The financial cost of doctors emigrating from sub-Saharan Africa: human capital analysis OPEN ACCESS
نویسندگان
چکیده
Objective To estimate the lost investment of domestically educated doctors migrating from sub-Saharan African countries to Australia, Canada, the United Kingdom, and the United States. Design Human capital cost analysis using publicly accessible data. Settings Sub-Saharan African countries. ParticipantsNine sub-Saharan African countries with an HIV prevalence of 5% or greater or with more than one million people with HIV/AIDS and with at least one medical school (Ethiopia, Kenya, Malawi, Nigeria, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe), and data available on the number of doctors practising in destination countries. Main outcome measures The financial cost of educating a doctor (through primary, secondary, and medical school), assuming that migration occurred after graduation, using current country specific interest rates for savings converted to US dollars; cost according to the number of source country doctors currently working in the destination countries; and savings to destination countries of receiving trained doctors. Results In the nine source countries the estimated government subsidised cost of a doctor’s education ranged from $21 000 (£13 000; €15 000) in Uganda to $58 700 in South Africa. The overall estimated loss of returns from investment for all doctors currently working in the destination countries was $2.17bn (95% confidence interval 2.13bn to 2.21bn), with costs for each country ranging from $2.16m (1.55m to 2.78m) for Malawi to $1.41bn (1.38bn to 1.44bn) for South Africa. The ratio of the estimated compounded lost investment over gross domestic product showed that Zimbabwe and South Africa had the largest losses. The benefit to destination countries of recruiting trained doctors was largest for the United Kingdom ($2.7bn) and United States ($846m). Conclusions Among sub-Saharan African countries most affected by HIV/AIDS, lost investment from the emigration of doctors is considerable. Destination countries should consider investing in measurable training for source countries and strengthening of their health systems.
منابع مشابه
The financial cost of doctors emigrating from sub-Saharan Africa: human capital analysis
OBJECTIVE To estimate the lost investment of domestically educated doctors migrating from sub-Saharan African countries to Australia, Canada, the United Kingdom, and the United States. DESIGN Human capital cost analysis using publicly accessible data. SETTINGS Sub-Saharan African countries. PARTICIPANTS Nine sub-Saharan African countries with an HIV prevalence of 5% or greater or with mor...
متن کاملThe financial cost of physician emigration from sub-Saharan Africa.
doi=10.1136/bmj.d6817 The financial cost of physician emigration from sub-Saharan Africa James Buchan professor A1 Queen Margaret University, Edinburgh EH21 6UU, UK [email protected] Research, doi:10.1136/bmj.d7031 A whole government approach is needed to mitigate the impact of the brain drain In the linked study (doi:10.1136/bmj.d7031), Mills and colleagues attempt to quantify the cost to sub-...
متن کاملNon-physician Clinicians – A Gain for Physicians’ Working in Sub-Saharan Africa; Comment on “Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians”
The changing demands on the health sectors in low- and middle-income countries especially sub-Saharan African countries continue to challenge efforts to address critical shortages of the health workforce. Addressing these challenges have led to the evolution of “non-physician clinicians” (NPCs), that assume some physician roles and thus mitigate the continuing shortage of doctors in these count...
متن کاملA New Generation of Physicians in Sub-Saharan Africa?; Comment on “Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians”
This commentary follows up on an editorial by Eyal and colleagues in which these authors discuss the implications of the emergence of non-physician clinicians (NPCs) on the health labour market for the education of medical doctors. We generally agree with those authors and we want to stress the importance of clarifying the terminology to describe these practitioners and of defining more formall...
متن کاملConstraints to Increasing Agricultural Production and Productivity among Women Farmers in Sub-Saharan Africa: Implications for Agricultural Transformation Agenda
Agriculture is an important engine of growth and poverty reduction in much of Africa, Nigeria inclusive. But the sector is underperforming in part because women, who are often crucial resource in agriculture and rural economy, face constraints that reduce their productivity. An understanding of these constraints is a prerequisite to devising policies to improve agricultural production and produ...
متن کامل