Wuliji, Tana; (2010) Factors influencing human resource development for pharmaceutical services. Doctoral thesis (Ph.D.), University College London (United Kingdom).

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Abstract

This thesis sought to explore the migration intentions of pharmacists in nine countries (Australia, Bangladesh, Croatia, Egypt, Portugal, Nepal, Singapore, Slovenia and Zimbabwe) and analyse pharmacy workforce development issues in Zambia, a country with a human resources for health crisis. Quantitative methodology was employed to study migration intentions through a pilot questionnaire with 791 responses. Data were analysed by means of Principal Components Analysis and two-step cluster analysis to determine the relationships between factors influencing migration and the characteristics of subpopulations most and least likely to migrate. A significant difference was identified in attitudes towards the professional and socio-political environment of the home country and perceptions of opportunities abroad between those that had no intention to migrate and those who intended long-term migration. Those planning long-term migration were observed to hold more negative attitudes towards the home environment and positive attitudes to opportunities. These attitudes together with male gender, knowledge of other migrant pharmacists and past experiences abroad were associated with an increased likelihood of migration. A grounded theory approach was utilised to undertake an in-depth case study in Zambia. Key pharmacy workforce issues, policy making processes and medicines problems were examined through 19 qualitative interviews with key opinion leaders. Emergent themes were identified and their theoretical relationships refined through open, axial and selective coding and constant comparative analysis. Pharmacy workforce development policies were perceived as a threat to power by the dominant medical profession and were often resisted to the point of inaction. The likely future scenario in Zambia is for slow and incremental shifts in attitudes and recognition of pharmacy workforce needs amongst decision making stakeholders such as the medical profession and donor agencies. Given the influence of the country context and environment on migration intentions, migration should be viewed as a form of workforce attrition rather than a stand-alone phenomenon. Pharmacy workforce development is part of a more complex construct interlinked to the policy making process and is vulnerable to policy neglect.

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