Social Remittances and Brain Drain in Africa: Encouraging the Return of Expatriate Health Professionals

Abstract

Most African states have too few health professionals. Even if training capacity can be expanded, it will take years to increase the flow of newly trained health professionals. Over the past thirty years, many doctors, nurses and pharmacists in Africa have emigrated to high income countries for specialty training and high paying jobs. Many migrated to escape conflict.

One way to expand the supply of health professionals in the short run is to encourage the return of expatriates, who have additional training, experience, and knowledge of the local language and culture. Some expatriates may be willing to return, especially now that local health budgets and international assistance for health have expanded. Those nearing the retirement may be willing to do so, but are reluctant to leave “defined benefit” pension systems where each additional year of employment increases retirement income. Economic research shows that employees in such systems exhibit reduced job mobility. We propose an experiment in which development agencies would continue retirement contributions (National Health Service, Social Security) for émigré professionals who return to practice in their natal countries, and illustrate the discussion with examples drawn from Liberia, Sierra Leone, and other post-conflict states. This has the potential to increase the supply of well trained, culturally competent health professionals.