Jigmi Wangdi

A recent study delving into the challenges leading to the emigration of healthcare professionals from the country has shed light on compelling factors driving this trend.

Titled ‘Factors Contributing to the Emigration and Retention of Health Workers in Bhutan’, the study revealed that between 2011 and 2018, Bhutan lost 39 doctors, constituting over 10 percent of the total doctor population.

In 2022, a total of 2,646 civil servants bid farewell to their roles, and health workers emerged as the second-largest group, with over 290 individuals departing, as reported by the study.

The primary objective of the research was to identify the reasons behind the emigration of doctors and nurses from the country.

Personal origins and values emerged as significant contributors to the migration phenomenon. The study underscored the shift from a strong sense of patriotism, focused on serving the country and its people, to a contemporary emphasis on pursuing financial gain.

Additionally, a growing materialistic mindset within the Bhutanese community was highlighted.

Family and community considerations also played a pivotal role, with health workers being drawn to countries like Australia for the promise of high-quality education for their children and improved family prospects. The allure of gaining permanent residency further intensified this appeal.

Peer influence was identified as a potent factor, as health workers observing colleagues succeed and enhance their livelihoods abroad triggered a peer-driven consideration of similar opportunities.

Career-related factors, including a lack of mobility and advancement, inadequate leadership support from superiors, and insufficient ministry backing, were also significant contributors to the emigration trend. Job security and financial aspects rounded out the array of factors influencing healthcare professionals’ decisions to leave.

The study proposes several recommendations to tackle the attrition rate of health workers. At the policy level, it suggests developing a comprehensive national retention strategy, instituting systems to recognize and reward health workers, and exploring the introduction of performance-based incentives, among other measures.

Interventional recommendations include introducing mentorship and support programs and integrating community service initiatives into the curriculum for nursing and medical students.

According to the Ministry of Health’s Attrition Report 2023, Bhutan has witnessed an average attrition rate of 4 percent for health workers since 2018. The highest rate occurred in 2022, reaching 4.84 percent, with 223 health workers leaving.

Nurses topped the attrition list at 4.6 percent, followed by specialists at 2.5 percent, and doctors at 1.7 percent.