Amid growing concern over the recruitment practices of high-income nations, the head of one of the world’s largest nursing groups has expressed alarm at the “out of control” situation. Evidence gathered by the BBC reveals the detrimental impact of Ghana’s struggling health system due to the ongoing ‘brain drain’ of its specialist nurses. The West African country has witnessed a significant exodus of highly skilled nurses who seek better remuneration abroad

A BBC report states that in 2022 alone, over 1,200 Ghanaian nurses joined the nursing register of the United Kingdom, one of the countries actively recruiting from Ghana. Despite the UK government stating that active recruitment in Ghana is prohibited, the widespread availability of information through social media platforms enables nurses to easily access and apply for vacancies in NHS trusts. Ghana’s dire economic circumstances act as a compelling push factor for many nurses seeking improved opportunities abroad. Howard Catton, representing the International Council of Nurses (ICN), has expressed deep concern regarding the magnitude of nurses leaving countries such as Ghana. The scale of this phenomenon not only negatively impacts the local health system but also perpetuates the inequalities in healthcare provision between richer and poorer nations. Organizations like the ICN emphasize the urgent need for collaborative efforts between governments, nursing associations, and international bodies to address the root causes of this brain drain and develop strategies to strengthen healthcare systems in source countries. Howard Catton from the International Council of Nurses (ICN) is concerned about the scale of the numbers leaving countries like Ghana. “I sense that the situation currently is out of control,” he told the BBC. “We have intense recruitment taking place mainly driven by six or seven high-income countries but with recruitment from countries which are some of the weakest and most vulnerable which can ill-afford to lose their nurses.” Gifty Aryee, the head of nursing at Greater Accra Regional Hospital, has expressed the serious consequences resulting from the brain drain phenomenon. During an interview with the BBC, she disclosed that her Intensive Care Unit has experienced a significant loss of 20 nurses to the United Kingdom and the United States in the past six months. “Care is affected as we are not able to take any more patients. There are delays and it costs more in mortality – patients die,” she said. Gifty Aryee highlighted the prolonged suffering of seriously ill patients in the emergency department as a direct consequence of nursing shortages. Additionally, a nurse at the hospital estimated that approximately half of her fellow graduates had already left the country, and she expressed a desire to join them. This alarming trend further emphasizes the pressing need to address the nursing shortage crisis to provide timely and adequate care to those in critical condition. Hospitals like Cape Coast Municipal Hospital are also losing experienced nurses, resulting in a lack of critical care staff and the need for repeated training. Smaller clinics are also affected, as even the departure of a single nurse can have significant repercussions, impacting services such as immunizations for children. Many nurses expressed their desire to leave Ghana due to poor working conditions and the significantly higher salaries offered elsewhere. Caroline Agbodza, the deputy head of nursing services at Cape Coast Municipal Hospital, revealed, “All our critical care nurses, our experienced nurses, have gone. So we end up having nothing – no experienced staff to work with. Even if the government recruits, we have to go through the pain of training nurses again.” Dr. Justice Arthur, the chief doctor at Ewim Health Clinic in Cape Coast, emphasized the dire consequences, stating, “Let’s take services like immunization of children. If we lose public health nurses, then the babies that have to be immunized will not get their immunization and we are going to have babies die.” The exodus of nurses is primarily driven by the significant salary disparity, as nurses in the UK reportedly earn over seven times more than their counterparts in Ghana. Mercy Asare Afriyie from Kwaso healthcare centre near Kumasi expressed her motivation to find a job in the UK, citing the poor conditions of service and inadequate salaries in Ghana. Perpetual Ofori-Ampofo from Ghana’s Nurses and Midwives Association stressed the ethical concerns of recruitment from Ghana, highlighting the disproportionate ratio of professional nurses to trainee or auxiliary nurses. While she acknowledged the right to migrate, Ofori-Ampofo called on the Ghanaian government to take stronger measures to retain nurses and address the healthcare system’s challenges. The Ghanaian health ministry in Accra declined to comment on the situation. The increasing departure of nurses from Ghana raises urgent concerns and underlines the need for comprehensive efforts to improve working conditions, offer competitive salaries, and implement strategies to retain healthcare professionals, ensuring the provision of quality care for the population. Ghana, categorized as a vulnerable country on the World Health Organization’s list due to low nurse-to-population ratios, is facing challenges with systematic recruitment from high-income countries. The UK government has provided £15m ($18.6m) to Ghana, Nigeria, and Kenya to strengthen their healthcare workforces. While the UK is considering a formal agreement with Ghana to facilitate proactive recruitment in exchange for financial support per nurse, Howard Catton from the International Council of Nurses questions whether such deals truly consider the costs incurred by source countries. Brexit’s impact on the UK labor market has led to a shift towards African countries to address nursing vacancies in the National Health Service, as explained by Jim Campbell, the WHO’s Director of Health Workforce. “The labour market is extremely competitive around the world and, having closed off the potential labour market from European freedom of movement, what we’re seeing is the consequences of that in terms of attracting people from the Commonwealth and other jurisdictions.”

cc: BBC