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Brain drain in sub-Saharan Africa: contributing factors, potential remedies and the role of academic medical centres
  1. Jennifer Kasper1,
  2. Francis Bajunirwe2
  1. 1Division of Global Health, Massachusetts General Hospital for Children, Harvard Medical School, Boston, Massachusetts, USA
  2. 2Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda
  1. Correspondence to Dr Jennifer Kasper, Division of Global Health, Massachusetts General Hospital for Children, Harvard Medical School, 100 Cambridge St, 15th Floor, Boston, MA 02114, USA; jkasper1{at}


A double jeopardy exists in resource-limited settings (RLS) in sub-Saharan Africa (SSA): there are a disproportionately greater number of acutely ill patients, but a paucity of healthcare workers (HCW) to care for them. SSA has 25% of the global disease burden but only 3% of the world's HCW. Thirty-two SSA countries do not meet the WHO minimum of 23 HCW per 10000 population. Contributing factors include insufficient supply, inadequate distribution and migration. Potential remedies include international workforce policies, non-governmental organisations, national and international medical organisations’ codes of conduct, inter-country collaborations, donor-directed policies and funding to train more people in-country, and health system strengthening and task-shifting. Collaborations among academic institutions from resource-rich and poor countries can help address HCW supply, distribution and migration. It is now opportune to harness bright, committed people from academic centres in resource-rich and poor settings to create long-term, collaborative relationships focused on training, clinical skills and locally relevant research endeavours, who mutually strive for HCW retention, less migration, and ultimately sufficient HCW to provide optimal care in all RLS.

  • Health Service
  • Medical Education

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