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Giving Back: A mixed methods study of the contributions of US-Based Nigerian physicians to home country health systems

Nwadiuko, J and James, K and Switzer, GE and Stern, J (2016) Giving Back: A mixed methods study of the contributions of US-Based Nigerian physicians to home country health systems. Globalization and Health, 12 (1).

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Background: There is increased interest in the capacity of US immigrants to contribute to their homelands via entrepreneurship and philanthropy. However, there has been little research examining how immigrant physicians may support health systems and what factors facilitate or raise barriers to increased support. Methods: This study used an observational design with paper questionnaire and interview components. Our sample was drawn from attendees of a 2011 conference for US Based Nigerian physicians respondents who were not US residents, physicians, and of Nigerian birth or parentage were excluded from further analysis. Respondents were randomly selected to complete a follow-up interview with separate scripts for those having made past financial contributions or medical service trips to support Nigerian healthcare (Group A) and those who had done neither (Group B). Survey results were analyzed using Fischer exact tests and interviews were coded in pairs using thematic content analysis. Results: Seventy-five of 156 (48%) individuals who attended the conference met inclusion criteria and completed the survey, and 13 follow-up interviews were completed. In surveys, 65% percent of respondents indicated a donation to an agency providing healthcare in Nigeria the previous year, 57% indicated having gone on medical service trips in the prior 10years and 45% indicated it was "very likely" or "likely" that they would return to Nigeria to practice medicine. In interviews, respondents tended to favor gifts in kind and financial gifts as modes of contribution, with medical education facilities as the most popular target. Personal connections, often forged in medical school, tended to facilitate contributions. Individuals desiring to return permanently focused on their potential impact and worried about health system under-preparedness those not desiring permanent return centered on how safety, financial security and health systems issues presented barriers. Conclusions: This study demonstrates several mechanisms by which health systems may benefit from expatriate engagement. Greater identification of reliable local partners for diaspora, deeper collaboration with those partners and a focus on sustainable interventions might improve the quantity and impact of contributions. Ethnic medical associations have a unique role in organizing and facilitating diaspora response. Public-private partnerships may help diaspora negotiate the challenges of repatriation.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Nwadiuko, J
James, K
Switzer, GE
Stern, J
Date: 14 June 2016
Date Type: Publication
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Journal or Publication Title: Globalization and Health
Volume: 12
Number: 1
DOI or Unique Handle: 10.1186/s12992-016-0165-9
Institution: University of Pittsburgh
Schools and Programs: School of Medicine > Clinical and Translational Science
School of Medicine > Medicine
School of Medicine > Psychiatry
Refereed: Yes
Date Deposited: 15 Jul 2016 17:48
Last Modified: 30 Mar 2021 13:56


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