Intention to stay and labor migration of Albanian doctors and nurses Ertila DRUGA 3 rd Conference, LSEE Research Network on Social Cohesion in SEE Social Cohesion and Economic Governance 6-7 April 2017, Skopje
Content Background Literature Methods Results Conclusions
Background Long-lasting problems related to reformation and management of Albanian healthcare sector. A new reality: migration of healthcare professionals. Out of the scope of interest of political decision makers. Lack of public data and statistics. Very few studies were undertaken in Albania concerning this phenomenon.
Literature push factors in order to move abroad (Healthgrouper, 2014): (i) low wages, (ii) lack of job satisfaction, (iii) poor working conditions, and (iv) lack of possibilities for further education and career development. pull factors of countries abroad (Healthgrouper, 2014): (i) more attractive salaries, (ii) possibilities form professional development, (iii) professional work environments, proper management, equipment, tools, facilities, and (iv) sensitive employment policies that recognize good performance. An increase in migration flows of health workers, particularly the migration of young health professionals from SEE countries (Buchan, 2007; WHO regional Office for Europe, 2009, WHO regional Office for Europe & SEEHN, 2011) A growing interest from EU and WHO supporting the code of practice on International Recruitment of Health personnel for Better Management of Health Worker Migration (Human Resources for Health, Vol. 14 Suppl. 1, 2016)
Objective of the research To investigate and present some information regarding the intentions of the Albanian doctors and nurses to migrate for work to other countries in the European and non-european region. In particular, the study aimed to identify: i. the directions of intended migration; ii. iii. iv. the duration of intended stay abroad; their motives for leaving the country; barriers to the decision to migrate, and v. the nature of work undertaken by the respondents abroad in terms of the work position (lower, consistent with, or higher qualifications).
Methods The study included 141 professionally active health professionals working in Albania at the time the survey was conducted. A questionnaire was used to collect data through interviews, since January 2017 (work in progress). It was a purpose-designed three-part questionnaire, with unstructured and structured questions: I. Concerning their socio-demographic status; II. Related to their migration decision; respondents who did not intend to migrate gave reasons for their decision and finalized the questionnaire at this point III. Aimed at determining the motives underlying their desire to migrate, as well as the country of migration and the duration of the respondents who declared an intention to migrate.
Results Intention to migrate 55.32 % (78/141) of the respondents intended to migrate from Albania for professional reasons. Variables Do you intend to emigrate from Albania to another country to take up work there? n (%) Yes No Total Total 78 (55.32) 63 (44.68) 141 (100) Doctors 43 (55.13) 35 (44.87) 78 (55.32) Nurses 35 (55.56) 28 (44.44) 63 (44.68)
Results (cont..) Socio-demographic characteristics 66% women and 34% men. More than two third of the sample (71%) was ranged in two categories: 43% of the respondents were 26-35 years old and 28% of them were 34-46 years old. The majority of the respondents were married (61%) Variables Sex Do you intend to emigrate from Albania to another country to take up work there? n (%) Yes No Total Women 48 (61.54) 45 (71.43) 93 (65.96) Men 30 (38.46) 18 (28.57) 48 (34.04) Age Under 25 years old 6 (7.69) 6 (9.52) 12 (8.51) 26-35 years old 43 (55.13) 18 (28.57) 61 (43.26) 36-45 years old 23 (29.49) 16 (25.40) 39 (27.66) 46-55 years old 4 (5.13) 14 (22.20) 18 (12.77) Over 56 years old 1 (1.28) 8 (12.70) 9 (6.38) Data gaps 1 (1.28) 1 (1.59) 2 (1.42) Marital status Married 44 (56.41) 42 (66.67) 86 (60.99) No relationship 29 (37.18) 16 (25.40) 45 (31.91) Other 5 (6.41) 5 (7.94) 10 (7.09)
Results (cont..) Socio-demographic characteristics (cont..) 62.4% of them work in public sector, 20.6% in private institutions and 13.5% in both institutions. The sample was slightly predominated by professionals with 6-10 years of experience, but there were no important differences between the first four categories. Variables Place of employment Do you intend to emigrate from Albania to another country to take up work there? n (%) Yes No Total Public 42 (53.85) 46 (73.02) 88 (62.41) Private 22 (28.21) 7 (11.11) 29 (20.57) Both 11 (14.10) 8 (12.70) 19 (13.48) Data gaps 3 (3.85) 2 (3.17) 5 (3.55) Working experience Less than 2 years 16 (20.51) 12 (19.05) 28 (19.86) 3-5 years 16 (20.51) 9 (14.29) 25 (17.73) 6-10 years 25 (32.05) 6 (9.52) 31 (21.99) 11-20 years 10 (12.82) 14 (22.22) 24 (17.02) 21-30 years 2 (2.56) 8 (12.7) 10 (7.09) Over 31 2 (2.56) 12 (19.05) 14 (9.93) Data gaps 7 (8.97) 2 (3.17) 9 (6.38)
Results (cont..) Socio-demographic characteristics (cont..) The sample was predominated (73%) by respondents who have finished Master studies (37%) and Specializations (36%) Almost all levels of healthcare services are represented equally in this study. Variables Educational background Do you intend to emigrate from Albania to another country to take up work there? n (%) Yes No Total Bachelor studies 9 (11.54) 10 (15.87) 19 (13.48) Master studies 28 (35.9) 24 (38.1) 52 (36.88) Specializations / qualifications 30 (38.46) 20 (31.75) 50 (35.46) PhD. Prof. Assoc. 5 (6.41) 6 (9.52) 11 (7.8) Data gaps 6 (7.69) 3 (4.76) 9 (6.38) Level of healthcare service Primary 16 (20.51) 31 (49.21) 47 (33.33) Secondary 30 (38.46) 12 (19.05) 42 (29.79) Tertiary 27 (34.6) 17 (26.98) 44 (31.21) Data gaps 5 (6.41) 3 (4.76) 8 (5.67)
Variables Do you intend to emigrate from Albania to another country to take up work there? n (%) Yes No Total Total 78 (55.32) 63 (44.68) 141 (100) Indicate one major phenomenon which makes practicing your profession in healthcare in Albania hardly attractive a. Low remuneration in comparison with great responsibility and social expectations b. Great mental and physical load caused by an insufficient number of personnel in relation to the number of patients c. Low level of social respect for people practicing the profession in healthcare 44 (56.41) 45 (71.43) 89 (63.12) 4 (5.13) 3 (4.76) 7 (4.96) 27 (34.62) 13 (20.63) 40 (28.37) Data gaps 3 (3.85) 2 (3.17) 5 (3.55) Assessment of own material standing Too Bad 5 (6.41) 1 (1.59) 6 (4.26) Bad 23 (29.49) 20 (31.75) 43 (30.50) Nor good or bad 26 (33.33) 23 (36.51) 49 (34.75) Good 14 (17.95) 12 (19.05) 26 (18.44) Too good 6 (7.69) 6 (9.52) 12 (8.51) Data gaps 4 (5.13) 1 (1.59) 5 (3.55) Results (cont..) 63% of the respondents indicate that low remuneration in comparison with great responsibility and social expectations makes practicing their profession hardly attractive. 35% of the respondents assess their own material standing as nor good or bad and 31% of them as bad.
Results: Barriers to migration (n = 63) One major reason why you do not intend to migrate from Albania 30.16 23.81 25.4 11.11 6.35 3.17 Family situation does not allow it I find my present material and professional situation satisfactory I don t know foreign languages I am afraid I will not be able to cope in a new cultural and language environment. Age Data gaps
Results: Destination (n = 78) 38.46 The most preferred country to migrate for work 24.36 12.82 11.54 3.85 2.56 6.41 Germany Great Britain USA Canada Italy Greece Other countries Other countries: Australia (1), Denmark (1), Norway (1), Sweden (1), Swiss (1)
Results: Attractiveness of destination (n = 78) 29.49 32.05 19.23 10.26 7.69 1.28 High salaries Better living conditions (better support from the state) Better working conditions and professional development Higher public respect for the profession of a nurse Valuable experience Data gaps
Results: Duration of migration (n = 78) 55.13 30.77 11.54 1.28 1.28 One year or less From 2 5 years Above 5 years Permanently Data gaps
Results: Nature of work abroad (n = 78) 43.59 28.21 28.21 requiring lower qualifications than I have because I will work as consistent with my qualifications and skills because I will work as requiring higher qualifications than I have because I will work as
Conclusions In the studied group, there was a great interest for working abroad. They were young professionals (aged 25-36 years old), having a low or moderate working experience, and mostly offering their services in secondary and tertiary level. They tend to go abroad mostly for long-term or permanently, and the most preferred destinations were Germany and USA. Highly scored push factors resulted: (i) low remuneration in comparison with great responsibility and social expectations and (ii) bad & nor good or bad assessment of their own material standing; while highly scored pull factors resulted: (i) better working condition and professional development, and (ii) better living conditions. Some push factors were scored higher in non-migration intended respondents then those interested to migrate. Major barriers for non-migrating were: (i) family situation, (ii) being afraid not to cope in a new culture and environment, and (iii) age.
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