Kirigia Joses Muthuri, Gbary Akpa Raphael, Muthuri Lenity Kainyu, Nyoni Jennifer, Seddoh Anthony
World Health Organization, Regional Office for Africa, Brazzaville, Congo.
BMC Health Serv Res. 2006 Jul 17;6:89. doi: 10.1186/1472-6963-6-89.
Past attempts to estimate the cost of migration were limited to education costs only and did not include the lost returns from investment. The objectives of this study were: (i) to estimate the financial cost of emigration of Kenyan doctors to the United Kingdom (UK) and the United States of America (USA); (ii) to estimate the financial cost of emigration of nurses to seven OECD countries (Canada, Denmark, Finland, Ireland, Portugal, UK, USA); and (iii) to describe other losses from brain drain.
The costs of primary, secondary, medical and nursing schools were estimated in 2005. The cost information used in this study was obtained from one non-profit primary and secondary school and one public university in Kenya. The cost estimates represent unsubsidized cost. The loss incurred by Kenya through emigration was obtained by compounding the cost of educating a medical doctor and a nurse over the period between the average age of emigration (30 years) and the age of retirement (62 years) in recipient countries.
The total cost of educating a single medical doctor from primary school to university is 65,997 US dollars; and for every doctor who emigrates, a country loses about 517,931 US dollars worth of returns from investment. The total cost of educating one nurse from primary school to college of health sciences is 43,180 US dollars; and for every nurse that emigrates, a country loses about 338,868 US dollars worth of returns from investment.
Developed countries continue to deprive Kenya of millions of dollars worth of investments embodied in her human resources for health. If the current trend of poaching of scarce human resources for health (and other professionals) from Kenya is not curtailed, the chances of achieving the Millennium Development Goals would remain bleak. Such continued plunder of investments embodied in human resources contributes to further underdevelopment of Kenya and to keeping a majority of her people in the vicious circle of ill-health and poverty. Therefore, both developed and developing countries need to urgently develop and implement strategies for addressing the health human resource crisis.
过去估算移民成本的尝试仅局限于教育成本，并未涵盖投资回报损失。本研究的目的如下：（i）估算肯尼亚医生移民至英国和美国的财务成本；（ii）估算护士移民至七个经合组织国家（加拿大、丹麦、芬兰、爱尔兰、葡萄牙、英国、美国）的财务成本；（iii）描述人才外流造成的其他损失。
对2005年小学、中学、医学院和护理学校的成本进行了估算。本研究使用的成本信息来自肯尼亚的一所非营利性中小学和一所公立大学。成本估算代表无补贴成本。肯尼亚因移民造成的损失是通过将在接收国培养一名医生和一名护士的成本，按照移民平均年龄（30岁）至退休年龄（62岁）这段时间进行复利计算得出的。
从小学到大学培养一名医生的总成本为65,997美元；每有一名医生移民，一个国家就损失约517,931美元的投资回报。从小学到健康科学学院培养一名护士的总成本为43,180美元；每有一名护士移民，一个国家就损失约338,868美元的投资回报。
发达国家继续剥夺肯尼亚价值数百万美元的健康人力资源投资。如果目前从肯尼亚偷猎稀缺健康人力资源（以及其他专业人员）的趋势不被遏制，实现千年发展目标的机会仍将渺茫。这种对人力资源投资的持续掠夺导致肯尼亚进一步欠发达，并使该国大多数人民陷入健康不佳和贫困的恶性循环。因此，发达国家和发展中国家都需要紧急制定并实施应对健康人力资源危机的战略。
