232888 Need for new approaches to global health system reform: The case of health care worker migration in Uganda

Tuesday, November 9, 2010 : 12:30 PM - 12:50 PM

Doreen Mpirirwe Kamoga, MBChB, MPH , Master of Public Health Program, Department of Epidemiology and Biostatistics, School of Medicine,Case Western Reserve University, Cleveland, OH
Janet Winfred McGrath, PhD , Department of Anthropology, Case Western Reserve University, Cleveland, OH
Background: Migration of healthcare workers from developing to developed countries and from rural to urban centers within developing countries is a phenomenon of substantial importance to efforts to improve health systems. This study sought to identify views from stakeholders at different levels of the health care system about what they think causes health worker migration in Uganda. It explores views of Ugandan healthcare workers, students in training and healthcare policy makers and implementers. Methods: The cross-sectional study employed questionnaires administered to Ugandan health care workers in central and western Uganda. Participants (n=62) were selected starting at the village level moving up to the national level according to the Ministry of Health referral system. Descriptive analysis of demographics, and knowledge and attitudes surrounding healthcare worker migration were done using SPSS. Results: Reasons given for international migration included the search for better remuneration (79.7%), better training opportunities (44%), stable work environments (20%) and corruption free systems (18%). Reasons given for rural-urban migration included the search for better amenities (42.4%), more ‘moonlighting' options (20%), further training opportunities (17%), and work in NGO funded projects (5%). Existing understaffing in healthcare was given as the major challenge (>70%) fueling worker migration. Lack of essential medicines (57.6%) and poor hospital infrastructures (16.9%) were identified as challenges suffocating job satisfaction. Conclusions: The study shows that reforming the Ugandan health care system requires improving working conditions, ensuring timely supply of medicines and diagnostic equipment, and providing accommodations for workers in rural areas, in addition to increasing salaries.

Learning Objectives:
1. Assess awareness of health care worker migration in Uganda among Ugandan policy makers and implementers, health care workers, students training in health care, at different levels of the Uganda health system. 2. Assess the general knowledge of policy makers and implementers, health care workers and students training in health care, about what they think causes this migration. 3. Identify policy implementer, health care worker and student’s attitudes to health care delivery in their setting. What challenges they face in delivering health care and suggestions they have to improve service delivery.

Keywords: Health Care Workers, Health Care Reform

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an abstract Author on the content am responsible for because I am a Ugandan trained physician and a global health policy major at Case Western Reserve University.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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