Brain drain: Do economic conditions “push” doctors out of developing countries?

Okeke, Edward N.

doi:10.1016/j.socscimed.2013.09.010

Cited by 58 publications

(50 citation statements)

References 33 publications

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“…Many factors contribute to this physician shortage but the increasing rate of population growth coupled with the low retention of physicians in Ethiopia is undoubtedly important [2, 3]. The brain drain has resulted in an overwhelming number of Ethiopian physicians migrating to higher income countries in Europe, North America, or other African countries for higher salaries, improved working conditions, or better career options [4–6]. In response to the physician shortage, Ethiopia developed training programs to rapidly increase the number of non-physician healthcare workers, thus increasing coverage and lowering cost of health care [7, 8].…”

Section: Introductionmentioning

confidence: 99%

Student and faculty perceptions on the rapid scale-up of medical students in Ethiopia

et al. 2017

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BackgroundEthiopia is a country of over 94 million people that has a severe physician shortage with approximately only 2.5 physicians per 100,000 persons. Recently, the Ethiopian government implemented a “flood and retain” initiative to rapidly increase the quantity of physicians in Ethiopia. Consequently, medical student enrollment at Addis Ababa University (AAU) School of Medicine increased from 100 to approximately 300–400 students per class. This study evaluated the impact of the rapid scale-up in the number of medical students on the quality of medical education at AAU and the impact of the U.S. government-funded Medical Education Partnership Initiative (MEPI) grant awarded to AAU to provide resources to strengthen the quality of medical education at AAU.MethodsQualitative, semi-structured, in-depth interviews were conducted with 22 key informants including faculty members, administrators and medical students at AAU. The audio recordings were transcribed verbatim and interview data were analyzed with thematic analysis.ResultsFour key themes emerged from the data. Overall, participants perceived a decrease in the quality of medical education at AAU due to challenges created by the rapid scale-up in the number of medical students. Positive learning environments were described as difficult to achieve due to overcrowding in classrooms and the limited numbers of textbooks. Overall, participants stated that infrastructure improvement is needed to provide adequate medical student training. The medical education initiatives implemented and funded by MEPI have provided significant resources to support the medical student curriculum but additional resources are required to accommodate a large student body.ConclusionsThe unprecedented rapid scale-up of medical students has impacted multiple facets of medical education at AAU. It is important to consider the perspectives of students and faculty in order to focus future medical education policies, MEPI programming and the allocation of resources.

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Section: Introductionmentioning

confidence: 99%

Student and faculty perceptions on the rapid scale-up of medical students in Ethiopia

et al. 2017

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“…The economic benefits of health workforce migration on families and the economy are well documented [15, 17, 32]. An emerging body of research is recently focusing on the socio-cultural impact [16] on families and the broader society.…”

Section: Discussionmentioning

confidence: 99%

“…Vast literature confirms the economic-financial drive to migrate abroad [17], where ‘pull’ factors, higher income, better lifestyle, travel opportunities, and career development pull nurses out of developed countries and push factors of low wages, increased workload, and poor benefits encourage Filipino nurses to exit their home country.…”

Section: Introductionmentioning

confidence: 99%

Source country perceptions, experiences, and recommendations regarding health workforce migration: a case study from the Philippines

2014

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BackgroundThe Philippines continues to overproduce nurses for export. Little first-hand evidence exists from leading organisations in the Philippines concerning their experiences and perceptions in relation to Filipino nurse migration. What are their views about health workforce migration? This paper addresses this research gap by providing a source country perspective on Filipino nurse migration to Australia.MethodsFocus-group interviews were conducted with key informants from nine Filipino organisations in the Philippines by an Australian-Filipino research team. The organisations were purposively selected and contacted in person, by phone, and/or email. Qualitative thematic analysis was performed using a coding framework.ResultsHealth workforce migration is perceived to have both positive and negative consequences. On the one hand, emigration offers a welcome opportunity for individual Filipino nurses to migrate abroad in order to achieve economic, professional, lifestyle, and social benefits. On the other, as senior and experienced nurses are attracted overseas, this results in the maldistribution of health workers particularly affecting rural health outcomes for people in developing countries. Problems such as ‘volunteerism’ also emerged in our study.ConclusionsIn the context of the WHO (2010) Code of Practice on the International Recruitment of Health Personnel it is to be hoped that, in the future, government recruiters, managers, and nursing leaders can utilise these insights in designing recruitment, orientation, and support programmes for migrant nurses that are more sensitive to the experience of the Philippines’ education and health sectors and their needs.

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“…The conventional model is to train more doctors and other healthcare workers. This approach has not been successful because of failure to retain the skilled workforce, especially the doctors. The strategy that LMICs have used for several years in an attempt to resolve the crisis is task shifting.…”

Section: Task Shiftingmentioning

confidence: 99%

Innovation in income-poor environments

Oppong

2015

British Journal of Surgery

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Background: At the core of surgical development in any economic environment lies innovation. Innovation in high-income countries (HICs) often derives from research, whereas innovation in low-and middle-income countries (LMICs) may be spontaneous owing to a desperate drive to meet a local need. The local needs are substantial because of the unequal access to healthcare in LMICs.Methods: The experience of the author in working in LMICs through Operation Hernia, a medical charity, provides a backdrop for this review. Other published innovative devices and models are discussed.Results: Innovation in income-poor countries has provided cost-effective but efficient solutions to local health needs. Some innovations have been enhanced and adopted worldwide. Conclusion:HICs can learn more from innovative strategies adopted in LMICs.

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Brain drain: Do economic conditions “push” doctors out of developing countries?

Cited by 58 publications

References 33 publications

Student and faculty perceptions on the rapid scale-up of medical students in Ethiopia

Student and faculty perceptions on the rapid scale-up of medical students in Ethiopia

Source country perceptions, experiences, and recommendations regarding health workforce migration: a case study from the Philippines

Innovation in income-poor environments

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