Out-Migration/Brain Drain

This presentation was part of the University of New South Wales’ short course on managing human resources for health. It discusses health worker shortages, maldistribution, international health care labor markets, policy mix, factors contributing to migration, international recruitment and its ethical context. [adapted from author]

This volume presents an analysis of health professional mobility in Europe from a health system perspective. The central policy issue of this analysis is that health professional mobility impacts on the performance of health systems and that these impacts are increasing in line with increasing mobility in Europe. [from introduction]

This paper attempts to explore the migration of nurses from India in the context of nursing shortages in the country. It looks at the relationship between the development of the nursing profession in India, shortage of nurses in the country and international migration of Indian nurses. [from introduction]

The objectives of this code are to: establish and promote voluntary principles and practices for the ethical international recruitment of health personnel; serve as a reference in establishing or improving the legal and institutional framework; provide guidance in the formulation and implementation international legal instruments; and facilitate and promote international discussion and advance cooperation on matters related to the ethical international recruitment of health personnel. [adapted from author]

This report examines the growing phenomenon of the international migration of skilled health workers (nurses, doctors and more specialised workers, such as pharmacists, radiologists and lab technicians) in the Asia-Pacific region. [from summary]

This paper presents an analysis of the underlying mechanisms of health professional migration and possible strategies to reduce its negative impact on health services. [from summary]

This article considers the shortage and maldistribution of health personnel in countries in southeast Asia in the context of international trade in health services. It analyzes the situation and identifies factors contributing to shortages and maldistribution in many countries in the region. The effect of trade in health services on the health workforce is discussed. [from introduction]

This report compares the foreign and domestic policies regarding health workers in five European Union countries, which have some of the highest densities of doctors and nurses in the world. It looks at the reasons for health shortages in both source and destination countries, exploring what needs to change or to be put into practice in order to fulfil the requirements of the WHO Code of Practice on the International Recruitment of Health Personnel and to strengthen health systems in the developing world. [from summary]

This study focuses on the recruitment practices of Canada (a country with a long reliance on internationally trained HHR) and recruiters working for Canadian health authorities. [adapted from abstract]

The aim of this policy is to promote high standards of practice in the recruitment and employment of health professionals who are not South African Citizens or permanent residents in the health sector in South Africa. It attempts to preclude the active recruitment of health professionals from developing countries without specific government agreements. [adapted from author]

Regardless of the push and pull factors, migration of health care workers from developing countries to developed ones, have done more harm than good on the health care deliveries in the developing countries. This article reviews the literature on the effects of cross-border migration of health care professionals. [from abstract]

This review explored the contemporary understandings of the employment of overseas trained nurses in Australian regional and rural practice settings. [from abstract]

This short documentary film features struggles of health workers in both developed and developing countries. The film portrays a real-life journey of Dr Brian Kubwalo, a Malawian doctor working in Manchester, UK, who embarks on a personal quest to find out whether he should go back to his native Malawi, where his skills are sorely missed, or stay in Manchester, where he can provide better future for his children. [from publisher]

This policy brief provides new insights on recent migration trends for doctors and nurses up to 2008, and discusses the main causes and consequences for destination and origin countries. It presents possible policy responses stressing the importance of international co-operation to address the worldwide scarcity of health workers. [from author]

The migration of health workers and pharmacists in particular is seen as a problem with no easy solution. It is not simply a matter of difference in salary, but also in training and career progression opportunities and a conducive practice environment. A comprehensive package which offers a range of incentives is the best way forward. [from author]

Africa is in the grip of a medical crisis because its doctors are being lured away by lucrative jobs in Europe. This video reviews the situation in Malawi, which now only has one doctor for every 50,000 people. [from author]

Created by the Commonwealth Secretariat, this short film intertwines footage of health workers around the world and interviews taken from the September 2008 Council meeting in London, which was co-hosted by the Commonwealth Secretariat, to illustrate the work of the Council and others to manage the migration of health workers. [from author]

The focus of this study is to assess the level of migration expectation among health care professionals and to determine some of the factors which have pushed - and are likely to continue to push - them to seek employment outside Ghana. [from introduction]

This article discusses the evidence for claiming out-migration of health workers impacts health and how to address the issue ethically.

The purpose of this report is to provide background information to support the development of guidelines for the integration of internationally educated health professionals into the Ontario workplace. [from summary]

This paper presents the findings of qualitative research documenting the participant experiences in the Observer Program, a hospital-based pre-employment program for international medical graduates entering the Australian healthcare system. [adapted from author]

This report examines demographic, social, and political factors driving the increased international migration of workers to provide long-term care services in developed countries. [from introduction]

This background study to the World Health Report 2006 is an attempt to provide a preliminary analysis of inflow and outflow patterns of health service providers in sub-Saharan Africa. The analysis is limited only to three types of health workers—doctors, nurses and midwives—and to countries in the region with critical shortages of health workers. [from publisher]

This commentary paper highlights changing patterns of outward migration of Zambian nurses. The aim is to discuss these pattern changes in the light of policy developments in Zambia and in receiving countries. [from abstract]

This paper focuses on some of the challenges and the opportunities created by migration of nurses, specifically focusing on the issue of return. Divided into five main sections, the paper looks at migration and population mobility in general to set the context, then focuses on the migration of health professionals. [from summary]

Brain drain impedes maternal, neonatal, and child health and the fight against HIV/AIDS, and translates into loss of potential employers, teachers, and role models. Improving the health workforce database, wages, health resources and working conditions, task shifting, pay-back from recipient countries and migrant health professionals, securing additional investment in the health workforce, and the development of locally relevant medical training and research are useful measures to combat this problem. [from abstract]

The aim of the study was to investigate the profile of South African qualified physicians who had emigrated from South Africa. [from abstract]

This paper brings into focus the magnitude of the problem in terms of the number of nurses migrating to and from various countries and its impact on developing countries. The paper also examines some of the ongoing efforts in developing countries to mitigate the problem and sheds light on the prospects for improvement in the foreseeable future. [from abstract]

The proportion of international medical graduates (IMGs) serving as primary care physicians in rural underserved areas (RUAs) has important policy implications. We analyzed the 2000 American Medical Association Masterfile and Area Resource File to calculate the percentage of primary care IMGs, relative to U.S. medical graduates, working in RUAs. [from abstract]

Foreign nurses are increasingly being sought, creating a lucrative business for new recruiting agencies both at home and abroad. This paper examines past and current foreign nurse use as a response to nurse shortages and its implications for domestic and global nurse workforce policies. [from abstract]