title: Is there any solution to the "brain drain" of health professionals and knowledge from Africa?
abstract: African public health care systems suffer from significant "brain drain" of its health care professionals and knowledge as health workers migrate to wealthier countries such as Australia, Canada, USA, and the United Kingdom. Knowledge generated on the continent is not readily accessible to potential users on the continent. In this paper, the brain drain is defined as both a loss of health workers (hard brain drain) and unavailability of research results to users in Africa (soft brain drain). The "pull" factors of "hard brain drain" include better remuneration and working conditions, possible job satisfaction, and prospects for further education, whereas the "push" factors include a lack of better working conditions including promotion opportunities and career advancement. There is also a lack of essential equipment and non-availability or limited availability of specialist training programs on the continent. The causes of "soft brain drain" include lack of visibility of research results in African journals, better prospects for promotion in academic medicine when a publication has occurred in a northern high impact journal, and probably a cultural limitation because many things of foreign origin are considered superior. Advocates are increasingly discussing not just the pull factors but also the "grab" factors emanating from the developed nations. In order to control or manage the outflow of vital human resources from the developing nations to the developed ones, various possible solutions have been discussed. The moral regard to this issue cannot be under-recognized. However, the dilemma is how to balance personal autonomy, right to economic prosperity, right to personal professional development, and the expectations of the public in relation to adequate public health care services in the developing nations.
authors.affiliation: Department of Community Health, University of Malawi College of Medicine, Private Bag 360, Blantyre 3, Malawi. amuula@medcol.mw
authors.forename: Adamson S
authors.initials: AS
authors.lastname: Muula
mesh_terms: D000349:Africa; D019049:Developed Countries; D003906:Developing Countries; D004467:Economics; D004641:Emigration and Immigration; D004651:Employment; D006280:Health Workforce; D006801:Humans; D007182:Income; D010506:Periodicals as Topic; D011157:Population Dynamics; D012106:Research; D012456:Salaries and Fringe Benefits; D014171:Transients and Migrants