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Table 6 Internal brain drain

From: Vertical funding, non-governmental organizations, and health system strengthening: perspectives of public sector health workers in Mozambique

Subtheme Quote
Impact of exodus from public sector to NGOs “The big problem we had and still have with NGOs, is the competition for resources, human resources, they steal almost all human resources we have. Most NGOs, although they have expatriates they also have a lot of national staff, and that makes imbalances in the system.” (Provincial director)
“[I]t’s a profound loss for the health sector, as most of the time, they [human resources] are key elements in the system, with long experience and sometimes they are essential staff…the NGOs are more unlikely to contract workers who are recent graduates.” (Provincial manager)
Salary and work conditions “People leave the national system and go to NGOs, international agencies and private sector just because they are looking for better salaries.” (National director)
“[I] have received proposals from organizations to leave the national system. First, the salary proposed was 3 or 4 times higher. Besides the salaries, they were giving me other incentives like a house, transport and others. So you start making your short term plan and realize that if you stay in public sector you will not have a chance to meet those short term goals.” (District manager)
“[T]he difference is huge, if I work for an NGO and have the job like I have here, I would earn probably US$ 2000, and here I don’t earn more than US$ 300, you can see the difference? US$ 1700. It’s a lot.” (Provincial manager)
Upgrading skills “[S]ometimes we have someone learning monitoring and evaluation skills with a partner, but when he/her is trained to perform the job, he/she leaves the national system and surprisingly the same partner will offer them a job.” (Provincial manager)
“For example, in this province, the only chance to study at university is to do management and pedagogy courses. Because my goal is to upgrade my skills, I can work for an NGO and make more money and pay the school fees so I can move to another NGO….I have many colleagues doing Biology, others are doing management.” (Provincial manager)
Source: 41 interviews of Mozambique Ministry of Health managers 2008