Private sector contributions and their effect on physician emigration in the developing world

Loh, Lawrence C.; Ugarte-Gil, César; Darko, Kwame

doi:10.2471/blt.12.110791

Cited by 23 publications

(24 citation statements)

References 19 publications

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“…By adopting a private (or even non-profit) approach, diaspora might be able to innovate to adapt to non-security related challenges and provide efficient care outside of governmental mechanisms. One study demonstrated that the proportion of physicians working the private sector was inversely related to rates of expatriation within a series of countries [ 45 ]. Public-private partnerships in LMICs however remain irreplaceable as a means to maintain private for-profit venture survival as well as equitable access for patients, as has been shown in other studies [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

Giving Back: A mixed methods study of the contributions of US-Based Nigerian physicians to home country health systems

Nwadiuko¹,

James

Switzer

2016

Global Health

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BackgroundThere is increased interest in the capacity of US immigrants to contribute to their homelands via entrepreneurship and philanthropy. However, there has been little research examining how immigrant physicians may support health systems and what factors facilitate or raise barriers to increased support.MethodsThis study used an observational design with paper questionnaire and interview components. Our sample was drawn from attendees of a 2011 conference for US Based Nigerian physicians; respondents who were not US residents, physicians, and of Nigerian birth or parentage were excluded from further analysis. Respondents were randomly selected to complete a follow-up interview with separate scripts for those having made past financial contributions or medical service trips to support Nigerian healthcare (Group A) and those who had done neither (Group B). Survey results were analyzed using Fischer exact tests and interviews were coded in pairs using thematic content analysis.ResultsSeventy-five of 156 (48 %) individuals who attended the conference met inclusion criteria and completed the survey, and 13 follow-up interviews were completed. In surveys, 65 % percent of respondents indicated a donation to an agency providing healthcare in Nigeria the previous year, 57 % indicated having gone on medical service trips in the prior 10 years and 45 % indicated it was “very likely” or “likely” that they would return to Nigeria to practice medicine. In interviews, respondents tended to favor gifts in kind and financial gifts as modes of contribution, with medical education facilities as the most popular target. Personal connections, often forged in medical school, tended to facilitate contributions. Individuals desiring to return permanently focused on their potential impact and worried about health system under-preparedness; those not desiring permanent return centered on how safety, financial security and health systems issues presented barriers.ConclusionsThis study demonstrates several mechanisms by which health systems may benefit from expatriate engagement. Greater identification of reliable local partners for diaspora, deeper collaboration with those partners and a focus on sustainable interventions might improve the quantity and impact of contributions. Ethnic medical associations have a unique role in organizing and facilitating diaspora response. Public-private partnerships may help diaspora negotiate the challenges of repatriation.

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Section: Discussionmentioning

confidence: 99%

Giving Back: A mixed methods study of the contributions of US-Based Nigerian physicians to home country health systems

Nwadiuko¹,

James

Switzer

2016

Global Health

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“…24 However, emigration may decline as a result of increased private health care expenditure. 28 There is also a large discrepancy in conditions, salaries, and benefits between the private and public sectors, making the private sector far more attractive to potential employees. 24 A similar problem exists between the urban and rural regions, where urbanbased jobs also offer increased wages, stability, opportunity, and standard of living.…”

Section: Discussionmentioning

confidence: 99%

Lack of access to paediatric cardiology services in the public health system in four major urban centres in Perú

et al. 2018

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For one-third of the Peruvian population living in large cities outside the capital city Lima, there is no access to paediatric cardiology services provided by the public health care system. Children with suspected CHD living in these areas are referred to the adult cardiologist working at the regional hospitals for care and treatment. This is a consequence of the universal health care system and the heavily skewed distribution of the health care workforce towards the capital city of Lima. This imbalance has resulted in a severe shortage of paediatric cardiologists practicing outside of Lima and the adult cardiologists that remain are left to make up for this deficit.To gain a better understanding of the current model of care for children with suspected CHD within the public health care system in Peru, we surveyed adult cardiologists from four major urban centres that serve one-third of the Peruvian population outside of Lima. We determined that adult cardiologists spend a significant amount of time treating children, but lack the specialised training and equipment to provide model care. The cardiologists indicated that receiving additional training and appropriate equipment would help enable them to provide proper care for these children.

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“…On the contrary, at the time of independence, only 8% of Indian health care delivery was private and now Indian health care system is dominated by private players and around 87% of India's health care is privately funded. 25 This phenomenon is also seen in home health care segment of Indian health care system as it is now considered as an attractive venture for investors, and more and more players are entering with the passage of time.…”

Section: Elderly As Major Users Of Home Health Carementioning

confidence: 99%

Home Health Care: The Missing Link in Health Delivery System for Indian Elderly Population—A Narrative Review

Singh¹

2017

International Journal of Research Foundation of Hospital and Healthcare Administration

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Elderly population in India is at a disadvantageous position in comparison to other countries in matters of dedicated health facilities, health insurance, and geriatric specialist. Health issues of the elderly can be summarized as geriatric syndromes, cognitive decline, immobility, falls, and incontinence. These peculiar health characteristics of old age population can be better dealt with home health care, which is of recent origin in India and is limited to only metro cities in the private sector. Whereas home health care in the USA is present from over a century, in Europe it is present in most of the countries. This study presents the status of existing private home health care industry of India and advocates about the benefits of home health care for the elderly and supports that Indian policymaking bodies should incorporate home health care in its policy for improving access and quality of health care to elderly population.

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Private sector contributions and their effect on physician emigration in the developing world

Cited by 23 publications

References 19 publications

Giving Back: A mixed methods study of the contributions of US-Based Nigerian physicians to home country health systems

Giving Back: A mixed methods study of the contributions of US-Based Nigerian physicians to home country health systems

Lack of access to paediatric cardiology services in the public health system in four major urban centres in Perú

Home Health Care: The Missing Link in Health Delivery System for Indian Elderly Population—A Narrative Review

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