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					Strengthening and Supporting the Health Workforce

Retention and the Lesotho Nursing Initiative




           Dr. Mphu Ramatlapeng
           Minister of Health, Lesotho
           3 February 2012
Presentation Outline


• Introduction  
• Brain Drain out of Sub-Saharan Africa
• Push-Pull Factors
• MOHSW-Irish Aid-Clinton Foundation Partnership
• Challenges 
• Conclusion




2 • Strengthening and Supporting the Health Workforce • 3 February 2012
Introduction


Sub-Saharan Africa:
• The region is faced with high burden of communicable and 
  non communicable diseases ( HIV and AIDs, Malaria, TB, 
  Cancers and Diabetes) 
• Most of the countries in the region experience high demands 
  of health care services due to the high demand of health 
  care 
• However the supply of health professionals is low ( Doctors, 
  Nurses pharmacists and others) 
• Efforts are being applied in the region  to address the above 
  mentioned challenges




3 • Strengthening and Supporting the Health Workforce • 3 February 2012
The “brain drain” of health care professionals out of sub-
Saharan Africa has significant implications

• A significant number of African-born 
  health care professionals move 
  abroad
     o ~65,000 African-born physicians 
       and ~70,000 African-born nurses 
       working overseas
• A published BMJ article (Nov 2011) 
  shows that lost investment from the 
  emigration of physicians is significant
     − African-born physicians working 
       abroad educated by Africa at a 
       cost of over $2B USD
     − UK benefit: $2.7B USD
     − US benefit: $846M USD
Source: BMJ 2011;343:d7031 “The financial cost of doctors emigrating from sub-Saharan Africa: human capital analysis”; AAU
2007 “Optimizing the African Brain Drain: Strategies for Mobilizing the Intellectual Diaspora towards Brain-Gain”
4 • Strengthening and Supporting the Health Workforce • 3 February 2012
This loss of local talent is due to a variety of “push” and “pull” 
factors that can be social, economical, or political


              Push Factors                                                  Pull Factors

• Lack/limited jobs                                               • Better jobs
• Unsatisfactory pay                                              • Higher pay
• Limited opportunities for                                       • Greater opportunities for 
  professional development                                          professional development
• Poor social conditions                                          • High quality of life
• Political instability                                           • Political stability




5 • Strengthening and Supporting the Health Workforce • 3 February 2012
Lesotho initiatives in addressing brain drain (1 / 2)


Improvement of Infrastructure:
• Refurbishment and construction of the health facilities and 
  staff housing apartments
• Provision of requisite equipment for all health facilities 
• Upgrading of the MOHSW communication systems (networks)


Other Development strategies:
• The country developed the health work force retention 
  strategy and currently some components of the strategy are 
  being implemented (e.g personal development, financial 
  incentives) in collaboration with partners



6 • Strengthening and Supporting the Health Workforce • 3 February 2012
Lesotho initiatives in addressing brain drain (2 / 2)


Other Development Strategies:
• Health Systems Strengthening e.g the continuing education 
  strategy was developed and its implementation commenced 
  in March 2010 
• Launching of the Nurse Education Partnership Initiative 
  (NEPI) initiative to capacitate the nursing institutions
• Family medicine residency program is being run to train 
  young Basotho as specialists in family medicine
• Establishment of wellness centers to cater for the health of 
  workforce




7 • Strengthening and Supporting the Health Workforce • 3 February 2012
Challenges



• Attrition of health care professionals continues to 
  be high
• Production of Health professionals by academic 
  institutions is still low
• Demand for health care continues to grow due to 
  the increasing disease burden   
• Attainment of MDGs targets in accordance with the 
  schedule 




8 • Strengthening and Supporting the Health Workforce • 3 February 2012
Conclusion



• The support from different partners played 
  a significant role in improving the health 
  status of all the citizens of Lesotho

• The Government will keep accelerating the 
  initiatives which are meant to address HR 
  problems 




9 • Strengthening and Supporting the Health Workforce • 3 February 2012
Thank You




10 • Strengthening and Supporting the Health Workforce • 3 February 2012

				
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