Health worker migration, Africa’s tiresome burden
WHEN Josephine Bwire finally achieved her dream of becoming a doctor, she had a myriad of expectations, but above all, she was ready to give back to her community. She envisioned herself helping the poor and the sick in her beloved country of Tanzania, knowing very well that her new career will reward her in many ways, financially being one of them.
Five years down the line, her anxiety was overwhelming, considering that she was constantly dogged with a mounting pile of unpaid bills and she knew that sooner or later she would have to make serious decisions on her future as a doctor.
When a chance popped up for doctors to go and offer their services in Botswana, she grabbed the opportunity and as luck would have it she was shortlisted and within no time she was on board a plane destined for Gaborone. Many studies have investigated the migration intentions of sub-Saharan African medical students and health professionals within the context of a legacy of active international recruitment by receiving countries. International migration of healthcare workers has sustained the human resources crisis in many countries in sub-Saharan Africa.
The flow of health professionals from low-income to high-income countries has received much attention over the past few decades and is considered to be a significant contributor to the further weakening of already fragile health systems. Migration of health professionals worldwide has resulted in an unequal distribution of medical staff globally.
The movement of medical staff out of some developing countries, often termed “brain drain,” affects the health care system at multiple levels, including both doctors and nurses. Medical staffs are leaving their countries because of both push and pull factors. Pull factors include better remuneration and working environment, job satisfaction and prospects for further education.
During a media capacity building held in Malawi recently, Dr. Joachim Osur, Director, Regional Programmes and Field Offices, Amref Health Africa said the majority of these labor movements are due to low salaries, unfavorable working conditions and lack of equipment. In his representation, he said that it is depressing for health workers to see patients dying and they are helpless because of lacking equipment and drugs to provide treatment.
“If you are paying your health workers well, you are improving the conditions of work and helping them to develop their professional career, they will have no reason to move to other countries,’’ said Dr Osur.
According to him, there is need for all health experts, health organizations, health workers themselves and other concerned stakeholders in the health sector, to put governments on the spot to invest more in health care. Dr. Osur however, encourages governments to invest more money in the health sectors so as to tame such movements and retain the bulk of health workers in Africa.
The crisis of health workers is one of the most significant obstacles to improving the health system in Tanzania and other African countries. The global workforce crisis can be tackled if there is global responsibility, political will, financial commitment and public-private partnerships for country-led and country-specific interventions that seek solutions beyond the health sector.
“Only when enough health workers can be trained, sustained and retained in Sub-Saharan African countries, will the region attain the Millennium Development Goals,” says Dona Anyona of Amref Africa during the Malawi workshop. She says that to tackle the health workforce crisis, there is a need to increase training capacity, to improve retention and management of the health workforce, to address concerns related to international migration of health workers and better monitor these flows. According to World Health Organization, currently there is a global shortage of 4.25 million health care workers, with Sub-Saharan Africa alone in need of more than half of these workers. This shortage is fueled in part by the brain drain of medical personnel.
As of 2006, Tanzania, with a population of 40 million, had only 1,264 doctors working in the country and 1,356 doctors working abroad. Tanzania will need to triple its number of doctors if it is to achieve the Millennium Development Goals of reducing child mortality and improving maternal health.
Just like Tanzania, Kenya is also facing a human resource crisis in the public health sector, where many of its health professionals, such as doctors and nurses, are immigrating to developed countries to seek better employment prospects.
Within the country itself, they are leaving rural areas to work in urban areas for the same reason. In most African countries, the public health sector is seriously affected by the migration of health professionals, as the majority of the continent’s population relies on its countries’ public health systems and most of these people are very poor.
Unfortunately, most health professionals do not report their intention to emigrate so it is difficult to establish with certainty how many emigrate from Tanzania. According to World Health Organization, currently there are almost 60 million health workers globally, but they are unevenly distributed across countries and regions.
Typically, they are scarcest where they are most needed, especially in the poorest countries. In any case, the total number is incapable of meeting the demands of many populations for access to the health care they require.
Both developed and developing countries are struggling to cope with the huge challenges posed by the imbalance between increasing demand and faltering supply Health workforce migration is part of the globalization of the labor market and warrants better measurement and policy options to be managed rather than a problem to be solved.
Five years down the line, her anxiety was overwhelming, considering that she was constantly dogged with a mounting pile of unpaid bills and she knew that sooner or later she would have to make serious decisions on her future as a doctor.
When a chance popped up for doctors to go and offer their services in Botswana, she grabbed the opportunity and as luck would have it she was shortlisted and within no time she was on board a plane destined for Gaborone. Many studies have investigated the migration intentions of sub-Saharan African medical students and health professionals within the context of a legacy of active international recruitment by receiving countries. International migration of healthcare workers has sustained the human resources crisis in many countries in sub-Saharan Africa.
The flow of health professionals from low-income to high-income countries has received much attention over the past few decades and is considered to be a significant contributor to the further weakening of already fragile health systems. Migration of health professionals worldwide has resulted in an unequal distribution of medical staff globally.
The movement of medical staff out of some developing countries, often termed “brain drain,” affects the health care system at multiple levels, including both doctors and nurses. Medical staffs are leaving their countries because of both push and pull factors. Pull factors include better remuneration and working environment, job satisfaction and prospects for further education.
During a media capacity building held in Malawi recently, Dr. Joachim Osur, Director, Regional Programmes and Field Offices, Amref Health Africa said the majority of these labor movements are due to low salaries, unfavorable working conditions and lack of equipment. In his representation, he said that it is depressing for health workers to see patients dying and they are helpless because of lacking equipment and drugs to provide treatment.
“If you are paying your health workers well, you are improving the conditions of work and helping them to develop their professional career, they will have no reason to move to other countries,’’ said Dr Osur.
According to him, there is need for all health experts, health organizations, health workers themselves and other concerned stakeholders in the health sector, to put governments on the spot to invest more in health care. Dr. Osur however, encourages governments to invest more money in the health sectors so as to tame such movements and retain the bulk of health workers in Africa.
The crisis of health workers is one of the most significant obstacles to improving the health system in Tanzania and other African countries. The global workforce crisis can be tackled if there is global responsibility, political will, financial commitment and public-private partnerships for country-led and country-specific interventions that seek solutions beyond the health sector.
“Only when enough health workers can be trained, sustained and retained in Sub-Saharan African countries, will the region attain the Millennium Development Goals,” says Dona Anyona of Amref Africa during the Malawi workshop. She says that to tackle the health workforce crisis, there is a need to increase training capacity, to improve retention and management of the health workforce, to address concerns related to international migration of health workers and better monitor these flows. According to World Health Organization, currently there is a global shortage of 4.25 million health care workers, with Sub-Saharan Africa alone in need of more than half of these workers. This shortage is fueled in part by the brain drain of medical personnel.
As of 2006, Tanzania, with a population of 40 million, had only 1,264 doctors working in the country and 1,356 doctors working abroad. Tanzania will need to triple its number of doctors if it is to achieve the Millennium Development Goals of reducing child mortality and improving maternal health.
Just like Tanzania, Kenya is also facing a human resource crisis in the public health sector, where many of its health professionals, such as doctors and nurses, are immigrating to developed countries to seek better employment prospects.
Within the country itself, they are leaving rural areas to work in urban areas for the same reason. In most African countries, the public health sector is seriously affected by the migration of health professionals, as the majority of the continent’s population relies on its countries’ public health systems and most of these people are very poor.
Unfortunately, most health professionals do not report their intention to emigrate so it is difficult to establish with certainty how many emigrate from Tanzania. According to World Health Organization, currently there are almost 60 million health workers globally, but they are unevenly distributed across countries and regions.
Typically, they are scarcest where they are most needed, especially in the poorest countries. In any case, the total number is incapable of meeting the demands of many populations for access to the health care they require.
Both developed and developing countries are struggling to cope with the huge challenges posed by the imbalance between increasing demand and faltering supply Health workforce migration is part of the globalization of the labor market and warrants better measurement and policy options to be managed rather than a problem to be solved.
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