What are the return propensity of Nigerian medical doctors in the UK?

世界卫生组织（世卫组织2019年）的劳动力预测表明，到2030年，全球将出现约1800万卫生保健工作者的缺口。预计亚洲和非洲将出现最大的医生缺口，因为这些地区的许多医生正在向高收入国家迁移（世卫组织2019年）。Duvivier等人（2017）估计，大约五分之一的非洲出生的医生在高收入国家工作，一些非洲国家的卫生人力流失到这些国家的比例高达70%。世界卫生组织建议理想的医生与人口比例是1:10 000 （Kumar and Pal 2018）。因此，尼日利亚人口超过2亿（世界银行2020年数据），该国至少需要20万名医生。然而，2020年1月，只有约75,000名医生在尼日利亚医学委员会注册（Ezigbo 2020）， 2018年，约33,000名尼日利亚注册医生在国外执业（Ihua 2018）；其中不到五分之一（2019年为6974人）在英国工作（2019年非洲观察）。本研究旨在了解尼日利亚医生移民到英国，他们的劳动力市场经验，以及可能影响医生决定留在英国或返回尼日利亚的因素。尼日利亚医生是一个自由流动的群体，他们的技能在世界上被高度要求。这些发现可能有助于制定更好的政策来支持在英国工作的尼日利亚医生，或者使医生更容易回到尼日利亚。研究结果还可以为尼日利亚保留其医生的政策提供信息。此外，预计这项研究将结合对与移徙决定有关的微观和宏观因素的关注，对关于全球系统中结构、财政和资源不平衡后果的学术文献作出贡献。本研究的目的如下：确定影响尼日利亚医生决定留在英国或返回尼日利亚的因素。评估尼日利亚医生在英国的劳动力市场经验。了解尼日利亚医生如何从英国为尼日利亚做出贡献，如果有的话。评估尼日利亚政府目前为吸引本国医生从英国回国而采取的任何措施。调查尼日利亚目前的移民政策及其有效性。评估返回尼日利亚移民的好处。了解在英国执业的尼日利亚医生的情况和决策如何受到Covid-19大流行的影响。我将采用混合方法收集数据，这种方法被认为适用于调查复杂的社会现象（Creswell 2011），如移民（Crush 2019）。混合方法方法将包括在线调查、焦点小组和对英国尼日利亚医生的半结构化访谈。我还将审查和分析尼日利亚政府关于医生返回移民的政策和做法。我将邀请完成调查的受访者参与研究的进一步阶段：要么是在线焦点小组，要么是访谈，或者两者兼而有之，这取决于他们的喜好。在线焦点小组的参与者将分为三种不同的类别：有明确回国意图的参与者；不打算回国的；还有那些尚未决定回国意向的人。这些具有不同回国意向的不同群体将有助于全面了解尼日利亚医生在英国的回国倾向，这是目前的一个知识缺口。对回返移民政策的研究将包括在尼日利亚进行实地考察，以确定有关的文件材料。此外，还将与参与制订和执行回返移民政策的主要个人进行面谈。

World Health Organization (WHO 2019) workforce projections suggest that by 2030, there will be a shortfall of about 18 million healthcare workers worldwide. Asia and Africa are the continents predicted to have the largest shortfalls, as many of their doctors are migrating to High Income Countries (HICs) (WHO 2019). Duvivier et al. (2017) have estimated that around one fifth of African-born doctors are working in HICs, and some African countries lose up to 70% of their health workforce to these countries. The WHO suggests the desirable doctor-population ratio is 1:1,000 (Kumar and Pal 2018). Thus, with a population of over 200 million citizens in Nigeria (World Bank 2020), the country needs at least 200,000 doctors. However, only about 75,000 doctors were registered with the Medical Council of Nigeria in January 2020 (Ezigbo 2020) and in 2018, around 33,000 of Nigeria's registered doctors were practising abroad (Ihua 2018); with just under one in five of these (6,974 in 2019) working in the UK (African watch 2019).This study aims to understand the migration of Nigerian doctors to the UK, their labour market experiences and the factors that might influence doctors' decisions to stay in the UK or return to Nigeria. Nigerian doctors are a free-moving group, whose skills are highly demanded in the world. The findings could aid the development of better policies to support Nigerian doctors working in the UK, or to make it easier for doctors to return to Nigeria. The findings could also inform policies for Nigeria to retain its doctors. Furthermore, it is envisaged that this study will contribute to the academic literature on the consequences of structural, financial and resource imbalances in a global system, by combining a focus on both the micro-and macro-level factors associated with migration decisions.The research has the following objectives:1. To identify the factors affecting Nigerian doctors' decisions to stay in the UK or return to Nigeria.2. To appraise the labour market experiences of Nigerian doctors in the UK.3. To understand how Nigerian doctors contribute to Nigeria from the UK, if at all.4. To assess any measures currently adopted by the Nigerian government to attract its doctors back from the UK.5. To investigate current migration policies in Nigeria, and their effectiveness.6. To evaluate the benefits of return migration to Nigeria.7. To access how the situation and decision-making of Nigerian doctors practising in the UK have been affected by the Covid-19 pandemic.I will adopt a mixed methods approach of data collection, which is endorsed as appropriate for investigating complex social phenomena (Creswell 2011) such as migration (Crush 2019). The mixed methods approach will consist of an online survey, focus groups, and semi-structured interviews with Nigerian doctors in the UK. I will also review and analyse the Nigerian government policies and practices on return migration of medical doctors.I will invite the respondents who complete the survey to participate in a further stage of the research: either an online focus group or an interview, or both, depending on their preference. There will be three discrete categories of participants for the online focus groups: those participants who have the definite intention of returning home; those who do not have the intention of returning home; and those who are undecided on their return intentions. These different groups with diverse return intentions will help in building a holistic picture of the return propensities of Nigerian doctors in the UK, which is a current gap in knowledge.The study of return migration policies will involve fieldwork in Nigeria to identify relevant documentary material. In addition, interviews will be conducted with key individuals involved in formulating and implementing return migration policies.