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The financial cost of doctors emigrating from sub-Saharan Africa: human capital analysis

BMJ, 2011-11, Vol.343 (7835), p.1191-1191 [Peer Reviewed Journal]

Mills et al 2011 ;BMJ Publishing Group Ltd 2011 ;Copyright: 2011 © Mills et al 2011 ;Mills et al 2011 2011 Mills et al ;ISSN: 0959-8138 ;EISSN: 1468-5833 ;EISSN: 1756-1833 ;DOI: 10.1136/bmj.d7031 ;PMID: 22117056

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Title:
The financial cost of doctors emigrating from sub-Saharan Africa: human capital analysis
Author: Mills, Edward J ; Kanters, Steve ; Hagopian, Amy ; Bansback, Nick ; Nachega, Jean ; Alberton, Mark ; Au-Yeung, Christopher G ; Mtambo, Andy ; Bourgeault, Ivy L ; Luboga, Samuel ; Hogg, Robert S ; Ford, Nathan
Subjects: Acquired immune deficiency syndrome ; Africa South of the Sahara ; AIDS ; Brain drain ; Cost analysis ; Cost estimates ; Costs ; Costs and Cost Analysis ; Developing countries ; Developing Countries - economics ; Education, Medical, Graduate - economics ; Emigration ; Emigration and Immigration ; Health care costs ; Health education ; Health sciences ; HIV ; Human capital ; Human immunodeficiency virus ; Humans ; Immunology (Including Allergy) ; Industrialized nations ; Infectious Diseases ; LDCs ; Medical personnel ; Medical practice ; Medical schools ; Migration ; Physicians ; Physicians - economics ; Physicians - supply & distribution ; Primary care ; Recruitment ; Research universities ; Sexual Health ; Shortages ; Skills ; Workers
Is Part Of: BMJ, 2011-11, Vol.343 (7835), p.1191-1191
Description: Objective To estimate the lost investment of domestically educated doctors migrating from sub-Saharan African countries to Australia, Canada, the United Kingdom, and the United States.Design Human capital cost analysis using publicly accessible data.Settings Sub-Saharan African countries.Participants Nine sub-Saharan African countries with an HIV prevalence of 5% or greater or with more than one million people with HIV/AIDS and with at least one medical school (Ethiopia, Kenya, Malawi, Nigeria, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe), and data available on the number of doctors practising in destination countries.Main outcome measures The financial cost of educating a doctor (through primary, secondary, and medical school), assuming that migration occurred after graduation, using current country specific interest rates for savings converted to US dollars; cost according to the number of source country doctors currently working in the destination countries; and savings to destination countries of receiving trained doctors.Results In the nine source countries the estimated government subsidised cost of a doctor’s education ranged from $21 000 (£13 000; €15 000) in Uganda to $58 700 in South Africa. The overall estimated loss of returns from investment for all doctors currently working in the destination countries was $2.17bn (95% confidence interval 2.13bn to 2.21bn), with costs for each country ranging from $2.16m (1.55m to 2.78m) for Malawi to $1.41bn (1.38bn to 1.44bn) for South Africa. The ratio of the estimated compounded lost investment over gross domestic product showed that Zimbabwe and South Africa had the largest losses. The benefit to destination countries of recruiting trained doctors was largest for the United Kingdom ($2.7bn) and United States ($846m).Conclusions Among sub-Saharan African countries most affected by HIV/AIDS, lost investment from the emigration of doctors is considerable. Destination countries should consider investing in measurable training for source countries and strengthening of their health systems.
Publisher: England: British Medical Journal Publishing Group
Language: English
Identifier: ISSN: 0959-8138
EISSN: 1468-5833
EISSN: 1756-1833
DOI: 10.1136/bmj.d7031
PMID: 22117056
Source: BMJ Open Access Journals
MEDLINE
Alma/SFX Local Collection
ProQuest Central

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The financial cost of doctors emigrating from sub-Saharan Africa: human capital analysis

Mills et al 2011 ;BMJ Publishing Group Ltd 2011 ;Copyright: 2011 © Mills et al 2011 ;Mills et al 2011 2011 Mills et al ;ISSN: 0959-8138 ;EISSN: 1468-5833 ;EISSN: 1756-1833 ;DOI: 10.1136/bmj.d7031 ;PMID: 22117056

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