Why sub-Saharan African health workers migrate to european countries that do not actively recruit: A qualitative study post-migration

Background: Many studies have investigated the migration intentions of sub-Saharan African medicalstudents and health professionals within the context of a legacy of active international recruitment byreceiving countries. However, many health workers migrate outside of this recruitment paradigm. This paperaims to explore the reasons for migration of health workers from sub-Saharan Africa to Belgium and Austria;European countries without a history of active recruitment in sub-Saharan Africa.Methods: Data were collected using semistructured interviews. Twenty-seven health workers were interviewedabout their migration experiences. Included participants were born in sub-Saharan Africa, had trained ashealth workers in sub-Saharan Africa, and were currently living in Belgium or Austria, though not necessarilycurrently working as a health professional.Results: Both Austria and Belgium were shown not to be target countries for the health workers, who insteadmoved there by circumstance, rather than choice. Three principal reasons for migration were reported: 1)educational purposes; 2) political instability or insecurity in their country of origin; and 3) family reunification.In addition, two respondents mentioned medical reasons and, although less explicit, economic factors werealso involved in several of the respondents' decision to migrate.Conclusion: These results highlight the importance of the broader economic, social, and political contextwithin which migration decisions are made. Training opportunities proved to be an important factor formigration. A further development and upgrade of primary care might help to counter the common desire tospecialize and improve domestic training opportunities.