Abstract
BackgroundThis study sought to better understand the drivers of skilled health professional migration, its consequences, and the various strategies countries have employed to mitigate its negative impacts. The study was conducted in four countries—Jamaica, India, the Philippines, and South Africa—that have historically been “sources” of health workers migrating to other countries. The aim of this paper is to present the findings from the Indian portion of the study.MethodsData were collected using surveys of Indian generalist and specialist physicians, nurses, midwives, dentists, pharmacists, dieticians, and other allied health therapists. We also conducted structured interviews with key stakeholders representing government ministries, professional associations, regional health authorities, health care facilities, and educational institutions. Quantitative data were analyzed using descriptive statistics and regression models. Qualitative data were analyzed thematically.ResultsShortages of health workers are evident in certain parts of India and in certain specialty areas, but the degree and nature of such shortages are difficult to determine due to the lack of evidence and health information. The relationship of such shortages to international migration is not clear. Policy responses to health worker migration are also similarly embedded in wider processes aimed at health workforce management, but overall, there is no clear policy agenda to manage health worker migration. Decision-makers in India present conflicting options about the need or desirability of curtailing migration.ConclusionsConsequences of health work migration on the Indian health care system are not easily discernable from other compounding factors. Research suggests that shortages of skilled health workers in India must be examined in relation to domestic policies on training, recruitment, and retention rather than viewed as a direct consequence of the international migration of health workers.
Highlights
This study sought to better understand the drivers of skilled health professional migration, its consequences, and the various strategies countries have employed to mitigate its negative impacts
Causes of migration Migration intention: who is most likely to migrate? Evidence from the health worker survey indicates that the majority of health professionals surveyed were not intending to migrate in the 2 years
This paper offers an analysis of health care worker migration in terms of perceived causes and demographic factors associated with migration, an array of perceived consequences and appropriate policy responses in the case of India
Summary
This study sought to better understand the drivers of skilled health professional migration, its consequences, and the various strategies countries have employed to mitigate its negative impacts. The study was conducted in four countries—Jamaica, India, the Philippines, and South Africa—that have historically been “sources” of health workers migrating to other countries. India is a major source country (exporter) of health workers, but determining how skilled health worker migration interacts with the Indian health care system is challenging to measure, especially in terms of relationships. The costs and human capital losses associated with health worker migration are presumed to be significant for India, but, as we outline below, they have not been fully assessed in terms of overall numerical or policy significance. Our four-country study of “source” country for health professional migration included South Africa [8], Jamaica [9], India, and the Philippines, countries that have historically supplied trained health workers for other countries. We investigate these issues in the Indian context, with specific reference to the states of Kerala and Punjab
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