Health care providers migration and brain drain phenomenon: perception of health care workers in Lagos State in southwestern Nigeria.

Introduction: As the movement of trained health car e personnel out of developing countries in search o f greener pastures continues, an end is not yet in vi ew to the weak health systems created by imbalances and costs associated with brain drain in affected c ountries. The objective of this study is to determi ne knowledge and attitude of health care workers in La gos State towards brain drain Methods: Descriptive cross sectional study of caus es, implications and solutions to the phenomenon of brain drain among 600 health care workers in Lagos State, using multi stage sampling method. Research instruments were semi structured self admi nistered questionnaires, and data was analyzed using the SPSS softwares. Association between categ orical variables was determined at a P value<0.05. Results: Common causes of brain drain include a sea rch for more money 504(84.0%), improved or higher technology 220(36.7%), and improved living c onditions 519(86.5%). Felt implications of brain drain includes a shortage of health manpower 443(73 .8%), dearth of highly skilled health care workers 348(58.0%), and reduction in quality of care in 404 (67.3%) of respondents. Recommended solutions include the motivation of health workforce financia lly and professionally 556(92.7%), strengthening of the health systems 412(68.7%) and provision of a be tter living conditions for health care workers in 337(56.2%) of respondents. Conclusions: Causes of brain drain could be address ed if all relevant stakeholders strengthen the soci al and health system including better living condition s for both the society and health care providers KEYWORDS; brain drain, health care workers, health systems. INTRODUCTION Human resources are very important among the resour ces needed for delivery of services in any sector, b th in the developing and more developed world. The World Health Organization in 2002 equally reaffirmed that Human Resources for Health (HRH) are central to man aging and delivering health services. It has also b een recognized that insufficient human resources for he alt in developing countries have been identified a s one of the main constraints limiting initiatives towards t he achievement of the Millennium Development Goals (WHO and CDC 2004). The movement of trained health personnel out of dev eloping countries is one of the numerous health cri ses facing the African continent. This phenomenon of “b rain drain" has been described as rich countries "l ooting" doctors and nurses from developing countries (James 2005). However a closer look at the evidence for a nd against the medical "brain-drain" stress the potent ial gains in managing medical migration to produce outcomes that are beneficial to individuals, households and the country. Globally, imbalances in the health workforce, partl y influenced by the decision by these health profes sionals to migrate to parts of the world where incentives are better, tend to be influenced by a broad range of p olitical, social, economic and professional factors, several of which are beyond the control of policy makers wi thin the health sector (Vujicic 2004). As a result, the heal th worker population ratio is better in the urban a nd the developed countries as compared to the rural and th e developing countries where health services are ne eded more in view of their poorer health indices. The cost associated with the “brain-drain” phenomen on includes reduced quality of care in public hospi tals in the country (Daily Times 2005, Malawi CWQ 2002), lo ss of public educational investment and intellectua l