September 2014 TheObserver; Every year, over 250 medical workers leave Uganda to work, mainly, in South Africa, Botswana and the United Arab Emirates, ministry of Health statistics show.
Majority of these are anaesthetists, laboratory technicians, midwives and nurses. In a country where health professionals earn between Shs 400,000 for midwives and Shs 700,000 for medical doctors per month, working abroad, where remuneration is four times higher, is incredibly enticing.
For example, according to the ministry of Health statistics, in 2010, thirteen senior consultant surgeons left Uganda for Rwanda where each would earn Shs 9m monthly . In Uganda, a consultant surgeon is paid Shs 1.5m. Recent statistics show an estimated shortage of at least 817 doctors and 9,921 nurses and midwives in the country.
According to Dr Vincent Oketcho, the Intrahealth country director, this translates into a 42 per cent job vacancy rate in the public health workforce. And Prof George Kirya, the chairperson of the Advocates for Professionalism and Quality in Health (APROQUAH), is worried.
“Patients who are referred abroad often find our very cycle of migration and hiring, drains the country of vital expertise and makes it lose its return on investment made through training and education. The International Organisation for Migration (IOM) estimates that poor nations are spending $500m a year training medical workers who migrate to richer nations. In 2010, World Health Organisation (WHO) released a global code of practice on the international recruitment of health personnel, which discouraged member states from actively recruiting health workers in developing countries facing critical personnel shortages.
The code was adopted by the World Health Assembly in May 2010, but implementation is voluntary and will, according to Prof Kirya, depend on Uganda’s efforts to address factors that cause health workers to migrate. Despite releasing over 500 health workers into the job market every year, poor working conditions have stretched our health services, placing difficult demands on nurses and midwives in particular.
Dennis Odwe, AGHAU’s executive director, said challenges such as inadequate equipment, drugs, power outages at health facilities and difficulties in accessing health facilities in remote areas were rife. Also, workers’ pay cheques sometimes arrive months late and there is exposure to infections when protective gear is scarce.
The passing of the 2010/11- 2014/15 Health Sector Strategic and Investment Plan (HSSIP) aims to provide quality health for all in order to accelerate economic growth and reduce poverty. To achieve this, Dr Oketcho said, Uganda would need to rapidly scale up the recommended WHO interventions of educating, diversifying and providing financial incentives for health cadres.