By Sarah Ssali
In this session, Prof. McPake presented a paper “The Economics of Health Professionals’ Education and Career”, where she extended her analysis of the health labour market to the training of health professionals. She observed that failures in the market for health had led to failures of the health care market, which in turn had ended as failures in the training of health professionals (in that they were trained for elite interests than for actual health needs in societies). In most places, the rich, who had attended elite schools were the ones who got admitted in medical schools and were unlikely to be interested to work in rural areas after their training, despite the need being greatest there. Furthermore, medical specialists dominated all levels of policy making, making the curriculum tends to be skewed in favour of specialised curative care than primary health care, thereby serving elite interests versus the health needs of the majority. Globalisation has compounded the problem with the curriculum shifting to produce health professionals who can compete globally, as countries seek to tap into revenue from abroad, perpetuating their out-migration of health workers to the global north, where the technology exists to enable them practise what they learnt and where they can get the best returns to their training. Hence, the training curricula is driven more by the elite concerns (local and international), than by concerns about universal health coverage. She concluded with two key recommendations: taking training from elite institutions to rural, primary focused ones, and encouraging ultimate consumers of the products of private training schools (local elite and medical tourists) to do more to support better regulation and influence the quality if health professional training.
Photo courtesy of the UK Department for International Development https://www.flickr.com/photos/dfid/7138906747