scholarly journals Experiences of foreign medical graduates (FMGs), international medical graduates (IMGs) and overseas trained graduates (OTGs) on entering developing or middle-income countries like South Africa: a scoping review

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
M. I. Motala ◽  
J. M. Van Wyk
Keyword(s):  
South Africa ◽  
Scoping Review ◽  
International Medical ◽  
International Medical Graduates ◽  
Middle Income ◽  
Middle Income Countries ◽  
Medical Graduates ◽  
Foreign Medical Graduates

scholarly journals Impact of Merit-Based Immigration Policies on Brain Drain From Low- and Middle-Income Countries

2020 ◽  
pp. 185-189 ◽  
Author(s):  
Nagi S. El Saghir ◽  
Benjamin O. Anderson ◽  
Julie Gralow ◽  
Gilberto Lopes ◽  
Lawrence N. Shulman ◽  
...  
Keyword(s):  
Brain Drain ◽  
Care Delivery ◽  
International Medical ◽  
Immigration Policies ◽  
International Medical Graduates ◽  
Middle Income ◽  
Middle Income Countries ◽  
Medical Graduates ◽  
Trump Administration ◽  
Low And Middle Income

PURPOSE Brain drain is the migration of educated and skilled individuals from a less developed region or country to a more economically established one. The Trump administration proposed a merit-based immigration plan. This article addresses its potential impact on health care delivery in low- and middle-income countries (LMICs) and their preparedness to deal with it. MATERIALS AND METHODS Data on immigration policies, numbers of international medical graduates practicing in high-income countries (HICs), various scientific exchange methods, and efforts for capacity building in LMICs. RESULTS Talented individuals seek to advance their knowledge and skills, and may stay in HICs because of greater rewards and opportunities. HICs also rely on immigrant international medical graduates to supplement their physician workforces. CONCLUSION Ambitious individuals from LMICs need and should have opportunities to advance their education and training in more advanced countries. LMICs should increase their educational efforts, research capabilities, infrastructures, and living conditions to better serve their own populations and reduce their brain drain phenomenon.

scholarly journals International migration of health labour: monitoring the two-way flow of physicians in South Africa

2019 ◽  
Vol 4 (5) ◽  
pp. e001566 ◽  
Author(s):  
Akhenaten Siankam Tankwanchi ◽  
Amy Hagopian ◽  
Sten H Vermund
Keyword(s):  
South Africa ◽  
Low Income ◽  
Health Personnel ◽  
Health Workers ◽  
Oecd Countries ◽  
International Medical ◽  
International Medical Graduates ◽  
Medical Council ◽  
Medical Graduates ◽  
The Difference

IntroductionAlthough health labour migration is a global phenomenon, studies have neglected the flow of health workers into low-income and middle-income countries (LMICs). In compliance with the data-monitoring recommendation of the WHO Global Code of Practice on the International Recruitment of Health Personnel (Code), we estimated post-Code physician net migration (NM) in South Africa (SA), and SA’s net loss of physicians to Organisation for Economic Co-operation and Development (OECD) countries from 2010 to 2014.MethodsWe sourced data from the National Reporting Instrument reports, the OECD and the General Medical Council. Using the numbers of foreign nationals and international medical graduates (IMGs) registered in SA, and SA medical graduates registered in OECD countries (South African-trained international medical graduates (SA-IMGs)) as respective proxies for immigration and emigration, we estimated ‘NM’ as the difference between immigrant physicians and emigrant physicians and ‘net loss’ as the difference between OECD-trained IMGs and OECD-based SA-IMGs.ResultsIn 2010, SA hosted 8443 immigrant physicians, while OECD countries hosted 14 933 SA-IMGs, yielding a NM of −6490 physicians and a NM rate of −18% in SA. By 2014, SA-based immigrant physicians had increased by 4%, while SA-IMGs had decreased by −15%, halving the NM rate to −9%. SA-to-OECD estimated net loss of physicians dropped from −12 739 physicians in 2010 to −10 563 in 2014. IMGs represented 46% of 2010–2014 new registrations in SA, with the UK, Nigeria and the Democratic Republic of the Congo serving as leading sources. Registrants from conflict-scarred Libya increased >100-fold. More than 3400 SA-IMGs exited OECD-based workforces.ConclusionNM is a better measure of the brain drain than simply the emigration fraction. Strengthened health personnel data management and reporting through implementation of the Code-related system of National Health Workforce Accounts will further increase our understanding of health worker mobility in LMICs, with policymakers empowered to make more informed policies to address shortage.

scholarly journals Essential Medicines in Universal Health Coverage: A Scoping Review of Public Health Law Interventions and How They Are Measured in Five Middle-Income Countries

2020 ◽  
Vol 17 (24) ◽  
pp. 9524
Author(s):  
Katrina Perehudoff ◽  
Ivan Demchenko ◽  
Nikita V. Alexandrov ◽  
David Brutsaert ◽  
Angela Ackon ◽  
...  
Keyword(s):  
Public Health ◽  
South Africa ◽  
Universal Health Coverage ◽  
Scoping Review ◽  
Health Law ◽  
Health Coverage ◽  
Public Health Law ◽  
Middle Income ◽  
Middle Income Countries ◽  
Universal Health

Very few studies exist of legal interventions (national laws) for essential medicines as part of universal health coverage in middle-income countries, or how the effect of these laws is measured. This study aims to critically assess whether laws related to universal health coverage use five objectives of public health law to promote medicines affordability and financing, and to understand how access to medicines achieved through these laws is measured. This comparative case study of five middle-income countries (Ecuador, Ghana, Philippines, South Africa, Ukraine) uses a public health law framework to guide the content analysis of national laws and the scoping review of empirical evidence for measuring access to medicines. Sixty laws were included. All countries write into national law: (a) health equity objectives, (b) remedies for users/patients and sanctions for some stakeholders, (c) economic policies and regulatory objectives for financing (except South Africa), pricing, and benefits selection (except South Africa), (d) information dissemination objectives (ex. for medicines prices (except Ghana)), and (e) public health infrastructure. The 17 studies included in the scoping review evaluate laws with economic policy and regulatory objectives (n = 14 articles), health equity (n = 10), information dissemination (n = 3), infrastructure (n = 2), and sanctions (n = 1) (not mutually exclusive). Cross-sectional descriptive designs (n = 8 articles) and time series analyses (n = 5) were the most frequent designs. Change in patients’ spending on medicines was the most frequent outcome measure (n = 5). Although legal interventions for pharmaceuticals in middle-income countries commonly use all objectives of public health law, the intended and unintended effects of economic policies and regulation are most frequently investigated.

scholarly journals Multimorbidity of chronic non-communicable diseases in low- and middle-income countries: A scoping review

2020 ◽  
Vol 10 ◽  
pp. 2235042X2096191
Author(s):  
Fantu Abebe ◽  
Marguerite Schneider ◽  
Biksegn Asrat ◽  
Fentie Ambaw
Keyword(s):  
South Africa ◽  
Sample Size ◽  
Scoping Review ◽  
Grey Literature ◽  
Individual Country ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Middle Income Countries ◽  
High Prevalence ◽  
Low And Middle Income

Background: Multimorbidity is rising in low- and middle-income countries (LMICs). However, the evidence on its epidemiology from LMICs settings is limited and the available literature has not been synthesized as yet. Objectives: To review the available evidence on the epidemiology of multimorbidity in LMICs. Methods: PubMed, Scopus, PsycINFO and Grey literature databases were searched. We followed the PRISMA-ScR reporting guideline. Results: Of 33, 110 articles retrieved, 76 studies were eligible for the epidemiology of multimorbidity. Of these 76 studies, 66 (86.8%) were individual country studies. Fifty-two (78.8%) of which were confined to only six middle-income countries: Brazil, China, South Africa, India, Mexico and Iran. The majority (n = 68, 89.5%) of the studies were crosssectional in nature. The sample size varied from 103 to 242, 952. The largest proportion (n = 33, 43.4%) of the studies enrolled adults. Marked variations existed in defining and measuring multimorbidity. The prevalence of multimorbidity in LMICs ranged from 3.2% to 90.5%. Conclusion and Recommendations: Studies on the epidemiology of multimorbidity in LMICs are limited and the available ones are concentrated in few countries. Despite variations in measurement and definition, studies consistently reported high prevalence of multimorbidity. Further research is urgently required to better understand the epidemiology of multimorbidity and define the best possible interventions to improve outcomes of patients with multimorbidity in LMICs.

International Medical Graduates in Nephrology: A Guide for Trainees and Programs

2020 ◽  
Vol 27 (4) ◽  
pp. 297-304.e1
Author(s):  
Javier A. Neyra ◽  
Maria Clarissa Tio ◽  
Silvia Ferrè
Keyword(s):  
International Medical ◽  
International Medical Graduates ◽  
Medical Graduates

scholarly journals Exploration of recovery of people living with severe mental illness (SMI) in low/middle-income countries (LMICs): a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e045005
Author(s):  
Fadia Gamieldien ◽  
Roshan Galvaan ◽  
Bronwyn Myers ◽  
Zarina Syed ◽  
Katherine Sorsdahl
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Scoping Review ◽  
Data Extraction ◽  
Flow Diagram ◽  
Personal Recovery ◽  
Middle Income ◽  
Middle Income Countries ◽  
Provider Perspectives ◽  
Low Middle Income Countries

ObjectiveTo examine the literature on how recovery of people with severe mental illness (SMI) is conceptualised in low/middle-income countries (LMICs), and in particular what factors are thought to facilitate recovery.DesignScoping review.Data sources and eligibilityWe searched 14 electronic databases, hand searched citations and consulted with experts during the period May–December 2019. Eligible studies were independently screened for inclusion and exclusion by two reviewers. Unresolved discrepancies were referred to a third reviewer.Data extraction and synthesisAll bibliographical data and study characteristics were extracted using a data charting form. Selected studies were analysed through a thematic analysis emerging from extracted data.ResultsThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram offers a summary of the results: 4201 titles, 1530 abstracts and 109 full-text articles were screened. Ten articles were selected for inclusion: two from Turkey, two from India, and one each from China, Swaziland, Indonesia, Egypt, South Africa and Vietnam. Although most studies used qualitative methods, data collection and sampling methods were heterogeneous. One study reported on service provider perspectives while the rest provided perspectives from a combination of service users and caregivers. Three themes emerged from the data analysis. First, studies frame recovery as a personal journey occurring along a continuum. Second, there was an emphasis on social relationships as a facilitator of recovery. Third, spirituality emerged as both a facilitator and an indicator of recovery. These themes were not mutually exclusive and some overlap exists.ConclusionAlthough there were commonalities with how high-income countries describe recovery, we also found differences in conceptualisation. These differences in how recovery was understood reflect the importance of framing the personal recovery concept in relation to local needs and contextual issues found in LMICs. This review highlighted the current sparse evidence base and the need to better understand recovery from SMI in LMICs.

The Economic Cost of Violence Against Women and Girls in Low- and Middle-Income Countries: A Systematic Review of the Evidence

2021 ◽  
pp. 152483802110160
Author(s):  
Seema Vyas ◽  
Melissa Meinhart ◽  
Katrina Troy ◽  
Hannah Brumbaum ◽  
Catherine Poulton ◽  
...  
Keyword(s):  
South Africa ◽  
Systematic Review ◽  
Violence Against Women ◽  
Economic Burden ◽  
Data Availability ◽  
Female Genital Cutting ◽  
Middle Income ◽  
Middle Income Countries ◽  
Women And Girls ◽  
Low And Middle Income

Evidence demonstrating the economic burden of violence against women and girls can support policy and advocacy efforts for investment in violence prevention and response programming. We undertook a systematic review of evidence on the costs of violence against women and girls in low- and middle-income countries published since 2005. In addition to understanding costs, we examined the consistency of methodological approaches applied and identified and assessed common methodological issues. Thirteen articles were identified, eight of which were from sub-Saharan Africa. Eight studies estimated costs associated with domestic or intimate partner violence, others estimated the costs of interpersonal violence, female genital cutting, and sexual assaults. Methodologies applied to estimate costs were typically based on accounting approaches. Our review found that out-of-pocket expenditures to individuals for seeking health care after an episode of violence ranged from US$29.72 (South Africa) to US$156.11 (Romania) and that lost productivity averaged from US$73.84 to US$2,151.48 (South Africa) per facility visit. Most studies that estimated provider costs of service delivery presented total programmatic costs, and there was variation in interventions, scale, and resource inputs measured which hampered comparability. Variations in methodological assumptions and data availability also made comparisons across countries and settings challenging. The limited scope of studies in measuring the multifaceted impacts of violence highlights the challenges in identifying cost metrics that extend beyond specific violence episodes. Despite the limited evidence base, our assessment leads us to conclude that the estimated costs of violence against women and girls are a fraction of its true economic burden.

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