Documenting the Brain Drain in Malawi

26 June

In order to learn more about how and where nurses are trained, I spoke with Jacinta Mtengezo, director of education for the Nurses and Midwives Council of Malawi. The Council is a part of the government and serves as a regulatory body that regulates the training, education and practice of nurses and midwives in Malawi. It also has a mandate is to protect the public from unsafe health care practices.

Nurses who want to leave the country to work must register with the Council, which is where some of the statistics about nurse emigration come from. So for example, 614 nurses (95% of them registered nurses with bachelor's degrees) registered to leave Malawi from 2000 to 2008 so far.

The most common destination: the United Kingdom. From 2000 to 2008, 490 registered nurses and 10 nurse-midwife technicians headed for the U.K. To put that number in context, until fairly recently, Kamuzu College of Nursing—the main source of registered nurses in Malawi—graduated just 60 RNs. KCN's goal is to get that number up to 100 graduates. (Nurse-midwife technicians can also upgrade their credentials with additional education at another school in Blantyre.)

There's just one caveat to the emigration numbers: Registering for emigration is not the same as doing so. When I asked Mtengezo if the Council knows how many nurses actually followed up, she said they didn't, although there are plans to try to get at that number with a survey. Still, there's no question that a fair number of the nurses who registered to leave actually did so.

There is some hope in the numbers. The Council's figures show that the emigration trend is abating. Last year, 23 nurses registered to leave, down from 98 nurses in 2005 and a peak of 111 nurses in 2001.

Here's the raw data, copied from a printout Mtengezo gave me:

Nurses and midwives who migrated to other countries
2000 90
2001 111
2002 90
2003 81
2004 85
2005 98
2006 30
2007 23
2008 6


As for education, there are 15 different institutions that train nurses in Malawi. (That counts the two campuses of the Kamuzu College of Nursing as one institution since only one graduating class comes out of it.) Currently, only Kamuzu College of Nursing is graduating registered nurses with a bachelor's degree. But Mzuzu University is in its second year of a four-year bachelor's program of nursing and will graduate its first degreed RNs in two more years.
Here's the list based on another printout Mtengezo gave me:
1. Ekwendeni College is in the north and trains nurse-midwife technicians.
2. St. Johns College is in the north and trains nurse-midwife technicians
3. St. John of God College is in the north and trains psychiatric nurse technicians.
4. Mzuzu University is in the north and has just started offering the bachelors of science-registered nursing degree. It will graduate its first class in another two years.
5. Kamuzu College of Nursing (with campuses in Lilongwe and Blantyre) offers the bachelor's degree in registered nursing.
6. Malawi College of Health Sciences in Lilongwe (central region) trains community health nurse technicians.
7. Malawi College of Health Sciences in Blantyre trains nurses who want to upgrade their credentials to a bachelor in registered nursing.
8. Malawi College of Health Sciences in Zomba (South region) trains nurse-midwife technicians and offers psychiatry for nurse-midwife technicians.
9. Mulanje College is in the south and trains nurse-midwife technicians.
10. Nkhoma College is in the central region and trains nurse-midwife technicians
11. St. Luke's College is in the south and trains nurse-midwife technicians
12. St. Joseph's College is in the south and trains nurse-midwife technicians
13. Trinity College is in the south and trains nurse-midwife technicians
14. Holy Family College is in the south and trains nurse-midwife technicians
15. Malamulo College is in the south and trains nurse-midwife technicians

Two more training institutions are slated to open. They are Catholic University (on track for opening in 2009) and the Institute of Management for Nursing and Health Sciences (a definitive time for their opening has not yet been set).