Out-Migration/Brain Drain

The migration of medical professionals as a result of the expansion of the European Union is cause for concern. But there is a significant lack of information available about this phenomenon. This study did a search of secondary databases about the presence of european doctors working abroad and a survey of professional organisations and regulators in countries of the European Union. [from abstract]

One major challenge for all countries is to establish workforce planning mechanisms that effectively meet the demands for health care and provide workforce stability. However, few nations have developed strategic plans for meeting nursing resource requirements that effectively address supply and demand. Instead, many developed countries choose to implement short term policy levers such as increased reliance on immigration, sometimes to the detriment of developing countries.

This is an exploratory descriptive study that examined migration of locally trained doctors from Ghana using graduates of the country’s first medical school as a proxy. The objectives of the study were to describe trends in the loss of medical personnel to emigration and the influence this has on human resources planning, including forecasting of staff supply and requirements. It was also to provide some information towards the development of strategies to counteract such losses. [from abstract]

The migration of health professionals from developing countries in general, and sub-Saharan African countries in particular, has become the subject of considerable theoretical and case study research attention in international migration and human resources for health (HRH) literature. This report is a review of all available literature on the costs and benefits of the migration of health workers from East and Southern African (ESA) countries to developed nations. [from executive summary]

In this paper we present a comprehensive analysis of the literature and argue that, from a human rights perspective, there are competing rights in the international migration of health professionals: the right to leave one’s country to seek a better life; the right to health of populations in the source and destination countries; labour rights; the right to education; and the right to nondiscrimination and equality. Creative policy approaches are required to balance these rights and to ensure that the individual rights of health professionals do not compromise the societal right to health.

The ILO Sectoral Activities Department initiated an explorative research project on health worker mobility in Europe with focus on CEE countries. The purpose of the project was to explore and document current knowledge and information available in order to establish the current status, and identify both preliminary trends as well as information gaps and the need for further action.

This study aims to provide in-depth information on the migration of Filipino health workers and the repercussions this has on individual migrants, their families, their professions and the nation as a whole.

Because of its inherent complexities, the migration of health workers benefits from multidisciplinary research: solutions must be informed by a better understanding of the perspectives and underlying motivations of the many stakeholders. [author’s description]

The paper reports on a survey of recently arrived international nurses working in London, to assess their demographic profile, motivations, experiences and career plans. [from abstract]

This report presents an overview of the policy implications of the international migration of health workers in Europe, based on case studies conducted in five countries – Estonia, Germany, Lithuania, Poland and the United Kingdom – and draws on information from other WHO European Region countries, such as Israel and Latvia. [from introduction]

The paper investigates the magnitude of migration of health professionals from Zimbabwe, the causes of such movements and the associated impacts on health care delivery. International migration of health professionals has led to staff shortages and the situation is worse in public compared to private health institutions. The quality of care given to patients has also declined. The research calls for the adoption of an integrated approach in solving the concerns of health professions. [abstract]

This paper describes the practice of international recruitment of Indian nurses in the model of a business process outsourcing of comprehensive training-cum-recruitment-cum-placement for popular destinations like the United Kingdom and United States through an agency system that has acquired growing intensity in India. [from abstract]

The purpose of this paper is to examine what is known about the nurse workforce and nursing education in China in order to assess the likely potential for nurse migration from China in the future. [from abstract]

This case study provides information on Philippine nurse migration patterns and presents a sending-country perspective on the benefits and costs of this phenomenon. Our aim is to identify strategies that will ensure that international nurse migration is beneficial for both sending and receiving countries. [from abstract]

This paper was commissioned to identify and review reports, documents and data relating to nursing workforce dynamics in sub-Saharan Africa with the objective of analyzing, synthesizing, and presenting key information on nurse migration in the region. It reviews trends and impact of nurse migration derived from previously published work by various groups and reports to the High Level Forum on the millennium development goals on the human resources crisis. [from abstract]

This article intends to provide a contextual analysis of the Caribbean region with respect to forces shaping the current and emerging nursing workforce picture in the region; discuss country-specific case(s) within the Caribbean; and describe the Managed Migration Program as a potential framework for addressing regional and global nurse migration issues. [from abstract]

The objective of this article is to synthesize information about nurse migration in and out of Canada and analyze its role as a policy lever to address the Canadian nursing shortage. [from abstract]

This article synthesizes information about nurse migration into and out of the United Kingdom in the period to 2005, and assesses policy implications. [from abstract]

This article reviews estimates of U.S. nurse supply and demand, documents trends in nurse immigration to the United States and their impact on nursing shortage, and considers strategies for resolving the shortage of nurses in the United States without adversely affecting health care in lower-income countries. [from abstract]

The objective of this article is to look at nurse migration flows in the light of national nursing workforce imbalances, examine factors that encourage or inhibit nurse mobility, and explore the potential benefits of circular migration. [from abstract]

The issues surrounding nursing shortages and global nurse migration are inextricably linked. The shortage of practicing nurses worldwide has led to aggressive recruiting by healthcare employers in the United States, the United Kingdom, and other countries. Foreign-educated healthcare professionals represent more than a quarter of the medical and nursing workforces of Australia, Canada, the United Kingdom, and the United States. [author’s description]

The story of the international nurse in the U.S. workforce is generally one of perserverance - not only in obtaining a visa and a state license, but in adjusting to living and working in the United States. [author’s description]

The African Region continues to experience loss of a sizeable number of highly skilled health professionals (physicians, nurses, dentists and pharmacists) to Australia, North America and European Union. Past attempts to estimate cost of migration were limited to education cost only and did not include the lost returns from investment. The objective of this study was to estimate the social cost of emigration of doctors and nurses from the African Region to the developed countries. [from abstract]

Significant numbers of African-trained health workers migrate every year to developed countries including Canada. They leave severely crippled health systems in a region where life expectancy is only 50 years of age, 16 per cent of children die before their fifth birthday and the HIV/AIDS crisis continues to burgeon. The population of Sub-Saharan Africa totals over 660 million, with a ratio of fewer than 13 physicians per 100,000. [from introduction]

The migration of doctors and nurses from Africa to developed countries has raised fears of an African medical brain drain. But empirical research on the causes and effects of the phenomenon has been hampered by a lack of systematic data on the extent of African health workers’ international movements. We use destination-country census data to estimate the number of African-born doctors and professional nurses working abroad in a developed country circa 2000, and compare this to the stocks of these workers in each country of origin. [from abstract]

The three sources of nursing supply in Canada are new graduates, internationally educated nurses (IENs) and nurses returning to the workforce. This report focuses on IENs. Globalization has led to high rates of migration of professionals to economically vibrant countries such as Canada. Because many skilled and educated migrants do not always realize their full potential in their new country, policies to maximize brain gain are imperative. [from executive summary]

In southern Africa, rapid out-migration of health professionals is compounding the problems of health systems already faced with budget constraints and the impacts of HIV/AIDS. The authors outline a program of research on how Canada and the international community might address the negative impacts of the brain drain. [abstract]

This report is the result of a regional meeting held March 17-19 in Arusha, Tanzania and presents the regional context for work on migration and retention; an overview of the current situation, integrating evidence from background papers and country experiences; and summarizes the discussions held on follow-up work on migration and retention. [adapted from introduction]

International medical graduates (IMGs) have been a valuable resource for the United States physician workforce, and their contribution to the United States workforce is likely to increase. This article describes the historical trends and compare the characteristics of IMGs to United States medical graduates in the United States. It also recommends that policymakers consider the consequences for both the United States and source countries. [adapted from abstract]

Malawi has a critical human resources problem particularly in the health sector. The College of Medicine (COM)is the only medical school. For senior staff it heavily depends on expatriates. We explore to what extent a brain drain took place among the COM graduates by investigating their professional development and geographical distribution.