The Potential of African Diaspora
Professional Organizations in
Europe for Bridging Human
Resources for Health ‘Needs
Gap’ in Sub-Saharan Africa
Countries
Franklyn Lisk
CSGR, University of Warwick
Diaspora and Development:
Transnational Movement of People and
Resources
• Increasing interest in diasporas’ role in
development in Sub-Saharan Africa (SSA)
• Direct and personal involvement of diaspora
members in development initiatives in homeland
/ country of origin
• Positive connections between diasporas and
development
• Networks of cultural, economic, social and
political relations
• A better and cost-effective option for delivery of
development assistance?
Diaspora and Development: Areas
of Engagement
• Basic Social Services (health, education,
water and sanitation)
• Commercial activities (trade and export
promotion)
• Infrastructure (residential and community
buildings, access roads
Diaspora and Development: Types
of Engagement
• Transfer of financial ( remittances) and material
resources
• Transfer of knowledge, experience and contribution to
capacity development
• Raising awareness about global, regional and national
development issues and practices
• Influencing public policy through advocacy and personal
contacts in homeland government
• Collaborative research
• Facilitating foreign direct investment
• Collaborating with donor and development agencies in
host country and with multilateral organisations
Diaspora and Human Resources for Health
(HRH): The Origin and Nature of the
Problem
• Migration of health professionals from SSA countries to
Europe, North America and Australia – African ‘Brain
Drain’ and colossal loss of investment in expensivelytrained human capital; developed countries ‘free-riding’
on the education and training efforts of source countries.
• Massive health worker shortages (physicians, nurses
and medical technicians) in the many SSA countries
such as Gambia, Sierra Leone, Liberia, Ethiopia,
Mauritius, Zambia, Zimbabwe, Malawi, Uganda, Nigeria,
Burundi, Equatorial Guinea, Kenya, Mozambique,
Senegal, Ghana, Cameroon, Togo and Sao Tome
• Sub-standard and poorly-staffed health infrastructure
and ineffective services/systems, which reinforce
persistence of poverty and under-development and hold
back achievement of the Millennium Development Goals.
Diaspora and HRH: The Magnitude
of the Problem of Health Worker
Shortage
• Approximately 65,000 African-born doctors and
70,000 African-born professional nurses were
working abroad in a developed country in 2000,
representing about one-fifth of African-born
physicians and one-tenth of African-born nurses
in the world [Center for Global Development
study by Michael Clemens and Gunilla
Pettersson]
• E.g. 75% of people born in Mozambique who
now work as doctors do not live in Mozambique
Migration of African Health Professionals:
Another view – A ‘Brain Gain’ through
Diaspora Activity ?
• Clemens and some others have argued that on
average the emigration of African health
professionals to developed countries has not
been entirely harmful to the source countries,
contending that some African countries, such as
Ghana, Senegal and Mauritius, with the highest
health professional emigration rates tend to
have the best health systems in the region
• Apparently, there are possible beneficial
professional and technical assistance contacts
and promotion of knowledge exchange through
diasporas
Options to bridge HRH Needs Gap
• Retention Option: Ensuring that highly-skilled
professionals do not leave home country in the first place
– both non-voluntary (bonded to serve homeland for a
period of time after training) and incentive methods
[WHO’s Treat, Train and Retain; WHO proposed Code of
Practice on the international recruitment of health
professionals; WHO-sponsored Global Health Workforce
Alliance; WHO-OECD Dialogue on migration of health
workforce, ILO’s Health Worker Migration and a Fair
Globalization programme]
• Return Option: Luring professionals abroad back to
their countries of origin [IOM’s Return of Qualified African
Nationals programme; UNDP’s Transfer of Knowledge
Through Expatriate Nationals (TOKTEN)]
• Diaspora Option: Making use of the contributions of
nationals abroad without requiring them to relocate back
to their home countries
The Diaspora Option
Illustrative examples of African Professional Diaspora Organizations
in Europe engaged in Human Resources for Health and Health
Sector Development
•
•
•
Afro-European Medical and Research Network (AERN): A Swiss-based
non-government and non-profit Pan-African diaspora organization,
suppoted by the Swiss Development Cooperation,with activities designed to
help improve the quality of life of people in resource-poor settings in SSA
through provision of the services of volunteer medical professionals, mobile
clinics, equipment, knowledge exchange and training.
Sierra Leone Diaspora Network: A London-based charity and diaspora
organization, supported by DFID, with the aim of mobilizing Sierra Leone
health professionals in the Diaspora towards the improvement of health
facilities and delivery of healthcare in Sierra Leone through volunteering,
policy dialogue with the government and Knowledge exchange.
Environment and Health In Communities in Africa (ENHICA): An
international diaspora organization of Nigerian origin, based in both Europe
and North America, specializing in mobilizing intellectual and material
resources to support health sector projects in Africa.
Critical Issues and Challenges in
the Diaspora Option
• How to maximize the contributions of diasporas
• How to ensure accountability and maintain credibility,
including monitoring and evaluation
• Collaboration with homeland government and local
authorities without being ‘politicized’
• Cooperation with host government development
assistance machinery, to recognize and support the
diaspora option as a cost-effective complement or
alternative to conventional means of donor assistance
• Institutionalization of arrangements for contributing to
sustainable development