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2014 ; 64
(623
): e321-8
Nephropedia Template TP
gab.com Text
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English Wikipedia
The inverse primary care law in sub-Saharan Africa: a qualitative study of the
views of migrant health workers
#MMPMID24868069
Moosa S
; Wojczewski S
; Hoffmann K
; Poppe A
; Nkomazana O
; Peersman W
; Willcox M
; Derese A
; Mant D
Br J Gen Pract
2014[Jun]; 64
(623
): e321-8
PMID24868069
show ga
BACKGROUND: Many low-income and middle-income countries globally are now pursuing
ambitious plans for universal primary care, but are failing to deliver adequate
care quality because of intractable human resource problems. AIM: To understand
why migrant nurses and doctors from sub-Saharan Africa did not wish to take up
available posts in primary and first-contact care in their home countries. DESIGN
AND SETTING: Qualitative study of migrant health workers to Europe (UK, Belgium,
and Austria) or southern Africa (Botswana and South Africa) from sub-Saharan
Africa. METHOD: Semi-structured interviews with 66 health workers (24 nurses and
42 doctors) from 18 countries between July 2011 and April 2012. Transcripts were
analysed thematically using a framework approach. RESULTS: The reasons given for
choosing not to work in primary care were grouped into three main analytic
streams: poor working environment, difficult living experiences, and poor career
path. Responders described a lack of basic medicines and equipment, an
unmanageable workload, and lack of professional support. Many had concerns about
personal security, living conditions (such as education for children), and poor
income. Primary care was seen as lower status than hospital medicine, with lack
of specialist training opportunities and more exposure to corruption.
CONCLUSIONS: Clinicians are reluctant to work in the conditions they currently
experience in primary care in sub-Saharan Africa and these conditions tend to get
worse as poverty and need for primary care increases. This inverse primary care
law undermines achievement of universal health coverage. Policy experience from
countries outside Africa shows that it is not immutable.
|Africa South of the Sahara
[MESH]
|Austria
[MESH]
|Belgium
[MESH]
|Delivery of Health Care/economics/legislation & jurisprudence
[MESH]