Health workforce migration: The Uganda case
Uganda had a total of 81 982 health workers employed in the health sector. The number of medical doctors was estimated at 4,811, accounting for 6% of the total health workforce in the country. General practitioners (GPs) alone were estimated to total 3993, the equivalent of 83% of medical doctors in service. A total of 42 530 (52%) HWS were employed in the public sector, and 9,798 (12%) in the private not-for-profit sector, while about one third (29 654) were private practitioners, were unemployed or had emigrated. The 42 530 health workers were deployed across various public institutions comprising Ministry of Health headquarters, two national referral hospitals, three central specialized institutions, 14 regional referral hospitals, 47 general hospitals, 166 level IV health centres, 962 level III health centres and 1321 level II health centres. The overall staffing level in the public sector was estimated at 70% of approved posts according to Uganda Annual health sector performance report 2014/2015.
Between January and August 2018, close to 167 medical and dental practitioners left the country for various reasons including further education and search for better employment among others. Records further indicate that most significant about the profile of migrating doctors is the demographic element; most are aged between 25 and 30 years showing that attrition is taking place among the younger crop of cadres.
Migration cannot be stopped altogether- health workers enjoy the same basic rights as any other individuals who move across borders, according to their preferences for work or living environment beyond their country of birth, according to applicable laws and procedures disciplining migration. What is needed is a better and more ethical management of health worker migration both in-country and cross border mobility of personnel. In-country management of health workforce mobility calls for an appropriate policy and regularity framework.
Countries of modest means and limited access to health professionals can still achieve major gains in health by the policy choices they make to overcome health worker deficits, it is critical for the country to prioritize policy options that will ensure more health workers are present, ready, connected and safe. A variety of policy options for the country are available to be considered to both increase the number of health workers and maximize the potential of the current health workforces. These include policies and programs aimed at strengthening retention and health workforce management, training, technology, and on the job protection for health workers. Governments, donors, and development partners are increasingly recognizing that a strong health work force is vital to making sustainable gains in global health.
Engagements with the ministry of health reveal that Uganda lacks the necessary laws, policies and regulations that can mitigate the grave impacts caused by this HRH migration. A particular gap in the policy landscape is the absence of any instruments regulating the mobility of health personnel.
The Uganda UK Health Alliance is committed to supporting UK professionals to have a smooth experience while volunteering in Uganda. Through our program on Human Resources for Health, UK health professionals through UUKHA enjoy preferential treatments from the Ministry of Health including waivers of fees among others. The Uganda UK Health Alliance coordinates the process of Registration, in-country travels and stay at host facilities. We have assessed and partnered with several host facilities in every region of Uganda to ensure comfortable stay of Volunteers.
Our Consortium of Human Resources for Health further supports organisation that runs placement programs for professional exchange to jointly work and foster shared learning in Human Resource exchange.