Chapter 2 : Literature Review
2.8 Summary of the Determinants of Brain Drain in Developing Countries and Conceptual
Worldwide, there is brain drain of nurses. An increase in the brain drain of nurses from their home countries to recipient countries is having an effect on the healthcare system. This phenomenon stems from economic, political, technological, social, education and globalisation factors. Brain drain has a significant impact on both the individual and national level. This chapter has summarized the determinants of brain drain.
Brain drain would intensify in the coming decades given the rising gap in wages and the differing demographic features in developed and developing countries. Higher wages and better employment opportunities in developed countries create incentives for brain drain from developing countries. The economic conditions in African countries have been on a steep decline. Furthermore, favourable rewards for labour and the need to escape the harsh economic realities in the region partly account for brain drain to developed countries.
Many African countries experience ongoing violence and crime. The unstable political environment, very weak economies, a history of military coups, and non-existent democratic institutions encourage individuals from Africa to emigrate to other nations, especially developed economies in Europe and the United States. Thus, educated and skilled individuals from Africa often migrate to more stable economies primarily to flee from the unstable and often dire political climate, and, more importantly, for a better quality of life for the emigrants and their families.
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Technology in developed countries creates incentives for brain drain because lack of basic equipment is one of the challenges in developing countries. The lack of technology and equipment to perform professional tasks reduce job satisfaction among employees. Some countries have made significant investments in infrastructure and education but have not achieved the scientific development and technological and innovative capability either to retain or to recover the human capital that they have generated. This raises the question of whether it is justified to continue losing human capital or to make the additional investment in science and technology and bring about the innovations needed to stop the loss and convert it into wealth generation. However, conditions in which science and technology will prosper require political decisions, funding, infrastructure, technical support, and a scientific community but these are generally not available in developing countries.
The number of sub-Saharan Africans living in extreme poverty has risen. According to WHO (2006), it is estimated that over a billion people in the developing world are too poor to feed themselves adequately. Factors such as crop failure and famine contribute to economic instabilities experienced by sub-Saharan countries. There is also fear of contracting HIV/AIDS through work related injuries which is a push factor related to the functioning of the health system. The AIDS pandemic has contributed to the economic instability of some sub-Saharan countries by depleting human capital due to an increased death rate among professionals. Healthcare professionals also tend to migrate directly from their home countries to developed countries due to colonial relationship.
Post-independence in Africa and the emergence of the developed states is a global technological and industrial nation that leads to a growing increase in the number of Africans migration for the purposes of higher education. Reciprocally, the low average levels of education can slow down the economic growth, damage the gains of the slightly qualified workers and increase poverty. Many migrants in the developed world are highly skilled and in many situations, their educational capital is the only available vehicle for the action of migration. Owing to a number of factors, their education and skills may be underutilised in the host country and education standards in some developing countries have declined hence encourage brain drain.
The global free movement of labour and competition for human resources enables developed countries to fill their shortages of health workers from less developed countries. Globalisation entails the widening, deepening and speeding up of worldwide interconnectedness in all aspects of contemporary social life. It assumes a borderless world where events taking place in one part of the world quickly spread across the globe. Globalisation has resulted in a growing demand for skilled personnel because as societies become interdependent and
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interconnected, the mobility of skilled personnel is also increasing. Over the same period that globalisation has gathered pace, a number of sub-Saharan countries have emerged from dictatorships and liberalised their emigration policies.
Figure 2-7 is a conceptual framework showing the determinants of brain drain of healthcare professionals
Figure 2-7 Framework for brain drain of healthcare professionals
The framework illustrated in figure 2-7 shows that the developing countries’ healthcare professionals are influenced by economic, political, technological, social, education and globalisation factors.
2.9 Conclusion
The current chapter discussed the brain drain of healthcare professionals in developing countries. There are various determinants of brain drain of healthcare professionals in developing countries, which require both developing and developed countries to take initiatives in order to control or minimize brain drain. The current framework demonstrates that at the heart of healthcare professionals’ decisions to immigrate are economic factors. Other
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factors include political, technological, social, education and globalisation. Due to shortage of nurses, the UK government changed their immigration policies to facilitate employment of foreign nurses. The UK government influenced the NMC to facilitate registration of international nurses. Based on the review of available literature, the brain drain definition specifically related to healthcare professionals, theories and the concepts has been discussed.
Most countries in the African region continue to experience the loss of an increasing number of healthcare professionals to developed countries. In an increasingly globalised world, African countries are unable to compete with developed countries in retaining their own health professionals, let alone attract the specialized professionals they need from other countries. Though predominantly common in Africa countries, brain drain also occurs in Asia and Europe. The chapter has also discussed the concept of brain drain and the impact of brain drain on developing countries. The next chapter explores the study’s research methodology.
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