title: Contribution of Sudanese medical diaspora to the healthcare delivery system in Sudan: exploring options and barriers.
abstract: Medical diaspora options, including the engagement of expatriate physicians in development efforts within their home country, are being called for to reverse the effects of brain drain from developing countries. This paper presents the results of a study exploring the potential contributions for the Sudanese Medial Diaspora Options to the healthcare delivery system (HCDS) in Sudan, focusing on the options of temporal and permanent returns and the likely obstacles faced in their implementation.
  
  
  
  This was a cross-sectional study using a mixed methods design including quantitative and qualitative approaches. For the quantitative approach, the study, which focused on the possible contribution of the diaspora to healthcare delivery in Sudan, was based on an online survey using random purposive and snowballing sampling techniques involving 153 Sudanese physicians working in Saudi Arabia and other Gulf States, the United Kingdom, the Republic of Ireland, and the United States of America. The qualitative approach involved in-depth interviews with returnee physicians and key informants in Sudan, focusing on the return experiences, the barriers for return, and the options to improve future contributions.
  
  
  
  Despite contributions of the Sudanese medical diaspora being of a small scale considering the size of the phenomenon, as well as infrequent and not appropriately organized, their inputs to academia and the links built with overseas institutions and specialist clinical services were nevertheless remarkable. The main barrier to temporal return was inappropriate organization by the local counterparts, while those for permanent return of physicians were poor work environment, insufficient financial payment, unsecured accommodation, and offspring education. The study identified short-term return as a feasible option considering the country's current conditions. Proper coordination mechanisms for short-term returns and facilitation of permanent return through stakeholders' collaboration were proposed to improve diaspora contributions.
  
  
  
  The potentials of Sudanese medial diaspora contributions to the HCDS in Sudan are promising. Short-term contributions were observed as the best option for the current country situation. Creation of a coordinating body from within the healthcare sector in Sudan to effectively coordinate diaspora contributions is recommended.
authors.affiliation: School of Health Sciences, Ahfad University for Women, Arda Street, P.O. BOX 167, Omdurman, Sudan. fayrouz.abdalla@gmail.com.
authors.forename: Fayrouz Mohammed
authors.initials: FM
authors.lastname: Abdalla
authors.affiliation: Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK.
authors.forename: Maye Abu
authors.initials: MA
authors.lastname: Omar
authors.affiliation: Sudan Medical Specialization Board, Khartoum, Sudan.
authors.forename: Elsheikh Elsiddig
authors.initials: EE
authors.lastname: Badr
mesh_terms: D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D003906:Developing Countries; D004641:Emigration and Immigration; D006801:Humans; D007494:Ireland; D009938:Organizations; D010820:Physicians; D011365:Professional Practice Location; D012529:Saudi Arabia; D013397:Sudan; D014171:Transients and Migrants; D006113:United Kingdom; D014481:United States
keywords: Diaspora options; Healthcare delivery system; Migration; Physicians; Sudan