Abstract |
The Research examines the effects of an ‘enclave’ policy introduced by government in the public health sector in Ghana with an objective of reducing attrition and further induce return migration. In doing so, views of experts in public policy, trade union leaders, health sector professional administrators’, representatives of international organisations involved in migration, scholars from the academia, technocrats from the Ministries of Employment and Finance, health practitioners in the public and private sectors as well as returned and non-returned physicians and nurses were obtained through the use of semi-structured interviews. The study reveals that the ‘enclave’ policy is effective in addressing some of the push factors which underlie health sector migration in Ghana. To a large extent, the policy has helped in retention in the public health sector. What is more, it has induced internal health sector migration from the private sector to the public sector. Statistical information provided by the Ministry of Health and the Nurses and Midwifery council showed that migration figures for physicians began decreasing from 117 in 2003 to 32 in 2007 whilst that of nurses decreased from 252 in 2003 to 92 in 2007. The turnover to migration for both categories for the same period was 410 and 1002 with attrition rates of 32.9% and 16.2% respectively. These rates are lower compared to the periods between 1995 and 2002 which was 42.6% for physicians and 25.5% for nurses. What accounts for this is not only improvement in the conditions of service of physicians and nurses in terms of pay increases, as well as an effective bonding system coupled with the establishment of the Ghana College of physicians and surgeons as part of the enclave provisions, but also international actions in the form of restrictive migration laws and ethical recruitment protocols between Ghana and Great Britain. Furthermore, the creation of European Union has limited the job market opportunities for nonEuropean professionals including health personnel from developing countries. Regrettably, the responses to the policy by migrants are not encouraging. Those who return are either retirees or people who want to establish themselves elsewhere in the private sector. Reasons assigned for this, among others, include placement problems on return, loss of social capital at home due to long absence and poor human resource management in the health sector. |