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Medical careers and the Botswana health care system

This thesis examines, from a sociological perspective, the careers of doctors from a developing country without its own medical school or strongly organised medical profession. It argues that the interplay between the socio-economic and political forces and doctors' experiences internalised over the years at medical school, contribute to medical migration in Botswana from the public sector to private practice, and abroad. First, the thesis examines the influences that come into play when Botswana citizens choose a medical career. Then, the study explores students' medical school socialisation outside Botswana, and how this interfaces with subsequent workplace experience in Botswana. The retention efforts within the public health service and the 'pull' factors to the industrialised nations and international agencies are also studied. Data collection for this study was mainly through in-depth interviews with citizen doctors in the public and private sectors in Botswana. For doctors abroad, computer assisted interviewing was utilised. The data reveal that, in choosing a career in medicine, doctors came under varied and sometimes conflicting influences, at the family, community and institutional levels. While studying abroad, doctors were exposed to the modem technologies and facilities and an environment perceived as being conducive to work and study at the same time. These come to be pull factors when doctors, thus trained and socialised, wish to apply their skills and knowledge in practice on their return home. What obtains in medical practice, and the expectations from the state and the public for the medical profession are different from those the doctors have been socialised to expect. This situation leads to complaints and resignations by doctors. In themselves, such complaints are not peculiar to Botswana, but Batswana doctors are relatively well placed to leave the public sector. The study suggests that the solutions devised to address doctors' concerns should go beyond tinkering with monetary incentives

Identiferoai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:543578
Date January 2004
CreatorsNtau, Christopher Gopolang
PublisherRoyal Holloway, University of London
Source SetsEthos UK
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation

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