Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Fajara, Gambia.
Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
BMC Health Serv Res. 2024 Nov 28;24(1):1493. doi: 10.1186/s12913-024-11977-y.
The migration of healthcare professionals from developing countries to more developed nations poses a significant challenge to healthcare systems in low- and middle-income countries. This study aimed to determine the proportion of doctors in Ghana who intend to migrate abroad and to identify the sociodemographic and "pull and push" factors that influence their intention.
A cross-sectional survey was conducted among doctors in Ghana between March 1, 2024, and March 15, 2024, via an online-based semi-structured questionnaire. Doctors working in Ghana, regardless of nationality, were included. Descriptive statistics and logistic regression analyses were conducted to identify factors associated with the intention to emigrate. Statistical significance was set at a p-value of < 0.05.
Almost all the doctors who responded to the questionnaire consented to participate (99.4%, 641/645). More than half (53.8%, n = 345) of the respondents were medical officers. Most respondents intended to migrate to practice abroad (71.8%, n = 460). The United States (59.7%), the United Kingdom (39.1%), and Canada (34.8%) were the most preferred destinations. After adjusting for covariates, young doctors between 20-29 years [(Adjusted Odd Ratios) AOR = 2.69, 95% CI = 1.13-6.39)], male doctors (AOR = 1.53, 95% CI = 1.04-2.25), doctors in lower professional ranks, and doctors in the field of diagnostics (AOR = 5.70, 95% CI = 1.16 - 28.03) had significantly higher odds of intending to migrate. In descending order of magnitude, the respondents strongly agreed that better remuneration (1.22 ± 0.63), better quality of life (1.22 ± 0.67), better working conditions (1.26 ± 0.69), and better postgraduate training (1.41 ± 0.80) were pull factors. The push factors were economic challenges (1.17 ± 0.49), a lack of a conducive working environment (1.56 ± 0.86), slow career progression (1.95 ± 1.07), excessive workload (2.07 ± 0.12), personal circumstances (2.26 ± 1.19), and poor postgraduate training (2.48 ± 1.22).
A substantial proportion of doctors in Ghana are considering emigration, driven by a combination of attractive opportunities abroad and challenging conditions in Ghana. Addressing these issues through improved remuneration, better working environments, and enhanced career development and training opportunities is crucial to retaining healthcare professionals.
医疗专业人员从发展中国家向更发达国家的迁移,对中低收入国家的医疗体系构成了重大挑战。本研究旨在确定加纳医生中有多少人打算移民国外,并确定影响他们移民意愿的社会人口学和“推拉”因素。
2024 年 3 月 1 日至 3 月 15 日期间,通过在线半结构式问卷对加纳的医生进行了横断面调查。包括在加纳工作的医生,无论国籍如何。采用描述性统计和逻辑回归分析来确定与移民意愿相关的因素。统计显著性设定为 p 值<0.05。
几乎所有回答问卷的医生都同意参与(99.4%,641/645)。超过一半(53.8%,n=345)的受访者是医疗官。大多数受访者打算到国外行医(71.8%,n=460)。最受欢迎的目的地是美国(59.7%)、英国(39.1%)和加拿大(34.8%)。在调整了协变量后,20-29 岁的年轻医生(调整后的优势比(AOR)=2.69,95%置信区间(CI)=1.13-6.39))、男性医生(AOR=1.53,95% CI=1.04-2.25)、较低专业级别的医生和诊断领域的医生(AOR=5.70,95% CI=1.16-28.03)的移民意愿明显更高。按重要性降序排列,受访者强烈同意更好的薪酬(1.22±0.63)、更高的生活质量(1.22±0.67)、更好的工作条件(1.26±0.69)和更好的研究生培训(1.41±0.80)是吸引力因素。经济挑战(1.17±0.49)、不利的工作环境(1.56±0.86)、职业发展缓慢(1.95±1.07)、工作量过大(2.07±0.12)、个人情况(2.26±1.19)和研究生培训不足(2.48±1.22)是推动因素。
加纳相当一部分医生正在考虑移民,这是由国外诱人的机会和加纳国内挑战性的条件共同驱动的。通过提高薪酬、改善工作环境以及加强职业发展和培训机会来解决这些问题,对于留住医疗保健专业人员至关重要。