Abstract
The shortage of skilled healthcare workers in Sub-Saharan Africa is aggravated by their emigration to high resource countries. There is evidence that a small number of healthcare workers return to their home countries. It is important to understand the factors that influence decisions to return in order to develop appropriate strategies to attract more back. This study sought to investigate the perspectives of healthcare workers who returned to Botswana after working in the diaspora. We conducted semi-structured interviews of 8 healthcare workers. Using the thematic analysis method we developed a thematic index to code the data. The main reasons for returning were family ties and missing home whilst the key reasons for emigration were concerns about the quality of health care, lack of professional progression opportunities and feeling under-valued. Difficulties reintegrating into the Botswana health care system are a potential push factors for those who return. Policies that aim to attract back healthcare workers should address professional progression, reintegration and improvement of the healthcare system.
Highlights
Sub-Saharan Africa (SSA) has some of the worst health outcomes globally
The region has a severe shortage of human resources for health with only 10 out of 46 countries in the region having a physician-to-population ratio above the World Health Organisation (WHO) recommended minimum of 2.5 healthcare workers per 1 000 population [3,4]
This paper reports on the findings of a study of Batswana healthcare workers who returned after working in diaspora
Summary
Sub-Saharan Africa (SSA) has some of the worst health outcomes globally. Almost 50% of the world’s under-5 child and maternal mortality occur in the region [1,2]. The exodus of skilled HRH from SSA to developed countries in search of better livelihoods further aggravates this shortage. Efforts to curb healthcare worker migration are multi-tiered and include both source country and international strategies. Bilateral recruitment agreements between source and recipient countries have been developed and an international code of recruitment has been drawn up [4, 6, 8, 9,11,12]. Donor countries have increased training of both highly skilled and intermediate level healthcare workers and introduced financial and non-financial retention strategies [4, 8]
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