Exploring multiple job holding practices of academics in public health training institutions from three sub-Saharan Africa countries: drivers, impact, and regulation

Abstract

Background: The paper examines external multiple job holding practices in public health training institutions based in prominent public universities in three sub-Saharan Africa countries (Rwanda, Ethiopia, Mozambique). Objective: The study aims to contribute to broadening understanding about multiple job holding (nature and scale, drivers and reasons, impact, and efforts to regulate) in public health training schools in public universities. Methods: A qualitative multiple case study approach was used. Data were collected through document reviews and in-depth interviews with 18 key informants. Data were then triangulated and analyzed thematically. Results: External multiple job holding practices among faculty of the three public health training institutions were widely prevalent. Different factors at individual, institutional, and national levels were reported to underlie and mediate the practice. While it evidently contributes to increasing income of academics, which many described as enabling their continuing employment in the public sector, many pointed to the negative effects as well. Similarities were found regarding the nature and drivers of the practice across the institutions, but differences exist with respect to mechanisms for and extent of regulation. Regulatory mechanisms were often not clear or enforced, and academics are often left to self-regulate their engagement. Lack of regulation has been cited as allowing excessive engagement in multiple job holding practice among academics at the expense of their core institutional responsibility. This could further weaken institutional capacity and performance, and quality of training and support to students. Conclusion: The research describes the complexity of external multiple job holding practice, which is characterized by a cluster of drivers, multiple processes and actors, and lack of consensus about its implication for individual and institutional capacity. In the absence of a strong accountability mechanism, the practice could perpetuate and aggravate the fledgling capacity of public health training institutions.

Determinants of effective organizational capacity training: lessons from a training programme on health workforce development with participants from three African Countries

“…The narratives further show that while participation in the training was reported to improve staff contribution in most instances, the study suggests that training also has the unintended consequence of increasing turnover due to the marketability of newly acquired competencies and leads to capacity loss, as identified in several studies (55,57,58). An exploratory study in four eastern African countries focusing on competency gaps in health workforce management found, for example, that the health ministries of these countries fared poorly compared to the private and non-profit sectors in putting retention strategies in place (59).…”

Determinants of effective organisational capacity training: lessons from a training programme on health workforce development with participants from three African Countries

“…Individuals in comparable situations/positions/background, end up making varying decisions as to whether they stay or leave, due to the multiple intersecting factors. In three cases participants had the opportunity to augment their income through their engagement in external multiple job holding practices, thus keeping them in their posts but creating other consequences impacting on organisational capacity (25,55,56).…”

Mediators of effective organizational capacity training: lessons from a training programme on health workforce development with participants from three African Countries

“…Individuals in comparable situations/positions/background, end up making varying decisions as to whether they stay or leave, due to the multiple intersecting factors. In some cases participants had the opportunity to augment their income through their engagement in external multiple job holding practices, thus keeping them in their posts but creating other consequences impacting on organisational capacity (25,55,56).…”