brain drain and health workforce distortions in mozambique人才流失,在莫桑比克卫生人力的扭曲.pdfVIP

Brain Drain and Health Workforce Distortions in Mozambique 1 2 3 1 1 1 Kenneth Sherr *, Antonio Mussa , Baltazar Chilundo , Sarah Gimbel , James Pfeiffer , Amy Hagopian , Stephen Gloyd1 1 Department of Global Health, University of Washington, Seattle, Washington, United States of America, 2 Human Resources Department, Mozambique Ministry of Health, Maputo, Mozambique, 3 Eduardo Mondlane University, Maputo, Mozambique Abstract Introduction: Trained human resources are fundamental for well-functioning health systems, and the lack of health workers undermines public sector capacity to meet population health needs. While external brain drain from low and middle- income countries is well described, there is little understanding of the degree of internal brain drain, and how increases in health sector funding through global health initiatives may contribute to the outflow of health workers from the public sector to donor agencies, non-governmental organisations (NGOs), and the private sector. Methods: An observational study was conducted to estimate the degree of internal and external brain drain among Mozambican nationals qualifying from domestic and foreign medical schools between 1980–2006. Data were collected 26- months apart in 2008 and 2010, and included current employment status, employer, geographic location of employment, and main work duties. Results: Of 723 qualifying physicians between 1980–2006, 95.9% (693) were working full-time, including 71.1% (493) as clinicians, 20.5% (142) as health system managers, and 6.9% (48) as researchers/professors. 25.5% (181) of the sample had left the public sector, of which 62.4% (113) continued working in-country and 37.6% (6