Medical Paraprofessionals Helping To Replace ‘Brain Drain’ of African Doctors, New York Times Reports

The New York Times on Tuesday examined how health care paraprofessionals, or individuals trained to assist physicians, are performing medical duties -- such as emergency obstetrical and HIV/AIDS care -- in some African countries to help alleviate the "brain drain" resulting from doctors moving to "rich Western nations and more prosperous African countries." Ethiopia, Mozambique and Malawi, all of which have "extreme doctor shortages," are "virtually doubling" the number of paraprofessionals who are going through training, according to the Times. While some have raised concerns that the paraprofessionals may be inadequately trained for such duties, international health experts say that the "trend must accelerate if Africa has any hope of grappling with its catastrophic epidemics of disease," the Times reports. Paraprofessionals are less expensive to train, more willing to work in rural areas and less likely to leave the country "for greener pastures" than medical doctors, according to the Times. The Joint Learning Initiative, a network of scholars and experts, estimates that the continent, which has 600,000 nurses and doctors, needs one million more physicians, according to the Times.

Filling Gaps
Malawi's paraprofessionals, who are known as clinical officers, are "at the forefront" of providing obstetrical care and serve as "the backbone of AIDS care" in the country, which has one medical school that has produced 206 doctors in the last 12 years, the Times reports. In Mozambique, paraprofessionals conduct most of the surgical procedures. One study in Mozambique found that there was no statistically significant difference in the outcomes of caesarean-section deliveries performed by clinical officers and obstetricians, according to the Times. "The majority of countries in Africa don't accept these kinds of workers. They have doubts about their capacity," Fernando Vaz, a surgeon who trains paraprofessionals, said, adding, "But this is a solution for Mozambique." The Ethiopian government is making a "major push" to train health officers to perform c-sections. "We are not going to wait to produce surgeons," Girma Azene, the Ethiopian health ministry's planning director, said, adding, "Surgeons are like gold dust -- you can't find them." However, Shiferaw Teklemariam, who manages a public health system in southern Ethiopia, said, "I don't think any professional is immune from brain drain" (Dugger, New York Times, 11/23).