西非地區醫療專業人員遷徙模式的探討

Abstract

Background: The West African health sector is characterized by a human resource base lacking in numbers and specialized skills. Among the factors contributing to this lack of human resource for health include the migration of health professionals to rich countries. This study aims to explore some of the factors associated with migration of West African health professionals. Methods: An online cross-sectional survey and in-depth interviews of 118 health professionals who participated in the Young Professional Internship Program (YPIP) of the West African Health Organization (WAHO) from (2005-2013), was conducted. The survey and in-depth interviews inquired about their work preference, characteristics of their work experience, migration intentions, and the factors predicting their decisions to migrate. Results: Of the 118 health professionals, 100 responded to the online survey. The overwhelming majority (61%) indicated that they prefer to be posted in urban areas in their countries as opposed to (25%) who reported that their preference is to be posted in rural areas and (14%) who indicated semi-urban areas as their choice of posting. The overwhelmingly most important reason for their motivation to stay and work in their countries includes giving health professionals opportunities for career development (96%), which has also exerted the greatest influence on their intentions to migrate (93%), followed by desire to find a suitable job match (90%). The role of social capital and network was also noticeable in their characteristics of work experience. About (46%) reported that their first job position after they have graduated from the Young Professional Internship Program (YPIP) was obtained through informal channels such as family members, acquaintances or co-workers. The highest level of satisfaction expressed in their current job position were with their work itself (82%) and the significance of their task (80%), followed by collegial relations (77%) and the level of supervision they receive from their supervisors (74%). In only two categories was there less satisfaction: that is, with their pay (55%) and future prospects (61%). These two categories were also less favored by the larger majority in the qualitative findings. Multiple regression analysis shows that variables such as gender, marital status, working hours, previous job tenure, and country of previous job tenure and source of job information are all significant predictors in their decisions to migrate (p < 0.05). Conclusions: This study has provided some understanding of some of the factors associated with migration of West African health professionals. The findings could be used by policymakers in health workforce planning and in modifying the migration pattern of health professionals in the West African health sector.