Medical migration from Zimbabwe: magnitude, causes and impact on the poor

Figures & data

Figure 1: Location of provincial hospitals selected for the study

Table 1: Employment profile of the respondents

	Frequency	Percentage
Category of health team
Nurse	137	59.3
Midwife	20	8.7
Medical doctor	30	13.0
Pharmacist	10	4.3
Tutor/lecturer	17	7.4
Dentist	5	2.2
Any other category	12	5.2
Type of facility where employed
District hospital	39	16.9
Provincial or regional hospital	117	50.6
Tertiary hospital	41	17.7
Rural health centre	9	3.9
Nursing school in a university	2	0.9
Nursing school not in a university	13	5.6
Medical school	10	4.3
N = 231.

Table 2: Breakdown of participants in focus groups

Group	Composition
1 (n = 12)	• Religious leaders (2)
	• Senior teacher/teacher in charge (1)
	• Traditional healer/practitioner (1)
	• Community representatives/clubs (2)
	• Home based caregivers (3)
	• Traditional midwives (2)
	• Village community worker (1)
2 (n = 12)	Adolescent users of health services (6 females, 6 males, ages 15–19 years)
3 (n = 12)	Adult users of health services (6 women of child-bearing age, 30^+ years; 6 men, 30–50^+ years)
N = 36.

Table 3: Work permits issued to nurses in UK, 2002

Country	No. of work permits issued
Philippines	10 424
India	3392
South Africa	2835
Zimbabwe	2346
Nigeria	1501
Ghana	528
Australia	503
Pakistan	385
Kenya	354
Mauritius	351
Other	2983
Total	25 602
Source: Dovlo, 2003: 9.

Figure 2: Medical practitioners in Zimbabwe, 1995–2000

Figure 3: Nurses in Zimbabwe, 1995–2000

Table 4: Health professionals employed in the public sector, 1997

	No. registered in the country	MoHCW requirement	Approved posts	Filled posts	% of requirement filled
Doctors	1634	1851	676	551	28.7
Nurses	16,407	14,251	7923	7923	55.6
Pharmacists	524	198	59	37	18.7
Dentists	148	43	14	14	32.6
Source: Republic of Zimbabwe, 1999.

Table 5: Employment benefits

Do you agree with the following statements?	Yes (%)
The public health sector does not offer competitive salaries to health workers in this country	87
If I received a better salary, I would be happy to stay in my present position	87
I worry that I will not be adequately provided for when I retire	81
If you work in the public health service, it is necessary to do two (or more) jobs to make ends meet	79
The private sector offers better fringe benefits to health workers in this country than the public sector	78
I am considering moving to the private sector because I will receive a better salary	68
I find it difficult to live on the salary I receive	68
N = 231.

Figure 4: Most likely destinations of Zimbabwean health professionals

Table 6: Reason for intention to move

Reason	Percentage
Economic	55
Because I will receive better remuneration in another country	55
Because of a general decline in the economic situation in this country	55
To save money quickly in order to buy a car, pay off a home loan, or for a similar reason	54
Political	31
Because I see no future in this country	45
Because there is a general sense of despondency in this country	24
Because of the high levels of violence and crime in this country	23
Professional	30
Because of a lack of resources and facilities within the health care system of this country	45
Because there is a general decline in the health care services of this country	43
Because the workload in the health services of this country is too heavy	39
Because of insufficient opportunities for promotion and self-improvement	32
To gain experience abroad	32
Because of the poor management of the health services in this country	31
Because I need to upgrade my professional qualifications due to the unsatisfactory  quality of education and training in this country	23
Because I cannot find a suitable job in this country	11
Because an unacceptable work tempo is expected of me in this country	10
Social	24
In order to find better living conditions	47
Because the value systems in this country have declined to such an extent that I can no  longer see my way clear to remain here	32
To ensure a safer environment for my children	25
In order to travel and see the world	15
In order to join family/friends abroad	14
Because of family-related matters	10
N = 231.
Note: Question is multiple response.

Table 7: Reasons for leaving the home country

Reason	Yes (%)
Economic factors	40
Political factors	36
Professional factors	25
Social factors	16
N = 25.
Note: Question is multiple response.

Table 8: Patient attendance at selected health institutions in Zimbabwe

		Variable	1998	1999	2000
Doctors	Gweru Provincial Hospital	No. of outpatients	145 220	149 221	51 001
		No. at post	7	8	8
		Outpatient attendance/doctor	20 746	18 653	8650
	Kadoma District Hospital	No. of outpatients	171 372	168 522	155 462
		No. at post	7	6	6
		Outpatient attendance/doctor	24 482	28 087	2 5910
Nurses	Gweru Provincial Hospital	No. of outpatients	23 110	23 177	2 3428
		No. at post	238	232	235
		Outpatient attendance/nurse	97	100	100
	Kadoma District Hospital	No. of outpatients	171 372	168 522	155 462
		No. at post	105	113	112
		Outpatient attendance/nurse	1632	1491	1388
	Epworth Polyclinic	No. of outpatients	22 440	38 000	42 000
		No. at post	5	5	4
		Outpatient attendance/nurse	4488	7600	10 500

REPUBLIC OF ZIMBABWE . 1999 . Commission of review into the health sector, key messages report , Harare : Government of Zimbabwe .

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