The basics of any healthcare reform should be geared towards enhancing three elements: access, quality, and cost. Healthcare reform occupies an important place in the domestic policy of any country. A nation’s healthcare reform forms a part of its overall social policy. As a result, health policy formulation is influenced by the variety of social and economic factors that influence social policy development. In an attempt to explore the current healthcare issues, Oman has been chosen for analysis of its healthcare issues such as shortages of health workers that result from migration for better paying opportunities and bias in the recruitment of health professionals.
Analysis of the Current Healthcare Issues
In Oman, healthcare sector has been experiencing a reduction of labour supply and high job turnover. This is a sign of a dire weakness in the industry. The human resource management of the healthcare organization seems to be dangerously out-of-date. That would lead the system to irreversible damage (Kingma, 2007). There is a solution for every problem even though for this case. The problem can be managed even though that will take some time, effort and determination.
The employee turnover has grown to extreme levels in the Oman’s healthcare sector; the rate is so high that it is almost reaching the double mark of the country’s average in other sectors. This position is alarming, and it is fast deteriorating. The statistics reveal that as a result, the healthcare sector loses millions of dollars each year, and the problem is a direct danger to the sustainability of the healthcare systems at large (“Ministry of Information”, 2006).
There are a number of possible causes of migration among professionals of healthcare service provision (Ghosh, 2008). These determinants include social unrest in their home countries, poverty, and war. These are the main causes of the low and middle income countries (Aldossary, 2008). Middle income countries still suffer the problem of unemployment, and this also prompts healthcare professionals to find better working places, especially those from Middle East and Africa. The workers tend to move to areas where there is still some hope of employment. As a consequence, countries like Britain, Canada, and the United States are the main destination of these migrating workers (World Health Organization, 2009). The major attraction in this context is the lucrative pay and better working terms.
Aldossary (2008) states that some nations like Philippines encourage its citizens to emigrate. In Oman and other Arab nations, migration of healthcare workers is mainly because of the obstacles of the institutional systems hindering their personal prospects for social mobility. Besides, many emigrating healthcare workers complain that they are not well rewarded for their skills and the type of work they do. There are many obstacles in their efforts to advance their professions (Cowen & Moorhead, 2006). The factors that have been found to cause migration of professional healthcare providers fall into two broad categories, namely the push and pull factors.
The push factors include dangerous working conditions and high rate of crimes. Many people in Arab countries have experienced crime first hand, or they know someone who has suffered such fate (Aldossary, 2008). This is often a reason why healthcare professionals can choose to leave their country because of fear of these violent experiences. Therefore, they opt to move and practice their profession in a place that is safer (Connell, 2009).
Another cause is often the low salaries given to professional health workers in their countries. The developed countries have better pay for foreign workers. At times, it could be raised in 20 times (Aldossary, 2008). This is the reason why counties like Nigeria and India have become grounds where doctors are trained and then exported to the international market. The low wages and unguaranteed employment cause insecurity among the employees. Besides, the cost of living is constantly increasing. Therefore, it causes very high expenditure; the workers are often financial dependent (Cowen & Moorhead, 2006). This often causes them to move to places where they are able to gain financial independence and even start a family as they are guaranteed of the job.
There are also a number of other job related dissatisfaction issues. The home countries offer very high workload for less pay. The health systems are dysfunctional. There are a lot of problems of deprived professional standards when interacting with workmates or handling patients. The situation is getting worse considering unfair rules that govern educational and professional advancement (Connell, 2009). As a result, there are many cases of nepotism in the recruitment programs and the employees’ lack motivation.
The home countries have very limited career options because of underdeveloped healthcare systems and specialization; as a result, the qualifying doctors and nurses lack their desired type of specialty. Hence, the zeal to work is affected (Cowen & Moorhead, 2006). As there are many qualifying professionals, there is very high competition for the limited positions in training and at work.
On the other hand, most of the pull factors are just the opposite of the push factors. For instance, doctors, nurses, and paramedical personnel would migrate because of better pay and in search for better social and economic structures in foreign countries, something that they lack in their home countries (Aldossary, 2008). Health professionals are also attracted to top foreign countries because there are able to access a wider range of career options and professional development to advance their careers. This gives them the satisfaction and hope to better their lives. Foreign countries offer enough exposure to skills and the training focuses more on the procedural skills, where the trainee are able to access more responsibilities and get trained on stick adherence to the set standards of care (Aldossary, 2008).
The developed countries have well defined job responsibilities in the healthcare systems, therefore, present better working conditions. They also have regulated healthcare workload and employees do not have to work under pressure. Workplace relationships are well managed, and employees enjoy collegial relationships with each other. There are also better reward systems that are set in place for the healthcare workers for their dedicated and professional work. Regarding working conditions, the foreign countries offer lighter workload where employees work in functional health systems with better professional standard. The career advancements programs are based on the educational researches as well as teaching levels in the institutions of higher learning. Foreign nations especially the developed nations present a chance for continuous medical education and a guaranteed job security (Cohen, 2007). Other pull factors include good living standards, easy access and availability of information, better communication technology, security and promise of better education for children.
Moreover, the public sector depends on the private recruiting agents to this process and past research found out that the private practice did not depend too much on these agencies. These studies showed that for the recruitment agencies to maintain the ethical standards, they did not actively carry out the processes of recruitment in African countries since they were at the lower end of development (still developing countries) (Buchan, 2007). This is because the African nations still suffer the highest shortage of health service providers (Connell, 2009). Work permit or licenses are only issued when the workers meet some eligibility criteria after which they would then be allowed to start working.
The study will seek to confirm or disapprove that the reasons for migration to and out of Oman were similar to those encountered in other GCC sates like the United Arab Emirates. The reasons behind emigration previously highlighted included the search for good salaries and work benefits, the search for better work conditions and wider career prospects (Aiken & Cheung, 2008), the search for a system that has international work standardization at the place of work, and search for safer and stable job, pursuit of modern lifestyle where there are better infrastructure or social amenities and multi-cultural environment (Aldossary, 2008).
In conclusion, the reasons for migration among nurses were predicted by the push factors and they basically included the issues on deficient career development opportunities, meagre salaries, inequality with other workers and not being appreciated as health professionals. Causes for leaving the countries were very varied across different careers. For instance, the financial reasons were the major factors causing the nurses to leave the Middle East. While, in the European Union region, the factors influencing migration were mainly continuing education and career prospects. Even though, most nurses intending to leave the country did not have intents of returning home, others indicated that both financial and non-financial enticements could encourage them to come back and practice at home. Most health practitioners reported that the main pull factors to encourage their stay in Oman or cause them to return would be better salaries, improvement of the work benefits, appreciation of their effect and support from the management, improved workplace polices and environment, as well as, better social infrastructure and technology to improve performance of the nurses.