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This paper assessed the extent to which local government authorities have mainstreamed climate change adaptation strategies in their development policies in selected districts in Ghana, using a qualitative case study design within the phenomenological epistemology. Forty-four respondents participated in this study from the decentralised departments of local authorities key informant interviews (KIIs) were used for data collection in the study areas. The study findings revealed that climate policy integration at the study districts was done as a compliance measure rather than a response to real needs of the districts. A gaping chasm therefore exists between stated and actual climate change-related goals. Lack of collaboration, weak coordination of sector plans and weak community and private sector engagement were identified as the causal factors of the gap between the rhetoric and reality of integrating climate change concerns into district development plans in the study areas. Further, competing local priorities on the district agenda, institutional capacity constraints and information and technological constraints were identified as major barriers for the local authorities in adaptation to climate change. It is concluded that although climate change and its related policies have been integrated into the various national development policies, climate policy integration remains a challenge at the district level. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to examine the trend of return migration of health professionals to Ghana and how it is impacting the delivery of health services in the country. It also highlights the challenges facing returnees to the country. Design/methodology/approach – A qualitative exploratory case study approach was employed in the study. Data gathered were analysed using the sequential model of qualitative content analysis. Findings – It was found that while push factors dominantly influence out-migration, pull factors rather dominated reasons for return migration. Other determinants of return migration include social and financial benefits to the home country, achieving goals for travelling, skills’ improvement and spousal consideration. The paper also highlights some of the challenges returnees usually encounter in the home country. Social implications – This paper makes reasonable recommendations regarding how return migration of Ghanaian health professionals might be smoother. Originality/value – The study brings to the fore, the necessity for the government to plan for health professionals, who returned to Ghana to contribute to the health system. [ABSTRACT FROM AUTHOR]

Purpose – This study seeks to undertake a systematic review to consolidate existing empirical evidence on the impact of financial and non-financial incentives on motivation and retention of health workers in Ghana's district hospitals. Design/methodology/approach – The study employed a purely quantitative design with a sample of 285 health workers from ten district hospitals in four regions of Ghana. A stepwise regression model was used in the analysis. Findings – The study found that financial incentives significantly influence motivation and intention to remain in the district hospital. Further, of the four factor model of the non-financial incentives, only three (leadership skill and supervision, opportunities for continuing professional development and availability of infrastructure and resources) were predictors of motivation and retention. Research limitations/implications – A major limitation of the study is that the sample of health workers was biased towards nurses (n=160; 56.1 percent). This is explained by their large presence in remote districts in Ghana. A qualitative approach could enrich the findings by bringing out the many complex views of health workers regarding issues of motivation and retention, since quantitative studies are better applied to establish causal relationships. Originality/value – The findings suggest that appropriate legislations backing salary supplements, commitment-based bonus payments with a set of internal regulations and leadership with sound managerial qualities are required to pursue workforce retention in district hospitals. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to examine empirically the ways in which workforce knowledge and organisational factors of an implementing agency affected the implementation of health sector administration decentralisation in Ghana with insights from the Nkwanta district health administration. Design/methodology/approach – This is a qualitative study using data from individual and group interviews through purposive selection of health officials, who were directly involved in the work of actual implementation of the programme. Specifically, participants included senior management, middle management and junior workers, who had worked at least for the past three months in the district. Findings – The study found that most of the interviewees involved in the implementation process are knowledgeable of the objectives of the decentralisation process. Also, major factors that are militating against effective decentralisation in the district include inadequate funds, lack of qualified personnel, inadequate logistics and equipment, poor interpersonal relationships, lack of transparency and a good operational system, lack of incentives to motivate the staff, political interference, poor infrastructure and high rate of illiteracy. Originality/value – The findings of this study will help improve the implementation of decentralisation within the health sector in Ghana. The paper provides recommendations, which, if considered for implementation, will help improve the decentralisation process. [ABSTRACT FROM AUTHOR]