The Portuguese contribution to the brain drain from Portuguese speaking African countries.

In the first part of this paper, a secondary analysis of multiple data sources was done to identify how many nurses, physicians, dentists, pharmacists and other health workers have migrated from the Portuguese speaking African countries (PSAC) to Portugal between 1998 and 2002. In the second part, the results of a 2003 questionnaire based survey of 45 nurses, from Guinea-Bissau, residing in Portugal are reported. Health professionals are increasing as a proportion of total immigrants into Portugal. Relatively to the countries' of origin population, the PSAC contribute the most with foreign health professionals to the Portuguese healthcare system. Our study of Guinea-Bissau nurses in Portugal replicates the results of other studies and suggests that the decision to emigrate is multiply determined. The implication for policy makers is that the causal complexity among factors spurring emigration makes that the marginal effect of policy reforms addressing one or more of the multiple determinants of emigration may be sufficient to retain some proportion of health professionals, even when other determinants of emigration are present. The situation observed is also indicative of the need of programs for social integration of these professionals.