Workforce migration and brain drain - A nationwide cross-sectional survey of early career psychiatrists in Nigeria

Background

Nigeria's shortage of psychiatrists is exacerbated due to health worker migration.

Aim

This study explores migration experiences and tendencies among early-career psychiatrists in Nigeria.

Methods

We conducted a cross-sectional survey covering Nigeria's six geopolitical zones, using a 61-item online questionnaire assessing short-term mobility, long-term migration experiences and migration attitudes. Data was analysed using IBM SPSS version 29.

Results

Of 228 early-career psychiatrists surveyed, 9.7% had short-term mobility and 8.0% had long-term migration experiences. However, 85.8% had 'ever' considered migration, 69.2% were planning to leave 'now', and 52.9% had taken 'practical migration steps'. Over half (52.7%) said they would be working abroad in 5 years, with 25.2% indicating they would migrate within a year. The top reasons to leave were financial and academic, while personal and cultural factors were the key reasons to stay. Income dissatisfaction (OR = 2.27, 95%, CI = 1.05-4.88) predicted planning to leave 'now', while being in a relationship (OR = 3.46, 95%CI = 1.06-11.30) predicted taking 'practical migration steps'. Attractive job features were good welfare (85.4%) and high salaries (80.3%). Improvements in finances (90.8%) and work conditions (86.8%) were requested.

Conclusions

Systemic changes to address psychiatrists' migration from Nigeria are needed.

Arm area measurements as indices of nutritional reserves and body water in African newborns

Although application of non-invasive techniques for early evaluation of body water, calorie and protein reserves has been available for more than two decades, there is a dearth of information on the evaluation of extracellular water, protein and calorie reserves in the African newborn. A cross-sectional study of arm area measurements was undertaken in 510 term new-born infants consisting of 318 infants who were normal weight term infants (NWTI) with a mean birth weight of 2898.5 +/- 287.7 g and 192 low birth weight term infants (LBWTI) with a mean birth weight of 2176.5 +/- 194.7 g. The triceps skin fold thickness (TSF), the arm fat area (AFA), percentage of arm area (AFA%) and arm water area (AWA) were significantly greater in females than males weighing > 2500 g at birth (P < 0.05), though the mean birth weight and mid-upper arm circumference (MUAC) were similar (P > 0.05). With the exception of AFA%, all measured and calculated indices were significantly lower in LBWTI than in the NWTI irrespective of sex (P < 0.05). The measurements may aid detection of newborns at risk of developing malnutrition in an area of the world where childhood undernutrition is common.