在尼日利亚劳动力移民和社会政治动荡背景下，医生建议的卫生系统恢复力创新方法：一项基于调查的研究。

Physician-Suggested Innovative Methods for Health System Resilience amidst Workforce Emigration and Sociopolitical Unrest in Nigeria: A Survey-Based Study.

机构信息

University of Toronto, Temerty Faculty of Medicine, Toronto, Canada.

University of Toronto, Institute of Health Policy, Management and Evaluation, Toronto, Canada.

出版信息

Ann Glob Health. 2023 Feb 16;89(1):13. doi: 10.5334/aogh.4025. eCollection 2023.

DOI:10.5334/aogh.4025

PMID:36819969

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9936909/

Abstract

INTRODUCTION

Physician emigration (the ) and sociopolitical unrest significantly contribute to the instability of many low- and middle-income countries' healthcare systems. However, limited literature captures the and suggestions to promote and sustain these health systems' resilience. Thus, the purpose of this study is to 1) understand the effects of physician emigration and sociopolitical unrest on Nigeria's healthcare system, and to 2) synthesize solutions suggested by Nigeria-trained physicians in the form of a resilience framework.

METHODS

An anonymous online survey was conducted among Nigeria-trained physicians. Respondents were recruited using convenience and snowball sampling methods via a group for Nigeria-trained doctors. Quantitative data were analyzed using and qualitative themes were coded by two independent researchers.

RESULTS

The final sample included 49 Nigeria-trained physicians-35 physicians practicing in Nigeria and 14 emigrated physicians. All of the physicians currently practicing in Nigeria have considered emigrating, with 79% of them having concrete plans to emigrate in the next five years. Among emigrated physicians, factors such as remuneration (92%) and socioeconomic state of the country (92%) contributed to their decision to emigrate. Suggestions to enhance health system resilience fell into six broad themes: 1) policy and politics, 2) funding and resources, 3) organization and structure, 4) training and education, 5) research and primary health, and 6) health for peace initiatives.

CONCLUSIONS

The healthcare system is currently unstable and vulnerable due to physician emigration and sociopolitical unrest. To develop and implement solutions to mitigate these issues, capturing the locally trained physicians' perspectives are critical. While each country's healthcare system is unique, countries with similar strains can adapt this model for resilience building. Future studies should focus on adapting the model in different countries with policy-level action points.

摘要

简介

医师移民（the ）和社会政治动荡极大地影响了许多中低收入国家医疗体系的稳定性。然而，有限的文献资料记录了促进和维持这些医疗体系恢复力的（suggestions）。因此，本研究的目的是 1）了解医师移民和社会政治动荡对尼日利亚医疗体系的影响，以及 2）综合尼日利亚培训医师提出的解决方案，构建一个恢复力框架。

方法

对尼日利亚培训医师进行了一项匿名在线调查。通过一个为尼日利亚培训医生设立的（group），使用便利抽样和滚雪球抽样方法招募了受访者。采用（quantitative data）进行定量数据分析，由两名独立研究人员对定性主题进行编码。

结果

最终样本包括 49 名尼日利亚培训医师，其中 35 名在尼日利亚执业，14 名移民医师。所有目前在尼日利亚执业的医师都考虑过移民，其中 79%的人在未来五年内有具体的移民计划。在移民医师中，薪酬（92%）和国家社会经济状况（92%）等因素促成了他们的移民决定。增强医疗体系恢复力的建议分为六大主题：1）政策与政治；2）资金与资源；3）组织与结构；4）培训与教育；5）研究与初级卫生保健；6）和平倡议促进卫生。