Neil thank you for sharing Goran's post. And you asked, 'What is the role of quality improvement approaches in situations where basis needs cannot be met? Can they be tackled together?' .
Well Goran is right absenteeism (and if I may add, bad attitude and behaviour, truancy, work-to-rule, full strike, etc often are consequences of poor governance and lack of staff motivation and incentives often so common in LMICs, unfortunately.)
But to your question, that is why we introduced the 12-Pillar Clinical Governance programme and defined it as, 'Protecting patients, supporting practitioners in tandem'.
Extensive advocacy, education on a continuous and systematic manner 'converts' the politicians, policy makers and all stakeholders who control the resources that make implementation possible.
Satisfied and motivated workers do not play absenteeism and truancy. If they do the management have the sanctions anyway.
AFRICA CENTRE FOR CLINICAL GOVERNANCE RESEARCH & PATIENT SAFETY
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HIFA profile: Joseph Ana is the Lead Consultant and Trainer at the Africa Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria. In 2015 he won the NMA Award of Excellence for establishing 12-Pillar Clinical Governance, Quality and Safety initiative in Nigeria. He has been the pioneer Chairman of the Nigerian Medical Association (NMA) National Committee on Clinical Governance and Research since 2012. He is also Chairman of the Quality & Performance subcommittee of the Technical Working Group for the implementation of the Nigeria Health Act. He is a pioneer Trustee-Director of the NMF (Nigerian Medical Forum) which took the BMJ to West Africa in 1995. He is particularly interested in strengthening health systems for quality and safety in LMICs. He has written Five books on the 12-Pillar Clinical Governance for LMICs, including a TOOLS for Implementation. He established the Department of Clinical Governance, Servicom & e-health in the Cross River State Ministry of Health, Nigeria in 2007. Website: www.hriwestafrica.com Joseph is a member of the HIFA Steering Group and the HIFA working group on Community Health Workers.
Email: jneana AT yahoo.co.uk