The August 14th issue of the Lancet included a short comment piece on how health workers are leaving public-sector health positions, not for other countries, but rather for international research and non-governmental organizations based in-country (Health workers lost to international bodies in poor countries, authored by Southall, Cham and Sey).
The authors illustrate this internal brain drain phenomenon by describing the actions of the UK’s Medical Research Council (MRC) in the Gambia.
“…[T]he MRC informed the Ministry of Health and Social Welfare that 28 of the 96 nurses and midwives in the poorest Upper River Region (…) and trained by the government were working for the MRC. (…) Of the 28, three nurses are on the children’s ward helping with MRC study participants and offering about half the nursing care for NHS patients. Six nurses assist in paediatric and adult outpatients where they recruit patients for studies. There is a research nurse assisting in outpatients in minor health centres. Nine of these 28 nurses are qualified midwives but none support maternity services; they are all involved with patients under study.
“The MRC also said they make every effort not to recruit nursing staff who are working in government facilities or have been so employed during the previous six months, pointing out that most of their recent recruits have come from pharmacies. (…) However, our discussions with Gambian-trained staff tell us that MRC posts are so advantageous that, to be eligible, they will circumvent these rules by temporarily working outside the [national health service.”
This problem is not unique to the MRC, nor to the Gambia.
The question is, working in contexts of limited human resources and great need, what can NGOs and other organizations do to prevent the loss of health care workers from the public sector?
The article then outlines six things, one of which is to support the NGO Code of Conduct on Health Systems Strengthening.
Organizations interested in signing onto the Code and supporting public-sector health systems can do so here.