Ghana’s healthcare system is facing significant challenges as many specialized nurses are leaving the country for better-paying jobs overseas, particularly in the United Kingdom’s National Health Service (NHS). The recruitment of nurses from poorer nations by high-income countries is described as “out of control” by the head of one of the world’s largest nursing groups.
The BBC’s investigation uncovered evidence of the “brain drain” phenomenon, highlighting how Ghana’s health system is struggling as a result. In 2022 alone, over 1,200 Ghanaian nurses joined the UK’s nursing register, contributing to the NHS’s increasing reliance on staff from non-EU countries to fill vacancies.
Despite the UK stating that active recruitment in Ghana is not allowed, nurses can easily access job vacancies through social media and apply for positions directly. Ghana’s dire economic situation serves as a significant push factor for nurses seeking better opportunities abroad.
Howard Catton, representing the International Council of Nurses (ICN), expressed concern about the scale of nurses leaving countries like Ghana. He believes that the situation is currently “out of control,” with intense recruitment by high-income countries draining the weakest and most vulnerable nations of their nurses, which they can ill-afford to lose.
The impact of this brain drain is evident in Ghana’s hospitals. Gifty Aryee, the head of nursing at Greater Accra Regional Hospital, reported losing 20 nurses to the UK and US in just six months, leading to compromised patient care. Delays in care, increased mortality rates, and nursing shortages have severe implications for critically ill patients and emergency departments.
Similar situations were found at Cape Coast Municipal Hospital, where critical care and experienced nurses have departed, leaving a lack of skilled staff. Smaller clinics and health centers also suffer as even the departure of a single nurse can have a significant ripple effect on services, such as immunization programs and post-surgical care.
The BBC interviewed Ghanaian nurses who expressed their desire to leave the country due to better earning prospects abroad. They cited poor working conditions and low salaries as significant factors driving their decision to seek employment elsewhere. In the UK, they could earn over seven times what they receive in Ghana.
Perpetual Ofori-Ampofo from Ghana’s Nurses and Midwives Association acknowledged that it was not possible to prevent nurses from leaving, as migration is a right. However, she emphasized that Ghana’s healthcare system needs more support and called for the government to take further measures to persuade nurses to stay.
Ghana, listed as one of the 55 vulnerable countries with low nurse-to-population ratios by the World Health Organization (WHO), faces significant challenges due to systematic recruitment from wealthier nations. The UK government has provided financial support to Ghana, Nigeria, and Kenya to strengthen their healthcare workforces, but the ICN questions whether such deals truly reflect the costs incurred by countries losing their nurses.
Brexit has played a role in the UK turning to African countries, including Ghana, to address nursing vacancies after closing off labor market access through European freedom of movement. The competitive global labor market has led to increased recruitment efforts from the Commonwealth and other jurisdictions.
The situation highlights the need for ethical considerations and sustainable solutions to address the brain drain of nurses from countries like Ghana, as it poses a threat to patient care and exacerbates healthcare challenges in vulnerable nations.
The World Health Organization’s Director of Health Workforce, Jim Campbell, explained to the BBC that the UK’s shift towards recruiting nurses from African countries, including Ghana, is a consequence of Brexit and the closure of potential labor markets from European freedom of movement. This competitive labor market dynamics have led to an increased reliance on nurses from the Commonwealth and other jurisdictions.
While the UK government recently allocated £15 million ($18.6 million) to Ghana, Nigeria, and Kenya to strengthen their healthcare workforces, experts question whether such funding is sufficient. Howard Catton from the International Council of Nurses (ICN) argues that these initiatives aim to create an appearance of ethical respectability rather than adequately addressing the true costs borne by countries losing their nurses.
Ghana is listed among the WHO’s 55 vulnerable countries with low nurse-to-population ratios, known as the “red list,” which discourages systematic recruitment from these nations. To counteract the brain drain, the Ghanaian government must do more to incentivize nurses to stay and provide better working conditions and salaries within the country’s healthcare system.
The repercussions of the nurse exodus are significant, affecting patient care and exacerbating healthcare challenges in Ghana. Hospitals such as Greater Accra Regional Hospital and Cape Coast Municipal Hospital have reported critical shortages of experienced nurses, resulting in compromised care, longer wait times, and increased mortality rates. Smaller clinics and health centers also struggle to maintain services due to the departure of skilled staff.
Ghanaian nurses cited the prospect of higher salaries and better working conditions as their motivation to seek employment abroad. The dire economic situation in Ghana, coupled with inadequate compensation and limited career advancement opportunities, reinforces their desire to leave.
Efforts to address this issue should involve a comprehensive approach, including measures to improve working conditions, increase salaries, and create professional development opportunities within Ghana’s healthcare system. Collaboration between governments, international organizations, and professional nursing bodies can help establish sustainable solutions that ensure the retention of nurses in their home countries while addressing healthcare workforce needs in high-income nations.
The ethical implications of nurse recruitment and the need for a fair and equitable distribution of healthcare professionals worldwide should also be emphasized. While high-income countries benefit from the influx of skilled nurses, it is crucial to consider the long-term impact on the source countries, their healthcare systems, and the well-being of their populations.
