Zambia continues to face a severe shortage of healthcare workers as skilled professionals migrate abroad in search of better pay, working conditions, and career prospects.
The ongoing outflow of doctors, nurses, and specialists has placed immense strain on the country’s health system, undermining efforts to deliver quality care and achieve universal health coverage (UHC).
The scale of the challenge is stark. Zambia has just one doctor for every 12,000 patients and one nurse for nearly 15,000 people—far below World Health Organization (WHO) recommendations.
According to the Zambia Medical Association (ZMA), the country requires about 22,000 doctors but has only around 3,400 working in public institutions.
Although official registers list roughly 10,000 doctors nationwide, this figure includes those who have emigrated or died but still hold active licenses.
Each year, Zambia produces between 600 and 800 medical graduates, with an additional 100 to 200 foreign-trained doctors entering the country.
Yet only about 500 are absorbed into the public sector annually, leaving hundreds unemployed or underemployed despite widespread shortages. Nurses and other healthcare professionals face similar challenges, largely due to limited fiscal space for recruitment.
For those who do secure jobs, conditions can be difficult. Low salaries, long hours, inadequate facilities, and extra personal costs—such as paying for relocation or delayed gratuities—drive frustration and demotivation.
“Overworked staff leads to reduced service quality and undermines progress toward the Sustainable Development Goals and UHC,” says ZMA secretary general Dr Oliver Kaoma.
As a result, many healthcare workers seek opportunities abroad. While Zambia does not systematically track emigration, a 2012 Aspen Institute report estimated that 57% of physicians and 9.2% of nurses had emigrated.
The main destinations include the United Kingdom, United States, South Africa, Australia, Canada, and New Zealand, where demand for skilled professionals is high and migration pathways are well established. Better pay also enables many migrants to support families back home through remittances.
Personal stories highlight the dilemma. Doctors and nurses often leave reluctantly, torn between professional survival and national loyalty. Some, however, choose to stay.
Professor Emmanuel Makasa, an orthopaedic surgeon, argues that working in Zambia offers unparalleled clinical experience and a sense of purpose that money cannot replace.
Others, like physiotherapist Jude Bwalya, returned home after working abroad, citing the emotional cost of separation from family.
To address the crisis, the Zambian government has stepped up recruitment, employing more than 20,000 healthcare workers over the past three years.
It has also expanded the health establishment and introduced incentives under the Health Workers Retention Scheme, including hardship allowances, housing support, and education benefits for those in rural areas. Salary reviews and improved working conditions are also underway.
Partners such as SolidarMed are complementing government efforts through non-monetary incentives, including affordable housing and practical training centres that enhance early clinical exposure.
While global demand for health workers continues to fuel migration, experts agree that lasting solutions must be rooted locally. As Makasa notes, “Although stronger international cooperation is needed, the primary solutions can and must come from within Zambia.”
