In this interview with PREMIUM TIMES, Chrys Kaniki, a Senior Technical Officer for Strategy and Policy, Africa Centres for Disease Control and Prevention, sheds light on the disparities in healthcare workforce distribution on the African continent and the pressing challenge of brain drain.

PT: Can you provide an overview of the current state of healthcare professionals in Africa, with a focus on the youth demographic?

Kaniki: Recent studies conducted in the African continent have revealed a significant disparity in the healthcare workforce across the continent. This gap encompasses both the population of individuals residing on the continent and the availability of healthcare professionals. While certain countries boast of many health workers, they tend to be concentrated in urban areas, leaving rural communities underserved. In such regions, a single doctor or nurse often caters to the needs of thousands.

Efforts must be made to optimise the utilisation of our human resources across the continent. Despite the millions of healthcare professionals such as doctors, nurses, midwives, lab specialists, and epidemiologists, trained by universities annually, the existing gap remains a pressing concern.

Moreover, it is important to recognise the potential presented by young health workers. By harnessing this opportunity, we can provide training to a greater number of young individuals who can contribute to developing public health initiatives in Africa.

PT: In your view, what are the primary reasons behind the brain drain of young healthcare professionals from African countries?

Kaniki: One of the primary factors to consider is the remuneration of young healthcare professionals across the African continent. This is a matter of utmost priority that necessitates immediate attention and resolution. Regrettably, many healthcare workers are inadequately compensated or not compensated at all within the majority of our member states. Understandably, this predicament serves as a compelling incentive for them to seek better livelihoods elsewhere. It is crucial to acknowledge that these individuals are young leaders and parents, with financial obligations such as bills to settle, children to educate, and educational expenses to cover, amongst others. Given the absence of sufficient remuneration to sustain a harmonious work-life balance, it is only natural for them to explore alternative opportunities. Consequently, it would be unjust to blame them for their choices.

Another contributing factor is their aspirations for personal growth and professional advancement, which are key to securing a prosperous future. As they witness groundbreaking innovations in more developed countries, the allure of what they can accomplish elsewhere entices them to abandon their homelands in search of improved living and working conditions. To mitigate this trend, it is imperative to establish a comprehensive system of continual capacity building and programmes that enable young healthcare professionals to remain abreast of the ever-evolving landscape of knowledge. After all, no one wishes to lag in the ongoing global evolution, particularly young individuals who are connected through technology.

One more factor contributing to the migration of health professionals to developed countries is the substandard working conditions in the continent, particularly during disease outbreaks. It is evident that whenever an outbreak occurs, a healthcare practitioner is invariably among those affected. This is due to their inadequate protection. Unless we have a concrete plan to furnish them with sufficient safeguards, the issue of brain drain will persist. We must take measures to avert this situation by equipping our healthcare workers, particularly the frontline workers who face the greatest risk of exposure to various health hazards while attending to patients.

Ultimately, it is also evident that there are solutions to the problems that fuel brain drain in Africa. Therefore, we must proactively address the root causes rather than merely dealing with the consequences. Preventive measures are within our reach, and we must act promptly.

PT: How does the loss of skilled healthcare professionals affect the quality and access to healthcare services for the people? And what is the overall impact of the brain drain on the healthcare systems on the continent?

Kaniki: The outflow of skilled healthcare professionals, commonly known as “brain drain,” can have substantial and diverse implications for the quality and accessibility of healthcare services in Africa. The migration of skilled healthcare workers creates a deficit of qualified personnel, which directly impacts the overall standard of healthcare services.

Furthermore, the departure of specialists can lead to a scarcity of expertise in specific medical fields, thereby restricting the range and calibre of available healthcare services. For instance, countries like the DR Congo are consistently training a significant number of healthcare professionals each year. However, the loss of such personnel necessitates a continuous effort to train more individuals to fill the resulting void. The issue lies in the fact that even though we strive to bridge this gap through training, healthcare professionals still choose to leave, exacerbating the problem, especially considering the growing population on the continent. Consequently, the impact on our economy and the quality of care services remains substantial.

The phenomenon of brain drain frequently amplifies the pre-existing discrepancies in healthcare access across different regions. Rural areas and underserved communities suffer disproportionately as healthcare professionals relocate to urban centres or foreign nations.

The scarcity of healthcare professionals can result in extended waiting times, limited appointment options, and overall restricted access to healthcare services. Moreover, the departure of healthcare workers can cause an economic burden for the region, as countries allocate substantial resources to train healthcare professionals. The departure of these professionals signifies a financial burden on the country’s resources, as the investment in education and training does not yield a commensurate return.

The departure of healthcare professionals can significantly impede efforts to control and manage diseases, particularly in the case of infectious diseases that demand a well-coordinated and expert healthcare response. Furthermore, the health workers who remain may face amplified workloads and burnout, which can result in diminished morale and potential deterioration in the quality of care delivered.

PT: What incentives or strategies can be put in place to encourage young healthcare professionals to stay and contribute to healthcare development in their home countries?

Kaniki: To begin with, let’s consider the Abuja declaration, an imperative on the African continent. This declaration mandates African Governments to allocate a significant portion of 15 per cent, of their yearly budget towards the enhancement of health. However, it is crucial to evaluate the extent to which nations have successfully implemented this requirement. We must prioritise investments in public health and establish a robust system that places the well-being and invaluable contributions of healthcare professionals at the forefront of our concerns.

The brain drain of skilled healthcare professionals in Africa has profound consequences that extend far beyond what meets the eye. It greatly affects the quality and accessibility of healthcare services, creating an immense burden on healthcare systems. To tackle this pressing issue, a holistic and all-encompassing approach is needed, one that encompasses both domestic efforts to retain and train healthcare professionals in our continent.

It is also important for our governments to assume responsibility for the well-being of their citizens, rather than relying solely on external sources of funding.

In response to your question regarding incentives, I must express my profound opinion that incentives are not the optimal solution, (at least in the format I think and understand what incentives could be). Rather, individuals require genuine and satisfactory compensation, rather than incentives. Hence, one approach to tackle these concerns is by implementing policies aimed at retaining healthcare professionals. This could involve enhancing working conditions, offering competitive salaries, and facilitating opportunities for professional advancement.