The cost of health professionals' brain drain in Kenya

BACKGROUND: Past attempts to estimate the cost of migration were limited to education costs only and did not include the lost returns from investment. The objectives of this study were: (i) to estimate the financial cost of emigration of Kenyan doctors to the United Kingdom (UK) and the United States of America (USA); (ii) to estimate the financial cost of emigration of nurses to seven OECD countries (Canada, Denmark, Finland, Ireland, Portugal, UK, USA); and (iii) to describe other losses from brain drain. METHODS: The costs of primary, secondary, medical and nursing schools were estimated in 2005. The cost information used in this study was obtained from one non-profit primary and secondary school and one public university in Kenya. The cost estimates represent unsubsidized cost. The loss incurred by Kenya through emigration was obtained by compounding the cost of educating a medical doctor and a nurse over the period between the average age of emigration (30 years) and the age of retirement (62 years) in recipient countries. RESULTS: The total cost of educating a single medical doctor from primary school to university is US$65,997; and for every doctor who emigrates, a country loses about US$ 517,931 worth of returns from investment. The total cost of educating one nurse from primary school to college of health sciences is US$43,180; and for every nurse that emigrates, a country loses about US$ 338,868 worth of returns from investment. CONCLUSION: Developed countries continue to deprive Kenya of millions of dollars worth of investments embodied in her human resources for health. If the current trend of poaching of scarce human resources for health (and other professionals) from Kenya is not curtailed, the chances of achieving the Millennium Development Goals would remain bleak. Such continued plunder of investments embodied in human resources contributes to further underdevelopment of Kenya and to keeping a majority of her people in the vicious circle of ill-health and poverty. Therefore, both developed and developing countries need to urgently develop and implement strategies for addressing the health human resource crisis

Accessing parental perspectives to inform the development of parent training in autism in south-eastern Europe

Parent training has been shown to be an important means of supporting families living with autism – but such services are not universally accessible. A multinational project funded by the European Commission has been developed in order to establish such parent training in three south-eastern European countries. To ensure that the training was relevant and appropriate, a survey was carried out in autumn 2015 to ascertain the attitudes of parents of children with autism in Croatia, Cyprus and the Former Yugoslav Republic of Macedonia regarding this issue, and to identify the areas of training that they felt most important. Two hundred and fifty-three surveys were distributed, and 148 were returned, a response rate of 58%. Respondents in the three counties were overwhelmingly positive about parent training, with almost 90% stating that they would like to attend such training. Weekend training sessions were preferred by the majority of respondents. There was wide variation between the three countries with regard to what content was felt important to be included, with parents in the FYR of Macedonia seeking information in the greatest number of areas. Five topics were prioritised by parents across all three countries. These were: • Strategies for enhancing my child’s communication • Strategies on facilitating my child’s interaction with other children • Sensory integration and development • General information on behavioural management strategies • Identifying and/or developing socialisation opportunitie

Evaluation of urban local-scale aerodynamic parameters: implications for the vertical profile of wind speed and for source areas

Nine methods to determine local-scale aerodynamic roughness length (z0) and zero-plane displacement (zd) are compared at three sites (within 60 m of each other) in London, UK. Methods include three anemometric (single-level high frequency observations), six morphometric (surface geometry) and one reference-based approach (look-up tables). A footprint model is used with the morphometric methods in an iterative procedure. The results are insensitive to the initial zd and z0 estimates. Across the three sites, zd varies between 5 – 45 m depending upon the method used. Morphometric methods that incorporate roughness-element height variability agree better with anemometric methods, indicating zd is consistently greater than the local mean building height. Depending upon method and wind direction, z0 varies between 0.1 and 5 m with morphometric z0 consistently being 2 – 3 m larger than the anemometric z0. No morphometric method consistently resembles the anemometric methods. Wind-speed profiles observed with Doppler lidar provide additional data with which to assess the methods. Locally determined roughness parameters are used to extrapolate wind-speed profiles to a height roughly 200 m above the canopy. Wind-speed profiles extrapolated based on morphometric methods that account for roughness-element height variability are most similar to observations. The extent of the modelled source area for measurements varies by up to a factor of three, depending upon the morphometric method used to determine zd and z0