I wrote this recently released paper in anticipation to the forthcoming 68th World Health Assembly’s discussion of the relevance and effectiveness of WHO Code of Practice on the International Recruitment of Health Personnel. I hope some of you will find it informative. Please read and share among members of your various networks.

Monitoring Sub-Saharan African Physician Migration and Recruitment Post-Adoption of the WHO Code of Practice: Temporal and Geographic Patterns in the United States

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0124734

DOI: 10.1371/journal.pone.0124734

ABSTRACT

Data monitoring is a key recommendation of the WHO Global Code of Practice on the International Recruitment of Health Personnel, a global framework adopted in May 2010 to address health workforce retention in resource-limited countries and the ethics of international migration. Using data on African-born and African-educated physicians in the 2013 American Medical Association Physician Masterfile (AMA Masterfile), we monitored Sub-Saharan African (SSA) physician recruitment into the physician workforce of the United States (US) post-adoption of the WHO Code of Practice. From the observed data, we projected to 2015 with linear regression, and we mapped migrant physicians’ locations using GPS Visualizer and ArcGIS. The 2013 AMA Masterfile identified 11,787 active SSA-origin physicians, representing barely 1.3% (11,787/940,456) of the 2013 US physician workforce, but exceeding the total number of physicians reported by WHO in 34 SSA countries (N = 11,519). We estimated that 15.7% (1,849/11,787) entered the US physician workforce after the Code of Practice was adopted. Compared to pre-Code estimates from 2002 (N = 7,830) and 2010 (N = 9,938), the annual admission rate of SSA émigrés into the US physician workforce is increasing. This increase is due in large part to the growing number of SSA-born physicians attending medical schools outside SSA, representing a trend towards younger migrants. Projection estimates suggest that there will be 12,846 SSA migrant physicians in the US physician workforce in 2015, and over 2,900 of them will be post-Code recruits. Most SSA migrant physicians are locating to large urban US areas where physician densities are already the highest. The Code of Practice has not slowed the SSA-to-US physician migration. To stem the physician “brain drain”, it is essential to incentivize professional practice in SSA and diminish the appeal of US migration with bolder interventions targeting primarily early-career (age = 35) SSA physicians.

Homo sum, humani nihil a me alienum puto (I am a human being, nothing human is alien to me). — Terence

I sit on a man’s back, choking him and making him carry me, and yet assure myself and others that I am very sorry for him and wish to ease his lot by all possible means — except by getting off his back. — Leo Tolstoy.

A tiger does not shout its tigritude: it pounces. A tiger in the jungle does not say: I am a tiger. Only on passing the tiger’s hunting ground and finding the skeleton of a gazelle do we feel the place abound with tigritude. — Wole Soyinka

The great historical tragedy of Africa has been not so much that it was too late in making contact with the rest of the world, as the manner in which that contact was brought about. — Aime Cesaire.

La corruption explique en partie la faim. Sans la complicité active du président Paul Biya, Bolloré et Vilgrain n’auraient jamais pu s’approprier des centaines de milliers d’hectares de terres fertiles, au Cameroun, dont les paysans ont été expulsés et où les cultures vivrières ont été remplacées par de la canne à sucre destinée à la production de biocarburants. — Jean Ziegler

HIFA profile: Akhenaten BS Tankwanchi is an Independent Research Consultant in the United States. Professional interests: health disparities, telehealth, mental health, global health, health equity, minority health, human development, community psychology, program evaluation, noncommunicable diseases, sub-Saharan Africa.  akhenaton.tankwanchi AT gmail.com

__________

To send a message to the HIFA forum, simply send an email to: HIFA2015@dgroups.org