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Internal Migration of Physicians in Guatemala
Sussana Chen Qiu
ASOCEM - Guatemala Universidad de San Carlos de Guatemala sussana.ch.q@gmail.com
The migration of health professionals from one country to another is a phenomenon observed worldwide, and is due to a vast multitude of reasons, such as better opportunities, working conditions, or infrastructure. Amidst the WHO Global Code of Practice on the Recruitment of Foreign Healthcare Professionals and the Global Economic Crisis of last year, it is important to address the situation from our own perspective, here in Guatemala. In fact, migration of healthcare workers is not only taking place between countries, but also within our own borders, especially when it comes to medical doctors. Guatemala is a Central American country, with a surface area of 108,889 km2, and an estimated population of 15,073,375 persons1. There are five medical schools in six of the 22 departments of the country. A large proportion of students who leave their hometown to pursue medical education end up either staying in the city where they studied, migrating to the capital, or even leaving to another country, seeking better opportunities. According to a 2009 study2 carried out by the PanAmerican Health Organization (PAHO), the actual number of registered physicians in Guatemala was 13910, giving a ratio of 9.92 physicians per 10,000 people. What is really interesting in this study the variability of percentages and ratios from one region to another within Guatemala: Guatemala City has 71% of registered physicians (ratio 1:332), whereas departments such as Quiché have only 1% (ratio of 1: 9,064). 7 8
As would be expected, urban areas have more medical specialists than do rural areas; this could be due to the development of the urban cities, which have better infrastructure and facilities. Residencies and post-graduate training programs are
difficult to access, as the spots available within each specialty are limited, despite have large numbers of applicants and an ever-increasing demand. This is a problem our health system faces on a yearly basis that has yet to be solved. Migration of healthcare workers, whether internal or external, takes a heavy toll on the health of the population, especially in Guatemala. All hypotheses as to the specific reasons behind this phenomenon are yet confirmed by formal studies – at least in Guatemala. This problem needs to be addressed in collaboration with our healthcare department and our government to improve our overall development by creating more appropriate medical facilities and opportunities. “Achieving universal health coverage requires sound health workforce planning, quality transformative education systems for health professionals, innovative strategies of service delivery and regulation3.”
References: 1. Caracterización Estadística, República de Guatemala 2012. INE. Guatemala, 2013. Available at: http://ine.gob.gt/sistema/ uploads/2014/02/26/5eTCcFlHErnaNVeUmm3iabXHaKgXtw0C.pdf 2. Información sobre recursos humanos de Salud en Guatemala. PAHO. Guatemala. 2009. Available at: http://mspas.gob.gt/decap/files/ descargas/bibliotecaVirtual/RRHH/Informaci%C3%B3n%20sobre%20 recursos%20humanos%20de%20salud.pdf 3. Siyam A, Dal M. Migration of health workers: The WHO Code of Practice and the Global Economic Crisis. WHO. 2014. Available at: http://www. who.int/entity/hrh/migration/migration_book/en/ http://www.who.int/ hrh/migration/14075_MigrationofHealth_Workers.pdf?ua=1
medical students worldwide | AM 2015, Macedonia