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TLets543578
Medical careers and the Botswana health care system
[Thesis]
Ntau, Christopher Gopolang
Royal Holloway, University of London
2004
Ph.D.
Royal Holloway, University of London
2004
This thesis examines, from a sociological perspective, the careers of doctors from adeveloping country without its own medical school or strongly organised medicalprofession. It argues that the interplay between the socio-economic and politicalforces 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 whenBotswana citizens choose a medical career. Then, the study explores students'medical school socialisation outside Botswana, and how this interfaces withsubsequent workplace experience in Botswana. The retention efforts within the publichealth service and the 'pull' factors to the industrialised nations and internationalagencies are also studied.Data collection for this study was mainly through in-depth interviews with citizendoctors in the public and private sectors in Botswana. For doctors abroad, computerassisted interviewing was utilised.The data reveal that, in choosing a career in medicine, doctors came under varied andsometimes conflicting influences, at the family, community and institutional levels.While studying abroad, doctors were exposed to the modem technologies andfacilities and an environment perceived as being conducive to work and study at thesame 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. Whatobtains in medical practice, and the expectations from the state and the public for themedical profession are different from those the doctors have been socialised to expect.This situation leads to complaints and resignations by doctors. In themselves, suchcomplaints are not peculiar to Botswana, but Batswana doctors are relatively wellplaced to leave the public sector. The study suggests that the solutions devised toaddress doctors' concerns should go beyond tinkering with monetary incentives
Ntau, Christopher Gopolang
Royal Holloway, University of London
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[Thesis]
276903
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