Determinants of Internal and out Migration of Physicians from the Public Health

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Physicians are key personnel in the health care system. Currently there is a worldwide shortage of health workers, particularly physicians. In some countries this shortage of physicians is aggravated by migration. Ethiopia is one of those countries who face severe shortage of physicians. With the advent of private health sectors, the movement and migration of physicians From public to private sector becomes a common phenomenon. Moreover, there is a mass exodus of physicians outside Ethiopia. Because of these internal and external migrations of physicians, the service delivery of the public sector is highly affected. But this phenomenon is given little attention. The objective of this study is to find out the root causes of migration and its impact on service delivery. To do this research both primary and secondary source of data were used. Descriptive and econometric techniques had been employed for analysis. A pro bit estimation was used to analyze the determinants of migrate on. The findings of the study show that low salary and remuneration, unavailability of drugs, lack of professional resources and poor quality of management were the major push factors for internal migration. The significant pull factors for internal migration were found to be the opposite of push factors of internal migration. Concerning out-migration the study revealed that low salary, lack of incentives, poor quality of management, and feeling de-motivated by poor health care infrastructure, resources and facilities were the main endogenous push factors. From endogenous pull factors better salary, provision of different incentives, better opportunity and quality of education; and sophisticated health facilities, in Infrastructure and resources were found to be the most important attracting factors. Low quality of life in Ethiopia and political repression were found to be the most significant exogenous push factors of migration. The opposite of these factors were found to be the most influential exogenous pull factors.



physicians, internal migration, out immigration