1. Strengthening and Supporting the Health Workforce Dr. Mphu Ramatlapeng Minister of Health, Lesotho 3 February 2012 Retention and the Lesotho Nursing Initiative

2. 2 Strengthening and Supporting the Health Workforce 3 February 2012 Presentation Outline Introduction Brain Drain out of Sub-Saharan Africa Push-Pull Factors MOHSW-Irish Aid-Clinton Foundation Partnership Challenges Conclusion

3. 3 Strengthening and Supporting the Health Workforce 3 February 2012 Introduction Sub-Saharan Africa: The region is faced with high burden of communicable and non communicable diseases ( HIV and AIDs, Malaria, TB, Cancers and Diabetes) Most of the countries in the region experience high demands of health care services due to the high demand of health care However the supply of health professionals is low ( Doctors, Nurses pharmacists and others) Efforts are being applied in the region to address the above mentioned challenges

4. 4 Strengthening and Supporting the Health Workforce 3 February 2012 The “brain drain” of health care professionals out of sub- Saharan Africa has significant implications A significant number of African-born health care professionals move abroad o ~65,000 African-born physicians and ~70,000 African-born nurses working overseas A published BMJ article (Nov 2011) shows that lost investment from the emigration of physicians is significant −African-born physicians working abroad educated by Africa at a cost of over $2B USD −UK benefit: $2.7B USD −US benefit: $846M USD Source: BMJ 2011;343:d7031 “The financial cost of doctors emigrating from sub-Saharan Africa: human capital analysis”; AAU 2007 “Optimizing the African Brain Drain: Strategies for Mobilizing the Intellectual Diaspora towards Brain-Gain”

5. 5 Strengthening and Supporting the Health Workforce 3 February 2012 This loss of local talent is due to a variety of “push” and “pull” factors that can be social, economical, or political Push FactorsPull Factors Lack/limited jobs Unsatisfactory pay Limited opportunities for professional development Poor social conditions Political instability Better jobs Higher pay Greater opportunities for professional development High quality of life Political stability

6. 6 Strengthening and Supporting the Health Workforce 3 February 2012 Lesotho initiatives in addressing brain drain (1 / 2) Improvement of Infrastructure: Refurbishment and construction of the health facilities and staff housing apartments Provision of requisite equipment for all health facilities Upgrading of the MOHSW communication systems (networks) Other Development strategies: The country developed the health work force retention strategy and currently some components of the strategy are being implemented (e.g personal development, financial incentives) in collaboration with partners

7. 7 Strengthening and Supporting the Health Workforce 3 February 2012 Lesotho initiatives in addressing brain drain (2 / 2) Other Development Strategies: Health Systems Strengthening e.g the continuing education strategy was developed and its implementation commenced in March 2010 Launching of the Nurse Education Partnership Initiative (NEPI) initiative to capacitate the nursing institutions Family medicine residency program is being run to train young Basotho as specialists in family medicine Establishment of wellness centers to cater for the health of workforce

8. 8 Strengthening and Supporting the Health Workforce 3 February 2012 Challenges Attrition of health care professionals continues to be high Production of Health professionals by academic institutions is still low Demand for health care continues to grow due to the increasing disease burden Attainment of MDGs targets in accordance with the schedule

9. 9 Strengthening and Supporting the Health Workforce 3 February 2012 Conclusion The support from different partners played a significant role in improving the health status of all the citizens of Lesotho The Government will keep accelerating the initiatives which are meant to address HR problems

10. 10 Strengthening and Supporting the Health Workforce 3 February 2012 Thank You