Health Personnel in Southern Africa: Confronting maldistribution and brain drain

Exogenous push factors are also noted, including political insecurity, crime, taxation levels, repressive political environments and falling service standards.

Movement is also influenced by pull factors, including aggressive recruitment by recipient countries, improved quality of life, study and specialisation opportunities and improved pay.

These push and pull factors are mitigated by stick factors in source countries, which lead to greater personnel retention, including family ties, psychological links with home, migration costs, language and other social and cultural factors. Stay factors influence decisions to remain in recipient countries and influence rates of return of personnel. These include reluctance to disrupt family life and schooling, lack of employment opportunities in host country and a higher standard of living in the recipient country.

These factors are presented in the context of current approaches to training and retention of health personnel in southern Africa. They are analysed for their costs and benefits to source and recipient areas and countries, and for their impact on equity in health personnel distribution.