Senators have called for renewed efforts to address the problem of brain drain in the public health sector.

The call was made after a recent countrywide tour of health facilities, by a team of senators, which revealed that most medical personnel are leaving public service to join the private sector in search of greener pastures.

The tour of districts and health facilities by members of the senatorial standing committee on social affairs, human rights and petitions, aimed at assessing the state of non-communicable diseases (NCDs) in the country.

"Brain drain of medical workers is a problem we noticed during our tour. If a medic in public service earns Rwf300,000 yet they can earn Rwf1,000,000 in the private sector, they will leave,” Senator Jean Damascene Ntawukuriryayo said.

The concern was echoed by Dr Ndizeye Ntwali, the Director of Muhima Hospital, who said that the retention of workers in the health sector was a big challenge.

"Medical workers also wish to lead a good life and want better remuneration….. That is why many of them leave to go into other private businesses,” Dr Ntwali said.

Delayed promotions, salary increments

Senators also expressed concern about the ranking of academic and clinician doctors at University Teaching Hospital of Kigali (CHUK) which, as a referral hospital, should follow international ranking standards.

They noted that lack of a clear ranking and salary structure is one of the leading causes of brain drain of medics.

Dr Theobald Hategekimana, the Director of CHUK, noted that, in the past, medics who were recruited as teaching assistants immediately after graduating, and later went for further studies, rose through the ranks to become lecturers, senior lecturers, associate professors and professors. However, for 10 years, now, no medic has been promoted through that structure.

He revealed that specialist doctors have been earning the same salary for the last 10 years.

"If the Rwf690,000 salary of a specialist [doctor] in 2006 is the same salary they are getting now and without any plans of increasing their salary, that is demotivating enough,” he said.

The president of the Rwanda Medical Association, Dr Kayitesi Kayitenkore, told The New Times that together with the Rwanda Medical and Dental Council, they presented the grievances of medics which revolve around delayed promotions, and low salaries, among others, to the relevant authorities.

Efforts to address issue

The Minister for Public Service and Labour, Judith Uwizeye, said government is looking into the issue.

"We are working to ensure the retention of health workers by improving their living standards so that we address the issue of labour mobility in the health sector,” Uwizeye told The New Times recently.

The minister said the key issues being considered include salary increment and accommodation.

On the issue of salary structure and ranking, Uwizeye said the exercise of ranking medics (clinician specialists) was done last year, adding that what remains was to implementation.

During a news conference last week, the Minister for Health, Dr Agnes Binagwaho, acknowledged the problem but noted that efforts were on to address it.

"We are working with MIFOTRA (Minister for Public Service and Labour) and MINECOFIN (Ministry of Finance and Economic Planning) on incentives to retain medics in the public sector,” she said.

Binagwaho said education was the long term-solution to the shortage of medics in health facilities, citing ongoing plans to increase intake of medical students at the University of Rwanda, from 100 to 300 annually, beginning next year.

According to the 2014 National Human Resources for Health Policy, by the Ministry of Health, there are 678 medical doctors and 9,448 nurses/midwives working in Rwanda.

This represents a ratio of 1 doctor per 16,046 people, 1 midwife per 18,790 people, and 1 nurse per 1,227.

This is by far short of the Vision 2020’s target of a ratio of 10 medical doctors, 20 midwives and five laboratory technicians for every 100,000 people.

editorial@newtimes.co.rw