Why Ghana’s Nurses and Doctors Are Leaving in Record Numbers After COVID-19

Ghana is losing its healthcare workers at an alarming rate, and the exodus has accelerated sharply since the COVID-19 pandemic ended. A team of researchers at the University of Cape Coast has now laid out a detailed plan to systematically map the evidence behind this exodus, publishing a scoping review protocol in the journal Discover Social Science and Health. The protocol, led by Dean K. Attigah with senior author Edward W. Ansah, describes how the team will search, screen, and synthesize existing studies on the prevalence and drivers of post-pandemic brain-drain of healthcare workers from Ghana, with a particular focus on a factor that is rarely placed at the center of migration research: corruption within the healthcare system itself.

Brain-drain, the large-scale emigration of skilled professionals from lower-income countries to wealthier ones, is not a new story in West Africa. Ghana has trained nurses, physicians, and allied health professionals for decades only to see many of them recruited by health systems in the United Kingdom, the United States, Canada, and elsewhere in the high-income world. What is new, the researchers argue, is the pace. In the years following the COVID-19 pandemic, the migration of health workers from Ghana to high-income countries has increased to what the authors describe as alarming levels, threatening the country’s ability to achieve universal health coverage, the commitment that every person should be able to obtain the health services they need without financial hardship.

The protocol is explicit about why the pandemic appears to have acted as an accelerant. COVID-19 placed extraordinary strain on health systems in low- and middle-income countries, exposing chronic shortages of equipment, inadequate compensation, and difficult working conditions. For many Ghanaian health workers, the pandemic years intensified economic difficulties and dimmed already-poor job prospects at home. The authors also point to strained relations between health workers and leadership as a factor likely to feature prominently in the literature, alongside the systemic layer that underpins many of these grievances: corrupt practices within Ghana’s healthcare system that shape hiring, posting, promotion, and pay.

Methodologically, the study follows an established and transparent recipe. The review is guided by the framework developed by Arksey and O’Malley, one of the foundational methodological frameworks for scoping reviews, which allows researchers to systematically map the breadth of literature on a topic rather than answer a single narrow effectiveness question. Findings will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews, known as PRISMA-ScR, a checklist that standardizes how such reviews are documented so that readers can judge the completeness and rigor of the search and selection process.

The evidence base will be drawn from four major bibliographic databases: PubMed, Scopus, Web of Science, and CINAHL, the latter being the leading index for nursing and allied health literature. Because relevant policy documents, reports, and grey literature may not appear in those databases, the team will run supplementary searches in Google Scholar and Google. The search window is deliberately bounded, covering articles published between 2021 and 2026, a period chosen to capture the post-pandemic wave of migration rather than the longer historical record. Two research questions anchor the entire exercise: how prevalent is post-COVID-19 brain-drain of healthcare workers from Ghana, and which factors, including corruption, contribute to it.

Once records are gathered, the screening process will apply pre-determined inclusion criteria to full-text articles, a step designed to filter out studies that do not directly address the research questions or meet quality thresholds. Relevant data from the included articles will then be extracted and charted, a scoping-review technique in which key information from each study is organized into a structured form that allows patterns to emerge across the literature. The analysis itself will be qualitative: thematic analysis and synthesis will be performed on the charted data to generate findings upon which conclusions are drawn. This means the review will not pool numbers statistically, as a meta-analysis would, but will instead identify recurring themes, such as salary inadequacy, workplace mistreatment, or corrupt recruitment practices, across the body of published evidence.

The stakes of this mapping exercise are considerable. Ghana’s health system already operates under workforce constraints that predate the pandemic, and every departing nurse or physician represents not only a lost pair of hands but also a lost investment. Training a single health professional consumes significant public resources, and when that professional’s first years of service are delivered in a foreign health system, the country that paid for the training effectively subsidizes the wealthier destination. The authors frame this dynamic as a direct threat to Sustainable Development Goal 3, the United Nations target of ensuring healthy lives and promoting well-being for all, because a health system cannot deliver quality care without an adequate, retained workforce.

What distinguishes this protocol from much of the existing migration literature is its insistence that corruption be treated as a first-order variable rather than background noise. The authors state that many of the factors driving health workers out of Ghana remain rooted in corrupt practices in the country’s healthcare system, and they argue that addressing healthcare worker migration from Ghana means addressing these systemic factors directly. In practical terms, that could mean examining how favoritism in postings, informal payments, or opaque promotion pathways erode morale and push skilled workers toward the exit. By explicitly including corruption among the factors to be charted, the review is positioned to produce evidence that speaks to governance reform as much as to workforce policy.

The publication of a protocol, rather than a completed review, is itself a meaningful scientific practice. Registering the search strategy, inclusion criteria, and analytical approach in advance reduces the risk that researchers unconsciously steer a review toward convenient conclusions, and it invites scrutiny from other scholars before any findings exist. The article, which was received in March 2026, accepted in July 2026, and published as an open-access review on 13 July 2026, received no external funding, and the authors note that no ethical approval was required because the study collects no primary data, relying entirely on already-published literature.

For Ghana, the implications of the eventual findings could reach well beyond academia. If the synthesis confirms that economic hardship, poor job prospects, strained leader-worker relations, and corruption are the dominant drivers of the post-pandemic exodus, policymakers will have a consolidated evidence base for designing retention strategies that go beyond pay raises alone. The authors’ central argument is blunt: retaining the healthcare workforce that universal health coverage depends on requires confronting systemic problems, including corruption and related issues, rather than treating each departure as an individual career choice. As high-income countries continue to recruit aggressively from lower-income nations, the countries losing their health workers will increasingly need evidence of exactly this kind to defend their most critical asset, the people who deliver care.

Subject of Research: Post-pandemic emigration of healthcare workers from Ghana and its contributing factors, including corruption

Article Title: Factors affecting post-pandemic brain-drain of healthcare workers from Ghana: a scoping review protocol

Article References: Attigah, D. K., Acquah, P. K., Oppong, J. D., Donkor, L. A., Bio, J. Y., Agyemang, E. D., Boateng, J., Arhin, J., Prah, E., Fynn, H. P. K., Buabeng-Odoom, B., Nartey, K. T., Jingbeja, E., & Ansah, E. W. (2026). Factors affecting post-pandemic brain-drain of healthcare workers from Ghana: a scoping review protocol. Discover Social Science and Health. https://doi.org/10.1007/s44155-026-00451-1

Image Credits: AI Generated

DOI: 10.1007/s44155-026-00451-1

Keywords: Ghana, brain-drain, healthcare workers, COVID-19, corruption, scoping review, universal health coverage, health workforce migration, University of Cape Coast, PRISMA-ScR, Sustainable Development Goal 3, health policy