctors, pharmacists, and dentists were willing to receive 8,126 (95% CI: 3,477; 15,442) Baht per month, and nurses and interdisciplinary teams were willing to receive 7,733 (95% CI: 4,926; 11,502) Baht per month to work more than 48 h per week. The results of mixed and conditional logit models were found consistently.

CONCLUSION

Financial subsidies for all types of healthcare workers in rural and remote areas remain effective policies and need to be maintained. It is not merely a matter of national policy; hospital-level policies can change and contribute to resolving the problem of health personnel shortages. The short-term plan for retaining health staff would be to provide suitable, safe, and satisfying accommodations.

How and when paternalistic leadership influences service innovative behaviour while inhibiting counterproductive work behaviour among healthcare professionals: the roles of perceived supervisor support and public service motivation

PURPOSE

Healthcare is a service industry where fulfilling the needs of patients (customers) is challenging. Various factors, including cost, system complexity, staffing behaviours and technological advances, play vital roles. Drawing upon social exchange theory, this study seeks to determine how paternalistic leadership (authoritarianism, benevolence and morality) influences employee service innovative behaviour and counterproductive work behaviour via perceived supervisor support in the healthcare sector. Additionally, the study investigates the role of the public service motivation of individuals as a moderating factor in this relationship.

DESIGN/METHODOLOGY/APPROACH

A pilot study and a main study were conducted to test the hypotheses. We collected data from healthcare professionals in Pakistan's large public, private and semi-government hospitals. We applied bootstrapping with 5,000 replications and structural equation modelling to analyse the data.

FINDINGS

Results indicate that authoritarianism was negatively associated with service innovative behaviour, whereas benevolent and moral behaviours were positively associated with service innovative behaviour via perceived supervisor support (mediation). Our findings shed light on the moderating role of public service motivation.

ORIGINALITY/VALUE

This empirical quantitative study has several theoretical and practical implications. Findings of our study provide evidence that a paternalistic leadership style can influence both positive (service innovative behaviour) and negative (counterproductive working behaviour) working behaviours simultaneously via perceived supervisor support at an individual level in the service (healthcare) industry. This study also highlights the moderating role of public service motivation as an individual motivation factor.

Leadership Lived Experiences in Implementing Compassionate, Respectful, and Caring Practices: A Hermeneutic Phenomenological Study

Compassionate, respectful, and caring (CRC) programs have been introduced in Ethiopian health facilities in the last 5 years to transform health care quality and provide patient-centered, compassionate, and respectful care. Therefore, this study aimed to examine the lived experiences of leaders to understand the meaning of successful CRC implementation and identify factors that influence implementation success in the health sector. A hermeneutic phenomenological qualitative study was employed through in-depth interviews with 26 participants from January 2022 to January 2023. Participants were selected purposively based on their position and role in CRC implementation experience from 6 regions of Ethiopia: Amhara, Oromia, South Nation Nationality People Region (SNNPR), Sidama, Benishangul Gumuz, and Southwest Ethiopian People Region (SWEPR). The ATLAS.ti version 7.02 software was used for data analysis, and interpretative phenomenological analysis was carried out. We found 5 main themes and 14 sub-themes from an in-depth interview. The 5 main themes that emerged include health care leaders' commitment to CRC, lived enablers of CRC, embodying CRC through actions of volunteerism, leaders' call to transform CRC advocacy, and sustaining CRC integration into systems and structures. These themes stress the transformative impact of CRC in health care settings, emphasizing leadership, collaboration, volunteerism, advocacy, and sustainability as key pillars for CRC implementation success, which enhances health care quality. The findings highlight that the implementation of CRC programs across all health care facilities is successful, leading to improvements in health care quality, organizational effectiveness, person-centered care, and the promotion of fundamental human rights.

The impact of public leadership on collaborative administration and public health delivery

BACKGROUND

This research depicts the linkage of public leadership on public health delivery (PHD) and collaborative administration. The research is also focused to examine the effect of public leadership on public health delivery through the intervening variable of collaborative administration by using both social information processing theory and collaboration theory.

METHODS

This research is based on quantitative method. Data was collected from 464 public hospital administration in the context of Pakistan. This study evaluated data using SPSS, AMOS, and PROCESS Macro.

RESULTS

Public leadership has a positive profound effect on public health delivery and collaborative administration, and that collaborative administration significantly promotes public health delivery. The outcomes also exposed that public leadership has substantial influence on public health delivery through intervening collaborative administration.

CONCLUSIONS

Whilst public leadership demonstrated positive outcomes on public health delivery and collaborative administration, there is a need for more rigor studies on collaborative governance leadership, collaborative ethics and collaborative norms in the public health service.

Conflict, healthcare and professional perseverance: A qualitative study in a remote hospital in an Anglophone Region of Cameroon

Armed conflicts are a major contributor to global disease burden owing to their deleterious effects on health and healthcare delivery. The Anglophone crisis in Cameroon is one of the ongoing conflicts in Sub-Saharan Africa and has led to massive displacement of healthcare workers (HCWs). However, some HCWs have stayed back and continued working. An understanding of their experiences, perspectives and professional perseverance is lacking. We designed a phenomenological study using Focused Group Discussions (FGDs) and in-depth interviews to: understand the experiences of 12 HCWs in a remote hospital in the North West region of Cameroon with armed groups; evaluate how it affects healthcare delivery from HCWs perspective and examine HCWs coping mechanisms during the conflict with a view of informing HCW protection policies in conflict zones. Results revealed that HCWs go through all forms of violence including threats, assaults and murders. Overall insecurity and shortage of health personnel were major barriers to healthcare delivery which contributed to underutilization of healthcare services. Participants observed an increase in complications due to malaria, malnutrition and a rise in maternal and infant mortality. The hospital management and Non-Governmental Organizations (NGOs) played an essential role in HCWs adaptation to the crisis. Nevertheless they unanimously advocated for a cease fire to end the conflict. In the meantime, passion for their job was the main motivating factor to stay at work.

Willingness to Work during Public Health Emergencies: A Systematic Literature Review

The identification of the factors underlying the willingness or lack thereof to respond to public health emergencies is paramount to informing more capable health services. The interest in this topic appears renewed with each surge of threat, either referring to natural disasters, man-made violence, or epidemic and pandemics. However, there is no systematic approach to the research patterns and related main findings concerning individual and contextual determinants. The present article contributes to this theme through a systematic literature review of a sample of 150 articles published in the last 30 years on the subject of willingness and preparedness of health professionals to deal with public health threats. Our findings show that the research is mainly phenomena and contextual driven, responding to whichever emergency threat is more salient in a given period. Geographically, research on this topic is led by USA and China, mostly solely, while European countries invest in collaborations that are more international. Universities, including health institutes and schools, and researchers at hospitals conduct most of the research on the topic. The main research areas are medicine, psychology, and psychiatry. Pandemics, including COVID-19, influenza, and natural disasters, are the phenomena gauging more attention as opposed to terrorism events and biological accidents. The specific role of health professionals within the institution, their belief in ethical duties, preparation training, and concerns regarding infection of self and family are the main variables influencing the willingness and ability to report to work in public health emergencies.