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Open Access 01-12-2024 | Research

Factors influencing the intention of doctors to emigrate: a cross-sectional study of Ghanaian doctors

Authors: Baleng Mahama Wutor, Francisca Nyarko Sarfo, Louisa Afia Nkrumah, Luki Daniel Bakuoru, Chinenye Nneoma Amanze, Isaac Osei

Published in: BMC Health Services Research | Issue 1/2024

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Abstract

Background

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.

Methodology

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.

Results

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).

Conclusion

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.
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Literature
1.
go back to reference Asma S, Lozano R, Chatterji S, Swaminathan S, de Fátima MM, Yamamoto N, et al. Monitoring the health-related Sustainable Development Goals: lessons learned and recommendations for improved measurement. Lancet. 2020;395(10219):240–6.CrossRefPubMed Asma S, Lozano R, Chatterji S, Swaminathan S, de Fátima MM, Yamamoto N, et al. Monitoring the health-related Sustainable Development Goals: lessons learned and recommendations for improved measurement. Lancet. 2020;395(10219):240–6.CrossRefPubMed
2.
go back to reference Lim SS, Allen K, Bhutta ZA, Dandona L, Forouzanfar MH, Fullman N, et al. Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1813–50.CrossRef Lim SS, Allen K, Bhutta ZA, Dandona L, Forouzanfar MH, Fullman N, et al. Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1813–50.CrossRef
5.
go back to reference AU. Mobility and Migration of African health workers Post Covid-19. AU; 2020. p. Pg 2. . AU. Mobility and Migration of African health workers Post Covid-19. AU; 2020. p. Pg 2. .
6.
go back to reference Naicker S, Eastwood JB, Plange-Rhule J, Tutt RC. Shortage of healthcare workers in sub-Saharan Africa: a nephrological perspective. Clin Nephrol. 2010;74:S129–33.PubMed Naicker S, Eastwood JB, Plange-Rhule J, Tutt RC. Shortage of healthcare workers in sub-Saharan Africa: a nephrological perspective. Clin Nephrol. 2010;74:S129–33.PubMed
7.
go back to reference Wright D, Flis N, Gupta M. The'Brain Drain'of physicians: historical antecedents to an ethical debate, c. 1960–79. Philosophy, ethics, and humanities in medicine. 2008;3:1–8. Wright D, Flis N, Gupta M. The'Brain Drain'of physicians: historical antecedents to an ethical debate, c. 1960–79. Philosophy, ethics, and humanities in medicine. 2008;3:1–8.
9.
go back to reference Hagopian A, Thompson MF. The Migration Of Physicians From Sub-Saharan Africa To The United States Of America: Measures Of The African Brain Drain WWAMI Center for Health Workforce Studies. Department of Family Medicine, University of Washington, Seattle, Washington, USA, Department of Primary Health Care, University of Oxford. 2004. Hagopian A, Thompson MF. The Migration Of Physicians From Sub-Saharan Africa To The United States Of America: Measures Of The African Brain Drain WWAMI Center for Health Workforce Studies. Department of Family Medicine, University of Washington, Seattle, Washington, USA, Department of Primary Health Care, University of Oxford. 2004.
10.
go back to reference Brennan N, Langdon N, Bryce M, Burns L, Humphries N, Knapton A, Gale T. Drivers and barriers of international migration of doctors to and from the United Kingdom: a scoping review. Hum Resour Health. 2023;21(1):11.CrossRefPubMedPubMedCentral Brennan N, Langdon N, Bryce M, Burns L, Humphries N, Knapton A, Gale T. Drivers and barriers of international migration of doctors to and from the United Kingdom: a scoping review. Hum Resour Health. 2023;21(1):11.CrossRefPubMedPubMedCentral
11.
go back to reference Awases M, Bary A, Nyoni J. Migration of health professionals in six countries: a synthesis report. migration of health professionals in six countries: a synthesis report2004. Awases M, Bary A, Nyoni J. Migration of health professionals in six countries: a synthesis report. migration of health professionals in six countries: a synthesis report2004.
12.
go back to reference Onah CK, Azuogu BN, Ochie CN, Akpa CO, Okeke KC, Okpunwa AO, et al. Physician emigration from Nigeria and the associated factors: the implications to safeguarding the Nigeria health system. Hum Resour Health. 2022;20(1):85.CrossRefPubMedPubMedCentral Onah CK, Azuogu BN, Ochie CN, Akpa CO, Okeke KC, Okpunwa AO, et al. Physician emigration from Nigeria and the associated factors: the implications to safeguarding the Nigeria health system. Hum Resour Health. 2022;20(1):85.CrossRefPubMedPubMedCentral
13.
go back to reference Bidwell P, Laxmikanth P, Blacklock C, Hayward G, Willcox M, Peersman W, et al. Security and skills: the two key issues in health worker migration. Glob Health Action. 2014;7(1):24194.CrossRefPubMed Bidwell P, Laxmikanth P, Blacklock C, Hayward G, Willcox M, Peersman W, et al. Security and skills: the two key issues in health worker migration. Glob Health Action. 2014;7(1):24194.CrossRefPubMed
14.
go back to reference Lofters A, Slater M, Thulien N. The “brain drain”: factors influencing physician migration to Canada. 2013. Lofters A, Slater M, Thulien N. The “brain drain”: factors influencing physician migration to Canada. 2013.
15.
go back to reference Tensaba AA, Okeke A, Oreh AC. Pusk and pull factors of emigration among physician in Nigeria. West African J Med. 2023;40(12 Suppl 1):S44–S44. Tensaba AA, Okeke A, Oreh AC. Pusk and pull factors of emigration among physician in Nigeria. West African J Med. 2023;40(12 Suppl 1):S44–S44.
16.
go back to reference Dovlo D, Nyonator F. Migration by graduates of the University of Ghana Medical School: a preliminary rapid appraisal. Hum Resour Health Dev J. 1999;3(1):40–51. Dovlo D, Nyonator F. Migration by graduates of the University of Ghana Medical School: a preliminary rapid appraisal. Hum Resour Health Dev J. 1999;3(1):40–51.
17.
go back to reference Duvivier RJ, Burch VC, Boulet JR. A comparison of physician emigration from Africa to the United States of America between 2005 and 2015. Hum Resour Health. 2017;15:1–12. Duvivier RJ, Burch VC, Boulet JR. A comparison of physician emigration from Africa to the United States of America between 2005 and 2015. Hum Resour Health. 2017;15:1–12.
18.
go back to reference Tankwanchi ABS, Özden Ç, Vermund SH. Physician emigration from sub-Saharan Africa to the United States: analysis of the 2011 AMA physician masterfile. PLoS Med. 2013;10(9):e1001513.CrossRefPubMedPubMedCentral Tankwanchi ABS, Özden Ç, Vermund SH. Physician emigration from sub-Saharan Africa to the United States: analysis of the 2011 AMA physician masterfile. PLoS Med. 2013;10(9):e1001513.CrossRefPubMedPubMedCentral
19.
go back to reference Akinwumi AF, Solomon OO, Ajayi PO, Ogunleye TS, Ilesanmi OA, Ajayi AO. Prevalence and pattern of migration intention of doctors undergoing training programmes in public tertiary hospitals in Ekiti State, Nigeria. Hum Resour Health. 2022;20(1):76.CrossRefPubMedPubMedCentral Akinwumi AF, Solomon OO, Ajayi PO, Ogunleye TS, Ilesanmi OA, Ajayi AO. Prevalence and pattern of migration intention of doctors undergoing training programmes in public tertiary hospitals in Ekiti State, Nigeria. Hum Resour Health. 2022;20(1):76.CrossRefPubMedPubMedCentral
20.
go back to reference Hagopian A, Thompson MJ, Fordyce M, Johnson KE, Hart LG. The migration of physicians from sub-Saharan Africa to the United States of America: measures of the African brain drain. Hum Resour Health. 2004;2:1–10.CrossRef Hagopian A, Thompson MJ, Fordyce M, Johnson KE, Hart LG. The migration of physicians from sub-Saharan Africa to the United States of America: measures of the African brain drain. Hum Resour Health. 2004;2:1–10.CrossRef
21.
go back to reference Clarke N, Crowe S, Humphries N, Conroy R, O’Hare S, Kavanagh P, Brugha R. Factors influencing trainee doctor emigration in a high income country: a mixed methods study. Hum Resour Health. 2017;15:1–12.CrossRef Clarke N, Crowe S, Humphries N, Conroy R, O’Hare S, Kavanagh P, Brugha R. Factors influencing trainee doctor emigration in a high income country: a mixed methods study. Hum Resour Health. 2017;15:1–12.CrossRef
25.
go back to reference Cochran WG. Sampling techniques: john wiley & sons; 1977. Cochran WG. Sampling techniques: john wiley & sons; 1977.
26.
go back to reference Badru OA, Alabi TA, Okerinde SS, Kabir MA, Abdulrazaq A, Adeagbo OA, Badru FA. Investigating the emigration intention of health care workers: A cross-sectional study. Nurs Open. 2024;11(5):e2170.CrossRefPubMedPubMedCentral Badru OA, Alabi TA, Okerinde SS, Kabir MA, Abdulrazaq A, Adeagbo OA, Badru FA. Investigating the emigration intention of health care workers: A cross-sectional study. Nurs Open. 2024;11(5):e2170.CrossRefPubMedPubMedCentral
27.
go back to reference Eliason S, Tuoyire D, Awusi-Nti C, Bockarie A. Migration intentions of Ghanaian medical students: The influence of existing funding mechanisms of medical education (“ The fee factor”). Ghana Med J. 2014;48(2):78–84.CrossRefPubMedPubMedCentral Eliason S, Tuoyire D, Awusi-Nti C, Bockarie A. Migration intentions of Ghanaian medical students: The influence of existing funding mechanisms of medical education (“ The fee factor”). Ghana Med J. 2014;48(2):78–84.CrossRefPubMedPubMedCentral
28.
go back to reference Aduhene DT, Osei-Assibey E. Socio-economic impact of COVID-19 on Ghana’s economy: challenges and prospects. Int J Soc Econ. 2021;48(4):543–56.CrossRef Aduhene DT, Osei-Assibey E. Socio-economic impact of COVID-19 on Ghana’s economy: challenges and prospects. Int J Soc Econ. 2021;48(4):543–56.CrossRef
29.
go back to reference Hagopian A, Ofosu A, Fatusi A, Biritwum R, Essel A, Hart LG, Watts C. The flight of physicians from West Africa: views of African physicians and implications for policy. Soc Sci Med. 2005;61(8):1750–60.CrossRefPubMed Hagopian A, Ofosu A, Fatusi A, Biritwum R, Essel A, Hart LG, Watts C. The flight of physicians from West Africa: views of African physicians and implications for policy. Soc Sci Med. 2005;61(8):1750–60.CrossRefPubMed
30.
go back to reference Jenkins R, Kydd R, Mullen P, Thomson K, Sculley J, Kuper S, et al. International migration of doctors, and its impact on availability of psychiatrists in low and middle income countries. PLoS ONE. 2010;5(2):e9049.CrossRefPubMedPubMedCentral Jenkins R, Kydd R, Mullen P, Thomson K, Sculley J, Kuper S, et al. International migration of doctors, and its impact on availability of psychiatrists in low and middle income countries. PLoS ONE. 2010;5(2):e9049.CrossRefPubMedPubMedCentral
31.
go back to reference Ike SO. The health workforce crisis: the brain drain scourge. Niger J Med. 2007;16(3):204–11.PubMed Ike SO. The health workforce crisis: the brain drain scourge. Niger J Med. 2007;16(3):204–11.PubMed
32.
go back to reference Udonwa N. Human capital flight challenges within an equitable health system. Niger J Med. 2007;16(4):307–11.PubMed Udonwa N. Human capital flight challenges within an equitable health system. Niger J Med. 2007;16(4):307–11.PubMed
33.
go back to reference Sedeta ET, Abicho TB, Jobre BY. Perceptions of medical doctors living in Ethiopia about physician migration: a qualitative study. BMJ Open. 2022;12(6):e060830.CrossRefPubMedPubMedCentral Sedeta ET, Abicho TB, Jobre BY. Perceptions of medical doctors living in Ethiopia about physician migration: a qualitative study. BMJ Open. 2022;12(6):e060830.CrossRefPubMedPubMedCentral
34.
35.
go back to reference Labonté R, Sanders D, Mathole T, Crush J, Chikanda A, Dambisya Y, et al. Health worker migration from South Africa: causes, consequences and policy responses. Hum Resour Health. 2015;13:1–16.CrossRef Labonté R, Sanders D, Mathole T, Crush J, Chikanda A, Dambisya Y, et al. Health worker migration from South Africa: causes, consequences and policy responses. Hum Resour Health. 2015;13:1–16.CrossRef
36.
go back to reference Piper N. Gender and migration: A paper prepared for the policy analysis and research programme of the global commission on international migration. Geneva: Global Commission on International Migration; 2005. p. 12. Piper N. Gender and migration: A paper prepared for the policy analysis and research programme of the global commission on international migration. Geneva: Global Commission on International Migration; 2005. p. 12.
37.
go back to reference Amuakwa-Mensah F, Nelson AA. Retention of medical doctors in Ghana through local postgraduate training. J Educ Pract. 2014;5(5):120–33. Amuakwa-Mensah F, Nelson AA. Retention of medical doctors in Ghana through local postgraduate training. J Educ Pract. 2014;5(5):120–33.
40.
go back to reference Mills EJ, Kanters S, Hagopian A, Bansback N, Nachega J, Alberton M, et al. The financial cost of doctors emigrating from sub-Saharan Africa: human capital analysis. Bmj. 2011;343. Mills EJ, Kanters S, Hagopian A, Bansback N, Nachega J, Alberton M, et al. The financial cost of doctors emigrating from sub-Saharan Africa: human capital analysis. Bmj. 2011;343.
41.
go back to reference Witt J. Addressing the migration of health professionals: the role of working conditions and educational placements. BMC Public Health. 2009;9(Suppl 1):S7.CrossRefPubMedPubMedCentral Witt J. Addressing the migration of health professionals: the role of working conditions and educational placements. BMC Public Health. 2009;9(Suppl 1):S7.CrossRefPubMedPubMedCentral
Metadata
Title
Factors influencing the intention of doctors to emigrate: a cross-sectional study of Ghanaian doctors
Authors
Baleng Mahama Wutor
Francisca Nyarko Sarfo
Louisa Afia Nkrumah
Luki Daniel Bakuoru
Chinenye Nneoma Amanze
Isaac Osei
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2024
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-024-11977-y