Academic journal article International Journal of Population Research

The Brain Drain Potential of Students in the African Health and Nonhealth Sectors

Academic journal article International Journal of Population Research

The Brain Drain Potential of Students in the African Health and Nonhealth Sectors

Article excerpt

Jonathan Crush 1, 2 and Wade Pendleton 2

Recommended by Pranitha Maharaj

1, Balsillie School of International Affairs, Waterloo, ON, N2L 6C2, Canada 2, University of Cape Town, Rondebosch 7701, South Africa

Received 8 November 2011; Revised 31 January 2012; Accepted 28 February 2012

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Introduction

Studies of working health professionals across the African continent show extremely high levels of interest in emigration and a strong desire to leave, either temporarily or permanently [1-7]. Concerns about the long-term impact of the migration of health professionals from developing countries have recently led to a focus on the next generation, both in Africa [8-14] and elsewhere [15-20]. Many countries invest substantial financial resources in the training of physicians and nurses. Clemens [21] has recently argued that the actual costs of health professional emigration are difficult to quantify and are often exaggerated. However, African governments clearly expect a return on their investment in the form of an increased pool of health human resources. As Chikanda [22, 23] shows in Zimbabwe, however, the training of new health workers has not kept pace with the exodus of qualified and experienced professionals. This is probably inevitable in a country experiencing a massive crisis-driven skills exodus [24]. The more general question is whether trainee health professionals in other developing countries are committed to remaining in their home countries and, if so, for how long. If the answer to the question is negative, then strategies need to be developed to increase the chances of retention after graduation.

The Potential Skills Base Survey (PSBS) of the Southern African Migration Program (SAMP) has previously been used to examine the migration intentions on graduation of final-year students in universities and technical colleges across the SADC region [25-28]. This paper isolates and presents the findings for future health professionals. As well as providing insights into the likely migration behaviour of health professionals in training, the data provides a unique opportunity to compare the attitudes and emigration potential of health and other students. This paper examines whether health sector trainees are different from other students in the likelihood of joining the "brain drain." The answer to this question has important implications for "taming the brain drain" through retention strategies [29]. In other words, should retention be targeted at health or are there broader and more systemic problems to address?

2. Data

The PSBS was conducted in six Southern African countries (Botswana, Lesotho, Namibia, South Africa, Swaziland, and Zimbabwe) in 2003-2004 using the same questionnaire and methodology. The PSBS database contains information on almost 10,000 final-year students in universities and training colleges. The weighted database has over 8,000 students and is proportional to the number of final-year students in the faculties and training institutions selected. That is, for each country and training institution, the number of students was identified by faculty, and their percentage of the total student enrolment was determined. This percentage was used as the target for sampling for that faculty, and students were selected using a systematic random procedure. Weighting was necessary due to oversampling of some faculties. The students filled out a hardcopy questionnaire, and the data was cleaned, coded, and entered at the University of Namibia to create a single regional data set. A total of 651 health sector students were identified (about 8% of the database) in the various countries (Table 1). The analysis for this paper was carried out by comparing health with other students. …

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