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Action programme on the international migration
of health service workers: The supply side
At its 292nd (March 2005) Session, the Governing Body of the International Labour Office approved the launching of an Action Programme on "The International Migration of Health Service Workers: The Supply Side" for the 2006-07 biennium. The overall aim of the Action Programme is to develop and disseminate strategies and good practices for the management of health services migration from the supplying nations' perspective. Collaboration with the World Health Organization (WHO) and the International Organization for Migration (IOM) has been secured so as to join inter-agency forces in implementing this Action Programme.
International migration has become an accepted feature of globalized labour markets in health care, yet the effects of international migration of health-service workers on the nations supplying the workers are cause for concern. There is a growing shortage of health-care workers in developed countries. The reasons for this shortage include: increasing demand from ageing populations, chronic cases requiring longer treatment and care, unattractive working conditions in the sector (long working hours, shift work, workplace violence), and low wages. Women, who comprise 80 per cent of the health workforce, have been less attracted to health services as inroads have been made into other education and employment opportunities.
This shortage is being increasingly filled with migrant nurses and other health-care workers
from developing countries. Reasons and motivations for health-care workers to migrate
abound. While migrant health workers are a source of remittances for their families and
countries, migration creates its own subset of issues in the supplying nations. National systems that have invested a great deal in educating and training their health-service staff
see the dwindling of their qualified and experienced performers. In sub-Saharan Africa, health systems already weakened by deaths and disability caused by HIV/AIDS are further
depleted by the migration of health workers. The impact of migration on the individuals and their families can be acute. An ever-increasing number of women health-care professionals
are migrating, with family and social consequences that are not yet fully understood.
Six health-care worker supplying countries have been identified with a view to exploring the effects of health-worker migration on these countries, analysing their existing migration policies and practices, and identifying the lessons learned and best practices from each, such as ethical recruitment guidelines, pre-departure briefings, monitoring of employment placement, and mutual recognition agreements. The countries are Costa Rica, Kenya, Romania, Senegal, Sri Lanka and Trinidad and Tobago.
An orientation meeting for the six countries participating in the Action Programme was held in Geneva on 22 March (please see the report).
In a second phase at the end of the biennium, it is proposed that the findings from the selected countries would be compared, contrasted and analysed so as to develop strategies and good practices that could be shared with other supplying countries.
Links to other websites dealing with migration of health service workers
BMJ Journals (British Medical Journals)
- Buchan, James (2004). What difference does ("good") HRM make?
- Dovlo, Delanyo (2004). Using mid-level cadres as substitutes for internationally mobile health professionals in Africa: a desk review.
- Forcier, Mélanie Bourassa, Simoens, Steven, and Antonio Giuffrida (2004). Impact, regulation and health policy implications of physician migration in OECD countries.
- Rigoli, Felix and Gilles Dussault (2003). The interface between health sector reform and human resources in health.
- Stilwell, Barbara, Diallo, Khassoum, Zurn, Pascal, Dal Paz, Mario R., Adams, Orvill, and James Buchan (2003). Developing evidence-based ethical policies on the migration of health workers: conceptual and practical challenges.
- Vujicic, Marko, Zurn, Pascal, Diallo, Khassoum, Adams, Orvill, and Mario R. Dal Poz (2004). The role of wages in the migration of health care professionals from developing countries.
Other links
- 57th World Health Assembly (2004). International migration of health personnel: a challenge for health systems in developing countries, Agenda Item 12.11, 22 May.
- An Action Plan to Prevent Brain Drain: Building Equitable Health Systems in Africa. A Report by Physicians for Human Rights.
- Buchan, J., & Calman, L. The Global Shortage of Registered Nurses: An Overview
of Issues and Actions. The Global Nursing Review Initiative. (2004)
- Bureau of Health Professions
- Carrington, William, & Detragiache, Enrica. How extensive is the brain drain? Finance & Development, 36.2. (1999)
- Center for Policy Analysis on Trade and Health. International trade agreements: priorities for health in the US and abroad.
- Chikanda, Abel. Skilled health professionals' migration and its impact on health delivery in Zimbabwe. Centre on Migration, Policy and Society Working Paper No. 4. University of Oxford. (2004)
- Commonwealth Secretariat
- Davis, Catherine. Crossing Borders. International Nurses in the U.S. Workforce. Imprint Magazine. (2005)
- Davis, Catherine and Nichols, Barbara. Foreign-Educated Nurses and the Changing U.S. Nursing Workforce. Nursing Administration Quarterly. 26.2. (2001)
- Department for International Development UK. Buchan, James, Dovlo, Delanyo. International Recruitment of health workers to the UK: A report for DFID.
- de Veer, Anke et al. Experiences of foreign European nurses in The Netherlands. Health Policy 68.1. (2004)
- Diallo, Khassoum (2004). Data on the migration of healthcare workers: sources, uses, and challenges. Bulletin of the World Health Organization, 82.
- Dovlo, Dela & Martineau, Tim. A Review of the Migration of Africa’s Health Professionals. JLI Working Paper. (2004)
- Hagopian, Amy et al. The migration of physicians from sub-Saharan Africa to the United States of America: measures of the African brain drain. Human Resources for Health. 2.17.
- Health Affairs. Trends in international nurse migration
- Institute for Public Policy Research. Lowell, B. Lindsay, Findlay, Allan, and Emma Stewart (2004). Brain strain: optimising highly skilled emigration from developing countries. Asylum and Migration Working Paper 3.
- International Centre on Nurse Migration
- International Organization for Migration
- Jeans, Mary Ellen et al. Navigating to Become a Nurse in Canada: Assessment of International Nurse Applicants. Canadian Nurses Association. (2005)
- Joint Learning Initiative. Human resources for health: overcoming the crisis.
- King's Fund. Buchan, James, et al. London calling?: the international recruitment of health workers to the capital.
- Luxembourg Income Study Gupta, Neeru, Diallo, Khassoum, Zurn, Pascal, and Mario R. Dal Poz (2002). Human resources for health: an international comparison of health occupations from labour force survey data. Luxembourg Income Study Working Paper Series, 331.
- Migration Policy Institute. Hamilton, Kimberly and Jennifer Yau (2004). The global tug-of-war for health care workers. Feature Story, 1 December.
- Medact
- Mullan, Fitzhugh. The Metrics of the Physician Brain Drain. The New England Journal of Medicine. 353.17. (2005)
- NHS Magazine Carlisle, Daloni. Global workforce.
- Organisation for Economic Co-operation and Development (OECD).
The international mobility of health professionals: an evaluation and analysis based on the case of South Africa. Trends in international migration.
- Public Services International
- Scott, Mark et al. Brain drain or ethical recruitment?: Solving health workforce shortages with professionals from developing countries. Medical Journal of Australia. 180.4. (2004)
- Stilwell, Barbara et al. Migration of health-care workers from developing countries: strategic approaches to its management. Bulletin of the World Health Organization, 82. (2004)
- The healthcare skills drain - a call to action. British Medical Association. (2005)
- The Nursing Health Services Research Unit
- The Regulation and Supply of Nurse Practitioners in Canada. Canadian Institute for Health Information & Canadian Nurses Association (2005)
- US Congress. The Nurse Reinvestment Act of 2002.
How the Nurse Reinvestment Act amends Health Professions Education Partnerships Act
- Van Eyck, Kim. Women and International Migration in the Health Sector. Final Report of Public Services International’s Participatory Action Research 2003
- Vork, Andres et al. Migration of Healthcare Workers From Estonia : the potential extent of migration, its influence on the needs of healthcare workers and political choices. PRAXIS Centre for Policy Studies (2004).
- Zurn, Pascal et al. Nurse Retention and Recruitment: Developing a Motivated Workforce. International Council of Nurses.
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