Abstract
BackgroundUganda has severe shortage of human resources for health despite the heavy disease burden. The country has one of the highest fertility, and population growth rates in the world and is in dire need of trained health workers. The current doctor: patient ratio of 1:15000 is inadequate and this is further constrained by trained health workers leaving the country while others abandon the health sector. The aim of the study was to determine the career intentions of the final year medical students to leave the county and health field after graduating and the associated factors.MethodsWe conducted a cross-sectional study among 251 final year medical students from Makerere, Mbarara, Gulu and Kampala International Universities. We enrolled all the eligible final year medical students. The study was conducted using face-to-face questionnaires in each university. We determined the demographics, reasons for leaving the country and health sector and the intended destinations of medical students who planned to leave the country. Data was entered in Epidata then exported and analyzed in stata 12.ResultsOf the 251 students enrolled in the study, 28(11.2 %) wanted to leave the health sector, with Mbarara University of Science and Technology (MUST) having the highest percentage, 16.7 % and Kampala International University (KIU) the least, 7.7 %. Of the 28 who intended to leave the health sector, 82.1 % wanted to join the business sector, 10.7 % agriculture, and 7.1 % politics. Reasons given for the intent to leave were; lack of equipment and supplies in hospitals, over whelming patient numbers, very risky working environment, low payment to doctors, and political reasons. Overall, 112 (44.6 %) of the participants wanted to leave the country with 30.3 % intending to migrate to United States of America (USA), 11.9 % to United Kingdom (UK), 11.0 % to South Africa among others. Some of the reasons given were; doctors are paid a high salary abroad, safe working environment, and desire to continue academics. Age was associated with intention to leave the country (OR = 1.64; 95 % CI: 1.00 – 4.82).ConclusionsIn a country in dire need of health workers, the study showed high proportion of trainee health workers planning to abandon their professions or emigrate from Uganda after training.
Highlights
Uganda has severe shortage of human resources for health despite the heavy disease burden
Emigration is likely to lead to deterioration in the working conditions of the doctors who stay behind as it increases the workload for the remaining health workers, compromising access to and quality of health care to the population, and impairs the ability of the health care system to achieve the desired population health objectives [8]
Study design and setting This was a cross-sectional study of Ugandan undergraduate medical students in their fifth and final year of studies at the four medical universities in Uganda; Makerere University College of Health Sciences (MakCHS), Mbarara University (MUST), Gulu University and Kampala International University (KIU)
Summary
Uganda has severe shortage of human resources for health despite the heavy disease burden. The current doctor: patient ratio of 1:15000 is inadequate and this is further constrained by trained health workers leaving the country while others abandon the health sector. While Africa accounts for more than 24 % of the global disease burden, it has only 3 % of the world’s health workers and spends less than one percent of total global resources dedicated to health. This shortage is worsened by the emigration of doctors [6]. The doctor: patient ratio in Uganda is 1:15000 [11, 12], which implies that most of the general population may not access the much needed basic health care
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