The Issue Of Reflection Education Essay

Contemplation as defined by the Oxford English lexicon ( 1993 ) means ‘idea originating in the head ‘ and head means ‘seat of consciousness, thought, will, and experiencing ‘ . It seems therefore that contemplation, in an every twenty-four hours term is about believing that involves will and feeling, therefore contemplation is really personal as we are all alone persons. So, if contemplation is believing why are we being assessed on it, and how can it be assessed as certainly we all think otherwise. Are brooding model theoretical accounts, an assistance to assist me believe or an assistance to assist the assessor ‘s buttockss me? Am I being misanthropic or is cynicism accurate observation? Have we bury how to believe? Are we populating in an age where the gait of life is so fast that people do n't hold clip to believe any more? Is that why contemplation is now being incorporated into course of studies or is it to heighten acquisition and the forming of constructs and connexions? Is it to do me gain what my ain thoughts are, and which are person else ‘s? Or is it as King and Kitchener ( 1994 cited Moon 2001, p.8 ) propose to dispute my acquisition and thereby better my cognitive ability? At first I thought that contemplation was a complicated issue, but so I learnt that it was about thought. When I foremost received this assignment I ‘thought ‘ that I would truly bask it, as I would be able to be originative but whilst reflecting during the action of roll uping my portfolio, and researching for my brooding essay, I have become resentful, non because I am immune to alter but because I feel that it is intrusive and a small patronising to give me person else ‘s theoretical account or formula of how to believe. It seems that Moon ( 2001, p.16 ) would hold with me as she suggests Are pupils told to reflect when really they will merely follow a formula ( e.g. set inquiries ; rigorous attachment to the Kolb rhythm ( Kolb, 1984 ) ) ? Make pupils have their contemplations as kids own their drama? From my personal experience I would implore to differ as when I used the brooding theoretical account of Price ( 2002 ) to reflect upon my unit A assignments I found it smothering and found myself over-inflating my beliefs of segregation so that I would hold something to compose about in that portion of the model. Bolton ( 1998 ) would propose that my defensive attitude is ‘a get bying scheme ‘ and that I am defying ‘change and development ‘ . Whereas Lifton ( 1961 cited Atherton 2003 ) describes the procedure of idea reform as ‘brainwashing ‘ . For me these theoretical accounts are common sense and hence I have been resentful towards them. During one of our lessons we were given a sheet of paper with brooding theoretical accounts on it and asked to take one to reflect upon our presentation. Personally, I had already reflected upon my presentation briefly instantly after I had finished it, so once more in more deepness in my auto on the manner place and so once more in even more deepness when I discussed it with my hubby, read all the presentation press releases, and compared my presentation with everyone else ‘s. Therefore personally I do n't experience that I learnt anything by utilizing Price ‘s ( 2002 ) reflective model theoretical account. However I have since learnt upon reflecting on my acquisition manner that the bulk of my acquisition features are that of the ‘dreamer ‘ ( Cottrell 2003, p.63 ) . One of the strengths of the ‘dreamer ‘ is to reflect and measure good. Therefore I can appreciate that Price ‘s ( 2002 ) reflective model theoretical account may be more good to possibly, the leaner with ‘logician ‘ features as Cottrell ( 2003, p.63 ) proposes that their learning country to be developed is ‘personal contemplation ‘ . However I do non experience that pupils can be pigeon-holed into certain learning types, although I must acknowledge that most of my features were spot on with Cottrell ‘s ( 2003 ) dreamer larning manner. It would look that contemplation has been good to me after all, as it has made me cognizant of my learning manner or manners and made me gain that the usage of brooding models are smothering for me, hence I have thought approximately, ‘reflected upon ‘ and learnt something from ‘the experience ‘ . It seems that my learning experience is related to Boud et Al ‘s ( 1985 ) defini tion of contemplation as they defines it as A generic term for those rational and effectual activities in which persons engage to research their experiences in order to take to a new apprehension and grasp ( Draper 1999 ) . It seems that Boud et al view contemplation from the scholar ‘s point of position, underscoring the relationship of the brooding procedure and the learning experience. For illustration I have learnt from the experience of utilizing brooding model theoretical accounts that I find them smothering. Whereas Dewey ( 1993 ) defines contemplation as An active persistent and careful consideration of any belief or supposed signifier of cognition in the visible radiation of the evidences that support it and the farther decision to which it tends ( Draper 1999 ) . Dewey positions contemplation as experiential acquisition and that each experience influences future experiences. For illustration Dewey may hold that from the racial bias that I discussed in subdivision two that I take this experience with me to future experiences. For illustration through seeing some of the black citizens of Africa deformed via non being inoculated against infantile paralysis I have non hesitated to inoculate my kids against diseases such as infantile paralysis, epidemic parotitiss, rubeolas and German measles. Therefore a past experience can inform a present experience, such as whether I should let my adolescents to be inoculated against meningitis. Sch & A ; ouml ; n ( 1993, 1987 cited Moon 2001, p. 3 ) focal points on contemplation in professional cognition and its development. He has identified two types of contemplation. These are ‘reflection in action ‘ and ‘reflection on action ‘ . Sch & A ; ouml ; n proposes that these types of contemplations are used in alone state of affairss, where the practician is unable to use ‘theories or techniques antecedently learnt through formal instruction ‘ ( Moon 2001, p.4 ) . It would therefore look that ‘reflection in action ‘ and ‘reflection on action ‘ are extremely good to the attention and educational industries as practicians are working with persons who are more frequently than non, text book illustrations. Reflection is a cardinal portion of my child care pattern as I work with kids and households who are persons with alone qualities. This means that every clip I do an activity I may necessitate to make it otherwise as I w ill necessitate to see the person demands of the child/children and that of their parents. For illustration, if you were a mill worker and you packed bars your contemplation in action would n't take as long, because you would be working with inanimate objects. Therefore your contemplations may be more matter-of-fact whereas in my occupation I am covering with babies, yearlings, kids and grownups, hence my contemplations are changeless and are more likely to be based upon emotions, as I am working with persons who have emotions excessively. As the chief ethos of my pattern is to handle each kid and household member as persons, I therefore reflect ‘in action ‘ throughout my on the job twenty-four hours and reflect ‘on action ‘ , sometimes instantly after an action, and sometimes subsequently in the eventide. For illustration when a parent arrives they may inform me of the feverish weekend that they have had. This information that I am provided with affects my contemplation in action. For illustration if I have been informed that a kid is likely to be really tired today and I have planned a feverish twenty-four hours, I would be believing on my toes and accommodate the yearss activities to suit a slumber in for that kid. It would look that contemplation is a paradox as there are many different significances and types of contemplation, the above being merely a few. What is evident though is that contemplation is really complicated which is dry sing that thought is really easy. Possibly so it is non the procedure of contemplation that is difficult, ‘the thought ‘ but, it is covering with the emotions that reflection brings. Possibly I am being assessed on my contemplation abilities as they are of import to my holistic personal, instruction and pattern development. Possibly my cynicism in the debut is healthy as, No adult male who worships instruction has got the best out of instruction†¦ Without a soft disdain for instruction no adult male ‘s instruction is complete.Gilbert K. ChestertonI surely feel that I have got my initial disdain for contemplation out of my system as I have realised that contemplation has helped me do connexions such as the nexus between my learning manner and seting the practical authorship of assignments off for every bit long as possible. Contemplation has as King and Kitchener proposed ‘improved my cognitive ability ‘ , as I now have a better apprehension of contemplation and myself. I besides feel that pupils do have their contemplations as they own their yesteryear experiences which they draw upon during contemplation. Personally I do non like brooding model theoretical accounts but I appreciate that they can be really good for pupils who find contemplation hard.

Hsbc Strategy Essay

Proposal on HSBC’s strategic shift with the organization based growth model (410 words, 2011). Research topic: How HSBC’s changed its strategic direction using organization-driven growth model to achieve long-term economic and strategic success. Rationale and literature review The long-term economic success of an organization is dynamically associated with the organization’s ability to create new modes of production (Chandler 1990). A number of factors influence an organization’s ability to grow and achieve strategic success in today’s era of globalization. These are: * The dynamic processes that govern an organization’s operations are not uniform but diverse across different parts of the world (Martin & Verdier 2008). * Organization’s changes and the dynamic process that influence do not necessarily have a consistently progressive development phase. i. e they go through a phase of high-development and low-development (Martin & Verdier 2008). Organizations, like HSBC, who have recognized this, have invested resources to evolve their economic development over time. HSBC developed their organizational-driven growth model to successfully create a model for long-term sustainability, growth and profitability. The model is shown below: Figure: The HSBC organizational-growth model (Image source: Deans & Kroeger 2004) HSBC was founded by Thomas Sutherland in 1865 in Hong Kong and for many years was a small-sized bank that operated in Asia (Ahlstrom & Bruton 2009). In the 1980’s, the management developed the organizational growth-model to address the need for HSBC to become global and diversify in the long-term. This model led to the development of the ‘HSBC character’, which is the cornerstone of HSBC’s growth strategy today (Deans & Kroeger 2004). By implementing this model effectively across all areas of HSBC holdings, HSBC was able add scale to its business such as insurance, leasing and fund management and be cautious and thrifty while using their international experience to acquire or merge with a myriad of businesses (Syrett 2007). Using the model, training systems for employees were put in place that encouraged a growth culture within the organization (Syrett2007).

Unit 8 Assignment Example | Topics and Well Written Essays - 250 words

Unit 8 - Assignment Example al substance invites us to think deeply and conclude that ideas built by means of someone’s sense, memory and imagination are the only tools to create the presence of a material substance. By studying the arguments of Berkeley, one learns to incorporate the ideas of different senses to perceive the various objects, substances and materials. In short, Berkeley’s vision highlights the mind along with ideas and offsets the Newton’s absolute space and time. The time becomes merely a succession of ideas in individual’s mind, and the space is reduced to an extension perceived by senses. (Fogelin, 2001) Berkeley’s arguments positively relate with Phillonous who disagrees with majority of the philosophers to believe in the existence of matter. He like Berkeley emphasizes strongly upon mind and argues that every thing in this world depends upon mind. Hylas, who was the student of Phillonous believes in the matter. He states that all the worldly experiences of life remain unexplained without the existence of matter. This philosophy of Hylas does not resemble with that of Berkeley. Because Berkeley seems to stick on his famous principle, â€Å"Esse est percipi† (â€Å"to be is to be perceived†). Berkeley stated in his books that spirit itself cannot be perceived but can be perceived by its own effect. Similarly Locke states that one has a relative idea of substances in

The Family of Average Socio-Class Assignment Example | Topics and Well Written Essays - 1250 words

The Family of Average Socio-Class - Assignment Example He is not the only child and has one sister and two brothers.   He goes to a school within the metropolis where he neither has sufficient friends nor performs substantially in class. His colleagues cannot easily understand him; he leaves the school immediately after the children are let free and do not entertain any friendship. Brian keeps to himself, this illustrates that he is a depressed child contrary to his upbringing. The only person who interests him is Sophia. She is a humble girl, just as Brian. Two men dressed in black immediately jump out of the car that has its engine running and they gang his mother. They shove her ruthlessly into the trunk of the van; the street is full of people. Brian believes that at least anybody could have seen what had just taken place; unfortunately, no one comes for help. He is left alone and proceeds home in anticipation of telling his father what had just happened only to arrive and find no one there. After a few days, they are able to have their mother back with the help of the FBI. Brian and Sophia grow up together. Their friendship ends up being loved and people make fun of their childhood love. However, they are hardly intimidated by such talks. They end up joining the same college. Brian and Sophia planned for months about their wedding. Although they have been high school sweethearts and had been together for years, their excitement about their relationship never faded. All classmates knew that their love was genuine. Sophia’s parents were well up than those of Brian; they bought her a vehicle as a birthday present. Every morning, she would go picking the love of his life as they head to school. Weekends were their best moments; they went out for ice cream and have time to nurture their love and marriage. It seemed like a dream if not a joke, as the classmates’ gossiped saying that this was stupid of you.  

The Trafficking of Illicit Drugs Essay Example | Topics and Well Written Essays - 3250 words

The Trafficking of Illicit Drugs - Essay Example In order to halt the burgeoning economic, safety, and health issues related to these illicit substances, policymakers must address many issues including creating community-based prevention programs for youth and allocating funds for better access to drug rehabilitation programs (National Drug Control Strategy, 2011). Background In Alaska, drug use, and distribution is a massive problem and burden that affects the individual, communities, and the entire state. Illicit drug use is higher among Alaska natives than any other ethnic group (Young & Joe, 2009). In addition, Alaska natives have the greatest rates of use for marijuana, cocaine, inhalants, hallucinogens, and nonmedical use of psychotherapeutics (Young & Joe, 2009). According to the National Drug Control Strategy (2011) budget summary for the last fiscal year, the hindrance of drug use and its consequences contributes approximately $32 billion dollars in medical costs per year. Social Factors The entire United States is affecte d by illicit substance abuse. The impact of losing a loved one due to an overdose of illegal drug use is a paramount issue that cannot be qualified by any outside source. The youth of our nation is affected as well as their families. The National Youth Behavior Risk Survey (2011) for the years of 2009 – 2011 indicates that students in high school grades nine through twelve reported either an increase in incidence or no change for marijuana, cocaine, inhalants, heroin, and/or methamphetamine use (Centers for Disease Control and Prevention [CDC], 2011). Citizens of the entire nation are also affected by the crime that is created by means to obtain illicit substances; an average of 71% of males arrested in 10 metropolitan areas in 2011 tested positive for an illegal substance at the time they were taken into custody (Tombak, 2012). Economic Factors The problem of the use of illicit drugs in the United States and the trafficking of illegal drugs cost the nation billions of dollar s each year. Densely (2010) notes that the United States losses as much as $110bn on illicit drugs alone for each year. This loss comes about through a lot of avenues. In the first place, millions of dollars are spent on control and prevention programs that aim at ensuring that people in the country do not fall prey to a very dangerous act of dealing with or using illicit drugs. The control and prevention programs take several forms including strategic campaigns and law enforcement programs. Because there are specially designated agencies who are supposed to be responsible for the control and prevention of illicit drug use, special allocations are made for them in each year’s budget and this is the source of the huge cost involved (Weiler, 2004). Apart from the cost of control and prevention programs, huge liability is incurred by the nation through the cost of managing affected persons who have suffered the consequences of illicit drug use (Davis-Floyd, 2001). This is becaus e special budgetary allocation is provided for people in rehabilitation homes and other healthcare facilities who receive treatment for various forms of illicit drug use side effects. What is most disturbing is that because such people are often neglected by their families, the government is always forced to bear all the cost and this possesses a serious economic challenge for the nation.

Gender sexuality and law seminar Essay Example | Topics and Well Written Essays - 1500 words

Gender sexuality and law seminar - Essay Example Non-British people who happened to be in Britain assumed a rebellious attitude and harboured notions of giving it back to the English what they had learnt in terms of equal rights, prerogatives and position in society. This is reflected to this day in modern British society as remnants of the populations who had migrated to Britain in the post colonial era continue to maintain their distinct identities and regional preferences. Although hobnobbing with on equal terms with native English, their resentment and defiance shows its colours from time to time. The author has specifically implied that historical events have a definite impact on the emergence of collective identities in human populations. According to him, the late modern democracy as an entity has emerged out of ‘selected contradictory operations of politicized identity’ (Wilson, pg. 54). Forces of global capitalism and the disciplinary-bureaucratic regimes typical of the colonial period have shaped the politica l identities of people living in the modern world. Quote 2: â€Å"The tension between particularistic ‘I’ and a universal ‘we’ in liberalism is sustainable as long as the constituent terms of the ‘I’ remain unpoliticised....† (Wilson, Pg. ... The perception of ‘I’ imparts s degree of individualism despite remaining part of the mainstream society. This prevents the formation of a politicized identity. The author has specifically illustrated this by giving examples of homosexuals and Jews, as they exist in modern society. While remaining part of the society, both these identities continue to be characterized into a specialist category due to the peculiarities of their identified characteristics. The possibility of existence of democracy has been facilitated in liberalism only due to the fact that what is considered as universal does not have either a body or content i.e. it is an abstract entity. The author believes that social identities are established in modern liberalist democratic societies through the action of liberalism’s companion powers which he names as ‘capitalism and disciplinarity’, originally identified by Marx and Focault (pg. 57). Capitalism’s endeavours in the modern society produce desires in individuals which emerge as identities and disciplinary forces regulate subjects into behaviour-based identities which are recognizable in society. The exemplary examples of such identities provided by the author are those of ‘alcoholic professionals’ and ‘crack mother’ and many more categories can be visualised under this lens. Quote 3: â€Å"Within lesbian and gay rights movements, few, if any, people believe that winning human rights will achieve equality, much less liberation (Herman, pg. 33)†: The author, in his argument entitled ‘Beyond the Rights Debate’ contends that legal academicians’ have diagrammatically opposing inferences on what are considered as ‘rights’ in

What finding meaning in life is for you Essay Example | Topics and Well Written Essays - 500 words

What finding meaning in life is for you - Essay Example As we transition from childhood to adulthood, our experiences and mental capacities steer us in different directions. For example, in a school with 200 students who go through the same syllabus and share the same experiences, not all of them end up in similar careers. Some will find fulfillment in music, others will be inclined to pursue art, while some will end up settling in politics. In all the students, however, the common denominator is the fact that each of them sees their futures in different areas (Zimmerman 34). Individuals gravitate towards different things when seeking meaning in life, and this is what lead to fulfillment in different aspects. Meaning in life changes over time, but it can also be rigid. Again, this comes back to individual preferences and character. For example, at some point (e.g., in college) some people seek professional prosperity over other issues. However, once they attained this they start leaning towards other interests that they think are just as important in life. For example, a senior student in college may think, for a long time that getting a good job is the essence of life (Zimmerman 49). However, after building a successful career, the student may discover that having a family is the most important thing in life. As such, the career becomes secondary to family life. Other individuals may discover a newfound passion for business and community service, and then consider this to be the basis for their lives, relegating previous meanings to minor roles. The essence of a human being is to understand oneself and becoming self-actualized. This is part of finding meaning in life and that is what separates humans from animals. Human beings need to become aware of their surroundings, their priorities, and their trajectories (Zimmerman 83). In general, people who can be classified as having no meaning in life are often less

Report on Information System Analysis and Development - Comic Library Coursework

Report on Information System Analysis and Development - Comic Library - Coursework Example The content of this paper aims to describe the process of analysing and designing the system. These processes also entail the planning of the project development cycle and the management criteria utilized in achieving the project. Economic development within a business means there is an increase in demand for services therefore there is the need for increased and service delivery to always ensure the clients or customers are satisfied by the products. This project report aims to highlight on the challengers of using the current comic library system and subsequently propose new concepts of improving the current system operation to ensuring and increase customer satisfaction. The proposed system should offer reliable services through automating the operations that are considered to be manual in the current information system. That is why it is greatly advisable for the Comic Library business to upgrade its systems to support modern technologies that would include features and functions that support a wide area network. Installing a new technological system for the organization would be more efficient, reliable, and cheaper to implement. This is because it would not only help the institution to deliver quality services, but also enable it to increase their client foundation, hence get increased revenue generation for business. The existing system requires a lot of manual operations which consumes a lot of time. This current information system majorly depends on the manual method of storage for the resources offered by the institution. Furthermore, manually adding content from set locations leads to a lot of additional work which requires a high level of attentiveness to ensure there in no errors in cataloging and storing the information resource. The current system involves a lot of time consumption in terms of operating time and service delivery delay. This is not good for any business since it has a slow performance thus it is most likely to

Calcium Chloride Essay Example for Free

Calcium Chloride Essay The temperature should be kept at the same throughout the experiment to create a set of fair and even results.   The volume of Hydrogen peroxide must be kept the same otherwise the alginate balls would travel different distances.   The shape of the measuring cylinder must be kept the same otherwise the alginate balls would travel different distances. The size of the yeast beads must be kept the same. The height I drop the beads at must remain the same otherwise the distance that the bead has to travel will be faster for different beads. Independent Variable: During the experiment, I changed the concentration of both hydrogen peroxide and water. Concentration of Hydrogen Peroxide (%) Concentration of Water (%) Dependant Variable: I measured the time it took for the bead, after being dropped into the hydrogen peroxide and water solution, to sink to the bottom of the test tube and rise again to the top. The bead rises due to the production of Oxygen (O2) bubbles surrounding the bead. Apparatus: Diagrams: Making the beads Timing the rising of the beads List:   Alginate   Water. First of all I placed 3ml of alginate preparation into a small beaker.   I then added 3ml of well stirred yeast suspension. This means that the yeast-alginate solution was 1:2.   After that I mixed the contents of the beaker very thoroughly using a glass rod.   In a further beaker, I placed enough calcium chloride solution to give a depth of 3 ml. Using the glass rod, by holding it level with the rim of the beaker, I was able to drop some of the yeast-alginate mixture into the calcium chloride solution.   Following that I produced a bead of 5ml which lied at the bottom of the beaker.   I stirred the yeast-alginate mixture continuously with the glass rod, then I repeated this procedure to produce about 32 beads.   I examined the beads that I made.   I then removed and discarded any which were obviously different in size, distorted in shape, or which floated. The beads were picked up with a pair of tweezers. Method of the timing of the beads: First of all I set up the apparatus shown in the second diagram.   I then drop each bead in to the hydrogen peroxide and water solution (10ml).   As soon as the bead is dropped from the tweezers I start the stop watch and stop it again when the bead reaches the surface.   I will repeat each experiment 4 times and at 10 different concentrations of hydrogen peroxide and water.   Each time, I will change the concentration of the solution by 10%. Prediction I predict that if I halve the concentration of Hydrogen Peroxide the time taken for the alginate balls to rise will double. I think this because of the particle collision theory, which states that if there are twice as many particles there is twice the probability that the particles will collide. Therefore if there are half as many there is half the probability that the particles will collide. Results Table Concentration of Hydrogen Peroxide (%) Concentration of Water (%) Time (s) Conclusion/Analysis I think that my results turned out like I predicted in my prediction, but at the end of the results the alginate balls take longer than I predicted. By looking at the graph I have drawn you can see that if you take a point on the X axis (e. g. 40) then follow it along to the Y axis and read the result and then do the same twice as far up the X axis (e.g. 80) the number you get on the Y axis should be double the previous number. I have highlighted this on the graph to show that the results are correct to my prediction. The results turned out this way because of the particle collision theory that states that if there are twice as many particles there is twice the probability that the particles will collide. Therefore if there are half as many there is half the probability that the particles will collide. I could make this experiment better by making more accurate measurements. For example if I measured every alginate ball and weighed them to make sure all the balls are the same the results are likely to be more accurate. Also if I repeated the results many more times I would get a more accurate set of results. Another important factor to consider is that Human accuracy in measuring the time is not terribly accurate. You could make your results more accurate by using light gates to sense the alginate balls passing certain points (Top and bottom). By looking at my graph I think you can see that my results are good enough to support my conclusion.

Operations Decision Essay Example for Free

Operations Decision Essay This file of ECO 550 Assignment 2 Operations Decision consists of: 1. Briefly describe the details of the fictitious business that you created for this assignment. 2. Assess the current environmental scan factor. Determine the factors that will have the greatest impact on plant operations and management’s decision to continue or discontinue operations. 3. Evaluate the financial performance of the company using the information provided in the scenario. Consider all the drivers of performance, such as company profit or loss for both the short term and long term. Be sure to show the calculations that helped you reach your conclusions. 4. Recommend how the company can improve its profitability. Then develop a brief plan to implement the recommendations. 5. Assess the circumstances in which the company should discontinue operations. Provide a rationale with your response. Economics General Economics Assignment 2 Operations Decision Assume you have been hired as a managing consultant by a company to offer some advice that will help it make a decision as to whether it should shut down completely or continue its operations. It currently uses 100 workers to produce 6,000 units of output per month (working 20 days / month). The daily wage (per worker) is $70, and the price of the firms output is $32. The cost of other variable inputs is $2,000 per day. You are told that the firms fixed cost is â€Å"high enough† so that the firms total costs exceed its total revenue. The marginal cost of the last unit is $30. (Ch 7 8 to solve)  This assignment allows you to determine the specific details about this fictitious company in order to conduct an environmental scan of this company.   Write a three to four (4-5) page paper in which you: Briefly describe the details of the fictitious business that you created for this assig Follow the link to get tutorial https://bitly.com/12AXeqz When your classes begin, you have to get acquainted with your instructors. Make sure that you are aware of their office locations, hours of availability and how else to contact them. You must develop good relationships with your professors so that you will feel comfortable talking with them if you need help or an exception on a due date. Economics General Economics Assignment 2 Operations Decision Assume you have been hired as a managing consultant by a company to offer some advice that will help it make a decision as to whether it should shut down completely or continue its operations. It currently uses 100 workers to produce 6,000 units of output per month (working 20 days / month). The daily wage (per worker) is $70, and the price of the firms output is $32. The cost of other variable inputs is $2,000 per day. You are told that the firms fixed cost is â€Å"high enough† so that the firms total costs exceed its total revenue. The marginal cost of the last unit is $30. (Ch 7 8 to solve)  This assignment allows you to determine the specific details about this fictitious company in order to conduct an environmental scan of this company.   Write a three to four (4-5) page paper in which you: Briefly describe the details of the fictitious business that you created for this assignment. Assess the current environmental scan factors that are relevant to the decision making process. Determine the factors that will have the greatest impact on plant operations and management’s decision to continue or discontinue operations. Provide a rationale for your  determination. Evaluate the financial performance of the company using the information provided in the scenario. Consider all the key drivers of performance, such as company profit or loss for both the short term and long term and how each factor influences managerial decisions. Be sure to show the calculations that helped you reach your conclusions. Recommend how the company can improve its profitability to deliver more value to its stakeholders. Then, develop a brief plan to implement the recommendations. Assess the circumstances in which the company should discontinue operations and how management should react when c onfronted with these circumstances. Provide a rationale with your response.

Medical Brain Drain in Developing Countries

Medical Brain Drain in Developing Countries CHAPTER ONE BACKGROUND The loss of human capital from developing countries to developed countries is not a new phenomenon. It is commonly refer to as brain drain which broadly represents the migration of highly skilled professionals from one country or part of a country to another in search of a better prospect (Sako, 2002). The loss of highly skilled professional attributed to brain drain has been of interest internationally for over four decades (Giannoccolo, 2004). Concern over the international migration of health workers first came to limelight at the Edinburgh Commonwealth Medical Conference in 1965. This situation prompted the World Health Organisation (WHO) in 1970 to examine the global process and flows of doctors and nurses (Mejia, 1978). The report however made little impacts on migration of health workers which has continually been on the increase over the years (Levy, 2003, Pang et al. 2002) The concept of the medical brain drain, that is the migration of doctors and other health professionals from developing economies to developed countries has been the subject of interest and research across a variety of fields including labour economics, human resource studies and human geography (Diallo, 2004, Buchan, 2004 and Stilwell et al., 2004) The migration of medical personnel has been identified by WHO as the most critical problem facing the delivery of health service in developing countries (WHO, 2007), besides the emigration of doctors in particular to other countries have received a more considerable attention (Beecham, 2002) The extent to which health professionals migrate to developed countries has continue to be on the increase in recent years and this has been attributed to an apparent response to demand from the developed countries where medical professional are in short supply to cater for demands due to demographic changes, aging population, growing income, feminisation of workforce amongst others (Pond and McPake, 2006). Foreign-trained medical and nursing workforces are estimated to account for more than a quarter of health professionals of the Australia, Canada, the US, and the UK (OECD, 2002).The quest for highly skilled professionals has been on the increase in many developed countries. According to statistic report from the Global Atlas of Workforce cited in Pond and McPake, (2006), the United Kingdom (UK) was ranked among the least staffed of high income countries with 166 doctors and 497 nurses per 100,000 populations the second lowest doctors density and the fourth nurses lowest density among the Organisation for Economic Cooperation and Development (OECD) countries. Moreover, as at the year 2000, the UK health system currently require about 10,000 physicians and 20,000 more nurses to meet the demand of the NHS plan (Department of Health, 2000). Between the year 1999 and 2004 when the targets was achieved earlier than expected, a new target was set to increase the number of nurses by 35000 ( 10%) and physicians by 15000 (25%) between 2001 and 2008. In order to achieve the new target, several methods were adopted to recruit doctors and nurses from other country to fill the shortage within the NHS. However, the approach created a surge in the international recruitment of health worker (Department of Health, 2004). Conversely, the poor economy condition in the developing countries coupled with poor remunerations, lack of infrastructural facilities, and low morale, emigrating to developed countries by doctors is seen as an opportunity for a better prospect. Furthermore, the continuous rise in disease prevalence, emigration, productivity losses, and shortage of doctors in Sub-Saharan Africa, has resulted in health resource crisis (Aluwihare, 2005). Insufficiency in human capacity for health care delivery in developing countries have been identified as a significant factor that is responsible for the inability to achieve the target set by WHO for the treatment of 3 million HIV infected people by year 2005. (This initiative was tagged 3by5) (WHO, 2005). This has also been identified as a major constraint limiting the progress of Millennium Development Goals (MDGs) Initiatives (IOM, 2005). In response to the migration of health professionals to developed countries and the undermine effect to the economy, social and health status of exporting countries, the Commonwealth Ministers of Health agreed to uphold and keep the Commonwealth values of cooperation, sharing and supporting one another, thus a consensus approach to deal with the problem of international recruitment of health workers was adopted. The Code of Practice for the International Recruitment of Health Workers is intended to provide a framework to governments within which international recruitment should be carried out (Commonwealth Code of Practise, 2003). Similarly, Department of Health (2004), presented a revised policy on code of practise for international recruitment of health care professionals this demonstrated the concerned of the UK government in protecting the health care system of developing countries. The revised code of practise for recruitment addresses role of private employer and agencies in the international recruitment of health professionals from developing countries (Eastwood et al., 2005). Nevertheless, developing countries have made some effort in preventing the emigration of physician to developed countries. In spite of this, addressing factors that encourage emigration, such as large disparity in remunerations, standards of living, opportunities for career development amongst host other benefits are usually difficult to come by. At the 1998 UN Conference on Trade and Development, WHO study indicated that 56% of doctors from developing countries migrate to developed nations, while only 11% migrate in the opposite direction; the imbalance is even greater for nurses. (Chanda, 2002). As a result, further effort is being deployed by developing countries to search for means to manage the migration of the health workforce to developed countries (Hussey, 2007). Despite measures, it may be difficult to totally prevent health professionals from migrating. As the large scale of medical brain drain from developing countries is now having a negative impact on the development process of the health system of those countries, it is however imperative for stakeholders to develop a consequential means to curtail the continual movements of health professionals. Nigeria Health Services Historical Background Nigeria, the most populous black nation in the world with a total population of 140 million people (2006 census). As a country with mono-cultural economy, the major source of foreign earnings is from crude oil. The poor level of resources allocated to the health care sector is one of the main factors responsible for the deplorable health condition in the country (Campbell, 2007). The public health service in Nigeria started in 1946 with a 10-year colonial administration plan; the development came about when treatment was required for soldiers of the West African Frontier Force and the colonial administration staff. In 1975 attempt was made to adopt primary health care under the Basic Health Service Scheme (BHSS). The BHSS aimed to improve the accessibility to heath care in terms location, affordability, increase access to disease prevention and distribution of services, and provision of adaptable health services based on local need and socially acceptable method of technology (Hodges 2001). The Current Health Care System in Nigeria Over the last two decades, the health care system in Nigerias has deteriorated a fact ascribed to the countrys poor governance and leadership which was more pronounced during the military era. This was reflected in budget allocations and the fiscal requirements of the Structural Adjustment Programmes. The deficient of reliable data makes it difficult to provide a detailed assessment of the degree of financial commitment to the health sector (Ali-Akpjiak and Pyke, 2003). According to World Bank source, Nigeria public spending per capita for the health sector is less than $5 USD and is as low as $2 USD in some parts of the country. This is far below the $34 USD recommended by WHO for developing countries within the Macroeconomics Commission Report. Nevertheless the Federal Government recurrent budget on health showed an increasing trend from 1996 to 1998, a decline in 1999 and started to rise again in 2000, available evidence shows that most of the recurrent expenditure is spent on personnel. The Federal Government recurrent expenditure on health as a share of the total Federal Government recurrent expenditure which stood at 2.55% in 1996, 2.96% in 1997, and 2.99% in 1998, declined to 1.95% in 1999 and 2.5% rose in 2000. Beyond budgetary allocations, there is a wide gap in the available between the budgetary figures and the actual amount of funds released from the treasury for health activities (WHO 2009a). The decline in the Nigeria health sector was accompanied by collapse of institutional capacities, poor remuneration and lack of conducive environment, dilapidated equipment and infrastructure have over the years, job dissatisfaction and low motivation, have led to increase migration of health professionals to seek employment in overseas countries. In a bid to curtail the impasse, Nigeria has subscribed to the Commonwealth Code of Practice for the International Recruitment of Health Workers for which a framework of responsibilities is presently being developed (WHO 2009b). Demographic and Health Indicators The demographic data in Nigeria are not very reliable. Data gathered from various exercises such as census, vital registrations and surveys are often inconsistence and sometimes contradictory. Nonetheless, there is evidence that the key indicators have either remained constant or worsened (WHO 2005). Life expectancy declined from 52.6 years for male and 58.8 years for female in 1991 to 45 years and 46 years for both Male and Female respectively in 2004. The infant mortality rate (IMR) in 2004 is 103 per 1000 live births when compared to 87.2 per 1000 live births in 1999. Fifty percent of deaths under 5 years of age have been attributed to malnutrition. The maternal mortality rate (MMR) of 800 per 100,000 births is the second highest in the world after India. This has been attributed partly to shortage of skilled medical personnel. For instance only 41.9 % of primary health facilities is provides antenatal and delivery services. Moreover 57.3% of such health facilities operate without a doctor, midwives or senior community extension worker. The Nigeria health system is one of the worst in sub-Saharan African with a disability life adjusted expectancy of 38.3 years and ranked 187 in the world (WHO 2005) Health Workforce in Nigeria Among the several challenges facing the health system in Nigeria is the lack of competent health care professionals. This has been attributed to inadequate infrastructures and poor remunerations packages, making a sizeable numbers of doctors, nurses and other medical professionals vulnerable to be lured away to developed countries in search of a fulfilling and lucrative employments (Stilwell and Awofeso, 2004, Raufu, A., 2002) There are 52, 408 Nigerian Doctors registered with the Nigeria Medical Council as at December 2007, There are 128,918 nurses and 90,489 midwives on the register, although only a fraction of these pay the required practicing licensing fee. There are 13,199 pharmacists, 840 radiographers, 1,473 physiotherapists, 12,703 medical laboratory scientists, and 19,268 Community Health Officers. All these health workers are required to pay annual practicing licensing fees; however the lists have not been pruned for those have migrated out to foreign countries, deaths, retirements or those that have left the profession for another career entirely. Health workers are poorly distributed and most are in favour of urban areas, southern, tertiary health care services delivery, and curative care. For some cadres of health workers such as doctors and nurses, more than 50% have their place of work in the South Western part of the country with vast majority residing in the commercial city of Lagos (Labiran et. al, 2008). Medical Brain Drain in Nigeria Among the countries in sub-Saharan African, Nigeria is a major export of health professionals. An estimated number of 20, 000 health professionals emigrate from Africa annually. A trend that poses threat to sustainable health care delivery in Nigeria. Statistical data on Nigerian doctors who are legally migrating overseas are scarce and unreliable, this is largely due to the fact that most wealthy nations like Australia currently makes it very difficult for overseas trained doctors to practise in their country primarily on the basis of medical skills. However, hundreds of doctors trained in Nigeria continue to emigrate to developed countries annually (Stilwell and Awofeso, 2004). Better remunerations and medical facilities among other factors are cited as one of the major reason for flight of Nigerian doctors (Raufu, 2002) and also there are limited incentives and encouragement for overseas based Nigerian doctors that is willing to relocate back to the country (Stilwell et al., 2004) . Purpose of the study In sub-Saharan African, there is has been a significant rise in disease burden, loss of productivity and the emigration of medical doctors to developed counties have resulted in the in dearth of the most required health resource (Aluwihare, 2005). Most studies on medical brain drain have examined the subject from the perspective of recipient developed countries and little attention has been paid to the donor developing countries. Thus, scarcity of data from developing country makes it difficult to fully describe the impact of migration on countries of origin (Hagopian et al., 2004). Most studies on doctors migration from Sub-Saharan African have tended to focus on numbers, without exploring the underlying reason for migration, assessing the potential negative impact of migration on the health care systems, or considering means to alleviate the problem. In actual fact, information regarding the extent of migration is usually obtained through data from countries of destination (Stilwel l et al 2003). The migration of medical doctors from Nigeria and other countries in sub-Saharan African generates three areas of major concern. The first is a loss of the basic health services available to the citizen. for instance, Ghana, faced with a ratio of nine doctors to every 100 000 patients and no more than 22 paediatrician are licensed to practise in country and no more than 10 specialists of any kind practising in the remote area. Similarly, Nigeria lack adequate doctors to care for the sick especially patients residing in the rural communities The second effect doctor migration from Nigeria is that it prevent the health sectors the ability to organize and expand. Public health institutions heavily depend on doctors to lead, develop and promote them as they work to advance health care delivery. As obtained in US, doctors are well positioned to serve their organisation by actively involved in managing resources and articulating priorities. It is therefore speculated that as the numbers of available medical doctors in developing countries reduces. The third challenges are that doctors migration depletes a significant element of the middle class in developing countries. As in the developed countries, medical doctors in African comprise of an important segment of the social and economic make up of the middle class. They are generally accorded a lot of respect in the society, as being above corruption, they advocate for improvement in quality of education of public schools and they play a vital role in political (Hagopian et al., 2005). In Nigeria, over 70.2% of the population lives on $1 per day (WHO, 2006) Research aim and objectives The aim of this study is to analyse the causes of medical brain drain from developing countries, benefits and burdens associated with brain drain based largely on the views of Nigerian doctors practising in UK. The objectives are: To identify the factors that influence the decision of medical doctors to migrate to developed countries migration To identify the impacts of migration on healthcare in developing countries CHAPTER TWO LITERATURE REVIEW Concept of Brian Drain Brain drain has been defined by many analysts in different ways. It is not surprising the social phenomenon has been examined and analysed from different perspective, based on their general orientation and or awareness of the subject. Brain drain will be conceived in this study as the loss of medical professionals or significant number of human capital within the health care system to other sector of the economy or country. Migration of skilled professionals differs from one country to another and from time to time it is however misleading to generalise the possible impacts of migration in developing countries. Moreover, it can be argued that various studies have attempted to measure the phenomenon from different perspective. Single analytic measurement cannot be used to justify all migration although migration of highly skilled professionals from developing countries has been attributed to various factors which political, social and economical factors account for a significant reasons behind the phenomenon (AUN report, 2002). The migration of highly skilled workers can justify the use of the term brain drain however the expression should be used cautiously. Replacing drain by a more common and value expression such as migration may generate alternate meaning. The difference in the word may be heightened by saying while all brain drains constitute brain migration notwithstanding, brain migration may not necessarily refer to brain drain. Brain drain denote the de-facto transfer of resources spent on impacting education and developing both technical and professional skills of the drained brain in question by the parent (donor) country to the (recipient) country of transfer. The developed countries thus save financial resources on education and professional training and invariably obtain the service of professionals such as doctors, nurses, engineers, scientists who earn more than their colleague in developing countries with a better comfortable living environment (Glaser and Habers, 1978). Several efforts have been made to define the concept of brain drain, most especially by international organisation. According to United Nations Educational, Scientific and Cultural Organisation (UNESCO report, 1969), the brain drain could be defined as an abnormal form of scientific exchange between countries, characterized by a one- way flow in favour of the most highly developed countries. Approximately four decades later, the definition of brain drain has undergone no significant change with a lot of highly skilled workers still leaving the shores of developing countries in pursuit of greener pastures in the developed nations. Medical doctors, engineers and scientists usually tend to predominate or account for a larger proportion among the migrants. Their higher the level of skills or professional qualification, make them more susceptible to migration. Gillis, et al. (1987) suggested two main reasons why brain drain is detestable to most developing countries. The first is that the calibres of people that migrate represent one of the scarce human resources in these developing countries and secondly the amount of resources, financial cost and time involve in educating these group of people is expensive and heavily subsidise by the government. Such migration to foreign country therefore becomes expensive and costly to the donor countries. In most cases the developing countries completely loose these highly skill professionals to the developed countries (Edokat, 2000). This phenomenon has generated a lot of arguments that have been advanced for or against brain drain; however this is not a concern for this study. All that can be concluded is that migration of highly skilled workers from developing countries to develop countries creates a vacuum in the former countries (Edokat, 2000). Types of brain drain Primary external brain drain occurs when trained professional or skilled human resources emigrate from their country of origin to work in developed countries such as America, Europe and Australia. Secondary external brain drain occurs when a trained professional or skilled human resources leave their country or any other less developed country to work in a another developing country such as Botswana, South Africa, Zimbabwe and Namibia. Internal brain drain occurs when a trained professional or skilled or skilled human resources seek for employment in a field not related to his to his/her expertise or when such individual migrate from the public sector to private sector or to another sector within a particular country. While this may pose a problem for a country, it is however not a loss of human resource to the country or the continent. Brain Drain Theories These theories are based on general migration approaches. In brain drain discussion, these approaches have been referred to briefly or summarized. Occasionally specific remarks will be made to provide more clarity regarding the theories. It is however important to state that nearly the theoretical outlook consists of specific mix of different theories or based on the nature of the dominating factors. On the other hand, the scientific approach in which the theories were founded. Another approach in the use of division based on the level Micro, Meso or Macro. These groups cover greater number of theoretical approaches (Oderth, 2002). This level has been defined as: Micro level the decision making of individual is affected by his or her motives, circumstances and access to information. Meso level an aspect of social ties that affects migration such as the effect of network of friends and relatives on migration Macro level opportunities and constraints available at societal level which include political, socio-cultural and economical factors There is no Grand theory linked with research on brain drain although attempts have been made to integrate the subject with economic and social theory, spatial analysis and social science (Kangasniemi et. al., 2004). The study of brain drain and other behaviour by demographers was able to draw insights from other disciplines such as statistics, history, economy, medicine and anthropology (Oderth 2001). A common example is the push and pull model of labour mobility. The model states that individual migration decision is a combination of family, economic, social and political factors. Categories of factors identified to be affecting migration include: 1) Factors at the point of origin, 2) Factors at point of destination, 3) Intervening obstacles and 4) personal circumstances. The push and pull model has been widely used by scholars in studies. Economic factors of employment and material benefits are regarded to have the strongest influence on migration decision (Oderth 2002) Despite the frequent use of the push and pull model approach in migration literature, the approach has been seen as too mechanical and rational choice based and with less consideration for intervening obstacles or institutional and structural constraints (Massey et al, 1993). Most migration tends to be unidirectional from poor to rich nations. The rate of emigration also differs vary considerately between countries and regions on similar economic level and the poorest or the less educated people hardly ever move. A major challenge for the migration is lack of insights in the interconnectedness of all the processes (Kangasniemi et. al., 2004) Another model is the migration system approach it involves formation of a link that encourages migration between a sender and receivers which are strengthened over a period of time. Such links include economic, political and cultural interaction often based on historical activities. Once a link has been created between the migrant places subsequent migration is facilitated through the links. The migration system approach emphasis that social network of the migration provides the intending migrants with information and assistance to ease migration. An important feature of such system is that immigration to a country is directed to specific regions. Such migration is partly dependent on specific areas (Gillis, et al. (1987)). The scope of medical brain drain The World Health Report (2006) estimated that an approximately 817,992 (138%) health workers would be required In Africa to achieve the coverage of basic health interventions. The rate at which doctors and other health professional migrate differs from country to country. Nevertheless, the pattern of migration shares certain similarities. The severe shortage of doctors particularly in rural health facilities has critical negative effects on accessibility and equitable distribution of health care in sub-Saharan African (Ovberedjo, 2007). Studying a specific group of employments from a pool of migration statistics revealed a substantial net loss of human capital among certain key profession in sub-Saharan African. An obvious and highly skilled professional to emerge from such analysis are medical doctors (SOPEMI, 2008). This particular phenomenon can be described as Medical Brain Drain. However, to what extent doctors migrated from sub Saharan African to developed countries? This section will review the scope of migration among doctors in sub Saharan African. Medical brain drain is important and deserves consideration because it is obvious that any decrease in the labour supply among doctors in any country is bound to generate a significant negative impact on the health system of that particular country. In year 2000, statistical data revealed an average of 18.2% of employed doctors working in OECD countries were foreigners. The United States has the largest number of doctors (about 200,000) born and trained in foreign countries followed by the United Kingdom which account for almost 50,000 and France about 34,000. Health worker in India and Philippine formed a greater percentage of the immigrant health workforce OECD countries. In addition, doctors from India account for 56,000 of foreign born doctors practising in OECD countries while nurses of Philippine origin account for about 110, 000. These represent about 15% each of the total (SOPEMI, 2008). The French and the Portuguese African speaking countries contribute some of the highest emigration rate to OECD countries for medical doctors some of other African countries such as Guinea Bissau, Sao Tome and Principe, Senegal, Carpe Verde, Congo, Benin and Togo rank between 17th and 23rd places with emigration rate of 40%, while the English speaking countries in African such as Malawi, Kenya and Ghana have lower emigration rate ranked 25th, 28th and 38th respectively. South African and Nigeria were the only two countries in sub-Saharan African among the top 25 countries with foreign doctors and nurses practising in the OECD countries. This was due to the fact that most African countries have smaller population of workforce (SOPEMI, 2007). Statistical data from the American Medical Association (AMA) Physician Master file shows that 5, 334 non-federal trained doctors trained in Africa medical schools were licensed to practise medicine in the United States in 2002. Nigeria account for 2,158, while South Africa 1,943 doctors. Another 478 doctors are from Ghana medical schools. Other countries contributing to the list in sub-Saharan African include Ethiopia 257 physician, Uganda 153 doctors, and Kenya 93 doctors. The total number of 5,334 represents 6% of the total number African doctors (Hagopian et al. 2004). After United States, the United Kingdom and Canada are the most common destinations in developed countries for African Physicians, with a total of 3,451 and 2, 151 African trained doctors are recorded to be practising in United Kingdom and Canada respectively. Moreover figures in the UK include only doctors who arrived after 1992 thus the number may probably be higher, other destinations for African-trained doctors include Australia, New Zealand and the Gulf States (Hagopian et al. 2003) Migration of doctors also occurs between countries within African continent. For instance, countries such as South Africa, Senegal and Botswana export doctors to developed countries and likewise import doctors from other African countries to cater for shortfall in medical personnel (EQUINET, 2003). Causes of Brain Drain The factors guiding individual choice of migration is in essence personal and thus susceptible to the prevailing personal circumstances. Nonetheless, the economic and social context of such decision deserves an important consideration. Moreover, the disparity between the economic and social development status of different sectors within a particular country and of different countries within African has countries has broaden over the year (Stilwell, 2004). Brain drain of doctors and other highly skilled professional from Africa has been blame on unfulfilled dream at country of origin caused by strife, corruption and misuse that mark Africas post-colonial history (Bridgewater, 2003 cited in Mbanefoh, 2007). Also according to Dovlo (2003), causes can be linked using six gradients which include job satisfaction, salary, career opportunity, governance, social security and benefit, protection and risk. Furthermore the dualistic nature of the world economy has been found to be a major contributing factor to brain drain, as highly skilled medical professionals particularly doctors try to escape the endemic poverty by migrating to wealthy, developed and technologically advanced countries of the world (Mbanefoh, 2007). Factors guiding individual decision to emigrate are a result of the interplay of economic, cultural, social, political and legal forces. Others factors encouraging cross-border migration are usually considered under two main categories: Push factors (Supply) and Pull factors (Demand) (Kline, 2003). Over time the pattern of migration is facilitated through networks that provide prospective migrants with information about job opportunities in countries of destination as well as offer various support to help adjustment after migration (Matin, 2003). Push factors (Supply) these are conditions that make a doctor to be dissatisfied with work and professional careers in their country of origin. The factors may be evident both in the developed and developing countries facilitating the migration of health care professionals from one country to another which is perceive to offer better opportunities in some way. However, these factors are more prominent in developing countries, and they greatly influence the decision of doctors to emigrate in these countries. Pull factors (Demand) these are conditions in countries of destination that motivate workers to migrate. In the same manner as push factors, pull factors can also influence the migration of doctors from one developed country to another developed country. However, the pull factors has a more pronounced influence on individuals in developing countries for instance, there is surge in migration of nurses to Canada after the review of cost of Medical Brain Drain in Developing Countries Medical Brain Drain in Developing Countries CHAPTER ONE BACKGROUND The loss of human capital from developing countries to developed countries is not a new phenomenon. It is commonly refer to as brain drain which broadly represents the migration of highly skilled professionals from one country or part of a country to another in search of a better prospect (Sako, 2002). The loss of highly skilled professional attributed to brain drain has been of interest internationally for over four decades (Giannoccolo, 2004). Concern over the international migration of health workers first came to limelight at the Edinburgh Commonwealth Medical Conference in 1965. This situation prompted the World Health Organisation (WHO) in 1970 to examine the global process and flows of doctors and nurses (Mejia, 1978). The report however made little impacts on migration of health workers which has continually been on the increase over the years (Levy, 2003, Pang et al. 2002) The concept of the medical brain drain, that is the migration of doctors and other health professionals from developing economies to developed countries has been the subject of interest and research across a variety of fields including labour economics, human resource studies and human geography (Diallo, 2004, Buchan, 2004 and Stilwell et al., 2004) The migration of medical personnel has been identified by WHO as the most critical problem facing the delivery of health service in developing countries (WHO, 2007), besides the emigration of doctors in particular to other countries have received a more considerable attention (Beecham, 2002) The extent to which health professionals migrate to developed countries has continue to be on the increase in recent years and this has been attributed to an apparent response to demand from the developed countries where medical professional are in short supply to cater for demands due to demographic changes, aging population, growing income, feminisation of workforce amongst others (Pond and McPake, 2006). Foreign-trained medical and nursing workforces are estimated to account for more than a quarter of health professionals of the Australia, Canada, the US, and the UK (OECD, 2002).The quest for highly skilled professionals has been on the increase in many developed countries. According to statistic report from the Global Atlas of Workforce cited in Pond and McPake, (2006), the United Kingdom (UK) was ranked among the least staffed of high income countries with 166 doctors and 497 nurses per 100,000 populations the second lowest doctors density and the fourth nurses lowest density among the Organisation for Economic Cooperation and Development (OECD) countries. Moreover, as at the year 2000, the UK health system currently require about 10,000 physicians and 20,000 more nurses to meet the demand of the NHS plan (Department of Health, 2000). Between the year 1999 and 2004 when the targets was achieved earlier than expected, a new target was set to increase the number of nurses by 35000 ( 10%) and physicians by 15000 (25%) between 2001 and 2008. In order to achieve the new target, several methods were adopted to recruit doctors and nurses from other country to fill the shortage within the NHS. However, the approach created a surge in the international recruitment of health worker (Department of Health, 2004). Conversely, the poor economy condition in the developing countries coupled with poor remunerations, lack of infrastructural facilities, and low morale, emigrating to developed countries by doctors is seen as an opportunity for a better prospect. Furthermore, the continuous rise in disease prevalence, emigration, productivity losses, and shortage of doctors in Sub-Saharan Africa, has resulted in health resource crisis (Aluwihare, 2005). Insufficiency in human capacity for health care delivery in developing countries have been identified as a significant factor that is responsible for the inability to achieve the target set by WHO for the treatment of 3 million HIV infected people by year 2005. (This initiative was tagged 3by5) (WHO, 2005). This has also been identified as a major constraint limiting the progress of Millennium Development Goals (MDGs) Initiatives (IOM, 2005). In response to the migration of health professionals to developed countries and the undermine effect to the economy, social and health status of exporting countries, the Commonwealth Ministers of Health agreed to uphold and keep the Commonwealth values of cooperation, sharing and supporting one another, thus a consensus approach to deal with the problem of international recruitment of health workers was adopted. The Code of Practice for the International Recruitment of Health Workers is intended to provide a framework to governments within which international recruitment should be carried out (Commonwealth Code of Practise, 2003). Similarly, Department of Health (2004), presented a revised policy on code of practise for international recruitment of health care professionals this demonstrated the concerned of the UK government in protecting the health care system of developing countries. The revised code of practise for recruitment addresses role of private employer and agencies in the international recruitment of health professionals from developing countries (Eastwood et al., 2005). Nevertheless, developing countries have made some effort in preventing the emigration of physician to developed countries. In spite of this, addressing factors that encourage emigration, such as large disparity in remunerations, standards of living, opportunities for career development amongst host other benefits are usually difficult to come by. At the 1998 UN Conference on Trade and Development, WHO study indicated that 56% of doctors from developing countries migrate to developed nations, while only 11% migrate in the opposite direction; the imbalance is even greater for nurses. (Chanda, 2002). As a result, further effort is being deployed by developing countries to search for means to manage the migration of the health workforce to developed countries (Hussey, 2007). Despite measures, it may be difficult to totally prevent health professionals from migrating. As the large scale of medical brain drain from developing countries is now having a negative impact on the development process of the health system of those countries, it is however imperative for stakeholders to develop a consequential means to curtail the continual movements of health professionals. Nigeria Health Services Historical Background Nigeria, the most populous black nation in the world with a total population of 140 million people (2006 census). As a country with mono-cultural economy, the major source of foreign earnings is from crude oil. The poor level of resources allocated to the health care sector is one of the main factors responsible for the deplorable health condition in the country (Campbell, 2007). The public health service in Nigeria started in 1946 with a 10-year colonial administration plan; the development came about when treatment was required for soldiers of the West African Frontier Force and the colonial administration staff. In 1975 attempt was made to adopt primary health care under the Basic Health Service Scheme (BHSS). The BHSS aimed to improve the accessibility to heath care in terms location, affordability, increase access to disease prevention and distribution of services, and provision of adaptable health services based on local need and socially acceptable method of technology (Hodges 2001). The Current Health Care System in Nigeria Over the last two decades, the health care system in Nigerias has deteriorated a fact ascribed to the countrys poor governance and leadership which was more pronounced during the military era. This was reflected in budget allocations and the fiscal requirements of the Structural Adjustment Programmes. The deficient of reliable data makes it difficult to provide a detailed assessment of the degree of financial commitment to the health sector (Ali-Akpjiak and Pyke, 2003). According to World Bank source, Nigeria public spending per capita for the health sector is less than $5 USD and is as low as $2 USD in some parts of the country. This is far below the $34 USD recommended by WHO for developing countries within the Macroeconomics Commission Report. Nevertheless the Federal Government recurrent budget on health showed an increasing trend from 1996 to 1998, a decline in 1999 and started to rise again in 2000, available evidence shows that most of the recurrent expenditure is spent on personnel. The Federal Government recurrent expenditure on health as a share of the total Federal Government recurrent expenditure which stood at 2.55% in 1996, 2.96% in 1997, and 2.99% in 1998, declined to 1.95% in 1999 and 2.5% rose in 2000. Beyond budgetary allocations, there is a wide gap in the available between the budgetary figures and the actual amount of funds released from the treasury for health activities (WHO 2009a). The decline in the Nigeria health sector was accompanied by collapse of institutional capacities, poor remuneration and lack of conducive environment, dilapidated equipment and infrastructure have over the years, job dissatisfaction and low motivation, have led to increase migration of health professionals to seek employment in overseas countries. In a bid to curtail the impasse, Nigeria has subscribed to the Commonwealth Code of Practice for the International Recruitment of Health Workers for which a framework of responsibilities is presently being developed (WHO 2009b). Demographic and Health Indicators The demographic data in Nigeria are not very reliable. Data gathered from various exercises such as census, vital registrations and surveys are often inconsistence and sometimes contradictory. Nonetheless, there is evidence that the key indicators have either remained constant or worsened (WHO 2005). Life expectancy declined from 52.6 years for male and 58.8 years for female in 1991 to 45 years and 46 years for both Male and Female respectively in 2004. The infant mortality rate (IMR) in 2004 is 103 per 1000 live births when compared to 87.2 per 1000 live births in 1999. Fifty percent of deaths under 5 years of age have been attributed to malnutrition. The maternal mortality rate (MMR) of 800 per 100,000 births is the second highest in the world after India. This has been attributed partly to shortage of skilled medical personnel. For instance only 41.9 % of primary health facilities is provides antenatal and delivery services. Moreover 57.3% of such health facilities operate without a doctor, midwives or senior community extension worker. The Nigeria health system is one of the worst in sub-Saharan African with a disability life adjusted expectancy of 38.3 years and ranked 187 in the world (WHO 2005) Health Workforce in Nigeria Among the several challenges facing the health system in Nigeria is the lack of competent health care professionals. This has been attributed to inadequate infrastructures and poor remunerations packages, making a sizeable numbers of doctors, nurses and other medical professionals vulnerable to be lured away to developed countries in search of a fulfilling and lucrative employments (Stilwell and Awofeso, 2004, Raufu, A., 2002) There are 52, 408 Nigerian Doctors registered with the Nigeria Medical Council as at December 2007, There are 128,918 nurses and 90,489 midwives on the register, although only a fraction of these pay the required practicing licensing fee. There are 13,199 pharmacists, 840 radiographers, 1,473 physiotherapists, 12,703 medical laboratory scientists, and 19,268 Community Health Officers. All these health workers are required to pay annual practicing licensing fees; however the lists have not been pruned for those have migrated out to foreign countries, deaths, retirements or those that have left the profession for another career entirely. Health workers are poorly distributed and most are in favour of urban areas, southern, tertiary health care services delivery, and curative care. For some cadres of health workers such as doctors and nurses, more than 50% have their place of work in the South Western part of the country with vast majority residing in the commercial city of Lagos (Labiran et. al, 2008). Medical Brain Drain in Nigeria Among the countries in sub-Saharan African, Nigeria is a major export of health professionals. An estimated number of 20, 000 health professionals emigrate from Africa annually. A trend that poses threat to sustainable health care delivery in Nigeria. Statistical data on Nigerian doctors who are legally migrating overseas are scarce and unreliable, this is largely due to the fact that most wealthy nations like Australia currently makes it very difficult for overseas trained doctors to practise in their country primarily on the basis of medical skills. However, hundreds of doctors trained in Nigeria continue to emigrate to developed countries annually (Stilwell and Awofeso, 2004). Better remunerations and medical facilities among other factors are cited as one of the major reason for flight of Nigerian doctors (Raufu, 2002) and also there are limited incentives and encouragement for overseas based Nigerian doctors that is willing to relocate back to the country (Stilwell et al., 2004) . Purpose of the study In sub-Saharan African, there is has been a significant rise in disease burden, loss of productivity and the emigration of medical doctors to developed counties have resulted in the in dearth of the most required health resource (Aluwihare, 2005). Most studies on medical brain drain have examined the subject from the perspective of recipient developed countries and little attention has been paid to the donor developing countries. Thus, scarcity of data from developing country makes it difficult to fully describe the impact of migration on countries of origin (Hagopian et al., 2004). Most studies on doctors migration from Sub-Saharan African have tended to focus on numbers, without exploring the underlying reason for migration, assessing the potential negative impact of migration on the health care systems, or considering means to alleviate the problem. In actual fact, information regarding the extent of migration is usually obtained through data from countries of destination (Stilwel l et al 2003). The migration of medical doctors from Nigeria and other countries in sub-Saharan African generates three areas of major concern. The first is a loss of the basic health services available to the citizen. for instance, Ghana, faced with a ratio of nine doctors to every 100 000 patients and no more than 22 paediatrician are licensed to practise in country and no more than 10 specialists of any kind practising in the remote area. Similarly, Nigeria lack adequate doctors to care for the sick especially patients residing in the rural communities The second effect doctor migration from Nigeria is that it prevent the health sectors the ability to organize and expand. Public health institutions heavily depend on doctors to lead, develop and promote them as they work to advance health care delivery. As obtained in US, doctors are well positioned to serve their organisation by actively involved in managing resources and articulating priorities. It is therefore speculated that as the numbers of available medical doctors in developing countries reduces. The third challenges are that doctors migration depletes a significant element of the middle class in developing countries. As in the developed countries, medical doctors in African comprise of an important segment of the social and economic make up of the middle class. They are generally accorded a lot of respect in the society, as being above corruption, they advocate for improvement in quality of education of public schools and they play a vital role in political (Hagopian et al., 2005). In Nigeria, over 70.2% of the population lives on $1 per day (WHO, 2006) Research aim and objectives The aim of this study is to analyse the causes of medical brain drain from developing countries, benefits and burdens associated with brain drain based largely on the views of Nigerian doctors practising in UK. The objectives are: To identify the factors that influence the decision of medical doctors to migrate to developed countries migration To identify the impacts of migration on healthcare in developing countries CHAPTER TWO LITERATURE REVIEW Concept of Brian Drain Brain drain has been defined by many analysts in different ways. It is not surprising the social phenomenon has been examined and analysed from different perspective, based on their general orientation and or awareness of the subject. Brain drain will be conceived in this study as the loss of medical professionals or significant number of human capital within the health care system to other sector of the economy or country. Migration of skilled professionals differs from one country to another and from time to time it is however misleading to generalise the possible impacts of migration in developing countries. Moreover, it can be argued that various studies have attempted to measure the phenomenon from different perspective. Single analytic measurement cannot be used to justify all migration although migration of highly skilled professionals from developing countries has been attributed to various factors which political, social and economical factors account for a significant reasons behind the phenomenon (AUN report, 2002). The migration of highly skilled workers can justify the use of the term brain drain however the expression should be used cautiously. Replacing drain by a more common and value expression such as migration may generate alternate meaning. The difference in the word may be heightened by saying while all brain drains constitute brain migration notwithstanding, brain migration may not necessarily refer to brain drain. Brain drain denote the de-facto transfer of resources spent on impacting education and developing both technical and professional skills of the drained brain in question by the parent (donor) country to the (recipient) country of transfer. The developed countries thus save financial resources on education and professional training and invariably obtain the service of professionals such as doctors, nurses, engineers, scientists who earn more than their colleague in developing countries with a better comfortable living environment (Glaser and Habers, 1978). Several efforts have been made to define the concept of brain drain, most especially by international organisation. According to United Nations Educational, Scientific and Cultural Organisation (UNESCO report, 1969), the brain drain could be defined as an abnormal form of scientific exchange between countries, characterized by a one- way flow in favour of the most highly developed countries. Approximately four decades later, the definition of brain drain has undergone no significant change with a lot of highly skilled workers still leaving the shores of developing countries in pursuit of greener pastures in the developed nations. Medical doctors, engineers and scientists usually tend to predominate or account for a larger proportion among the migrants. Their higher the level of skills or professional qualification, make them more susceptible to migration. Gillis, et al. (1987) suggested two main reasons why brain drain is detestable to most developing countries. The first is that the calibres of people that migrate represent one of the scarce human resources in these developing countries and secondly the amount of resources, financial cost and time involve in educating these group of people is expensive and heavily subsidise by the government. Such migration to foreign country therefore becomes expensive and costly to the donor countries. In most cases the developing countries completely loose these highly skill professionals to the developed countries (Edokat, 2000). This phenomenon has generated a lot of arguments that have been advanced for or against brain drain; however this is not a concern for this study. All that can be concluded is that migration of highly skilled workers from developing countries to develop countries creates a vacuum in the former countries (Edokat, 2000). Types of brain drain Primary external brain drain occurs when trained professional or skilled human resources emigrate from their country of origin to work in developed countries such as America, Europe and Australia. Secondary external brain drain occurs when a trained professional or skilled human resources leave their country or any other less developed country to work in a another developing country such as Botswana, South Africa, Zimbabwe and Namibia. Internal brain drain occurs when a trained professional or skilled or skilled human resources seek for employment in a field not related to his to his/her expertise or when such individual migrate from the public sector to private sector or to another sector within a particular country. While this may pose a problem for a country, it is however not a loss of human resource to the country or the continent. Brain Drain Theories These theories are based on general migration approaches. In brain drain discussion, these approaches have been referred to briefly or summarized. Occasionally specific remarks will be made to provide more clarity regarding the theories. It is however important to state that nearly the theoretical outlook consists of specific mix of different theories or based on the nature of the dominating factors. On the other hand, the scientific approach in which the theories were founded. Another approach in the use of division based on the level Micro, Meso or Macro. These groups cover greater number of theoretical approaches (Oderth, 2002). This level has been defined as: Micro level the decision making of individual is affected by his or her motives, circumstances and access to information. Meso level an aspect of social ties that affects migration such as the effect of network of friends and relatives on migration Macro level opportunities and constraints available at societal level which include political, socio-cultural and economical factors There is no Grand theory linked with research on brain drain although attempts have been made to integrate the subject with economic and social theory, spatial analysis and social science (Kangasniemi et. al., 2004). The study of brain drain and other behaviour by demographers was able to draw insights from other disciplines such as statistics, history, economy, medicine and anthropology (Oderth 2001). A common example is the push and pull model of labour mobility. The model states that individual migration decision is a combination of family, economic, social and political factors. Categories of factors identified to be affecting migration include: 1) Factors at the point of origin, 2) Factors at point of destination, 3) Intervening obstacles and 4) personal circumstances. The push and pull model has been widely used by scholars in studies. Economic factors of employment and material benefits are regarded to have the strongest influence on migration decision (Oderth 2002) Despite the frequent use of the push and pull model approach in migration literature, the approach has been seen as too mechanical and rational choice based and with less consideration for intervening obstacles or institutional and structural constraints (Massey et al, 1993). Most migration tends to be unidirectional from poor to rich nations. The rate of emigration also differs vary considerately between countries and regions on similar economic level and the poorest or the less educated people hardly ever move. A major challenge for the migration is lack of insights in the interconnectedness of all the processes (Kangasniemi et. al., 2004) Another model is the migration system approach it involves formation of a link that encourages migration between a sender and receivers which are strengthened over a period of time. Such links include economic, political and cultural interaction often based on historical activities. Once a link has been created between the migrant places subsequent migration is facilitated through the links. The migration system approach emphasis that social network of the migration provides the intending migrants with information and assistance to ease migration. An important feature of such system is that immigration to a country is directed to specific regions. Such migration is partly dependent on specific areas (Gillis, et al. (1987)). The scope of medical brain drain The World Health Report (2006) estimated that an approximately 817,992 (138%) health workers would be required In Africa to achieve the coverage of basic health interventions. The rate at which doctors and other health professional migrate differs from country to country. Nevertheless, the pattern of migration shares certain similarities. The severe shortage of doctors particularly in rural health facilities has critical negative effects on accessibility and equitable distribution of health care in sub-Saharan African (Ovberedjo, 2007). Studying a specific group of employments from a pool of migration statistics revealed a substantial net loss of human capital among certain key profession in sub-Saharan African. An obvious and highly skilled professional to emerge from such analysis are medical doctors (SOPEMI, 2008). This particular phenomenon can be described as Medical Brain Drain. However, to what extent doctors migrated from sub Saharan African to developed countries? This section will review the scope of migration among doctors in sub Saharan African. Medical brain drain is important and deserves consideration because it is obvious that any decrease in the labour supply among doctors in any country is bound to generate a significant negative impact on the health system of that particular country. In year 2000, statistical data revealed an average of 18.2% of employed doctors working in OECD countries were foreigners. The United States has the largest number of doctors (about 200,000) born and trained in foreign countries followed by the United Kingdom which account for almost 50,000 and France about 34,000. Health worker in India and Philippine formed a greater percentage of the immigrant health workforce OECD countries. In addition, doctors from India account for 56,000 of foreign born doctors practising in OECD countries while nurses of Philippine origin account for about 110, 000. These represent about 15% each of the total (SOPEMI, 2008). The French and the Portuguese African speaking countries contribute some of the highest emigration rate to OECD countries for medical doctors some of other African countries such as Guinea Bissau, Sao Tome and Principe, Senegal, Carpe Verde, Congo, Benin and Togo rank between 17th and 23rd places with emigration rate of 40%, while the English speaking countries in African such as Malawi, Kenya and Ghana have lower emigration rate ranked 25th, 28th and 38th respectively. South African and Nigeria were the only two countries in sub-Saharan African among the top 25 countries with foreign doctors and nurses practising in the OECD countries. This was due to the fact that most African countries have smaller population of workforce (SOPEMI, 2007). Statistical data from the American Medical Association (AMA) Physician Master file shows that 5, 334 non-federal trained doctors trained in Africa medical schools were licensed to practise medicine in the United States in 2002. Nigeria account for 2,158, while South Africa 1,943 doctors. Another 478 doctors are from Ghana medical schools. Other countries contributing to the list in sub-Saharan African include Ethiopia 257 physician, Uganda 153 doctors, and Kenya 93 doctors. The total number of 5,334 represents 6% of the total number African doctors (Hagopian et al. 2004). After United States, the United Kingdom and Canada are the most common destinations in developed countries for African Physicians, with a total of 3,451 and 2, 151 African trained doctors are recorded to be practising in United Kingdom and Canada respectively. Moreover figures in the UK include only doctors who arrived after 1992 thus the number may probably be higher, other destinations for African-trained doctors include Australia, New Zealand and the Gulf States (Hagopian et al. 2003) Migration of doctors also occurs between countries within African continent. For instance, countries such as South Africa, Senegal and Botswana export doctors to developed countries and likewise import doctors from other African countries to cater for shortfall in medical personnel (EQUINET, 2003). Causes of Brain Drain The factors guiding individual choice of migration is in essence personal and thus susceptible to the prevailing personal circumstances. Nonetheless, the economic and social context of such decision deserves an important consideration. Moreover, the disparity between the economic and social development status of different sectors within a particular country and of different countries within African has countries has broaden over the year (Stilwell, 2004). Brain drain of doctors and other highly skilled professional from Africa has been blame on unfulfilled dream at country of origin caused by strife, corruption and misuse that mark Africas post-colonial history (Bridgewater, 2003 cited in Mbanefoh, 2007). Also according to Dovlo (2003), causes can be linked using six gradients which include job satisfaction, salary, career opportunity, governance, social security and benefit, protection and risk. Furthermore the dualistic nature of the world economy has been found to be a major contributing factor to brain drain, as highly skilled medical professionals particularly doctors try to escape the endemic poverty by migrating to wealthy, developed and technologically advanced countries of the world (Mbanefoh, 2007). Factors guiding individual decision to emigrate are a result of the interplay of economic, cultural, social, political and legal forces. Others factors encouraging cross-border migration are usually considered under two main categories: Push factors (Supply) and Pull factors (Demand) (Kline, 2003). Over time the pattern of migration is facilitated through networks that provide prospective migrants with information about job opportunities in countries of destination as well as offer various support to help adjustment after migration (Matin, 2003). Push factors (Supply) these are conditions that make a doctor to be dissatisfied with work and professional careers in their country of origin. The factors may be evident both in the developed and developing countries facilitating the migration of health care professionals from one country to another which is perceive to offer better opportunities in some way. However, these factors are more prominent in developing countries, and they greatly influence the decision of doctors to emigrate in these countries. Pull factors (Demand) these are conditions in countries of destination that motivate workers to migrate. In the same manner as push factors, pull factors can also influence the migration of doctors from one developed country to another developed country. However, the pull factors has a more pronounced influence on individuals in developing countries for instance, there is surge in migration of nurses to Canada after the review of cost of

David Livingstone Essay -- essays research papers

David Livingstone was one of the most revered and respected African explorers of his time. He spent almost 30 years exploring a region little known to the outside world. He often put ambition before family and his own personal health in his quest to open the interior of Africa to “Civilization, Christianity, and Commerce.';(Hollett 236) Through his daring explorations into the unknown, he discovered and documented many new landmarks inside the dark continent, and at times became obsessed with his determination to find a single source of the Nile. He had a major impact on later expeditions into central Africa. .   Ã‚  Ã‚  Ã‚  Ã‚   Livingstone was born to a poor Scottish family in 1813. Starting at age ten, Livingstone worked in a cotton mill while pursuing his studies at night. He was an avid reader, and would often stay up until twelve or later, buried in a book. Livingstone enjoyed reading on a variety of subjects, but read mostly scientific works and explorer’s journals. As a boy, David made few friends. Others described him as quiet, sulky, and unremarkable. Yet despite this, David was a tireless worker, and extremely motivated toward his goals.   Ã‚  Ã‚  Ã‚  Ã‚   By age 17, Livingstone had decided he wanted to leave the mill and become a doctor. Livingstone’s father, a deeply religious man, wanted him to go into a religious field, and would not allow him to go. Livingstone eventually convinced his father to let him go to school and become a missionary in China. After finishing school, Livingstone had planned to go to China to perform his missionary duties, but because of the Opium War, Livingstone’s plans were altered. He continued his studies, and became a respected member of the medical community. Soon though, he offered his services to the London Missionary Society, and was assigned to a mission in Africa.   Ã‚  Ã‚  Ã‚  Ã‚   Early knowledge and exploration of Africa was confined to desert and coastal regions. The interior humid regions held many difficulties for prospective explorers. This included climate, vegetation, and hostile peoples and creatures. Throughout the 18th and 19th centuries, most of Africa was unexplored, and unmapped. The British were the first Europeans to make a serious attempt at exploration of the interior of Africa. Earlier European contacts were rel... ...lf that the Lualaba River was the source of the Nile, it was not confirmed until after Livingstone’s death that Lake Victoria and the Mountains of the Moon were the actual sources of the Nile. Livingstone’s missions began and ended in Africa. His explorations were primarily in the Lake Tanganyika and Lualaba River regions. He enjoyed living with the native peoples, eating their food, sleeping in their huts, and without losing his own identity, he made their life his own. He probably understood the African people; their beliefs, fears and needs better than anyone outside of Africa at that time. He sacrificed personal needs for what he believed was his mission to Africa,and was probably more spiritually content to meet his death there than any place else. David Livingstone’s three works on South and South Central Africa had major impacts on the worlds understanding of, and social and political attitudes and policy towards Africa. Although his books made him one of the most famous and respected explorers, he was not as concerned with fame and riches as much as having the backing and resources to pursue his objectives in the then dark continent of Africa.