The Effect of Relocation of Health Workers on Health Care Services Delivery in Nigeria
Chapter One
Objective of the Study
The broad objective of this study is to examine the effect of the relocation of health workers on healthcare service delivery in Nigeria. Specifically, the study seeks:
- To examine the extent to which heath workers relocate to international countries.
- To investigate the causes of relocation of health workers to international countries.
- To ascertain the impact of health workers’ relocation in Nigeria
- To establish ways Ways to reduce health worker’s emigration in the country.
CHAPTER TWO
REVIEW OF LITERATURE
INTRODUCTION
Our focus in this chapter is to critically examine relevant literature that would assist in explaining the research problem and furthermore recognize the efforts of scholars who had previously contributed immensely to similar research. The chapter intends to deepen the understanding of the study and close the perceived gaps.
Precisely, the chapter will be considered in three sub-headings:
- Conceptual Framework
- Theoretical Framework
- Empirical Framework
CONCEPTUAL FRAMEWORK
Concept Of Relocation
Goga (2020) explained that brain drain is the movement (emigration) of high skilled workers from a developing country to a developed country. The highly skilled workers that move from a developing nation to a developed one move due to factors that are highly desired in the country they are moving to. There are several industries that are affected by brain drain, and when the phenomenon was first conceptualized by the Royal Society of Britain in the 1960s, it was due to the migration of scientists from the United Kingdom to North America (specifically the United States and Canada). Brain drain has become such a huge part of the economies of developing countries, and while the history dates back to the 1960s, it is a phenomenon that has continued to garner interest.
General History Of Relocation
Human migration has been well documented in history. Dell’Amore (2011) revealed that over 20,000 years ago, humans migrated from Africa due to a warm spell during the Ice Age. This warm spell paved the route out of Africa which could possibly be the first documented migration of humans. 24 The term brain drain was first coined by the council of the Royal Society during their inquiry into scientists that were moving from the United Kingdom to North America. Oldfield et al. (1963) reported that in a 10-year period the Royal Society stated, during that 10-year period, many scientists with Ph.D. relocated to North America from the United Kingdom. Balmer et al. (2009) summarized the 1963 report by the Royal Society to further explain the origin of the brain drain terminology. The Royal Society was a nongovernment entity that was concerned about the political nature of science in the United Kingdom and was highly critical about the excessive involvement of the government in science-related fields. Balmer et al. (2009) further asserted in the Royal Society’s report that it was more of a political discussion that the actual migration problem that was happening. It should be understood from their perspective that the society’s 1963 report on emigration of scientists, which was instrumental in the ‘brain drain’ debate of the 1960s, reflected its desire to raise awareness of this issue but to remain conscientious of the brain drain issue but also remaining adamant that there was a political caution that needed to be taken into consideration. The subject of brain drain is not new. After the Royal Society reported on their findings about brain drain, researchers started to take greater interest in the topic as the brain drain trend continued to affect areas such as the Caribbean, Asia, and Africa. According to Docquier (2014), there had been a significant shift in foreign born nationals in westernized countries. That number is envisioned to have tripled since the 1960s. This 25 is about the time that brain drain became a phenomenon in Britain and the study of brain drain began. Historically, brain drain was an involuntary process. Involuntary brain drain occurred with the transatlantic slave trade in the middle of the 15th century when the first Africans stepped onto European soil. By the year 1518, after America was discovered, slaves were shipped directly from the Western parts of Africa such as what is now modern-day Benin, Nigeria, and Cameroon to America (Adi, 2012). Whatley and Gillezeau (2011) asserted that Africa, with its vast rich resources, suffered a devastating reversal of fortune that is still very prevalent in the dire outlook the continent faces today. Furthermore, Ukwandu (2020) explained that slavery also contributed to the underdevelopment and poverty in Africa.
Healthcare Industry
The healthcare sector in Nigeria is composed of the public and private sector. The public hospitals are owned on the federal and state level and receive their funding from the government. The private hospitals, as the name denotes, are wholly owned, and operated by private organizations or by a single entity such as a medical doctor. Flood and Gross (2014) reported that while Nigeria has a mixed private and public healthcare system, many people in Nigeria still do not have access to healthcare due to its “gross inequalities and nascent healthcare system” (p. 69). Furthermore, according to Adeloye et al. (2017), the healthcare sector lacks the training, policies, funding, and employment for 38 people who graduated with healthcare related degrees. The poor administration of the government and lack of funding from the government has rendered state-owned hospitals almost underfunded to the point of extinction. Also, many of the healthcare practitioners are unhappy and will often strike due to non-payment of wages and poor working conditions. Many people who majored in healthcare related fields end up working in other sectors because of the poor wages and inadequate infrastructures of the healthcare facilities in Nigeria. The biggest challenge in the Nigerian healthcare sector is the lack of policy formulation. Policies are drivers to understanding the process for each given task. For the healthcare sector of Nigeria to work, there needs to be a policy that aligns with the healthcare indicators and the population. According to Omoleke and Taleat (2017), Nigeria’s Ministry of Health needs to formulate healthcare policies that are not only driven by the federal government but include input from other agencies and people that the policies will benefit.
CHAPTER THREE
RESEARCH METHODOLOGY
INTRODUCTION
In this chapter, we described the research procedure for this study. A research methodology is a research process adopted or employed to systematically and scientifically present the results of a study to the research audience viz. a vis, the study beneficiaries.
RESEARCH DESIGN
Research designs are perceived to be an overall strategy adopted by the researcher whereby different components of the study are integrated in a logical manner to effectively address a research problem. In this study, the researcher employed the survey research design. This is due to the nature of the study whereby the opinion and views of people are sampled. According to Singleton & Straits, (2009), Survey research can use quantitative research strategies (e.g., using questionnaires with numerically rated items), qualitative research strategies (e.g., using open-ended questions), or both strategies (i.e., mixed methods). As it is often used to describe and explore human behaviour, surveys are therefore frequently used in social and psychological research.
POPULATION OF THE STUDY
According to Udoyen (2019), a study population is a group of elements or individuals as the case may be, who share similar characteristics. These similar features can include location, gender, age, sex or specific interest. The emphasis on study population is that it constitute of individuals or elements that are homogeneous in description.
This study was carried out on the the effect of relocation of health workers on health care services delivery in Nigeria using Federal Medical center in Abuja as a case study. Health workers form the population of the study. And, this information was gotten from health workers that were present as at the day and time of this research.
CHAPTER FOUR
DATA PRESENTATION AND ANALYSIS
INTRODUCTION
This chapter presents the analysis of data derived through the questionnaire and key informant interview administered on the respondents in the study area. The analysis and interpretation were derived from the findings of the study. The data analysis depicts the simple frequency and percentage of the respondents as well as interpretation of the information gathered. A total of two hundred and sixty-six (266) questionnaires were administered to respondents of which only two hundred and fifty-nine (259) were returned and validated. This was due to irregular, incomplete and inappropriate responses to some questionnaire. For this study a total of 259 was validated for the analysis.
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATION
SUMMARY
In this study, our focus was on the effect of relocation of health workers on health care services delivery in Nigeria using Federal Medical center in Abuja as a case study. The study specifically was aimed at highlighting the extent at which heath worker relocate to international countries, investigate the causes of relocation heath worker to international countries, ascertain the impact of health workers relocation in Nigeria and establish ways Ways to reduce health workers emigration in the country. A total of 141 responses were validated from the enrolled participants where all respondent are drawn from health care workers.
CONCLUSION
Based on the finding of this study, the following conclusions were made:
- The extent at which heath worker relocate to international countries is high.
- The causes of relocation heath worker to international countries is higher standard of living, increased life quality, access to sophisticated technologies and greater income.
- The impact of health workers relocation in Nigeria is hospital beds are overcrowded, staff are overwhelmed by the apparently never-ending influx of people on the verge of death, can provoke a sense of uncertainty and isolation and failure to retain existing staff incurs additional costs to the health system
- The ways to reduce health workers emigration in the country is through financial rewards, career development and continuing education, improving hospital infrastructure and resource availability, better hospital management and improved recognition of health professionals.
RECOMMENDATION
Based on the responses obtained, the researcher proffers the following recommendations:
The hospital managers and the government should provide a conducive-working environment, better remuneration, attractive retirement benefits, and other incentives as a push in factor for nurses to stay back in their home countries.
REFERENCES
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