Physician Brain Drain in Sub-Saharan Africa: The Career Plans of Rwanda's Future Doctors

Introduction: Brain drain is defied as the migration of health personnel in search of the better standard of living and quality of life; higher salaries; access to advanced technology and more stable political conditions. Methods: A novel survey was created and distributed to 97 sixth year medical students in Rwanda. The survey queried respondents regarding their likelihood to work abroad or to seek opportunities within NGO's to evaluate the impact of internal and external brain drain. The data were tabulated and analyzed using Microsoft Excel. Results: More than half of students reported a strong desire to study or work abroad. When asked about employment and training after medical school; 29% answered that they will seek opportunities outside Rwanda. When asked on the will to work for NGOs/Public health oriented organization; 64.9% responded that they would do it collaboratively but still practice medicine. Respondents reported financial opportunity as the fifth motivations for their potential desire to depart from clinical care of patients if such opportunities emerged. Conclusion: Our findings suggest that internal brain drain (work for NGO's) may potentially coexist alongside and external or international brain drain as an important contributing factor in the shortage of medical doctors in Rwanda and Sub-Saharan Africa

The Relationship Experiences of Professional Nurses with Nurse Managers

This qualitative study was undertaken to explore and describe the experiences of professional nurses in their relationships with nurse managers. Concerns about declining nursing care standards have been expressed in radio newsbulletins; television interviews and newspapers. This decline is thought to come from the pressures brought about by rapid changes in political; socio-economic and technological spheres. It therefore became important to the researcher to acquire knowledge about the manner in which nurses support each other during these times of change. Data were collected by means of individual interviews. Interviews were audiotaped and field notes were taken to provide the researcher with complementary information. Data analysis was done using the data analysis method described by Tesch (in Creswell; 1994:155). Results revealed that professional nurses experience a breakdown in their relationships with nurse managers and that the professional nurses' expectations relating to the work environment are not being met. The experiences manifested in feelings of anger; pain and disillusionment and led to demotivation of the professional nurses. Guidelines were proposed to address the aforementioned experiences

Report of a study into factors affecting staffing level of health institutions in Matabeleland North

There has been a reasonable expansion in Health Care Services infrastructure in Matabeleland North Province since 1980 with very little increase in the staffing levels. It is observed that there is reluctancy amongst health workers to working in rural areas. This study was set up to analyse staffing levels and to investigate factors affecting staffing levels with the ultimate aim of making recommendations to policy makers. Two focus groups discussions were held; one with urban based and one with rural based in health workers. Currently staffing levels were also investigated and related to existing approved establishment. It was found that 77 of the establishment of nurses in districts and rural hospitals was filled. In these institutions only seven (7) out of fourteen (14) approved posts for doctors were filled. It has been found also that there is need to expand the current establishment; to meet the prejected criteria of 1983 manpower projections. Next; a descriptive study has been carried out into aspects of conditions of service and social environment affecting health workers attitude to working in rural areas. [abstract terminated]