Abstract
It is estimated that in 2000 almost 175 million people, or 2.9% of the world's population, were living outside their country of birth, compared to 100 million, or 1.8% of the total population, in 1995. As the global labour market strengthens, it is increasingly highly skilled professionals who are migrating. Medical practitioners and nurses represent a small proportion of highly skilled workers who migrate, but the loss of health human resources for developing countries can mean that the capacity of the health system to deliver health care equitably is compromised. However, data to support claims on both the extent and the impact of migration in developing countries is patchy and often anecdotal, based on limited databases with highly inconsistent categories of education and skills.The aim of this paper is to examine some key issues related to the international migration of health workers in order to better understand its impact and to find entry points to developing policy options with which migration can be managed.The paper is divided into six sections. In the first, the different types of migration are reviewed. Some global trends are depicted in the second section. Scarcity of data on health worker migration is one major challenge and this is addressed in section three, which reviews and discusses different data sources. The consequences of health worker migration and the financial flows associated with it are presented in section four and five, respectively. To illustrate the main issues addressed in the previous sections, a case study based mainly on the United Kingdom is presented in section six. This section includes a discussion on policies and ends by addressing the policy options from a broader perspective.
Highlights
Introduction perspectivesIt has been interpreted by sociologists, econ-Migration can be analysed and understood from many omists, demographers and particular professional groupsHuman Resources for Health 2003, 1 http://www.human-resources-health.com/content/1/1/8 within labour markets
The aim of this paper is to examine some key issues related to the international migration of health workers in order to better understand its impact and to find entry points to developing policy options with which migration can be managed
The migration of highly skilled workers represents a large component of total migration [1,2] and medical practitioners and nurses make up only a small proportion of professional migrants, the loss of health human resources for developing countries usually results in a loss of capacity of the health system to deliver health care equitably
Summary
Medical practitioners and nurses make up a small proportion of all migrating professionals, but the loss of health human resources for developing countries represents a loss of capacity of the health system to deliver health care equitably. While there is international concern at the increasing outflow of health professionals from developing countries, for individuals and families an improved standard of living through the receipt of remittances is likely to be of more direct importance [28]. Child care, educational opportunities and recognition are known to be important [31,32,18] In this sense migration is a symptom of the deteriorating health systems in many poor countries. Compensating the donor country for the cost of educating the migrating health professional may be more likely to preserve individual freedom than policies to restrict exit or entrance of individuals [33], though evidence and further analysis are needed to support such a policy recommendation. All authors participated in interpreting the results, and read and approved the final manuscript
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