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Ethiopia plans to train extra 9000 doctors to fill gap left by migration

BMJ 2008; 336 doi: https://doi.org/10.1136/bmj.39525.419803.4E (Published 27 March 2008) Cite this as: BMJ 2008;336:689
  1. Henry Wasswa
  1. 1Kampala

    Ethiopia has set a target to increase the number of doctors practising in the country by 9000 in four years to fill an acute shortage of medical staff, government officials have said.

    Ethiopia has just 1600 doctors serving a population of 83 million but needs a minimum of 8000, the government estimates.

    “We face a very critical problem. We plan to train more doctors and increase their pay. It will be a massive training [of doctors] because we have a gap of over 80%,” said Mohammed Hussein, one of Ethiopia’s assistant health ministers, at a recent international conference in Uganda to tackle the global shortage in health workforce.

    Ethiopian doctors have been leaving the country to earn better salaries offered in the United States and some rich African countries, such as Botswana.

    The aim of the conference, which was organised by the Global Health Workforce Alliance, was to draft strategies to tackle the shortage in health workforce that is largely affecting poor nations, mostly in Africa.

    “The problem is migration and many of our doctors are in the US. In 2002 there were 586 Ethiopian doctors in the US. The problem has been salaries [in Ethiopia] which have been very low compared with those offered in the West. But the government has increased the salaries of the doctors by 75%. We have also put up incentives,” said Mr Hussein.

    As part of the programme to retain its doctors, Ethiopia now pays them a monthly salary equivalent to $300 (£150; €190). Doctors working in rural areas are also paid an extra $300 per month in allowances, he said.

    Despite its problems retaining doctors, the latest figures show that the country is ahead of schedule in meeting its target for increasing the number of primary health workers, including nurses, nursing assistants, midwives, clinical officers, and pharmacists.

    “We have a health extension programme. We planned to deploy 30 000 health extension workers to 15 000 health units by 2010 in a three year programme. We have reached 24 000 already, and we are deploying those remaining next year,” said Mr Hussein.

    The country has a concurrent programme to train and recruit 4200 health officers, who will manage the country’s primary healthcare centres, he added.

    Jim Campbell, senior health adviser and specialist at the alliance, told the BMJ, “There has been good success in Ethiopia in the past three years. They have set up a successful target to train and recruit community health workers, and it has been a major success on a significant scale.”

    He added, “Like other countries, including Zambia, which has also increased the salaries of doctors to retain them at home, Ethiopia still faces a problem of its doctors migrating to other countries because even the $300 is still too low compared with payments in Western states.”