Ethiopia suffers from a medical shortage or brain drainthat has severely affected its already fragile health care system. The country has a very low physician-to-population ratio,whilemany in the medical community continue to leave in great numbers. Aphenomenological approach was used in this study to explore the lived experiences of medical doctors who have left Ethiopia, with contemporary migration theory serving as the conceptual framework. The central research question focused onwhy Ethiopian medical doctors leave their country and what can be done to retain them. Participants were 10 medical doctors of Ethiopian origin who live and practice medicine in the Washington, DC metropolitan area. Participantswere purposively selected, and in-depth interviews and a focus group discussion were used to collect data from them. The study followed Moustakas' recommendations for phenomenological analysis, which representeda modification of the Stevick-Colaizzi-Keen method. The themes that emerged during data analysis have economic, political, professional, and personal dimensions. The findings includelow pay, lack of professional development, poor working conditions, the threat of political persecution, fear of contracting HIV, and inability to participate in health care decision-making. Recommendations accordingly include offering pay raises and fringe benefits, creating opportunities for professional development, improving working conditions, and limiting political interference in the health care system. Implications for positive social change include the fact that stemming the outflow of medical doctors could help save the lives of thousands of Ethiopians threatenedby preventable and curable diseases.

This thesis in Global Development has looked at the personal experiences of non-European medical doctors that have migrated to Sweden to find out what they have encountered during the process of trying to obtain a Swedish medical license and if there are signs of discrimination. Sweden has a shortage of doctors, but has not resorted to brain drain. Contrary, it is difficult for non-European doctors to work as doctors in Sweden. This thesis has used a qualitative research strategy and five non-European unemployed doctors that were trying to get Swedish medical licenses as well as one non-European doctor that was working, were interviewed. Empirical data from a seminar with Swedish doctors about the pro-cess that foreign doctors have to go through to be able to work in Sweden has also been used in this thesis. The results showed that doctors from non-European countries have stricter requirements to fulfill in order to be able to practice medicine in Sweden than doctors coming from European countries. The system for accepting foreign doctors and validating their competence was flawed. The pro-cess was confusing, frustrating and unnecessarily long. Although there was no direct discrimina-tion or prejudice, European doctors were favored by the system. / Denna C-uppsats i Global Utveckling har tittat på personliga erfarenheter av icke-europeiska läkare som har migrerat till Sverige för att ta reda på vad de har stött på under processen av att skaffa svensk läkarlegitimation och om det finns tecken på diskriminering. Sverige har brist på läkare, men har inte tillgripit ”brain drain”. Tvärtemot är det svårt för icke-europeiska läkare att arbeta som läkare i Sverige. En kvalitativ forskningsstrategi har använts och fem icke-europeiska arbetslösa läkare som försökte få svenska läkarlegitimationer samt en icke-europeisk läkare som arbetade intervjuades. Empiriska data från ett seminarium med svenska läkare som handlade om processen som utländska läkare måste gå igenom för att kunna arbeta i Sverige har också använts i denna C-uppsats. Resultaten visade att läkare från icke-europeiska länder har strängare krav att uppfylla för att kunna arbeta som läkare i Sverige än läkare som kommer från europeiska länder. Systemet för att ta emot icke-europeiska läkare och validera deras kompetens var bristfällig. Processen var förvirrande, frustrerande och onödigt lång. Även om det inte fanns någon direkt diskriminering, så var europeiska läkare gynnade av systemet.

Despite an increase in the number of Ecuadorian medical professionals, health outcomes in rural areas of the country have steadily declined over the past decade. Using a political economic framework and data collected from interviews with Ecuadorian doctors, government officials, policy makers, and local rural populations, this thesis investigates how the interplay among medical migration, educational structures, and public health policy contributes to growing health disparities between urban and rural dwellers. Addressing each of these factors both individually and collectively, this thesis also outlines a series of policy recommendations that will allow the Ecuadorian healthcare system to better meet the needs of its rural population.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-07-11T19:54:02Z No. of bitstreams: 1 brunosilvademoraesgomes.pdf: 1747428 bytes, checksum: 7e53b68b70076b1659f5a8389f52ebbb (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-08-08T15:42:18Z (GMT) No. of bitstreams: 1 brunosilvademoraesgomes.pdf: 1747428 bytes, checksum: 7e53b68b70076b1659f5a8389f52ebbb (MD5) / Made available in DSpace on 2017-08-08T15:42:18Z (GMT). No. of bitstreams: 1 brunosilvademoraesgomes.pdf: 1747428 bytes, checksum: 7e53b68b70076b1659f5a8389f52ebbb (MD5) Previous issue date: 2017-05-31 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Essa tese busca analisar as questões espaciais de saúde nos municípios brasileiros. Dessa forma, o artigo 1 investiga as evidências de ciclos eleitorais e partidários e interação espacial nas despesas com saúde e saneamento. O modelo de painel dinâmico espacial propiciou observar se ocorre o aumento das despesas com saúde e saneamento nos anos de eleição municipal e quais os partidos que mais gastam com saúde e saneamento. Identificou que o padrão dessas despesas é influenciado pelo comportamento das despesas nos municípios vizinhos. Nota-se a presença do efeito spillovers, pois os governantes reduzem suas despesas com saúde e saneamento ao observarem que os vizinhos aumentam as despesas. O artigo 2 analisa as questões espaciais da Estratégia Saúde da Família (ESF) capazes de influenciar a taxa de mortalidade infantil e de crianças de 1 a 4 anos nos municípios brasileiros entre 1998 e 2012. A estimação se dá por dados por painel espacial. Como resultado, observa-se a presença dos efeitos do tipo feedback, em que os efeitos diretos da ESF passam para os vizinhos e retornam e o espraiamento da razão de cobertura dos vizinhos na redução da mortalidade infantil e de 1 a 4 anos. Assim, conclui-se que um aumento da ESF em um município reduz as taxas de mortalidade infantil e de 1 a 4 anos nos vizinhos, sendo esse efeito maior para mortalidade infantil. E o artigo 3 analisa a migração médica identificando se há efeito gotejamento nos municípios brasileiros para médicos generalistas e especialistas. Utiliza-se os dados do Censo 2010 e o modelo hierárquico espacial de dois níveis, o primeiro com os dados individuais e o segundo com os dados municipais (incorporando as defasagens espaciais). Como resultados confirma-se a importância da inclusão das variáveis individuais, municipais e espaciais e verifica-se a inexistência do efeito de gotejamento para migração médica tanto de generalistas (que estão dispersos pelos municípios aleatoriamente) quanto de especialista nos municípios brasileiros. / This thesis aims to analyze spatial health issues in Brazilian municipalities. Thus, article investigates the evidence of electoral and partisan cycles and spatial interaction in health and sanitation expenditures. The spatial dynamic panel model allowed us to observe whether there is an increase in health and sanitation expenses in the years of municipal elections and which parties spend the most on health and sanitation. Identified that the pattern of these expenditures is influenced by the behavior of expenditures in neighboring municipalities. The spillovers effect is noticeable, as governors reduce their health and sanitation expenditures by observing that neighbors increase expenditures. Article 2 analyzes the spatial issues of the Family Health Strategy (FHS) that can influence the infant and child mortality rate of 1 to 4 years in Brazilian municipalities between 1998 and 2012. The estimation is given by data per space panel. As a result, the effects of the feedback type are observed, in which the direct effects of the FHS pass to the neighbors and return and the spreading of the coverage ratio of the neighbors in the reduction of the infant mortality and from 1 to 4 years. Thus, it is concluded that an increase in FHS in one municipality reduces infant and 1 to 4 year mortality rates in neighbors, and this effect is higher for infant mortality. And article 3 analyzes the medical migration, identifying if there is trickle down effect in Brazilian municipalities for general practitioners and specialists. Data from the Censo 2010 and the two-level spatial hierarchical model are used, the first with the individual data and the second with the municipal data (incorporating spatial lags). As a result, the importance of including individual, municipal and spatial variables is confirmed and there is no trickle down effect for medical migration, either by generalists (who are dispersed by the municipalities at random) or by specialists in the Brazilian municipalities.