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Hospital and health system managers are facing several problems following the introduction of Ghana's national health insurance policy. This study aims to investigate the opinions of health managers about the problems emanating from the national health insurance policy for hospital managers in regard to reimbursement, claims management, service delivery and waiting time.

The study involved key informants from 12 National Health Insurance Scheme (NHIS) accredited district hospitals, which were purposively selected from five regions in Ghana. Data were collected using in‐depth personal interviews with managers of pharmacy, supply/procurement, accounts and insurance scheme units of the hospitals. Data analysis was guided by the major themes that emerged during the interviews. A framework approach to analysis was used, grouping and incorporating themes and sub‐themes that emerged from the interview data.

The major findings identified by interviewees with regards to problems confronting hospital management were: cash flow delays from the health insurance authority; lack of capacity to procure essential drug and non‐drug consumables; and the inability to take initiatives and carry on effective administrative work. Other problems identified by the interviewee included inadequate logistics and human resources, limited space within the hospitals to cope with the increasing number of service users and “moral hazard” on the part of policy holders.

The NHIS has brought many organizational and service management challenges to hospitals. To overcome these challenges, services under the health insurance authority need to be streamlined to remove cash flow bottlenecks. Also, accredited hospitals need to adopt and use new technology, especially computerization and automation of the health insurance service delivery system. This would enable the authority to cope with the huge management problems confronting hospitals and the national insurance scheme. Above all, appropriate fund management systems would have to be established in the hospitals to reduce moral hazards.

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.

A qualitative exploratory case study approach was employed in the study. Data gathered were analysed using the sequential model of qualitative content analysis.

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.

This paper makes reasonable recommendations regarding how return migration of Ghanaian health professionals might be smoother.

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.

This paper investigates whether financial sector development promotes economic globalization (EG) using data from 45 African countries.

Using panel data of the selected African countries, the two-step system generalized method of moments estimation technique which is capable of solving any possible endogeneity problem is employed for the empirical analysis.

The main finding is that all measures of financial sector development have a significant positive impact on EG in Africa. The results suggest that improving the financial sector development in a holistic manner is key in fostering EG in Africa.

This present paper uses broader measures of EG and financial sector development. Using broader measures of these variables widens the policy scope in terms of policy adoption and implementation.

This paper aims to examine lecturers' experiences of moonlighting in the Ghana Institute of Management and Public Administration (GIMPA).

A qualitative approach was used. Data were collected through in-depth semi-structured interviews with 18 purposively selected informants. Data were transcribed and analyzed thematically.

The findings are that moonlighting is common at GIMPA, and the institutional environment is conducive for the practice. Knowledge of the practice is unclear. However, moonlighting serves as a source of additional income for lecturers, which a significant majority describe as enabling their continuing employment at GIMPA, but many pointed out the negative effects as well. Lack of a policy to control the behavior has been cited as a reason for the problem, which left lecturers to self-determine what to do. Moonlighting practice is affecting the quality of teaching and support to students by the lecturers.

The sample of the respondents who participated in the study is small and limited to 18. Their views cannot be generalized to all higher education institutions. But, the results show the seriousness of the problem and its implications.

Moonlighting is prevalent in GIMPA. It suggests that employees of other public higher education institutions are no immune to it.

This study is the first of its kind to explore the practice of moonlighting in a quasi-public higher education institution in Ghana. It has added to the empirical literature on the practice and the effects on the institution.

The purpose of this paper is to examine the barriers to the implementation of management decentralisation of health services and programmes at district level in Ghana.

Data for the study were collected through a qualitative technique in the Sekyere West district.

The findings are: transfer of authority for management decision making and planning was rarely operational at district level; and control over financial and personnel decisions remained centralised. The paper identified lack of staff capacity, lack of commitment and inter‐organisational conflict between health managers and local government officials as factors obstructing the implementation of management decentralisation in the district.

The lesson from the study is that the implementation of health care management decentralisation at district level has stalled because of the combined effect of internal and external constraints. The paper suggests that given the enormity of the problem of paucity of capacity to undertake new service management responsibilities, the process of transferring responsibilities, resources and control to lower level health managements should be gradual and incremental; the sequencing of reform too should be such that district health officers and stakeholders are given adequate training prior to the inauguration of new management reform.

A few decades ago, most research works on internationalisation were aligned to studies in developed economies. In recent times, business entrepreneurs in developing and emerging economies have shown their potential to permeate international markets. The current capability of business entrepreneurs in developing and emerging economies, which drives their ability to overcome the numerous barriers to internationalisation, particularly within clusters, requires a critical examination. As a result, the study situates the discussion on internationalisation within the theory of agglomeration in developing and emerging economies and argues that the gains enjoyed by business entrepreneurs from operating in close proximity in clusters are critical for overcoming the barriers of internationalisation. This research adopts a systematic review of secondary data to tease out the unique attributes of clusters in developing and emerging economies, which supports the internationalisation drive. The findings show that most emerging economy clusters are engaged in exports but there is minimal work on international entrepreneurs operating within clusters. The unique features that drive exporting clusters are the presence of multinational companies, public agencies and collaborative relationships. These unique features have the capacity to minimise the constraints to internationalisation and determine the export performance of businesses in the cluster.

This study explores the critical success factors (CSFs) in humanitarian supply chain management (HSCM) by focussing on flood disaster management (FDM) in Ghana.

An in-depth semi-structured interview and questionnaire surveys in a sequential data collection approach were used to collect data from definitive stakeholders of humanitarian organisations. The data was analysed using exploratory factor analysis (EFA), confirmatory factors analysis (CFA) and structural equation modelling (SEM) techniques.

Seventy-four factors were identified as success factors of HSCM of flood disaster management. However, 41 of these factors were statistically significant and considered as critical. In descending order, these factors relate to management practices, education and training, stakeholder involvement and cooperation, infrastructure, innovation and technology, materials and resources, administrative practices, socio-cultural and economic. Whilst some factors are internal to the humanitarian organisations, others are external factors that are beyond the control of humanitarian organisations.

Even though this study offers empirical results that could guide policymakers in their decision-making about humanitarian operations, care needs to be taken since the data is within one country and within a specific disaster context – hence, policymakers need to consider the local contextual dynamics. Future studies could look at different disasters context to make a comparative analysis of various types of disaster operations.

Institutions such as World Health Organization, Red Cross organisations and UN seeking to curbs global-warming-related disasters and the reduction of the effects of flood disaster can use findings as a guide during the formulation of HSCM policies and strategies.

Unlike previous studies of humanitarian operations that focussed extensively on theoretical expositions, simulations, conceptual frameworks and models, this present study offers empirical evidence of humanitarian operations in the context of SCM. Further, by highlighting on the HSCM CSFs, this study contributes to disaster reduction and their effects on humanity in the context of FDM. This research could be used as guide by governments and FDM organisations to make informed decisions on SCM areas to focus the most during FDM.

The Ghanaian insurance industry has been transformed significantly from state-led to a market-driven one over the past decades. The empirical literature on the causal relationship between insurance and economic growth has been mixed, but little study on this has been done in Ghana. This study therefore empirically examines the effect of the growing insurance industry on the economic growth in Ghana.

Quantitative research design was deployed in the study. The study used Johansen–Juselius cointegration test and vector error correction model. The study deployed quarterly data from the first quarter of 2006 to the second quarter of 2018 sourced from the World Bank (World Development Indicators), National Insurance Commission, Ghana Statistical Service and Bank of Ghana.

Findings revealed that there is a significant and positive short and long-run relationship between insurance and economic growth in Ghana, bidirectional causality between insurance and economic growth and also a long-run effect of innovations (shocks) in insurance on economic growth.

One of the limitations of the study is the unavailability of quarterly data of some of the variables.

The study recommends the development and implementation of policies that promote an increase in coverage and access to insurance products to enhance economic growth.

The study finds a bidirectional causality running from insurance premium to economic growth and from economic growth to insurance which is consistent with the feedback hypothesis in the case of Ghana. Impulse response functions and the variance decompositions revealed that innovation (shock) in the insurance industry has a positive impact on economic growth.

In spite of the observation that nurse managers’ style of authority in sub-Saharan Africa is one of antagonistic vibe and lordship, there is not much information on the kind of leadership provided in the hospitals by nurse managers. Following the notion that transformational leadership is a solution to many leadership problems and often creates valuable positive change in followers, this study aims to examine the level of transformational leadership behavior of nurse leaders; determining the effects of the sub-constructs of emotional intelligence (EI) on the transformational leadership behavior of leaders; and determining whether there is a difference in the exhibition of transformational leadership behavior due to the gender of leaders.

The study uses five of the major public hospitals in the Greater Accra Region (the capital) of Ghana. Evidence of such links would be considerable for Ghanaian healthcare providers in their quest to find potential nurse leaders to train, so as not to dwell highly on the seniority criterion in the selection of leaders. Using a quantitative approach, the Wong Law EI Scale (2002) and leadership items adapted from Rafferty and Griffin (2004) were used to collect the data. A descriptive statistics (mean) revealed that nurse leaders from the selected hospitals exhibited a high level (M= 3.90, SD = 0.14) of transformational leadership behavior.

A multiple regression analysis revealed that three of the sub-constructs of EI significantly affected transformational leadership with the “self-emotion appraisal” construct having the strongest effect on transformational leadership behavior (β = 0.508, p = 0.000). However, the others’ emotion appraisal sub-construct did not significantly affect transformational leadership. Furthermore, the results from the independent sample t-test revealed no significant difference in the exhibition of transformational leadership due to gender.

Based on the findings, when leaders are trained to be emotionally intelligent and their skills are fostered, they are more likely to exhibit transformational leadership behaviors, which will further result in organizational effectiveness and follower satisfaction. Hospitals must focus on the control of one’s emotions at work, and subsequently, understanding others’ emotions. In developing transformational leaders, there is the need to identify some tools that will increase EI level, more specifically, traits related to the understanding of others’ emotion. The findings from this study indicate that one of the factors to check when selecting nurse leaders should be their EI and not necessarily a matter of seniority in many cases in emerging economies.

The originality of this study is in the fact that it focuses on an emerging economy, which is under researched. In Ghana, the criteria for promotion of nurse leaders’ is based strictly on seniority and age and not on factors such as the leaders EI. The profession of nursing is such that leaders need to understand that certain soft skills such as EI are considered necessary to transform the hospitals and staff they lead. This study, therefore, sheds light on these key areas from the perspective of an emerging economy, which are usually not in the domain of literature in the area of healthcare leadership.

This study examined the influence of income and health insurance on the health-seeking behaviour of rural residents, addressing the concerns of endogeneity and heterogeneity bias.

A two-stage residual inclusion was utilised to correct self-selection-based endogeneity problems arising from health insurance membership.

This study provides support for Andersen's behavioural model (ABM). Income and health insurance positively stimulate rural residents' use of modern healthcare services, but the effect of insurance risks a downward bias if treated as exogenous. Further, the effect of health insurance differs between males and females and between adults and the elderly.

This study advances the literature, arguing that, within the ABM framework, enabling (i.e. income and insurance) and predisposing factors (i.e. age and gender) complement each other in explaining rural residents' use of modern health services.

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-03-2023-0223