Wednesday, May 30, 2007

It's the Salaries, Stupid

Low salaries, poor working conditions and lack of professional development opportunities keep showing up as major factors in explaining why so many doctors, nurses, pharmacists and other healthcare workers leave their homes in the poorest countries of sub-Saharan Africa to work in South Africa, Europe, Canada and the U.S.

And yet the panel for the GHC session on countering the brain drain actively avoided talking about salaries for health care providers.

Indeed, the moderator, Edward Elmendorf of the World Bank actually discouraged any talk about providing a living wage for doctors and nurses in the public sector of the poorest countries, because, goodness knows, then teachers and other civil servants will want better wages and that could lead to runaway inflation.

I would have liked to have seen more discussion on that point. What's the evidence that paying doctors, nurses, teachers and other public servants a living wage is counterprouctive? After all,the NGOs and various other research organizaions seem to be doing very well by providing their employees wit living wages. Why wouldn't such an effort in the publc sector pay dividends as well?

Certainly the panel seemed very earnest and well-meaning but I was disappointed that it was either unable or unwilling to get at the deeper issue of why the subject of salary should be off the table.

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