African health worker gap catastrophic

It has been revealed that the global shortfall in healthcare professionals has reached four million people – with one million needed in Africa alone. The figures were voiced at the Global Forum on Human Resources for Health, which opened in the Ugandan capital of Kampala on March 3rd.

Poor working conditions in Africa, along with heavy incentives from the West, are drawing a heavy proportion of newly-trained health professionals out of the continent. Some 57 countries, especially in Africa and Asia, are particularly affected and unable to effectively provide health services for the population, which also hampers prevention and information campaigns, drug distribution and other life-saving interventions.

Africa has been particularly badly hit as measures from wealthy countries to encourage skilled workers to emigrate have stripped African countries, particularly in sub-saharan regions, of up to 75% of their physicians (Mozambique) and up to 82% of nurses.

"They seek better employment and quality of life. Income is an important motivation for migration [as well as] better working conditions, career opportunities and more job satisfaction," Sigrun Mogedal, one of the conference organisers, said.

Across the continent, Africa has 11% of the world population and 24% of the global burden of disease, but only 3% of the world’s health workers. Nine countries, including Britain, the US, France, South Africa, Belgium, Spain, Canada, Australia and Portugal, received the vast majority of all migration from Africa – 92.4%, amounting to over 65,000 people in the year 2000 (the most recent figures available).

Britain has been particularly active in Kenya, recruiting the vast majority of the 51% of healthcare workers which have left the country, leaving many of those injured in recent fighting around the elections unable to find medical help.

At the conference, Ugandan health minister Stephen Malinga said that wealthier African countries, particularly South Africa, had been poaching healthcare workers as their own emigrate – around 5% of South African health professionals leave the country. The effect created is of a feeder chain, with the wealthiest countries buying in doctors and nurses from African countries, wealthier African countries copying the tactic to draw people away from weaker neighbours, and the poorest and most vulnerable populations left with the least protection.

Uganda is facing an acute shortage as there is only one doctor for every 15,000 patients, far below the recommended 1.5 per 10 patients. Last October, the Ugandan Ministry of Health reported a staggering shortfall of 2,290 nurses out of the required 5,568 in government funded hospitals alone.

While money is often sent back to the country by healthcare workers abroad, the absence of proper healthcare is contributing to a catastrophic fatality rate. The Global Health Workforce Alliance said one in four doctors trained in Africa was working in western industrialised countries.

The conference aims to produce a 10-year global action plan to deal with the problem, which would require £1.6bn per year to train 1.8 million health workers in Africa for the next eight years. Another £13bn would be required to pay them to stay.