African portfolio entrepreneurship and the creation of jobs

Purpose The purpose of this paper is to focus on large-scale portfolio entrepreneurship and its impact on the creation of stable wage employment in African economies. Design/methodology/approach The three studies focussed on Egypt, Uganda, and Malawi were all exploratory, inductive, and qualitative studies, which involved semi-structured interviews with 65 entrepreneurial founders of some of these countries’ most prominent business portfolios between 2009 and 2012. The data were collected through face-to-face interviews, which lasted between one and four hours, with the founders of each of these portfolios. Findings This inductive and qualitative study finds a connection between the creation of stable wage-paying jobs and portfolio entrepreneurship in three countries, representing three of the four different archetypal African economies. It also finds a strong connection between the development of new industries and portfolio entrepreneurship. Practical implications The practical and societal implications of these findings are incredibly important. The current and looming shortage of stable wage employment in Africa is reaching calamitous proportions. The growth in religion-affiliated terrorism and high-risk economic migration to Europe can be directly related to the lack of employment opportunities in African nations. The findings indicate that portfolio entrepreneurs are major players in the creation of such employment opportunities and government policies focussing on this area, as compared to focussing solely on SMEs, may be more effective in mitigating some of the drivers for emigration and terrorism. Originality/value This is the only study of its kind that investigates the role of large-scale portfolio entrepreneurship in the growth of employment opportunities in Africa

High growth and rapid internationalisation of firms from emerging markets: the case of the Middle East and North Africa (MENA) Region

The aim of this thesis is to understand the phenomena of the high growth and rapid internationalisation of firms from emerging markets. It explores the applicability of international entrepreneurship theory to the context of the emerging market enterprises in the Middle East and North Africa (MENA) region. It integrates the literature of strategic entrepreneurship and that of portfolio entrepreneurship with the literature of international entrepreneurship to provide a closer fit of applicability in that context. The main research questions of this thesis focus on: why, where, and how do some emerging market enterprises grow fast and internationalise early and rapidly? Particular attention is paid to entrepreneurs, entrepreneurial teams and the entrepreneurial process in the discovery, evaluation, and exploitation of new business opportunities. Despite the strength of the international entrepreneurship theory in identifying the sources of rapid internationalisation for small and medium enterprises from developed markets, it has been criticized for failing to address the same phenomena for firms from emerging markets. This thesis explores why, where, and how the MENA region emerging market firms have attained their spectacular performance over the last few years up to 2008, and contributes to filling the theoretical gap in the literature. This exploratory study suggests that the entrepreneurial and management processes of international business opportunities play an important role in achieving the high growth and rapid internationalisation of firms from emerging markets. A multiple case study strategy was adopted, and qualitative data was collected through interviews with entrepreneurs and entrepreneurial team members in the research site of the emerging markets of the MENA region. Other interviews with financial experts, staff of international financial institutions, and international analysts in specialized publications were conducted in order to achieve triangulation and bias minimization. Guided by a newly formulated conceptual theoretical framework, data was explored and thematically analysed by coding into different categories to enhance the understanding of the processes that underlined the entrepreneurial strategies associated with the rapid internationalisation and high growth of the theoretically sampled case companies. Resource orchestration, innovativeness, entrepreneurial leadership and international diversification were found to be crucial elements employed by lead entrepreneurs and their entrepreneurial team members through utilising human and social capital of networks and knowledge throughout the internationalisation process. The findings revealed that integrating the concepts of strategic entrepreneurship and portfolio entrepreneurship with international entrepreneurship produced a coherent approach to the application of those theories to understanding the behaviour of multinational enterprises from the MENA region. However, other valuable themes emerged from the findings. Chief among those are: strategically targeting hostile markets with inefficient institutional competencies and insufficient infrastructure, thus benefiting from a no competition status. Networking internally with entrepreneurial team members and international churning were other key elements revealed by the findings that explained the interactions and processes which enhanced the companies’ rapid internal growth, A recommendation for management practice is made for firms to encourage internal networking with entrepreneurial teams’ members thus enhancing trust and supporting intrapreneurs’ initiatives in identifying and exploiting new international opportunities. A mainstream policy recommendation for emerging markets is to strengthen the private sector performance with government incentives of a financial (tax reductions, banking facilities) and non-financial (political reform, education and health services) nature to encourage such entrepreneurial activities. In addition to its contribution to the theoretical understanding of high growth and rapid internationalisation from emerging markets, the findings of this thesis accentuate the impact of the pattern of internationalisation into antagonistic environments with scarce infrastructure as a strategic entrepreneurship process of deployment of dynamic capabilities to craft unique competitive advantages thus achieving and sustaining high growth and performance in new international markets. This thesis is also unique in compiling the first dataset for MENA region enterprises with similar attributes of high growth and rapid internationalisation

Do accountabilities change when public organisations transform to service systems?

In this conceptual paper we discuss from the service systems perspective how accountabilities differ from a hierarchic and organisational perspective within the domain of New Public Management, looking to shed new light upon accountability as a research topic. The concept of service systems and their accountabilities are scrutinized and the role of integrated social and health care services are discussed in particular. The main argument in the text is the changing nature of accountabilities as the public organisations are being transformed into service systems. To date, the understanding of accountability has remained structural by nature – such is the case also for productivity measurement – but the shift from organisations towards services systems means that accountability ought to be considered as processual by nature. By processual it is meant that accountability should be considered as flows within systems – that is: flows between agents the content of which we argue includes not only knowledge on the outputs of public services, but also values, empathy and thus multi-layered understanding of accountability. The paper concludes with practical insights for managerial purposes on the basis for this accountability shift

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely