TIRANA, May 26, 2023 – The growing number of doctors and other health professionals migrating away from Albania in recent years, part of a much larger brain drain and migration trend, is increasing anxiety of the population left behind over getting proper services in the years to come at a time when the country already features one of Europe’s lowest per capita number of physicians.
Researchers are now looking into the reasons for the emigration as well as the factors that would influence the return of such professionals. A recent study published by the University of Sussex in the UK notes that the main drivers are economic and social. The study was based on interviews with doctors from Albania who have emigrated in the past three decades.
Emigration of doctors is first due to economic reasons, followed by the need to get more education and uncertainties about the future in Albania.
“If we look at the first group of factors, the standard of living and the improvement of working conditions emerge. And if we look at education, the emphasis is on personal education. While the third factor has to do with how they see the future in Albania. About 10 percent do not see a better future in Albania and therefore think that emigration is the best solution,” according to Ilir Gëdeshi of the Center for Economic and Social Studies in Tirana. He is one of the study’s authors.
The findings also confirm that the departure of doctors from the country has escalated in recent years. In a diaspora of more than 2,500 doctors, there are those who left in the 1990s, mainly to the US, with few opportunities to practice the profession, students who finish their medical studies abroad and do not return to Albania, which make up a third of the total, as well as the doctors who left during the recent years, destined for EU countries, mainly Germany and Italy, where there is a growing need for professionals to cater to the aging population.
The professional body that issues licenses for doctors in Albania notes that 800 doctors left the country in the last five years. OECD data notes more than 1,000 Albanian doctors are now working elsewhere, but that number does not include dual nationals. Germany alone notes 980 Albanian doctors work there as of 2021, about six times more than in 2012, according to Mr. Gëdeshi.
Doctors have noted that the unreformed and poorly financed health system in the country has caused doctors to work in inappropriate conditions and not provide quality service.
The authorities have taken measures by increasing the salaries of employees in the health system, to prevent the departure of doctors, but according to this study, the salary is only one of the reasons for the departure, but not the main one.
“Doctors leave, because according to this study and others before it, they are not satisfied with the working conditions, with the safety at work, with the options offered to them in Albania to have a professional career that develops according to the rules of the game and with honesty. If only the salary is dealt with, the problem is not resolved,” according to Erion Dasho, a public health expert.
He added: “Today medicine is not only provided by the knowledge of doctors, today medicine is technology. If there are no clinical practice guidelines, adapted to the possibilities of the system, if there are no disease treatment protocols, continuing education to apply these, if there are no top-of-the-line medications, the doctor cannot practice the profession properly.”
The authors of the study think that the departure of doctors is a serious blow to the health system in conditions where Albania has a low indicator of the number of doctors per inhabitant, 188 per 100,000 inhabitants, when it is 374 in EU countries and 446 in Germany.
Another element of the study is related to the reasons that would bring doctors back to the country, which are also more or less the same as those for leaving, including economic conditions, political stability, the fight against corruption and reforming the health system.
Other doctors point out to the difficulties that medical students have encountered over the years to specialize, despite some recent improvements. Moreover, Albanian medical facilities lack proper equipment, and where it is available it is not often well maintained due to lack of qualified staff.
Albania is not alone in this predicament. Emigration of doctors is also a concern for the countries of the region as there is an increased demand by EU countries, Germany in particular. But in Albania this phenomenon has more serious consequences due to weaknesses in the health system.
According to the calculations of experts in the field, it takes 20 years to prepare a doctor, so the concern about their departure from the country is considered an alarm bell. Albania’s expenditures on public health services, according to this study that refers to Eurostat data, are the lowest in the Western Balkans and in Europe, 3.2 percent of GDP compared to 5 or 6 percent in Serbia and Bosnia and Herzegovina, or with an average of 8.1 percent in the EU.
Today, many citizens ask the question if it is right for countries with a high level of poverty like Albania to pay dearly for the education of doctors so that they then leave to fill the gaps in the health systems of rich countries?
The answer to this question, according to researchers, is found in the freedom of operation of demand and supply in global markets, as well as in the need for serious efforts of government authorities to curb the departure of doctors from the country, according to a report by VoA’s Albanian service.
