Contextual factors that are not currently included in the MUSIQ tool, but were reported in various studies (n = 8) included organizational level of programme implementation, patient turnover and bed occupancy, staffing levels, quality of evidence and guidelines, maturity of systems on which CDSS are based, trust in and quality of information sources and educational outreach visitors [ 20– 27].
A randomized control trial of an enhanced supervision programme for eye care in three sub-Saharan African countries, including Tanzania, found only modest improvements in the skills and knowledge of health workers receiving enhanced supervision, with authors concluding that the lack of programme impact may be linked to poor health system functioning and high staff turnover [ 32].
High turnover of laboratory professionals is a drain on programme funds, as more time and resources need to be devoted to advertise, interview, hire, and train new laboratory professionals.
When it appointed Burns in November, it was clear that Ofcom was not alone in worrying about the lack of managerial turnover in key areas of C4 – where originally staff were meant to return to programme production after a few years – especially in the shaping of schedules and allocation of programme funds.
Cost of programme set up.
There is valuable knowledge to be gained by studying the evolutionary turnover of these functional roles involved in plant developmental programmes and abiotic stress resistance.
Despite a significant increase in the number of health protection staff who had received training, there remained some that had not received any, suggesting the need for an ongoing training programme that also takes into account turnover of staff.
Another effect of the restructuring was the high turnover of staff so that, despite the constantly organized training programmes, about 30% of the existing staff operates without having passed through any professional training programme101.
Although nurses acknowledged the importance of induction programmes, they strongly urged that the programme for medical staff be reviewed so that the frequent turnover of juniors (every 3 to 6 months) would not take up their time.
Turnover of key staff was a major factor affecting integration of the programme.
