Strengthening and Supporting the Health Workforce
Retention and the Lesotho Nursing Initiative
Dr. Mphu Ramatlapeng
Minister of Health, Lesotho
3 February 2012
Presentation Outline
• Introduction
• Brain Drain out of Sub-Saharan Africa
• Push-Pull Factors
• MOHSW-Irish Aid-Clinton Foundation Partnership
• Challenges
• Conclusion
2 • Strengthening and Supporting the Health Workforce • 3 February 2012
Introduction
Sub-Saharan Africa:
• The region is faced with high burden of communicable and
non communicable diseases ( HIV and AIDs, Malaria, TB,
Cancers and Diabetes)
• Most of the countries in the region experience high demands
of health care services due to the high demand of health
care
• However the supply of health professionals is low ( Doctors,
Nurses pharmacists and others)
• Efforts are being applied in the region to address the above
mentioned challenges
3 • Strengthening and Supporting the Health Workforce • 3 February 2012
The “brain drain” of health care professionals out of subSaharan Africa has significant implications
• A significant number of African-born
health care professionals move
abroad
o ~65,000 African-born physicians
and ~70,000 African-born nurses
working overseas
• A published BMJ article (Nov 2011)
shows that lost investment from the
emigration of physicians is significant
− African-born physicians working
abroad educated by Africa at a
cost of over $2B USD
− UK benefit: $2.7B USD
− US benefit: $846M USD
Source: BMJ 2011;343:d7031 “The financial cost of doctors emigrating from sub-Saharan Africa: human capital analysis”; AAU
2007 “Optimizing the African Brain Drain: Strategies for Mobilizing the Intellectual Diaspora towards Brain-Gain”
4 • Strengthening and Supporting the Health Workforce • 3 February 2012
This loss of local talent is due to a variety of “push” and “pull”
factors that can be social, economical, or political
Push Factors
Pull Factors
• Lack/limited jobs
• Better jobs
• Unsatisfactory pay
• Higher pay
• Limited opportunities for
professional development
• Greater opportunities for
professional development
• Poor social conditions
• High quality of life
• Political instability
• Political stability
5 • Strengthening and Supporting the Health Workforce • 3 February 2012
Lesotho initiatives in addressing brain drain (1 / 2)
Improvement of Infrastructure:
• Refurbishment and construction of the health facilities and
staff housing apartments
• Provision of requisite equipment for all health facilities
• Upgrading of the MOHSW communication systems (networks)
Other Development strategies:
• The country developed the health work force retention
strategy and currently some components of the strategy are
being implemented (e.g personal development, financial
incentives) in collaboration with partners
6 • Strengthening and Supporting the Health Workforce • 3 February 2012
Lesotho initiatives in addressing brain drain (2 / 2)
Other Development Strategies:
• Health Systems Strengthening e.g the continuing education
strategy was developed and its implementation commenced
in March 2010
• Launching of the Nurse Education Partnership Initiative (NEPI)
initiative to capacitate the nursing institutions
• Family medicine residency program is being run to train
young Basotho as specialists in family medicine
• Establishment of wellness centers to cater for the health of
workforce
7 • Strengthening and Supporting the Health Workforce • 3 February 2012
Challenges
• Attrition of health care professionals continues to
be high
• Production of Health professionals by academic
institutions is still low
• Demand for health care continues to grow due to
the increasing disease burden
• Attainment of MDGs targets in accordance with the
schedule
8 • Strengthening and Supporting the Health Workforce • 3 February 2012
Conclusion
• The support from different partners played
a significant role in improving the health
status of all the citizens of Lesotho
• The Government will keep accelerating the
initiatives which are meant to address HR
problems
9 • Strengthening and Supporting the Health Workforce • 3 February 2012
Thank You
10 • Strengthening and Supporting the Health Workforce • 3 February 2012