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 Barriers and facilitators to online medical and nursing education during the COVID-19 pandemic: perspectives from international students from low- and middle-income countries and their teaching staff

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Wen Li ◽  
Robyn Gillies ◽  
Mingyu He ◽  
Changhao Wu ◽  
Shenjun Liu ◽  
...  
Keyword(s):  
Nursing Students ◽  
Online Education ◽  
Response Rate ◽  
International Medical ◽  
Teaching Staff ◽  
Middle Income ◽  
Middle Income Countries ◽  
Education Satisfaction ◽  
Education In China ◽  
Low And Middle Income

Abstract Background The COVID-19 pandemic posed a huge challenge to the education systems worldwide, forcing many countries to provisionally close educational institutions and deliver courses fully online. The aim of this study was to explore the quality of the online education in China for international medical and nursing students from low- and middle-income countries (LMICs) as well as the factors that influenced their satisfaction with online education during the COVID-19 pandemic. Methods Questionnaires were developed and administered to 316 international medical and nursing students and 120 teachers at a university in China. The Chi-square test was used to detect the influence of participants’ personal characteristics on their satisfaction with online education. The Kruskal–Wallis rank-sum test was employed to identify the negative and positive factors influencing the online education satisfaction. A binary logistic regression model was performed for multiple-factor analysis to determine the association of the different categories of influential factors—crisis-, learner-, instructor-, and course-related categories, with the online education satisfaction. Results Overall, 230 students (response rate 72.8%) and 95 teachers (response rate 79.2%) completed the survey. It was found that 36.5% of students and 61.1% of teachers were satisfied with the online education. Teachers’ professional title, students’ year of study, continent of origin and location of current residence significantly influenced the online education satisfaction. The most influential barrier for students was the severity of the COVID-19 situation and for teachers it was the sense of distance. The most influential facilitating factor for students was a well-accomplished course assignment and for teachers it was the successful administration of the online courses. Conclusions Several key factors have been identified that affected the attitudes of international health science students from LMICs and their teachers towards online education in China during the COVID-19 pandemic. To improve the online education outcome, medical schools are advised to promote the facilitating factors and cope with the barriers, by providing support for students and teaching faculties to deal with the anxiety caused by the pandemic, caring for the state of mind of in-China students away from home, maintaining the engagement of out-China students studying from afar and enhancing collaborations with overseas institutions to create practice opportunities at students’ local places.

scholarly journals Factors influencing the migration intention of health professionals in low and middle income countries: Critical review with a theoretical model

2020 ◽  
Vol 6 (6) ◽  
Author(s):  
Sara Hajian ◽  
Shahram Yazdani ◽  
MohammadPooyan Jadidfard ◽  
MohammadHossein Khoshnevisan
Keyword(s):  
Health Workers ◽  
Final Decision ◽  
Middle Income ◽  
Poor Countries ◽  
Middle Income Countries ◽  
Medical Graduates ◽  
Factors Influencing ◽  
Decision To Stay ◽  
Push And Pull ◽  
Low And Middle Income

Objective Migration of healthcare workers could result in shortage of human resources and rising inequalities in service provision in resource poor countries. The aim of this review was to determine the factors influencing the migration decisions of medical and dental graduates migrating from low- and middle-income countries as well as introducing a practical model for health professional’s migration. Methods Google Scholar and PubMed were searched together with relevant journals for English studies from January 2005 to January 2020. The original studies which evaluated the motivational factors of dental and medical graduates migrating from low or middle income countries were included. The migration model was developed by investigating the factors and frameworks of selected studies. Results Twenty-five articles were met the inclusion criteria. Push and pull theory was the most popular way to describe the driving factors of migration. These factors were classified into three macro-, meso- and micro-level with eight key domains.  Poor income, unfavorable socio-economic situation, political instability, lack of professional and educational opportunities together with family and personal concerns found as strong common reasons perpetuating migration. Conclusion Despite the fact that health workers migrate for different reasons, they follow a same route for decision to stay or leave their home countries. Un-fulfillment of expectations in mother land in addition to media reconstructed reality of life in foreign land can develop a positive attitude for better quality of life improvement after migration. Once individuals could overpass their national identity and barriers of migration, the final decision toward migration would be more feasible.

scholarly journals Evidence gap map of performance measurement and management in primary care delivery systems in low- and middle-income countries – Study protocol

2018 ◽  
Vol 2 ◽  
pp. 27 ◽  
Author(s):  
Wolfgang Munar ◽  
Birte Snilstveit ◽  
Jennifer Stevenson ◽  
Nilakshi Biswas ◽  
John Eyers ◽  
...  
Keyword(s):  
Primary Care ◽  
Global Health ◽  
Performance Measurement ◽  
Study Design ◽  
Care Delivery ◽  
Delivery Systems ◽  
Middle Income ◽  
Middle Income Countries ◽  
Primary Care Delivery ◽  
Low And Middle Income

Background. For the last two decades there has been growing interest in governmental and global health stakeholders about the role that performance measurement and management systems can play for the production of high-quality and safely delivered primary care services. Despite recognition and interest, the gaps in evidence in this field of research and practice in low- and middle-income countries remain poorly characterized. This study will develop an evidence gap map in the area of performance management in primary care delivery systems in low- and middle-income countries. Methods. The evidence gap map will follow the methodology developed by 3Ie, the International Initiative for Impact Evaluation, to systematically map evidence and research gaps. The process starts with the development of the scope by creating an evidence-informed framework that helps identify the interventions and outcomes of relevance as well as help define inclusion and exclusion criteria. A search strategy is then developed to guide the systematic search of the literature, covering the following databases: Medline (Ovid), Embase (Ovid), CAB Global Health (Ovid), CINAHL (Ebsco), Cochrane Library, Scopus (Elsevier), and Econlit (Ovid). Sources of grey literature are also searched. Studies that meet the inclusion criteria are systematically coded, extracting data on intervention, outcome, measures, context, geography, equity, and study design. Systematic reviews are also critically appraised using an existing standard checklist. Impact evaluations are not appraised but will be coded according to study design. The process of map-building ends with the creation of an evidence gap map graphic that displays the available evidence according to the intervention and outcome framework of interest. Discussion. Implications arising from the evidence map will be discussed in a separate paper that will summarize findings and make recommendations for the development of a prioritized research agenda.

scholarly journals Maternal and neonatal data collection systems in low- and middle-income countries: scoping review protocol

2020 ◽  
Vol 4 ◽  
pp. 18 ◽  
Author(s):  
Mabel Berrueta ◽  
Ariel Bardach ◽  
Agustin Ciaponni ◽  
Xu Xiong ◽  
Andy Stergachis ◽  
...  
Keyword(s):  
Data Collection ◽  
Scoping Review ◽  
Care Delivery ◽  
Grey Literature ◽  
Adverse Event Reporting ◽  
Vulnerable Groups ◽  
Recent Analysis ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Background: Pregnant women and neonates represent one of the most vulnerable groups, especially in low- and middle-income countries (LMICs). A recent analysis reported that most vaccine pharmacovigilance systems in LMICs consist of spontaneous (passive) adverse event reporting. Thus, LMICs need effective active surveillance approaches, such as pregnancy registries. We intend to identify currently active maternal and neonatal data collection systems in LMICs, with the potential to inform active safety electronic surveillance for novel vaccines using standardized definitions. Methods: A scoping review will be conducted based on established methodology. Multiple databases of indexed and grey literature will be searched with a specific focus on existing electronic and paper-electronic systems in LMICs that collect continuous, prospective, and individual-level data from antenatal care, delivery, neonatal care (up to 28 days), and postpartum (up to 42 days) at the facility and community level, at the national and district level, and at large hospitals. Also, experts will be contacted to identify unpublished information on relevant data collection systems. General and specific descriptions of Health Information Systems (HIS) extracted from the different sources will be combined and duplicated HIS will be removed, producing a list of unique statements. We will present a final list of Maternal, Newborn, and Child Health systems considered flexible enough to be updated with necessary improvements to detect, assess and respond to safety concerns during the introduction of vaccines and other maternal health interventions. Selected experts will participate in an in-person consultation meeting to select up to three systems to be further explored in situ. Results and knowledge gaps will be synthesized after expert consultation.

25 Years of Health Care Delivery in Low- and Middle-Income Countries

2019 ◽  
Author(s):  
Paul Clyde ◽  
Andrew Haig ◽  
Ekta Jhaveri ◽  
Monika Karazja ◽  
Pascale Leroueil ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Methodology to Forecast Volume and Cost of Cancer Drugs in Low- and Middle-Income Countries

2018 ◽  
pp. 1-8 ◽  
Author(s):  
Yehoda M. Martei ◽  
Sebathu Chiyapo ◽  
Surbhi Grover ◽  
Christina Hanna ◽  
Scott Dryden-Peterson ◽  
...  
Keyword(s):  
Care Delivery ◽  
Population Based ◽  
Public Health Care ◽  
Essential Medicines ◽  
Cancer Drugs ◽  
Middle Income ◽  
Middle Income Countries ◽  
Incident Cancer ◽  
Incident Cases ◽  
Low And Middle Income

Purpose In low- and middle-income countries (LMICs), frequent outages of the stock of cancer drugs undermine cancer care delivery and are potentially fatal for patients with cancer. The aim of this study is to describe a methodologic approach to forecast chemotherapy volume and estimate cost that can be readily updated and applied in most LMICs. Methods Prerequisite data for forecasting are population-based incidence data and cost estimates per unit of drug to be ordered. We used the supplementary guidelines from the WHO list of essential medicines for cancer to predict treatment plans and ordering patterns. We used de-identified aggregate data from the Botswana National Cancer Registry to estimate incident cases. The WHO Management Sciences for Health International Price Indicator was used to estimate unit costs per drug. Results Chemotherapy volume required for incident cancer cases was estimated as the product of the standardized dose required to complete a full treatment regimen per patient, with a given cancer diagnosis and stage, multiplied by the total number of incident cancer cases with the respective diagnosis. The estimated chemotherapy costs to treat the 10 most common cancers in the public health care sector of Botswana is approximately 2.3 million US dollars. An estimated 66% of the budget is allocated to costs of rituximab and trastuzumab alone, which are used by approximately 10% of the cancer population. Conclusion This method provides a reproducible approach to forecast chemotherapy volume and cost in LMICs. The chemotherapy volume and cost outputs of this methodology provide key stakeholders with valuable information that can guide budget estimation, resource allocation, and drug-price negotiations for cancer treatment. Ultimately, this will minimize drug shortages or outages and reduce potential loss of lives that result from an erratic drug supply.

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