Sub-Saharan Africa: Beyond the health worker migration crisis?
Sub-Saharan Africa: Beyond the health worker migration crisis?
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DOI：
10.1016/j.socscimed.2006.12.013
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发表时间：
2007-05-01
影响因子：
5.4
通讯作者：
Braichet, Jean-Marc
中科院分区：
文献类型：
--
作者：
Connell, John;Zurn, Pascal;Braichet, Jean-Marc
来自撒哈拉以南非洲国家的熟练卫生工作者的移徙在本世纪显著增加，大多数国家成为移徙者的来源国。尽管卫生工作者为卫生保健系统的有效运作而移徙的问题日益严重，但数据明显缺乏和不完整。因此，很难确定来自非洲和非洲内部的移徙的实际程度，从而制定有效的预测或补救政策。这一全球概览和最全面的数据表明，主要目的地仍然是美国和英国，主要来源是南非和尼日利亚，但在这两个背景下，现在有更大的多样性。移徙者主要是出于经济原因而移徙，越来越多的人选择保健职业，因为它们提供了移徙前景。移徙造成了相当大的经济代价，它耗尽了劳动力，降低了提供保健服务的效率，降低了剩余劳动力的士气。各国已设法实施国家政策，管理移徙，减轻其有害影响，并加强非洲卫生保健系统。受援国一直不愿制定有效的招聘行为道德守则，也不愿制定其他形式的补偿或技术转让，因此，今后移徙很可能进一步增加，从而降低实现联合国千年发展目标的可能性，并加剧在获得适当保健方面的现有不平等现象。(c) 2007 Elsevier Ltd.版权所有。
Migration of skilled health workers from sub-Saharan African countries has significantly increased in this century, with most countries becoming sources of migrants. Despite the growing problem of health worker migration for the effective functioning of health care systems there is a remarkable paucity and incompleteness of data. Hence, it is difficult to determine the real extent of migration from, and within, Africa, and thus develop effective forecasting or remedial policies. This global overview and the most comprehensive data indicate that the key destinations remain the USA and the UK, and that major sources are South Africa and Nigeria, but in both contexts there is now greater diversity. Migrants move primarily for economic reasons, and increasingly choose health careers because they offer migration prospects. Migration has been at considerable economic cost, it has depleted workforces, diminished the effectiveness of health care delivery and reduced the morale of the remaining workforce. Countries have sought to implement national policies to manage migration, mitigate its harmful impacts and strengthen African health care systems. Recipient countries have been reluctant to establish effective ethical codes of recruitment practice, or other forms of compensation or technology transfer, hence migration is likely to increase further in the future, diminishing the possibility of achieving the United Nations millennium development goals and exacerbating existing inequalities in access to adequate health care. (c) 2007 Elsevier Ltd. All rights reserved.