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By Andualem Sisay - Capital
04 June, 2007
As the number of doctors joining private hospitals and migrating to the developed nations increases some government hospitals have virtually no doctors. Minister of Health, Dr. Tewodros Adhanom, urged Ethiopian health professionals to commit themselves and stay on their jobs.
“The salary you get in Ethiopia could be lower than anywhere also, but you have to be proud that your scarifice results in a better future for our children and our country,” he said. “Besides, the Ministry is trying to provide a monetary incentive package. You have to work on your individual commitment to reverse the crisis that we are facing.”
Describing the situation, “At the moment, our hospitals are running out of doctors. In fact, it is difficult to call these institutions hospitals anymore, since there are hospitals without even one doctor,” stated the Minister, while opening the 43rd Conference of the Annual Ethiopian Medical Association on May 30, 2007 at the Economic Commission for Africa, (ECA) Hall.
Health professionals and especially doctors leaving to developed nations has been an unfortunate phenomenon in most African countries including Ethiopia, where the situation is getting worse. To curb the problem, the Ministry of health is recently working on a short-term package of incentives for doctors that includes salary increments, research grants, training opportunities and awards that give due recognition to their work.
In addition, the Ministry is working towards a new strategy of retention and production that shifts its dependency on doctors. The Ministry is now focusing more on training 30,000 nurses for emergency surgery and health extension workers by 2010 twenty hospitals that can serve as teaching hospitals have been identified by the ministry.
“It is not a new practice that we are introducing to the world; It has been tested and proved by some African states and it was even tried during the Second World War,” Tewodros said. For this purpose,
The World Health Organization (WHO), recommends a minimum ratio of 100 nurses for every 100,000 people, but many poor countries hardly come close: In the Central African Republic, Liberia and Uganda, for example, the ratio is less than 10 nurses per 100,000 people, as compared to more than 2,000 nurses per 100,000 people in Finland and Norway.
The Ethiopian Ministry of Health is also collaborating with health professionals associations in the country to finalize the long-term incentive package within the coming six month, according to Dr.Tewodros.
The 2005 Demographic and Health Survey (DHS), maternal and child health indicators in Ethiopia show considerable room for improvement. Only 27.6 percent of mothers who had had a live birth in the five years before the survey had received any antenatal care from a health professional, and only 5.7 percent were attended by a health professional during delivery.
Much lower results for these measures in rural areas suggest that ensuring universal delivery of health services to the entire population will be a lengthy process.
Infant mortality was reported at about 77 infant deaths per 1,000 live births in the five years preceding the survey, a slight decline from 83 infant deaths per 1,000 live births for the previous nine years before this latest survey.
The annual exodus of 20,000 nurses and doctors from Africa is magnifying an already grave public health situation in the region most affected by AIDS and with high maternal mortality. For instance, in 1999, Ghana certified 320 new nursing graduates and lost the same number to emigration. The following year, it lost twice as many. Meanwhile, more than half of Ghana’s nursing positions are unfilled.
This pattern prevails throughout much of sub-Saharan Africa. Africa as a continent gets only 1.3 per cent of the world’s health workers while it carries 25 per cent burden of disease, according to WHO 2004.
To meet the UN Millennium Development Goals, sub-Saharan Africa will need one million more health workers – including 620,000 nurses. But many countries are losing ground.
According to the 2006 United Nations Population Fund (UNFPA) Report on Migration, providing improved social and economic conditions in the sending countries is believed to minimize factors that make people leave their countries in search of self-improvement.
In addition, promoting regularized consultative processes on international migration at global, regional and sub-regional levels and supporting bi-lateral and Multi-lateral agreements between sending and receiving countries are also among the recommendations of the report.