Maternal Survival and the Crisis in Human Resources for Health in Africa: Impact of the Brain Drain
This chapter focuses on what might be the ultimate challenge in human resources for health: currently there are more pregnancy-associated deaths than all deaths from AIDS, malaria and tuberculosis combined. Every year more than half a million women and girls die during pregnancy or childbirth (WHO, 2007). Of all health indicators, maternal mortality shows the starkest disparity between rich and poor countries; 99 per cent of maternal mortality occurs in low- and middle-income countries (WHO, 2007). The staggering number of maternal deaths still represents a small minority of deaths due to pregnancy complications; approximately seven per cent. We tend to forget the ‘passenger deaths’ of babies when we focus on the ‘carrier deaths’ of mothers. There are, annually, around four million stillborn babies in the world and three million early neonatal deaths (deaths very soon after birth), amounting to seven million deaths (Stanton et al., 2006; Lawn et al., 2006). In comparison, AIDS causes around 2.1 million deaths, tuberculosis around 1.6 million and malaria around 1.3 million, or, combined, around five million deaths per year.
Unable to display preview. Download preview PDF.
- Briasco, C., Floate, H., Tate, A. (2004), Feeding the System, unpublished MPH dissertation, Brisbane: University of Queensland.Google Scholar
- Chen, L., Evans, T., Anand, S., Boufford, J. I., Brown, H., Chowdhury, M., Cueto, M., Dare, L., Dussault, G., Elzinga, G., Fee, E., Habte, D., Hanvoravongchai, P., Jacobs, M., Kurowski, C., Michael, S., Pablos-Mendez, A., Sewankambo, N., Solimano, G., Stilwell, B., de Waal, A. and Wibulpolprasert, S. (2004), ‘Human Resources for Health: Overcoming the Crisis’, Lancet, 364, 1984–90.CrossRefGoogle Scholar
- Chilopora, G. C., Pereira, C., Kamwendo, F., Chimbiri, A., Malunga, E., Malewezi, J. and Bergström, S. (2007) ‘Postoperative Outcome of Caesarean Sections and Other Major Emergency Obstetric Surgery by Clinical Officers and Medical Officers in Malawi’, Human Resources for Health, 5, 17–23.CrossRefGoogle Scholar
- Connel, J. (Ed.) (2007), The International Migration of Health Workers, Oxford: Routledge.Google Scholar
- Dovlo, D. (2003), ‘The Brain Drain and Retention of Health Professionals in Africa: A Case Study’, paper presented at Regional Training Conference on Improving Tertiary Education in sub-Saharan Africa: The Things That Work! 23–25 September 2003, Accra.Google Scholar
- Fathalla, M. F. (1991), ‘How Much are Mothers Worth?’ Proceedings of the XIII World Congress of Gynecology and Obstetrics, 15–20 September, Singapore, Carnforth, UK: Parthenon.Google Scholar
- Joint Learning Initiative (JLI) (2004), Human Resources for Health: Overcoming the Crisis, http://www.healthgap.org/camp/hcw_docs/JLi_Human_Resources_for_Health.pdf [accessed 22 December 2009].
- Lowell, G. and Findlay, A. (2001), Migration of Highly Skilled Persons from Developing Countries: Impact and Policy Responses, Geneva: International Labour Office.Google Scholar
- Padmanathan, I., Liljestrand, J. and Martins, J. M. (2001), Investing in Maternal Health in Malaysia and Sri Lanka, Washington: World Bank.Google Scholar
- Pereira, C., Cumbi, A., Malalane, R., Vaz, F., McCord, C., Bacci, A. and Bergstrom, S. (2007), ‘Meeting the Need for Emergency Obstetric Care in Mozambique: Work Performance and Histories of Medical Doctors and Assistant Medical Officers Trained for Surgery’, BJOG, 114, 1530–3.CrossRefGoogle Scholar
- Rao, K. B., Harrison, K. A. and Bergström, S. (2002), ‘Organization of Maternity Care in Developing Countries’, in J. B. Lawson, K. A. Harrison and S. Bergström (Eds), Maternity Care in Developing Countries, London: Royal College of Obstetricians and Gynaecologists.Google Scholar
- Tawfik, L. and Kinoti, S. N. (2001), The Impact of HIV/AIDS on the Health Sector is in Sub-Saharan Africa: The Issue of Human Resources, Washington, United States Agency for International Development, Bureau for Africa, Office of Sustainable Development.Google Scholar
- Thonneau, P. F. (2001), ‘Maternal Mortality and Unsafe Abortion: A Heavy Burden for Developing Countries’, in V. de Brouwere and W. van Leerberghe (Eds), Safe Motherhood Strategies: A Review of the Evidence, Antwerp: Studies in Health Services Organization and Policies.Google Scholar
- USAID (2003), The Health Sector Human Resources Crisis in Africa: An Issue Paper, Washington: United States Agency for International Development, Bureau of Africa, Office of Sustainable Development.Google Scholar
- Vaz, F., Bergström S., Vaz, M. L., Langa, J. and Bugalho, A. (1999), ‘Training Medical Assistants for Surgery’, Bulletin of the World Health Organization, 77, 688–91.Google Scholar
- WHO (2002), Reducing Risks, Promoting Healthy Life, Geneva: World Health Organization.Google Scholar
- WHO (2005), The World Health Report 2005: Make Every Mother and Child Count, Geneva: World Health Organization.Google Scholar
- WHO (2007), Maternal Mortality in 2005: Estimates Developed by WHO, UNICEF, UNFPA, and The World Bank, Geneva: World Health Organization.Google Scholar
- World Bank (1993), Investing in Health: World Development Report, Oxford: Oxford University Press.Google Scholar
- Xu, K., Evans, D. B., Carrin, G. and Aguilar-Rivera, A. M. (2005), Reducing Catastrophic Health Expenditure in the Design of Health Financing Systems, Technical Brief for Policy-Makers, Number 2, Geneva: World Health Organization.Google Scholar