Dr Kenneth Yakubu completed his PhD at the Faculty of Medicine at the University of New South Wales, Australia, and the co-lead of the George Institute's Ubuntu Initiative for research partnerships in Africa. Dr Yakubu trained as a family physician in Nigeria and practiced there before moving to Australia in 2019. His PhD thesis focused on human-rights based approaches for defining and achieving a sustainable skilled health workforce.
Episode summary:
01.15 Dr Yakubu’s journey into family medicine and experiences with rural health in Nigeria
06.00 Challenges in rural areas of Nigeria
10.50 How does the Nigerian primary care system work?
14.30 How did Dr Yakubu decide to work more in research?
18.50 How did he end up in Australia and the George Institute?
22.00 Health workforce challenges
30.30 How are health workforce issues perceived?
36.15 Health as a human right and how it affects migration
39.30 Positive examples
44.45 Insights into rural health workforce and migration
49.30 George Institute projects
Key insights:
Feeling of satisfaction and of connection with the people when working in rural areas.
Lack of resources and lack of security of healthcare workers in rural areas.
Hub and spoke arrangement of primary care in Nigeria - a feeling that rural areas are where you send people you don’t like.
A distance from where decisions are made and the issues on the ground.
The health facility felt foreign in the community. The community had better connections with other systems of care that were more traditional.
Not a sense of trust and ownership from the community towards the healthcare facility.
Everyday he was left with issues that left him perplexed, caused frustration but also fed his curiosity. This led him to research and network with international colleagues.
His experience as a family medicine doctor in Nigeria helped him to successfully apply for his PhD in Australia.
1.8 skilled health workers per 1000 people in Nigeria. African countries have a large shortfall in the health workforce.
Deconstructing the problem as “our problem”, not continuing with the narrative that high income countries are the bad guy and low middle income countries are the victims. Taking away you vs them.
How can we define the health workforce issue as a human rights issue? So that everyone has a stake in it.
Fostering a system of collaborative governance.
Asking questions around sustainability. Understanding formal and informal rules.
Societal narratives influence how people look at the workforce issue.
The more successful we are in framing it as a human rights issue the more we will be able to find collaborative and equitable ways to solve the issue.
Societal perception of skilled health workers as being arrogant and aloof.
Cultural system and value systems - civic engagement at the community level has been absent when looking at the health workforce issue.
No political pressure, no social pressure to resolve the health workforce issue.
Fragmentation of advocacy and accountability.
Governments can make promises to the population about their right to healthcare without enabling the conditions for that to happen. Danger of violence towards healthcare workers when they are not able to fulfill these “promises”.
Healthcare workers also have the rights, the right to fair work and remuneration, to live securely and to migrate.
The importance of safety for healthcare workers and how it affects their choice of workplace.
Migration is the last symptom of a faulty health system. Important to focus on other underpinning issues - repairing the social contract.
Each system has to learn from itself and find a local way for holding itself accountable.
Whole of government approach is needed to address the issues.
Email Dr Yakubu: kyakubu@georgeinstitute.org.au
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