31/10/13

US-based African migrant doctors ‘grows by 38 per cent’

Doctor examines patients
Copyright: Flickr/ Curt Carnemark /World Bank

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  • Africa has only 2 per cent of doctors worldwide despite its high disease burden
  • Lack of job satisfaction in Africa influences migration of doctors abroad
  • Experts say governments must retain doctors with incentives, among others

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[NAIROBI] The migration of doctors from Africa for greener pastures in the United States has increased over the past decade despite relative economic growth and reduced political instability in many countries, according to researchers.
 
Doctors from the continent migrated to the United States in even bigger numbers compared to previous years, growing by 38 per cent between 2002 and 2011, according to a study published in PLOS Medicine last month (17 September).
 
The findings, which resulted from the analysis of the 2011 American Medical Association Physician Master file, a register of medical practitioners in the United States, notes that Africa, while bearing a quarter of the global disease burden, has only 2 per cent of the physician population in the world.
 
The US-based researchers examined migration of doctors from 28 countries in Sub-Saharan Africa, including Cameroon, Ethiopia, Ghana, Kenya, Liberia, Nigeria, South Africa, Sudan, Tanzania, Uganda, Zambia and Zimbabwe.
 
The findings show a worsening situation in Sub-Saharan Africa in terms of doctor-to-patient ratio.
 
Some African doctors, the authors observe, are working in the United States doing jobs "incommensurate" with their training, meaning that they are doing all manner of jobs for survival other than practising medicine.
 
On average the migrant doctors work in the United States for 18 years.

“It may be too ambitious and probably unrealistic to completely stop the migration of physicians from poor countries in Africa to the United States or Canada. However, in the interest of health equity, it is possible and desirable to reduce the scale of such movements”

Akhenaten Tankwanchi

 
South Africa was the exception in 2011, with the figures of doctors moving to the United States declining by 8 per cent, according to the study, which attributes the continued brain drain to lack of job satisfaction at home.
 
"It may be too ambitious and probably unrealistic to completely stop the migration of physicians from poor countries in Africa to the United States or Canada. However, in the interest of health equity, it is possible and desirable to reduce the scale of such movements," says the study's lead author Akhenaten Tankwanchi, an independent consultant based in the United States.
 
The study shows that Liberia, which is emerging from a prolonged period of conflict, has a ratio of 1.37 doctors per 100,000 people compared to the United States with 250 doctors for every 100,000 people, according to 2008 estimates.
 
Tankwanchi recommends that greater emphasis should be placed on non-wage retention strategies, including improving working and living conditions of Africa’s doctors in order to help retain them in their countries of origin.
 
Developed countries could also help reverse the trend by training more of their own physicians, or by refusing to grant residency permit to migrant doctors aged below 36 years, according to Tankwanchi.
 
Esther Ogara, a deputy director at Kenya’s Ministry of Health, agrees, noting that doctors migrating from Africa to developed countries tend to be mostly youthful in age and at the peak of their productivity.
 
She urges governments to consider improving pay as well as giving incentives such as housing, good working facilities and opportunities for career advancements to doctors to help improve and keep the physician population at adequate levels in Africa.
 
Link to full paper in PLOS Medicine
 
This article has been produced by SciDev.Net's Sub-Saharan Africa desk.
 

References

PLOS Medicine  doi 10.1371/journal.pmed.1​001513 (2013)

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