PATTERNS AND CONSEQUENCES OF MIGRATION OF SKILLED PROFESSIONALS IN HEALTH INSTITUTIONS IN SOUTHWESTERN NIGERIA, 1986 - 2010

Abstract

There has been large scale migration of health professionals from Nigeria to other countries with estimated 40,000 emigrants between 1975 and 1984 and over 90,000 in 2000. However, the patterns of movement and the associated consequences on non-migrants health professionals have not been empirically researched. This study, therefore, analysed the patterns and consequences of migration of skilled professionals in health institutions in Southwestern Nigeria from 1986 to 2010. The Push-Pull model provided the framework, while survey design was adopted. Ten percent of the population in each category of health professionals (doctors, nurses, pharmacists, and medical laboratory scientists) were selected in the University College Hospital (UCH) Ibadan, Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife and 20.0% in Adeoyo Maternity Teaching Hospital (AMTH), Yemetu, Ibadan. A structured questionnaire on demographic, spatial and temporal characteristics, factors and consequences of colleagues’ movement was purposively administered on selected professionals at UCH- 165, OAUTHC- 129 and AMTH- 54. Three sessions of focus group discussion were held with skilled professionals in the institutions, while in-depth interviews were conducted with three management officials in each of the institutions. Descriptive statistics, ANOVA, Logistic Regression and Chi-Squares were used to analyse the data at p≤0.05. Qualitative data were content analysed. Over sixty-eight percent of health professional emigrants were males, with age 35.5+8.9. A total of 576 (UCH - 83 doctors, 135 nurses, 9 pharmacists and 11 medical laboratory scientists (MLS); OAUTHC - 84 doctors, 163 nurses, 12 pharmacists and 9 MLS and AMTH - 16 doctors and 73 nurses) emigrated from the institutions. Only 33 (UCH - 3 doctors and 7 nurses; OAUTHC - 6 doctors and 2 nurses and AMTH - 12 nurses) foreigners immigrated into the institutions between 1986 and 2010. Health professionals from the institutions that emigrated were: the United Kingdom (33.3%), the United States of America (USA) (27.0%), Canada (12.0%), Saudi Arabia (5.2%) and Dubai (4.0%), while health professionals immigrated into the institutions from Italy and Sweden (24.0% each), Finland (20.0%) and the USA and South Africa (6.9% each). Age (β=0.78), year of qualification (β=0.929), designation (β=1.038), marital status (β=1.224) and sex (β=1.238) were perceived factors predisposing migration of health professionals from the institutions. The loss of expertise due to poor working conditions was perceived as significant negative consequence by non-migrant skilled professionals: UCH (doctors - χ2=3.95, nurses - χ2=1.72 and pharmacists - χ2=3.00); AMTH (doctors - χ2=1.33 and nurses - χ2=4.02) and OAUTHC (nurses - χ2=2.19) (F=2.32). There was a shortage of skilled professionals in neurosurgery, oncology and plastic surgery in the health institutions. Few emigrated professionals assisted in facilitating the procurement of books, laboratory and theater equipment and presentation of seminars/lectures. Migration patterns of skilled professionals to different countries varied across the selected health institutions in Southwestern Nigeria from 1986 to 2010 with loss of skilled professionals in the sensitive areas of healthcare delivery. The returning health professionals should be encouraged in order to mitigate the consequences. Keywords: Migration of health professionals, Health institutions in Southwestern Nigeria, Skilled health professionals. Word count: 483