project integration management research paper

Facilitating Integration in Complex Projects: A Case Study

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• Yinbo Li 23 ,
• Cheryl Shu-Fang Chi 24 &
• Yilong Han 23  

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• International Symposium on Advancement of Construction Management and Real Estate

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The increasing complexity of engineering projects is a result of multiple stakeholder interfaces, interdependent processes of different tasks, and large amounts of information generated and flowing within project networks. To cope with complexity and deliver quality projects, the current literature argues that integration is needed in the mindsets and skills of both project managers and project teams. However, how to facilitate integration through project management, especially in complex environments, has yet to be explored with empirical evidence. We studied an ongoing construction project with highly complex characteristics and examined the transition from fragmented management practices to an integrated approach and how it helped improve the project team’s ability to manage project complexity. The results of the case study reveal the elements of integration management and its dynamic nature, where routine development and boundary spanning are critical to its effectiveness.

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Department of Real Estate and Construction, University of Hong Kong, Hong Kong, Hong Kong

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School of Management, Guangzhou University, Guangzhou, Guangdong, China

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Li, Y., Chi, C.SF., Han, Y. (2023). Facilitating Integration in Complex Projects: A Case Study. In: Li, J., Lu, W., Peng, Y., Yuan, H., Wang, D. (eds) Proceedings of the 27th International Symposium on Advancement of Construction Management and Real Estate. CRIOCM 2022. Lecture Notes in Operations Research. Springer, Singapore. https://doi.org/10.1007/978-981-99-3626-7_132

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• Project management |
• Guide to project integration management ...

Guide to project integration management (7 step process)

No two projects are the same in terms of deliverables, budget, and timeline. To ensure all projects meet requirements and objectives, many companies use project integration management as a standard practice. 

Project integration management involves coordinating all project elements, from delegating tasks and managing resources to communicating with stakeholders. By taking a holistic approach to managing projects and their interdependencies, it allows you to execute projects while keeping the big picture in mind.

To succeed in integrated project management, read on to learn about this practice in detail, including the key steps and skills required. 

What is project integration management?

You need project integration management when there are interactions between different processes and teams. When projects have competing objectives or scheduling conflicts, project integration management helps you make cost or schedule trade-offs that enable your team to complete the project and meet stakeholder expectations.

Here’s a project integration management example: Let’s say the marketing team requires data from the sales team in order to produce a report for stakeholders. Project integration management is used to ensure that the data from the sales team is properly handed off to the marketing team and that the deliverable meets requirements.  

Project integration management also involves overseeing the five project management phases that occur during the project lifecycle.

These five phases include:

Project initiation: The aim of this phase is to establish the vision and goals for the project and secure stakeholder approval through project objectives. This phase consists of creating the project charter to provide an overview of the project, a clear road map, and the stakeholder register to specify the stakeholders involved. 

Project planning: The planning process is where you set up the project infrastructure to help you achieve the project goals within time, budget, and resource constraints. You’ll create more detailed project documents to help your team understand the project vision and what’s required to see it through. 

Project execution: This is when you’ll put your project plan into action and get the project underway. Most of the budget will be spent during this phase to produce the deliverables. It also includes activities such as stakeholder engagement and communications, quality assurance, and team development. 

Project performance: This phase involves supervising the progress of the project and comparing it against the original plan. It means taking corrective action when there are blockers or delays. 

Project closure : This is where you formally close out the project by getting approval from the client or stakeholder. Records and lessons learned from the project should be archived for future reference. 

As one of the key knowledge areas in the PMI’s PMBOK® Guide (Project Management Book of Knowledge), mastering this practice allows project managers to improve their processes. 

The 7 steps of project integration management

Project integration management offers a holistic approach to project planning and execution. The practice consists of seven processes to effectively coordinate project activities. Let’s break them down. 

1. Create project charter

Projects typically start out with the creation of a project charter, a short document that provides an overview of the project and identifies the project manager and key stakeholders .

A project charter includes the following:

Objectives and deliverables

Project team members 

Project risks 

Benefits or returns on investment

Business case

A project charter essentially acts as a foundation on which you can further plan your project. It also helps you gain buy-in from stakeholders, which enables you to move forward quickly and autonomously within the project scope . 

2. Develop project management plan

The next step involves developing a more detailed project plan , which specifies the project scope statement, deliverables, timeline , milestones , and metrics to evaluate success. 

The project plan is used to direct the execution of the project to meet overall requirements and objectives. 

Here are the steps to creating a project management methodology:

Meet with stakeholders to set project requirements, deliverables, and objectives.

Define the project scope.

Create a work breakdown structure (WBS) to delegate tasks and assign resources.

Create a project schedule .

Conduct a risk assessment and develop contingency plans .

Come up with a performance measurement baseline to assess project performance.

Develop additional plans for any of the following: scope management, cost management , resource management , change management , stakeholder management , or risk management .

To help you with this process, you can use a project planning template as a starting point to build your plan. 

3. Direct and manage project work

The next phase is project execution, in which the project manager takes charge of the day-to-day work that must be done, such as:

Directing the project team

Holding stakeholder meetings

Tracking project progress

This phase ensures that tasks are being carried out effectively according to the project plan and scope statement. 

4. Manage project knowledge

Project knowledge management refers to the process of using existing information or obtaining additional knowledge to reach project goals. This step ensures team members have all the information they need to produce the required deliverables.

Any knowledge or expertise gained during this step contributes to the company’s overall body of knowledge, which is useful for future strategic endeavors.  

5. Monitor and control project work

Since processes in project integration management are interconnected, they should be followed closely to ensure that everything adheres to the project management plan. 

The purpose of this step is to keep the project on track. If there are any deviations from the project plan, they need to be identified and corrected. 

There are three approaches to this:

Preventive action: an action performed to reduce the negative impact of project risks

Corrective action: an action performed to bring the future project performance back in line with the project plan

Defect repair: an action to repair or replace a documented project defect

A common technique to measure performance is to do an earned-value analysis to assess the current status of the project’s budget and schedule. If project changes need to be made and are approved, project documents such as the work performance report may need to be updated.

Monitoring the project ensures that it is on track to meet objectives. 

6. Perform integrated change control

Changes to projects can sometimes be stressful if not handled properly, but with a change control process in place they don’t have to be. 

That’s why change requests must be assessed to ensure they don’t exceed the scope or approach scope creep , which refers to the increase in requirements during the project lifecycle. Some companies even have a dedicated change control board to review change requests related to budget, timelines, and resources, for example. 

An example of project change is if the client asks for additional assets, in which case you’ll need to evaluate the level of impact on the project. 

Use a change control log to document all change requests, including which ones were approved, the associated costs and resources, and how they impact the project timeline. Smooth integration of change requests to current project activities is crucial for the success of the overall project. 

7. Close out the project

After all project work is complete and deliverables are shipped and approved by the client, it’s time to close the project. 

Project closure involves processes such as:

Holding a final stakeholder meeting 

Conducting a formal review of the project

Closing the contract

Organizing and archiving project materials for future use

Project closure serves as a reference for future endeavors and provides insight on how to improve the project integration management system. 

How to implement project integration management

Performing project integration management requires a combination of technical and leadership skills. Here are some tips to help you get started with project integration management. 

Have a project manager oversee integrated project management

Projects have many moving parts to keep track of and a project manager plays an important role in resolving conflicts. A project manager oversees:

Project schedule

Project deliverables

Project goals

Project managers need a thorough understanding of how each factor affects one another and the overall impact on the project. Integrated project management specifically involves a process, phase, and output that the project manager keeps track of.

For instance, if a project has a change in scope, you may run the risk of resource shortages, budget overruns, and delays. Project integration management allows you to reorganize teams and redistribute resources as required to minimize impact to the project and business.

Project integration management can be especially helpful when you have to manage cross-functional teams and organize their project interdependencies. 

Track time diligently

If you don’t already, implementing time-tracking software could be beneficial, not only for billing purposes but also for future project scheduling. While team calendars provide a high-level overview of how time will be allotted, tracking the number of hours spent on tasks gives you more precise metrics. 

Having this data on hand will be useful for scheduling future projects since it’ll help you make more accurate estimates when planning out specific tasks.  

Establish well-rounded project teams

A good project team can make all the difference in project performance. It’s your job to put together a balanced project team and assign tasks to match team members’ skills and expertise. Make sure everyone has the resources they need and coordinate communication between the teams involved.   

Use project templates to save time

Creating project plans and materials can be time-consuming, especially given how many are required for a single project. Rather than making them from scratch, take advantage of project templates, either from previous projects or premade ones. 

For example, project plan templates or meeting agenda templates can be tailored for various purposes. Templates provide you with a base that you can alter and customize to suit your needs.  

Collaborate with a team communication tool

Each department has their own communication styles and tools, and projects often require collaboration between different departments. 

To prevent miscommunication or a lack of communication between teams, use a communication plan to establish which channels teams should use to share knowledge, resources, and project status updates . That way, teams can directly communicate with one another and you don’t have to act as the intermediary. 

For example, team communication tools allow you to create a centralized hub for projects, enabling real-time communication and feedback. T eam communication tools can also complement the tools you already use since they can integrate with popular remote work tools like Google Drive and Slack. 

The importance of project integration management

Projects are often dynamic and complex, involving multiple teams and organizational processes. To ensure all elements are working cohesively toward the end goal, project integration management is necessary. Here are some benefits of this practice.

Provides coordination and organization throughout the entire project

Project integration management is like an instruction manual you can use to help steer the project in the right direction and make sure all the processes are in sync. As the project moves from phase to phase, it ensures the outputs and documents are in order for the next phase to go smoothly.

Ensures everyone understands their responsibilities

With project integration management, all stakeholders and team members will have a clear understanding of their roles and responsibilities. By monitoring the project diligently, you’ll be able to address questions from teams or stakeholders if there are any points of confusion or issues. 

Keeps project on track

Project integration management keeps projects on track to meet the deadline and budget. It also keeps the project aligned with the project management plan in order to get the promised results or returns. Project integration management helps you resolve conflicts or changes while minimizing the impact on the overall project. 

Maintains smooth communication with stakeholders

Integrated project management ensures stakeholders are kept up to date on project progress. It allows you to create a system for communicating with stakeholders regarding project changes, whether they’re approved or not. It also emphasizes the importance of holding a final meeting after the project is completed to get closure. 

Makes decisions more clear

Each step in project integration management has defined purposes and outputs. By walking through all the steps, you’ll be able to gain deeper insight into the best course of action for each project phase. Creating thorough project documentation will also allow you to clearly communicate the reasoning behind the plans.

Overall, project integration management benefits everyone involved in the project—the project team, project manager, and stakeholders. 

Deliver results with project integration management

Project integration management brings all your project processes and tasks together. With Asana’s project management software, you have a single source of truth for planning and organizing projects from start to finish.    

To boost project success rates, find out if project management software is right for your team.

Related resources

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Smooth product launches are simpler than you think

What is stakeholder analysis and why is it important?

Understanding dependencies in project management

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An Analysis of Integration Management in Developing Project Performance-Evidence from Pakistan

Journal of Economics, Management & Business Administration

Objective: The purpose of this research was to ascertain how management integration influenced project performance. Integration of management contributes to project success. investigating the impact of the management integration dimensions on project performance and gauging the significance of the management integration elements. Methodology: Data were collected by a standardized survey questionnaire by employing the convenience sample method. Results: Shown that although the other criteria have a negligible association, there is a favorable relationship between the company's integration with its consumers. Conclusion: Controlling the integration aspects effectively boosts project performance and success chances.

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The Minister of State for Higher Education, Hon. Dr. John C. Muyingo on Thursday 25 th April 2024 officially launched the inaugural Annual Forum for Graduate Research and Policy Dialogue as well as the Research Information Management System (RIMS). Organised under the theme “Regional Integration and Development” , the two-day event being held in the Yusuf Lule Central Teaching Facility will witness over 70 paper presentations by PhD fellows, Research and Publication opportunities by the Makerere University Press as well as presentations on Mental Health and Wellness.

“I am here because I am coming back home and you are talking a language I love and enjoy. I am also here to confirm Government’s commitment to support Makerere ’s efforts to become a research-led University,” reassured Hon. Dr. Muyingo as he commenced his remarks.

Addressing the event theme, Hon. Dr. Muyingo underscored the importance of regional integration as a cornerstone of Uganda’s aspirations for a brighter future, noting that it is through cohesive efforts and shared endeavours that the region can overcome numerous challenges and unlock its full potential for growth and development.

He pointed out that higher education and research play a pivotal role in driving regional integration and development, and called upon scholars and researchers to play their respective roles. “Your pursuit of knowledge and academic excellence holds the promise of transformative change, serving as a catalyst for innovation, progress, and inclusive growth.”

Hon. Dr. Muyingo expressed the Government of Uganda’s appreciation of the strides made by Makerere University in as far as conducting research that informs national development priorities. He therefore applauded the two-day Annual Forum for Graduate Research and Policy Dialogue and launch of RIMS not only as milestones in graduate training but also platforms that will make the institution’s research more visible to government, funding agencies, research partners and other stakeholders.

He nevertheless reiterated the need for Higher Education Institutions (HEIs) such as Makerere “to play a more practical role in engaging the policy space and contribute to nurturing a policy environment receptive to evidence-based solutions.”

Delivering the first keynote of the two-day event, the Vice Chancellor, Prof. Barnabas Nawangwe expressly thanked Hon. Dr. Muyingo for presiding over a second event at Makerere in less than a week. On 19 th April 2024, he represented the First Lady and Minister of Education and Sports Hon. Janet Museveni, at the launch of the Digitalisation of Academic Records and Processes (DARP) project.

In the same measure, Prof. Nawangwe thanked the Government of Uganda substantially tackling the chronic shortage of funds for research by instituting the Makerere University Research and Innovations Fund (Mak-RIF). “With the money that Government is giving us, we have changed the research landscape of Makerere tremendously.

“Additionally, we have with the help of UNDP established a state-of-the-art Innovation Pod. We have put in place an office specializing in Intellectual Property and they are doing a great job; they have already registered several copyrights and applied for several patents” he added.

The Vice Chancellor nevertheless regretted the timing of ongoing budget cuts which are likely to affect funding for research. Noting that we are in the era of the knowledge economy where those in the know get ahead of those who are not, he reiterated that it is Nations such as China that have prioritised knowledge production through funding of Higher Education and research that are making leaps economically.

“If Africa is going to industrialise, we must produce more PhDs because no amount of foreign direct investment is going to industrialise Africa. Africa will be industrialised by the small and medium enterprises, which will come mostly out of research by PhD and Masters students, and a few undergraduate students – the Kiira Motors came from undergraduate students” explained Prof. Nawangwe.

Citing the presentations made during the opening ceremony by Mr. Erick Jacob Okek on Immunological and parasitological impact of co-deployment of Indoor Residual Spraying (IRS) and bed nets for malarial mosquito vector control in Uganda and Ms. Adella Grace Migisha on Environmental influences on electricity reliability in Uganda’s grid system , Prof. Nawangwe emphasised that PhD students are addressing pertinent issues and ought to be supported by the Government.

“Let us put our heads together and see how best to unlock the potential of Makerere University . There is so much potential here that we are not utilising as a country, and we need to unlock it to the letter” summed up the Vice Chancellor.

In line with contributing to unlocking Makerere ’s potential, the Director, Directorate of Research and Graduate Training (DRGT), Prof. Edward Bbaale said that the Annual Forum provides a platform to showcase the potential of graduate research as a driver for socioeconomic transformation. “Additionally, it serves to enhance the capacity of graduate students to engage effectively in policy dialogues and debates.”

Prof. Bbaale reiterated DRGT’s commitment to augmenting the skills of graduate scholars in policy engagement and communication as part of their doctoral research and education toolkit, owing to the impact these graduates have. “There is now evidence that return on investment in Higher Education is higher than the return on investment in lower education and hence Government is encouraged to support graduate training through scholarships and loan schemes.”

Citing the Makerere University Policy on Establishment of Research Institutes and Institutions, Prof. Bbaale said that DRGT is encouraging the growth of research groups into dynamic hubs such as research units, centres, institutes and centres of excellence. Furthermore, and in respect of packaging and marketing of research output as enshrined in the Makerere University Strategic Plan, he added that the multidisciplinary Makerere Innovation Pod is poised to foster creativity, innovation and collaboration among students, researchers and entrepreneurs.

On the need for scholars and researchers to publish works in books and journals, Prof. Bbaale put forth the Makerere University Press as an avenue for disseminating new knowledge across the various disciplines. “I would like to implore all faculty and students to use the press as a publishing house and promote our works.”

Developed by the Directorate for ICT Support (DICTS) with funding from Mak-RIF, the Research Information Management System (RIMS) was unveiled at the Forum as digital solution to track the graduate student journey, report every stage of progress, centrally manage research produced by students, and streamline the graduation process. Addressing the Forum, the Academic Registrar and Principal Investigator RIMS, Prof. Buyinza Mukadasi noted that the system is going to Makerere enhance its visibility as a research-led university.

“The architecture of RIMS has seven modules that include: Masters and PhD research; Postdoctoral research; Dissemination, Conferences and Seminars; Research Innovations; Inventory of Senior Researchers; International Collaborations; and e-Supervision” shared Prof. Buyinza.

He added that the system will not only enhance student tracking but also e-Supervision and thesis management through a simple easy-to-use dashboard. “It is a moment of joy that we are transiting from the manual system to an online digital platform. This will enhance efficiency, and completion rates will be assured.”

Providing a background to RIMS, the Director DICTS, Mr. Samuel Paul Mugabi noted that the ongoing development and launch of various Information Systems at Makerere University is as a result of a strategic shift by the leadership from outsourcing to solving challenges related to business processes digitalisation through in-house development.

RIMS was developed by a team made up of Mr. Juma Katongole, Mr. Joshua Muhumuza and Mr. Denis Wamala. The latter who presented on behalf of his colleagues demonstrated how the e-Supervision module can be used to track a scholar’s progress right from the conceptual stage right to the dissertation and defence. He added that the College of Agricultural and Environmental Sciences (CAES) will pilot the RIMS rollout.

The President PhD Fellows at Makerere University (Pf@Mak), Ms. Clare Cheromoi in her opening remarks said that the lineup of paper presentations would at the end of the two-day Forum clearly demonstrate to the public that PhDs remain highly relevant to addressing the challenges in the country. She observed that Makerere has created the supportive environment through avenues such as the Annual Forum for PhD fellows to collectively address national development priorities.

She thanked the University Management and Annual Forum organisers led by the Chairperson Prof. Julius Kikooma for their support in making the event a success. In particular, the President Pf@Mak thanked the Vice Chancellor for maintaining an open-door policy that has enabled Student Leaders to share their ideas. In appreciation the Pf@Mak Leadership presented a book How to Lead Smart People: Leadership for Professionals to Prof. Nawangwe.

The Forum was moderated by the Principal Public Relations Officer, Ms. Ritah Namisango, while the Department of Performing Arts and Film (PAF) kept guests entertained.

Book of Abstracts

Presentations from the Opening Ceremony

Joint Postdoctoral Fellowship in Ethics, Global Health and Infectious Disease

Call for applications: getspa project post-doctoral fellowships.

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Call for Applications:

The Johns Hopkins Berman Institute of Bioethics and the Wellcome Centre for Ethics and Humanities at the University of Oxford have established a Collaborative Bioethics Research and Training Program with support from the Wellcome Trust. Through this partnership, we have created joint post-doctoral training opportunities. We are pleased to invite applications from uniquely qualified individuals who are committed to interdisciplinary and transnational collaboration and who have a particular interest in the ethical issues at the intersection of global health and infectious disease. This two-year fellowship will begin September 1, 2024.

Qualifications, Responsibilities and Opportunities:

• Doctoral-level degree in bioethics, philosophy, public health, law, medicine, social science, history or other relevant discipline, with fewer than five years of post-PhD research by the start date.
• Scholarly interests in ethical issues at the intersection of global health and infectious disease.
• Primary, in-residence appointment at Johns Hopkins and a residency requirement at the Wellcome Center. The exact nature, duration and timing of the Oxford residency is flexible and case-specific.
• Regular seminars, presentations and discussions with leaders in the field;
• Individualized research program;
• Bioethics coursework and mentorship;
• Professional development training;
• Teaching opportunities (commensurate with experience and background);
• Participation in outreach efforts via social media

Salary/Benefits:

• $62,500 per year, plus health benefits
• Travel for the residency requirement and modest living expenses when overseas
• A modest discretionary fund for travel to relevant conferences

To apply: The application window is now open. Applications are due by May 10 th , 2024 and must be uploaded via Interfolio ( http://apply.interfolio.com/143815 ).

• Cover Letter
• Personal statement in support of your application
• Copy of Graduate Transcript(s)
• Writing Sample
• Two Letters of Reference

For more information on the Berman-Oxford Joint Post-doctoral Fellowship Program, please contact the Berman Institute’s Director of Education Initiatives (Gail Geller, ScD, MHS at [email protected]) or Associate Director for Global Programs (Joseph Ali, JD at [email protected]).

The Institute of African Studies (IAS) at the University of Ghana, with funding support from the Open Society Foundation, is calling for applications for post-doctoral fellowships as part of the Gender Equitable and Transformative Social Policy for Post-COVID-19 Africa (GETSPA) Project.

Focus of the fellowships

For Phase 2 of GETSPA, the project has selected themes that we consider integral to transformative social policy agenda for Africa.

• Interfaces and synergies of social and economic policy
• Gender equitable social policy
• Political and democratic underpinnings of social policy and citizenship
• Informal social policy systems and practices
• The debt crisis, austerity and implications for social policy
• The influence of the SDGs on social policy in Africa
• Social policies and the AfCFTA
• Financing social policy in Africa
• Lessons for Africa from a comparative analysis of social policy in the Global South
• Neglected areas of social policy

Eligibility

• Applicants must have been submitted their thesis and/or been awarded a doctoral degree from a recognized university within the past 5 years (that is, not earlier than 2018).
• A record of research and/or publications in social policy-related areas in African contexts would be an advantage.

Format of Applications

Applications should be submitted in English and contain the following:

• Proof of award of degree or submission of final thesis
• presents the applicant’s proposed area of focus for their research/writing, including topic, research questions, theoretical framing and methodology to be used;
• explains how the applicant intends to use the fellowship period, with a clear timeline of activities and outputs.
• Two letters of reference
• Deadline for applications: 25 May 2024
• Notification to successful applicants: 15 June 2024
• Start date of fellowship: 15 July 2024

Submit applications and enquiries to [email protected] , cc:ed to [email protected] , with the subject line “GETSPA post-doc application – [name of applicant]” .

You will receive an email acknowledgement of receipt of your application. If you do not receive such an email, please resend the application or call/WhatsApp +233 20 956 2427.

See Download below for details

By Okeya John & Davidson Ndyabahika

As the COVID-19 pandemic swept across Africa, it brought with it a wave of unprecedented challenges, impacting economies, social dynamics, and political structures. National healthcare systems were particularly strained, prompting governments to implement various strategies to combat the virus and its repercussions. Among these measures were the introduction of incentives, both financial and non-financial, aimed at boosting the morale of health workers and bolstering the capacity of healthcare systems to respond to health emergencies.

Due to COVID-19’s increased risks and demand on healthcare workers working in already overburdened health systems, incentive packages must be strengthened. Researchers conducted a multi-country qualitative study in DRC, Nigeria, Senegal, and Uganda with funding from the Bill and Melinda Gates Foundation and Gates Ventures/Exemplars in Global Health. The study examined pandemic-related workplace incentives. In 60 virtual interviews via phone and Zoom, ministry officials, policymakers, and health care providers provided important viewpoints.

Entitled “Health Workforce Incentives and Dis-Incentives During the COVID-19 Pandemic: Experiences from Democratic Republic of Congo, Nigeria, Senegal, and Uganda,” the research conducted by healthcare experts delved into the realm of incentive mechanisms, their allocation, and the inadvertent dis-incentives experienced by the health workforce amidst the pandemic response efforts.

The researchers were from Makerere University School of Public Health (Uganda), University of Kinshasa (DRC), University of Ibadan (Nigeria) and University of Dakar (Senegal). The research team comprised Suzanne Kiwanuka, Ziyada Babirye, Steven Kabwama, Andrew Tusubira, Susan Kizito, Rawlance Ndejjo, Marc Bosonkie, Landry Egbende, Berthold Bondo, Mala Ali Mapatano, Ibrahima Seck, Oumar Bassoum, Mamadou Leye, Issakha Diallo, Olufunmilayo Fawole, Segun Bello, Mobolaji Salawu, Eniola Bamgboye, Magbagbeola David Dairo, Ayo Steven Adebowale, Rotimi Afolabi, and Rhoda Wanyenze,

In their work, the scientists authoritatively note that: “Health worker incentives during the COVID-19 response were mostly unplanned, predominantly non-financial, and invariably implemented. Across these countries, there were neither guiding frameworks nor standard pre-determined packages of financial and non-financial incentives for health workers during emergencies.”  

Before the outbreak of the COVID-19 pandemic in December 2019, “Africa already had weak health systems,” they note, citing that the pandemic exposed this challenge, increasing work overload for health workers, mental stress, infections and deaths, who in turn, needed incentives to adequately work to respond and deliver good health outcomes during the emergency.

However, due to the dire working conditions, the Word Health Organization (WHO) had warned that frontline healthcare workers were most at risk of acquiring the deadly COVID-19 virus. In their report, WHO highlighted that between January 2020 and May 2021 alone, over 80,000 to 180,000 health and care workers respectively, had died of COVID-19 globally, calling for urgent need to reverse the tide.

From this study, Senegal faces a doctor and nurse shortage with only 0.38 healthcare workers per 1,000 people, well below the WHO recommendation. By December 2021, Senegal had recorded 75,055 COVID-19 cases and 1,890 deaths, including five health workers. Similarly, Uganda, with approximately 2.58 healthcare workers per 1,000 people, reported 146,030 COVID-19 cases and 3,306 deaths, including 37 health workers.

The researchers also noted that the DRC had 1.05 healthcare workers per 1,000 people, with 79,632 cases and 1,225 deaths, including 35 health workers. Nigeria faced a similar challenge, with 2.0 healthcare workers per 1,000 people, 243,450 cases, and 3,031 deaths by December 2021, including seven health workers. These findings stressed the strain on Africa’s fragile healthcare systems in responding to the COVID-19 pandemic.

“These challenges and consequences resulted in health workers either absconding from duty or in extreme circumstances, resigning from the health profession and opting for alternative professions,” the researchers note in their review of the COVID-19 response in Africa. They state that elsewhere by this time, measures had already been mounted to motivate health workers, necessitating a similar response in the continent.

In the countries where the study was conducted, the strategies adopted by governments and development partners to counter declining health worker motivation included offering financial rewards like allowances and salary increments, and non-financial incentives like adequate provision of medicines and supplies, on the job trainings, medical care for health workers, social welfare including meals, transportation and housing, recognition, health insurance, psychosocial support and increased supervision.

The researchers found that the financial rewards were a big motivating factor for the health workers in these countries in sustaining the health systems and COVID-19 efforts, while the non-financial incentives also contributed to improved health worker determination.

The incentives, although a success, however in their strength lied the weaknesses. The multi-country study reveals that the incentives had the double effect of creating disincentives and demotivating healthcare workers. This was occasioned by the lack of personal protective equipment, transportation to health facilities during lockdown, long working hours, harassment by security forces and perceived unfairness in access and adequacy of the rewards.

The study got its findings from virtual key informant interviews with the staff at ministries of health, policy makers, and health workers. In the study report, health managers and workers in DRC, Nigeria, Senegal, and Uganda confirmed that health workers received monetary benefits as a means of motivation for their effort towards the continuity of health services.

In Senegal, incentives were reported to mostly be financial. However, in DRC, although the salaries of the health workers involved in COVID-19 testing were reported to be similar to all other staff in response committees like epidemiological surveillance, case management, and communication, the government moved to temporarily waiver taxes to bait the COVID-19 health workers during the pandemic.

“Since financial incentives were mostly administered in an ad-hoc manner, some health workers felt they were unfairly distributed and complained about the lack of transparency in the allocation of these incentives. In Nigeria, it was reported that payments did not meet the health worker expectations, while in Uganda, it was reported that allowances were given selectively to some health workers such as those involved in contact tracing, COVID 19 testing, and COVID 19 isolation units but not to others.” The study report reads in part.

Respondents also revealed that although allowances were availed, there was dissatisfaction caused by delays and non-payment. In Uganda for example, the recruitment of additional 700 staff on contract although initially perceived positively, their irregular dismissal following budget shortfalls created discontentment and immense pressure for the government.

Accordingly, the authors observe that the incentive packages in the four African countries were inconsistent, lacked transparency, adequacy, and equity. “Therefore, there is a need to develop guiding frameworks within which governments and partners can deliver incentives and reduce dis-incentives for the health workforce during emergencies.”

The study suggests that during health emergencies like COVID-19, increased risks and workloads should mandate the provision of safety gear and adequate supplies. However, the researchers caution that both financial and non-financial incentives can have unintended consequences if perceived as unfair in their implementation.

They also call for incentives to be pre-determined, equitable and transparently provided during health emergencies ‘because arbitrarily applied financial and non-financial incentives become dis-incentives’, while still holding that the financial incentives are only useful in as far as they are administered together with non-financial incentives such as supportive and well-resourced work environments.

“Governments need to develop guidelines on incentives during health emergencies with careful consideration of mitigating potential dis-incentives. The harmonization of roles across state and non-state sector players in incentivizing the health personnel during health emergencies is paramount.” The study affirms.

Find the detailed scientific study  here .

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