One of the greatest challenges in quality healthcare delivery in Africa is not the lack of technology but inadequate human resource, especially amongst the medical personnel where the doctor-nurse, doctor-patient and nurse-patient ratios are below the recommended by WHO. At the same time, we have a population of unemployed medics in some of our countries. These statements sound like a paradox considering that many medical people especially doctors and nurses are always leaving Africa for Europe and the USA for what has come to be termed as greener pastures. Nurses from Africa are globally known to be very professional and diligent in their patient care. To this end, employment agencies are always looking for nurses for foreign lands. This is especially common of Kenyan and South African nurses.
Contributing to the issue that has been a concern in the ever-expanding industry Jayesh Saini says there are various factors affect this scenario. He points out that though most are common amongst the countries, some are more pronounced in some countries than in others. As an example, he said there are generally few training institutions with limited capacity for the medics and therefore fewer graduates available for absorption. In the poorer nations, inception into such institutions is limited due to the cost of the courses, without political will to increase capacity. Another key factor has been that nations have generally not kept abreast with changing health patterns that have seen increased demand for the medics.
Attrition rate has been on the increase due to various factors including the search for greener pastures out of Africa, more and more people leaving the career for more financially rewarding careers such as administration and management jobs even in health facilities, while the older generations that took careers like nursing as a vocation are retiring and leaving vacuums. More and more of the younger generation on the other hand are looking for more money, more time for themselves and less taxing jobs and nursing is not one of them for example. Where they would consider medicine, they find time in college too long and many are not willing to venture into that pathway. The search for more money has left some of them unemployed because they decline offers available on the basis on salary. Another unfortunate scenario that has created unemployment is that there are no facilities with capacity to absorb them due to financial constraints or other considerations such as facility size. In some instances, available vacancy in such remote or insecure places that individuals opt out of such opportunities as they regard the hardship allowance nothing compared to the emotional, mental and relational strain this would have on them.
There is need for incentives, one to discourage medics from living their home countries for other countries and to go to remote and risky areas. Governments should either build training facilities or where not possible put in place incentives such as tax exemptions for private investors to invest in training facilities and more health centers of different levels – from basic to tertiary care facilities.
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