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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 36  |  Issue : 1  |  Page : 25-30

Factors Leading to Brain Drain of Speech and Hearing Professionals in India


1 All India Institute of Speech and Hearing, Department of Audiology, Mysuru, Karnataka, India
2 Indian Speech and Hearing Association, Mysuru, Karnataka, India
3 School of Allied Health Sciences, Manipal Academy of Higher Education, Department of Audiology, Manipal, Karnataka, India
4 AYJNISHD, In-charge Director, Manipal, Karnataka, India
5 JSS Institute of Speech and Hearing, Department of Audiology, Mysuru, Karnataka, India
6 AYJNISHD, ERC, Department of Audiology and Speech-Language Pathology, Kolkata, Karnataka, India
7 Shravana Institute of Speech and Hearing, Principal, Bellari, Karnataka, India
8 Department of Speech Pathology and Audiology, NIMHANS, Bengaluru, Karnataka, India
9 AYJNIHH, ERC, Department of Speech-Language Pathology, Noida, India
10 Nayak's Hearing Clinic, Bengaluru, Karnataka, India
11 Cavery Hearing Clinic, Madikeri, Karnataka, India
12 All India Institute of Speech and Hearing, Department of Speech-Language Sciences, Mysuru, Karnataka, India
13 Topiwala National Medical College and B. Y. L. Nair Charitable Hospital, Mumbai, Karnataka, India
14 School of Allied Health Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
15 All India Institute of Speech and Hearing, Department of Speech-Language Pathology, Mysuru, Karnataka, India
16 Insight Rehabilitation, Bengaluru, Karnataka, India

Date of Submission25-Nov-2021
Date of Decision11-Apr-2022
Date of Acceptance20-Apr-2022
Date of Web Publication27-Jun-2022

Correspondence Address:
Amulya P Rao
Isha Office, C/O All India Institute of Speech and Hearing, Manasagangothri, Mysuru - 570 006, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jisha.jisha_25_21

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  Abstract 


Introduction: India lacks workforce in the field of speech and hearing leading to the hire of speech and hearing technicians at many work setups. They are allowed to work independently which affects the efficacy of rehabilitation to a greater extent. This alarm necessitates the investigation of reasons for brain drain which will, in turn, help in improvising the speech and hearing services in India. Methods: An e-survey was conducted by circulating a questionnaire which included 10 questions seeking information on the type of job placement, number of shifts in job, the reasons for shifting jobs, satisfaction level at workplace, and percentage of professionals preferring India and/or abroad for job placement. The questionnaire was sent to 3700 professionals, out of whom 360 professionals responded. Results: Lower income, poor professional growth, and unsatisfied job profile were found to be the major reasons for brain drain in India. Conclusion: A regular detailed investigation of reasons for frequent brain drain is required by the concerned bodies in India. In addition, steps should also be taken to rectify the same. Such careful actions may increase the potential employment opportunities for efficient fully trained speech and hearing professionals in India. This will, in turn, raise good quality speech and hearing services in India.

Keywords: Brain drain, lower income, manpower, work satisfaction


How to cite this article:
Singh NK, Rao AP, Krishna Y, Arun B, Yathiraj A, Indranil C, Sunil K R, Pradeep, Kumar P, Suman K, Nayaka J, Achaiah, Reuben T V, Valame D, Bajaj G, Shetty HN, Priya M B, Krishnan G, Hegde P. Factors Leading to Brain Drain of Speech and Hearing Professionals in India. J Indian Speech Language Hearing Assoc 2022;36:25-30

How to cite this URL:
Singh NK, Rao AP, Krishna Y, Arun B, Yathiraj A, Indranil C, Sunil K R, Pradeep, Kumar P, Suman K, Nayaka J, Achaiah, Reuben T V, Valame D, Bajaj G, Shetty HN, Priya M B, Krishnan G, Hegde P. Factors Leading to Brain Drain of Speech and Hearing Professionals in India. J Indian Speech Language Hearing Assoc [serial online] 2022 [cited 2022 Aug 12];36:25-30. Available from: https://www.jisha.org/text.asp?2022/36/1/25/348427

FNx01Note - The article is edited by Dr. Hariprakash P, Associate Professor, Manipal University.





  Introduction Top


Speech-language-hearing professionals are integrated health-care professionals who identify, prevent, assess, and rehabilitate individuals with communication disorders. They work in varied setups such as hospitals, private clinics, schools, industries, speech and hearing/medical institutions, and private clinics in India.[1] A study by the United States Bureau of Labor Statistics projected an increasing demand for speech and hearing professionals with an increase in the incidence of individuals with communication disorders.[2] The same has been predicted worldwide. An earlier study reported insufficiency in the number of capable professionals providing speech and hearing services.[3] In addition, the Applied Manpower Research report indicates a lack of comprehension of the scope of practice by professionals leading to a failure in asserting the role of speech, language, and hearing professionals.[4]

India, a developing country, also lacks workforce in the field of speech and hearing. Brain drain has been found to be the major reason for the same. Nambiar and Shah reported brain drain among 48% of speech and hearing postgraduates with main cause being better income (62%), better career prospects (62%), and better academics.[5] They also reported that 50% of the professionals/students go abroad seeking employment, 30% for higher education, and 20% for personal reasons. Even after 14 years of this study, the condition remains the same. Many students and professionals in the field travel abroad to either pursue higher studies or jobs. It has been reported that to overcome the lack of workforce in India, many training programs were initiated, such as diploma programs by the Rehabilitation Council of India. The main aim of such programs was to generate speech and hearing technicians who would work under the guidance of a fully trained graduate or postgraduate speech and hearing professional. However, more than fully trained professionals, such diploma holders are being hired in many private and government sectors. This will, in turn, have an impact on the efficacy with which individuals with communication disorders would receive the rehabilitation.[6] This alarms a major concern to the field of speech and hearing in India. To avoid such brain drain, it is important to investigate the reasons for it as previous studies on this have used a small sample size indicating replication of such studies. Documenting the reasons for brain drain will help improvise speech and hearing services in India. Hence, the present study aimed to investigate the factors leading to brain drain of speech and hearing professionals in India.

Methods

An e-survey method was used to collect information on factors responsible for brain drain of speech and hearing professionals in India. An ethical clearance was taken before the study from the executive council committee of ISHA, which included the chairman of Educational Standards and Ethics Committee. The study comprised two stages, the first involving the development of a checklist and the second stage conducting an e-survey.

Participants

Speech and hearing professionals working in India and abroad served as participants. A total of 3700 professionals were approached through E-mail and WhatsApp messenger. Responses were received from a total of 360 professionals, out of which 64.72% were females and 35.27% were males. The majority of them belonged to the age group 21–30 years (41.94%), followed by 31–40 years (39.16%). More percentage of professionals (40.30%) had either M.Sc. in Speech and Hearing or M.ASLP as their educational qualification and 18.20% were qualified with a bachelor's degree. Following this, 15.50% of them had Master's degree in Audiology and 10.50% of them had Master's degree in SLP. The percentage of professionals having a Ph.D. degree was <10%.

Materials

A questionnaire was prepared after a few brainstorming sessions. The questionnaire was sent to 10 professionals working in different work setups to check its feasibility. Later, multiple-choice questions were incorporated as per the expert committee advice. Then, a pilot study was conducted with 29 professionals working in different setups. No changes were made in the questionnaire post the pilot study. The finalized questionnaire included 10 questions seeking information on the type of job placement, number of shifts in job, the reasons for shifting jobs, satisfaction level at workplace, and percentage of professionals preferring India and/or abroad for job placement. The final questionnaire [Appendix 1] was transformed into a Google Forms. The responses were obtained using multiple choice and long answers.

Procedure

The Google Forms link was emailed to 3700 speech and hearing professionals. Due to invalid email addresses, 14 emails reverted back. Hence, the reminder was sent to 3686 professionals and the responses were received from 360 professionals.

Data analysis

For each multiple-choice question, the percentage of speech and hearing professionals selecting a particular option was calculated. In addition, for questions with long answers, the answers were first grouped, and then, the percentage of professionals under each option was calculated.


  Results Top


The results are represented either in the form of pie charts or bar graphs. The results are described under the headings of Job Placement, Job Shift, Job Satisfaction, and Job in India or Abroad.

Job Placement

Under this section, the results are reported with respect to the state of India, in which they are working and the work setup. A comparison has also been made with respect to the percentage of speech and hearing professionals working in various setups at two different points of time.

State of employment

Professionals working in seven different states of India and from abroad have responded to the e-survey. The majority of the participants (26%) are reported to work in Karnataka, followed by 19.6% working in Maharashtra. Following this, 9.1% have reported to work in abroad, 8.6% in Delhi, 6.1% each in Kerala and Tamil Nadu, 4.1% in West Bengal, and 3.6% in Gujarat [Figure 1].
Figure 1: State of employment of the participants

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Work set-up

Professionals were asked to indicate their earlier work setup and the current work setup. A comparison was made with respect to the percentage of professionals working in different setups at these two points of time. It was found that earlier, more percentage of professionals (56.1%) were working in hospital setup, followed by 53.6% were working in clinical setup, 50.3% were working in teaching institutes, 25.4% were in private practice, 19.9% were in school setups, and 11.3% were in nongovernmental organizations (NGO). In contrast, the overall percentage of speech and hearing professionals working in all these setups has reduced drastically except private practice, which has increased to 34.7%. In the present scenario, the least percentage of professionals (4.7%) is working in school setups [Figure 2].
Figure 2: Percentage of participants working in various setups at two different timelines

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Job shift

More percentage of professionals (92.22%) reported to have shifted their job. Out of this 92.22%, 63.74% were females and 36.25% were males. Similar trend was observed even in the category of professionals who had not shifted their job, where 76% were females and 24% were males. Majority of those who did not shift the job reported to work in Out of these majority of the male and female professionals reported to work in an institutional set-up (71.42% males and 52.38% females) followed by 28.57% of females working in private practice [Figure 3].
Figure 3: Percentage of participants on job shifts

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Although the major percentage of female professionals shifted jobs compared to males, the frequency of job shifts was more by males than females. The majority of the females have either shifted jobs twice or thrice (28.43% and 27.83%, respectively). More percentage of males (32.83%) were found to shift their job thrice [Figure 4].
Figure 4: Frequency of job shifts

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The major reason for job shifts was reported to be personal reasons by 46.44% of the female professionals, whereas no scope for professional growth was found to be the major reason for job shift by 45% of males and 36.49% of females. These were followed by salary dissatisfaction (34.16% males and 30.33% females), management dissatisfaction (24.16% males and 22.27% females), work dissatisfaction (27.50% males and 12.32% females), and educational qualification not matching with the job profile (14.16% males and 7.58% females) [Figure 5].
Figure 5: Various reasons for job shifts

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Job satisfaction at current workplace

Professionals were asked to rate their job satisfaction on a five-point rating scale where 1 – “highly unsatisfied,” 2 – “unsatisfied,” 3 – “neutral,” 4 – “satisfied,” and 5 – “highly satisfied.” The majority of them (38.4%) reported to be satisfied with their job followed by 27.6% being neutral, 21% highly satisfied, 10.5% unsatisfied, and 2.5% highly unsatisfied [Figure 6].
Figure 6: Level of work satisfaction at current workplace

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Views of professionals working in India

The major percentage of professionals (58.61%) working in India have reported their liking toward continuing working in India. However, 29.44% have expressed their liking to work abroad and 10.83% to work both in India and abroad [Figure 7].
Figure 7: Views of participants working in India

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Family was reported to be the major reason to continue working in India by 39.33% of the professionals, followed by 36.49% to serve the country. Better salary was reported to be the main factor by 66.03% of the professionals out of 29.44% who chose to work abroad, followed by better respect (32.07%), better scope for professional growth (24.52%), and better quality of life (10.37%) [Figure 7].

Views of professionals working abroad

The majority of the professionals (69.69%) working abroad have expressed to continue there itself. Higher salary has been reported to be the major reason by 50% of them, followed by professional growth by 27.27%, good work culture by 18.18%, better quality of life by 13.63%, and better scope for research by 9.09% [Figure 8].
Figure 8: Views of participants working abroad

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On the other hand, 21.21% of those working in abroad have reported their liking to shift to India. Job satisfaction was viewed to be the major reason to return back to India by 57.14% of the professionals, followed by personal reasons (42.85%), better clinical exposure (28.57%), and the lack of workforce in India (14.28%). In addition, 9.09% of them want to work both in India and abroad [Figure 8].

Major factors for job selection

Scope for professional growth was reported to be the major factor in selecting the job by 24.72% of the speech and hearing professionals. Job profile was found to be the second major factor (17.50%), followed by salary (14.16%), work environment (13.16%), job satisfaction and work setup (11.11% each), workplace (4.16%), respect (1.38%), and job security (1.11%) [Figure 9].
Figure 9: Factors related to job selection in the field of speech and hearing in India

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  Discussion Top


The results of the present study are discussed under six headings as provided in the result section. The six headings are as follows: job placement, job shift, job satisfaction, views of professionals working in India, views of professionals working abroad, and major factors for job selection.

Job placement

The majority of the professionals who responded to the current survey were from Karnataka, followed by Maharashtra. This can be because of the fact that 18% of the professionals who received the survey e-mails were from Karnataka and 8% from Maharashtra. It was also observed that more participants from South India responded to the e-survey compared to North as 54% of the participants, who received the e-mails, represented South India.

The participants reported that earlier, the majority of them worked either in a hospital setup, clinical setup, or institutional setup compared to private practice, school setup, and NGOs. However, in the present scenario, an exponential decrease in the percentage of professionals working in these setups and a slight increase in the percentage of professionals working as private practitioners have been observed. The reason for decrease in the percentage of professionals can be less job opportunities in hospital, clinical, and institutional setups. Furthermore, less pay scale at these setups, especially in school set-up and NGOs, could have also contributed to this decrease. Meanwhile, private practice has started taking its own position in providing a good income to professionals.

Job shift

More percentage of professionals were found to have shifted their jobs for a minimum of two to three times during their professional tenure. Among them, the percentage of females was learned to be more compared to males. However, the frequency of shifts was more in males compared to females. This can be due to the fact that in India, females have their own limitations to shift their jobs as they are bounded by personal factors compared to males. On the other hand, males reported to shift their job frequently due to poor scope of professional growth at workplace.

Similar trend was observed in the group of professionals who had not shifted their job even once, where the percentage of females was more compared to males. However, the majority of male and female professionals who have reported no job shift were found to work in institutional setup. In addition, female professionals were found to be private practitioners and no male professionals were observed to be in private practice. This can be due to the fact that female professionals' personal reasons might have bound them to take up private practice.

Job satisfaction at the current workplace

The majority of the professionals reported the presence of job satisfaction. Almost the same percentage of professionals also expressed neutral view on job satisfaction. However, a few of them reported to be unsatisfied with their current job. This can be due to low salary, no scope of professional growth, and unsatisfied job profile as mentioned by the participants. Further, unsatisfied job profiles can be related to educational qualification of the professionals. Goswami et al. found out that income satisfaction is directly correlated with work satisfaction.[7]

Views of professionals working in India

More percentage of professionals working in India reported that they would want to continue to work in India. In the Indian scenario, females outnumber males in the field of speech and hearing, and females are bound to work in a place where the family is put up. They have also reasoned out that the main reason to stay back in India is family. A few express that better salary, respect, scope of professional growth, and quality of life are the major factors to work abroad. It has been reported that imbalance between income and workload was found to be a major reason for job dissatisfaction in India.[7]

Views of professionals working abroad

The majority of the professionals working abroad preferred working in abroad due to income satisfaction. As indicated earlier, income satisfaction has been found to be directly correlated to work satisfaction.[7] The current findings are also in consonance with the findings of Nambiar and Shah, who found that better financial gains were the main reason for brain drain among speech and hearing postgraduates.[5] Job satisfaction and personal reasons were found to be main reason for preferring to work or shift back to India. This is unlike what has been reported in the study by Goswami et al. as the salary provided here in India is relatively less compared to foreign countries.[7]

In sum, lower income, poor professional growth, and unsatisfied job profile are the major reasons for brain drain in India. Similar findings have been found in the previous studies as well.


  Conclusion Top


A regular close evaluation of reasons for frequent brain drain is required by the concerned bodies in India. After such evaluations, steps should be taken to rectify the same. Such careful actions can lead to increase in potential employment opportunities for efficient fully trained speech and hearing professionals in India. This will, in turn, escalate good quality speech and hearing services in India. It is suggested to conduct such studies in every region of India to know the requirements in each state and accordingly take actions to improvise the same. Furthermore, future follow-up studies should be taken up in terms of impact studies.

Acknowledgment

We would like to thank all the speech and hearing professionals participating in the e-survey.

Financial support and sponsorship

This study was supported by Indian Speech-Language and Hearing Association.

Conflicts of interest

There are no conflicts of interest.

Appendix

Questionnaire

Factors affecting job selection by speech and hearing professionals in India

Instructions: Answering all the questions is MANDATORY. We assure you that your name or your institution name will not be disclosed anywhere. Please fill in the following questionnaire based on your opinion and experience. In case any question is not applicable to you, please write the same. We assure you that your name will not be disclosed anywhere

DEMOGRAPHIC DETAILS

Name:

Age/Gender:

Your highest educational qualification in the field of speech and hearing (Multiple Choice):

  • B. Sc. in Speech and Hearing/B. ASLP
  • M. Sc. in Speech and Hearing/M. ASLP
  • M. Sc. in Audiology
  • M. Sc. in Speech-Language Pathology
  • Ph. D. in Speech and Hearing
  • Ph. D. in Speech-Language Pathology
  • Ph. D. in Audiology
  • Other


Currently working in (Dropdown – States Name plus abroad)

Present Designation (Checkboxes – where a person can choose more than one option):

  • Audiologist
  • Speech-Language Pathologist
  • Lecturer/Assistant Professor
  • Reader/Associate Professor
  • Professor
  • Research Officer
  • Director
  • Principal
  • Private Practitioner
  • Presently unemployed
  • Other


Setup in which you are currently working (Checkboxes – where a person can choose more than one option):

  • Central Government
  • State Government
  • Private
  • Nongovernmental Organization
  • Teaching Institute
  • Nonteaching Institute
  • Hospital Setup
  • Clinical Setup
  • School Setup
  • Industrial Setup
  • Others


Actual Salary (INR) per month:

If in government setup, then you come under which of the following pay commission?

  • 6th pay commission
  • 7th pay commission
  • Other


If 6th pay commission, then mention the grade pay in the space given below or if you come under 7th pay commission, then mention the pay band and the level in the given space

If working in a private sector, then mention the increment in salary given per year in the space provided below.

QUESTIONS

  1. How many places have you worked till date?
  2. What kind of setups were those?


    • Hospital
    • Institution
    • School
    • Industry
    • Private Clinic
    • Freelancer
    • Independent Practice
    • Central Government
    • State Government
    • NGO
    • Other


  3. Why did you choose to work there?


    • Interested in the job profile
    • Salary was good
    • Workplace is in my hometown
    • Had no other option
    • To explore various work setups
    • To gain experience
    • Other


  4. What made you change/shift workplace?


    • Unsatisfied with the salary
    • No scope for professional growth
    • My educational qualification did not match with the job profile
    • Unsatisfied with the management
    • No work satisfaction
    • Personal reasons
    • Other


  5. What factors do you basically look for while choosing a setup or job? (Please mention the factors in order of your preference separating them with semicolons)
  6. Rate your satisfaction level with your current work on the following scale


    • Completely unsatisfied
    • Unsatisfied
    • Neutral
    • Satisfied
    • Highly satisfied


  7. Cite the reasons for your satisfaction level at your current workplace
  8. Do you think that your job profile was worth your educational qualification in the places you have worked?


    • Yes
    • No
    • Maybe


  9. Would you like to work in India or abroad?
  10. Cite the reasons for working either in India or abroad
  11. Any other remarks




 
  References Top

1.
Indian Speech and Hearing Association. Scope of Practice in Audiology and Speech-Language Pathology 2011. Available from: https://www.ishaindia.org.in/pdf/Scope_of_Practice.pdf. [Last accessed on 25.05.2022].  Back to cited text no. 1
    
2.
United States Bureau of Labour Statistics. Occupation Outlook Handbook; 2019. Available from:https://www.bls.gov/ooh/healthcare/speech-language-pathologists.htm#tab-6. [Last accessed on 25.05.2022].  Back to cited text no. 2
    
3.
Windmill IM, Freeman BA. Demand for audiology services: 30-yr projections and impact on academic programs. J Am Acad Audiol 2013;24:407-16.  Back to cited text no. 3
    
4.
Sharma SK. Projection of Human Resource Requirement in the Field of Rehabilitation of Persons with Disabilities IAMR Report No. 1; 2009. Available from:http://www.rehabcouncil.nic.in/writereaddata/projhrdbook.pdf. [Last accessed on 25.05.2022].  Back to cited text no. 4
    
5.
Nambiar S, Shah U. Brain Drain – Is it Affecting the Speech and Hearing Services in India? Unpublished Project Report Mumbai: AYJNIHH; 2006.  Back to cited text no. 5
    
6.
Sanju HK, Choudhury M, Kumar A. The Status of Audiology in India-Research Gate. 2017. Available from: https://hearinghealthmatters.org/hearinginternational/2017/status-audiology-india/. [Last accessed on 25.05.2022].  Back to cited text no. 6
    
7.
Goswami SP, Ramkumar S, Mathews S. Income and work satisfaction among speech and hearing professionals in India: Two sides of the same coin. J Indian Speech Lang Hear Assoc 2018;32:16-22.  Back to cited text no. 7
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8], [Figure 9]



 

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