[afro-nets] Africa Losing Nurses to Britain (7)

General afro-nets
1

Africa Losing Nurses to Britain (7)
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Dear colleagues,

I cannot take credit for writing the piece on "Africa Losing
Nurses to Britain" - I only forwarded it onto the list. I also
sent this item to ProNUT-HIV (Nutrition and HIV), a sister forum
to AFRO-NETS, run by SATELLIFE. Again, I am forwarding a message
from ProNUT-HIV - please read below the passionate plea for help
from a nurse in South Africa.

In response to the last message from Azeh John Muma in the Cam-
eroon and Dolly Nyasulu's in KwaZulu Natal, I also ask myself,
what can we do? There is no doubt that the issues are complex
and there are no simple solutions. But, given our worldwide com-
munity of Afro-Netters, more than 1500 subscribers in over 75
countries, all of you with remarkable experience and expertise
in a variety of fields, is there a way for us to bring our col-
lective thinking to better understand and address the issues? Do
we have an opportunity to use the power of information technol-
ogy to bring us together and as Azeh John Muma said, "we can to-
gether look at the major (root) causes of this problem and pro-
pose a solution".

I like Azeh's idea. We can engage in thoughtful and constructive
discussion on AFRO-NETS. But, I would also like to explore how
we move beyond the 'discussion' to make a difference. I'm not
sure how this happens given the magnitude of the problems but I
do look forward to hearing your
thoughts.

Kind regards,
Leela McCullough
mailto:leela@healthnet.org

--
Message from Dolly Nyasulu

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Africa Losing Nurses to Britain (8)
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With all due respect to Leela McCullough, Azeh John Muma and the
community of 'Afro-netters' seeking "collective thinking to bet-
ter understand the root causes and solutions to the [brain
drain] problem", it is fair to assert that copious literature on
causes, effects and proposed solutions already exist.
(See Datelinehealth-Africa.net at
http://www.datelinehealth-africa.net/betav1.0/researchreports/detailreport.asp?report_id=217

for recently updated and comprehensive bibliography on the sub-
ject).

The main task that remains largely un-addressed is the main-
streaming of proposed solutions into policy and action at the
"push" and "pull" domains of this problem.

What can or should "Afro-netters" do or be doing?

The following are my proposals:
a) Collaborate with others (which may include focal institutions
like the WHO) to identify, organize, form and fund a broad-based
collective of knowledgeable parties ("Task Force") to develop
and implement a 5-year strategic action plan for policy advocacy
to action on the problem.

b) Task Force should be charged with:
(i) Evaluating and producing a summary dataset/blue-print from
the copious existing body of knowledge on the "push" and "pull"
[root] causes of the problem;
(ii) Crystallising all feasible proposed solutions into specific
and practical policy recommendations and implications;
(iii) Defining policy advocacy strategies and action steps for
measurable policy objectives;
(iv) Implementing advocacy strategies with sustainable recommen-
dations and action steps targeted at governments, national and
multilateral institutions of major 'brain' exporting and import-
ing countries.

The major "brain" exporting countries to be targeted in Africa
are: Ghana, Kenya, Nigeria, Senegal, South Africa and Uganda
among others. The major "brain" importing countries to be tar-
geted are; USA, UK, France, Australia among others.

Without taking away from the complexity of the problem, there is
every likelihood that such a 'Task force' as proposed above im-
plementing a five-year "Developing country 'brain drain' policy
advocacy to action strategic plan" could indeed begin to achieve
significant and measurable solutions to this complex problem.

I'll be delighted to read what others propose.

--
A. Odutola
Centre for Health Policy & Strategic Studies
34 Town Planning Way, Ilupeju
P.O. Box 7597, Ikeja, Lagos, Nigeria
Tel. +234-1-470-1255
Fax: +234-1-263-5285
mailto:chpss_abo2@yahoo.com

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Africa Losing Nurses to Britain (9)
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Dear Dr. Odutola,

Thanks very much for your message that I think shows us the way
to go. There have been quite a lot of activity on migration and
HRH and it is time for more concrete action. I will like to re-
fer AFRO-Netters to a couple of other resources that cover the
problem of health worker migration.

The Global Health trust website -
http://www.globalhealthtrust.org/Publication.htm

This features work on HRH as part of a "Joint Learning Initia-
tive" a Rockefeller Foundation, World Bank, WHO supported ven-
ture with 7 working groups studying the available information on
Human Resources in Health (all aspects) but with work on migra-
tion. This is ongoing but final reports are expected soon.

The DFID Health Systems resource Centre -
http://www.eldis.org/healthsystems/dossiers/hr/
has some HR resources including on migration

The Human Resources for Health Journal (Online free access jour-
nal) http://www.human-resources-health.com/articles/browse.asp
has published articles of work on various aspects of HRH with
interesting articles on wage differentials etc.

I understand NEPAD, AU and IOM have done some consultations with
registering and using diaspora resources for some specific coun-
tries in addition to the MIDA (?Migration for Development of Af-
rica?) and RQAN (Return of Qualified African Nationals) programs
which were run by IOM.

I believe in Ghana, The Ghana Health Service organized a Na-
tional Forum on Human Resources in July 2003 with wide stake-
holder participation and some of the ideas (e.g. a Task force on
HRH) that you have raised have been proposed. I think South Af-
rica has had a similar forum.

The 2003 East and Southern Africa Health Ministers Conference in
Livingstone Zambia in November 2003 was on the subject of Human
Resources with a strong element of the debates on what to do
about migration and its effects on services and as I think was
reported on this list the recent WHO World Health Assembly dis-
cussed at length and with some difficulty the issue of migration
of HRH and came out with a resolution - but alas, if only reso-
lutions changed things....

I agree with your suggestion, I do think that each affected
country also needs an internal "Task Force" working to plan and
implement the right policies whilst the regional and interna-
tional ones work to gain the international/global consensus
needed to save the health of Africans.

Delanyo Dovlo
Accra, Ghana
mailto:dovlod@yahoo.com