Theses (PhD)

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Browsing Theses (PhD) by Subject "Reward management"

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    The role of human resource management practices in the migration of medical doctors in developing countries: The case of Tanzania
    (University of Agder 181, 2018) Ndikumana, David Emmanuel
    This study is part of a Doctoral research within the International Management PhD Programme offered at the University of Agder, Norway. Data were collected in two hospitals in Tanzania (a small hospital in a distant rural area and a bigger hospital in a city setting.) between July 2008 and August 2009 following a one-year course work. The study sought to explain the factors that influence the decision and choices of medical doctors to stay in Tanzania hospitals or leave to work outside the country. An underlying issue is to explain the role of HRM policies and practices in employee retention. Exploring a little known phenomenon like the dynamics of migration decisions to stay or leave in a developing country context like Tanzania merit adoption of an inductive approach to unearth lived experiences of the participants. Cognisant of the multi dimensional nature of the mobility of talent across countries, this study attempts to distil tenents from HRM, human capital, social capital, social exchange and organizational support theories through the the Psychological contract, Dual factor theory and meaning seeking lenses to identify and explain the factors that are potential levers for improving our understanding of the migration decision making process in a less developed country context. It transpires from the study that leadership style, duties to family and society, trusting relationships and opportunities for building professional competence overshadowed factors such as income. The insights indicate that a person’s work values increases job satisfaction irrespective of displeasure experiences in the work environment. While past studies attributed migration to be largely driven by economic rewards, this study revealed that the tendency to migrate is modified by doctors having a strong sense of duty and it may be reversed with good leadership practices such as employee recognition even in the wake of limited wages and scarce resources. Collegial recognition, supportive team work and respect and fulfillment of career expectations, cultural values in terms of duty to extended family and nuclear family appear to have considerable influence on employee retention. It emerges that there is synergy between the literatures of IHRM and careers in less developed countries with limited technological capabilities required to enhance professional skills atypical of health specialties. These insights underpin the ethos of global management literature. The findings illustrate the extent to medical doctors’ resort to dual practice, the motives for doing so, and the outcome of this engagement which had hitherto been under studied in Tanzania. This study integrates spirituality and retention literature and vindicates their relationship with employee motivation and commitment to stay in an organization. It brings to the fore the role of spiritual/religious values in enhancing employee motivation and commitment. It underscores the fact that spirituality in the work place may enhance employee loyalty and commitment to provide physical and spiritual services to the patients. The role of spirituality and religion in the work place and in the management literature is a relatively new area of inquiry with regard to developing countries. In spite of the fact that religious diversity has been accommodated in work places through fair recruitment policies in the public sector, the influence of moral satisfaction in employee retention noted in hospital B has been largely under theorized in western HRM literature. Loss of human capital through migration of highly skilled professionals like medical doctors and associated loss of investment in health and education in a resource limited developing country like Tanzania is a significant obstacle to improving the health system in the wake of development challenges such as high population growth and increased burden of diseases. This make Tanzania to be a good research setting to unravel the root causes of the mobility of talent outside the country. This knowledge can facilitate design of appropriate strategies to attract and retain skilled human resources.