Kwaku Owusu, Lillian Ohene and Mary Setrana report on the first workshop held on 13-14 June 2019 at the University of Sheffield as part of the Worldwide Universities Network Research Development Fund grant – Migrants’ Decision Making in the Context of Shifting Migration Regimes: Highly Skilled Health and Social Care Professionals – a grant held by Sustainable Care researchers Dr Majella Kilkey and Professor Louise Ryan.
Ghana! The highest emigration rate of health professionals in West Africa.
Despite the increasing interest in migration issues among policymakers and researchers, little is known about the dynamics of health and social care professionals’ migration from West Africa, including Ghana, to developed countries. The migration of health professionals from Ghana include all levels or grades of health professionals ranging from medical doctors, largely young and non-specialists, nurses, pharmacists, dentists and lab technicians. The majority of these health professionals migrate to UK, US, Canada and South Africa to work in the health and social care sector. Historically, the United Kingdom has been the main receiving country until the early 2000s when the numbers reduced due to the implementation of the 2004 UK code of practice for the international recruitment of health care professionals. This code was a deliberate strategic approach formulated to restrict the National Health Service (NHS) employers from actively recruiting from developing countries without the existence of government-to-government agreements. Meanwhile, the absence of bilateral labour migration agreements between Ghana and other countries also means that individual health professionals explore and migrate on their own initiatives. Despite the paucity of migration data on health professionals emigrating from Ghana, anecdotal data estimates that these movements began with a few health professionals in the 1960s and subsequently increased tremendously in the 1980s. Ghana’s economic and political turmoil in the 1980s is generally perceived key to the exodus of highly skilled healthcare professionals in search of security and greener pastures. For instance, in 2009, more than 56% doctors and 24% nurses trained in Ghana migrated to advanced countries (IOM, 2009). Recent data from the number of nursing and midwifery professional verification highlight an increasing trend, from 260 in 2016 to 689 in 2018 (Nurse and Midwifery Council of Ghana, Registrars’ office). The reasons for migrating are numerous, ranging from the push factors in Ghana, such as expectations of higher salaries abroad, lack of opportunities for further studies, poor conditions of service, and low salaries among others. On the other hand, some attractive indicators in the host countries include the visa lottery system in the US, the points system in Canada, as well as the shared language, common educational systems and established networks in the UK, US and Canada.
In the past, many African governments including Ghana, only recognised the negative consequences of health professionals’ emigration. However, in recent times, several other nations have acknowledged the increasing positive linkages between the migration of health professionals and national development. Contemporary narrative is less focused on the negative lens through which migration previously was viewed, such as brain drain and lost revenue through training and taxation. Instead, the governments of Ghana in collaboration with its global diaspora have been emphatic about the positive developmental impact of financial remittances, brain gain and knowledge circulation. Evidence of the government’s commitment to this vision is reflected in a draft Diaspora Engagement Policy for Ghana. Other national initiatives engage Ghanaian diaspora health professionals through short-term engagement with government health facilities to address the insufficient highly skilled health professional-to-patient ratio in the country. In spite of these positive impacts, what is less known is a cross-sectional comparative study between receiving and sending countries.
In light of the above, the WUN RDF Project, led by Dr Majella Kilkey, with Professor Louise Ryan as Co-I, seeks to bridge the knowledge gap through empirical research initiatives. The first workshop organised at the University of Sheffield, UK, brought together researchers from Global South and North countries, including Sustainable Care partners from the Universities of Warsaw, Western Australia and Alberta, to deliberate on different situational contexts of health and social care professionals. Acknowledging that it is something of a false dichotomy, the countries were categorised into two groups: predominantly sending countries and predominantly receiving countries. Among the sending countries were Ghana, a country with the highest emigration rate of health professionals in West Africa and Poland a member of the EU since 2004. The receiving countries included the UK, Canada, Australia and Ireland. In attendance was also a complementary network of researchers, consisting of established scholars, Early Career Researches (ECRs) and PhD students, to develop innovative, comparative and multi-sited research on migration of health and social care professionals among the selected countries. Participants discussed the processes and requirements needed for submitting funding application to diverse funding sources such as the UK’s Economic and Social Research Council (ESRC). Professor Sue Yeandle delivered an informative presentation about how to develop a successful ESRC proposal from a WUN grant. In addition, participants explored key avenues to engage beyond academia by publishing blogs and newspaper articles in response to health professional migration-regime changes. The proposed themes focus on issues of decision-making and migration processes, integration processes and return possibilities. The ECRs and PhD participants also had ample opportunities to interrogate with established scholars about techniques on writing and publishing academic articles in prestigious peer-reviewed journals.
The team will re-convene in November, 2019 at the University of Ghana, Accra, Ghana to concretise these initial proposals.