Emigration Of Health Professionals Research Articles

MOTIVATION OF CROATIAN HEALTH WORKERS TO GO ABROAD

Introduction: Prior to Croatia's accession to the European Union, nurses could be employed in Germany under an agreement between the German Federal Agency and the Croatian Employment Service. Following Croatia's accession to the European Union in 2015, thelabor market has become more accessible and open. Objective: Explore the motivation of Croatian health workers to go abroad.Subjects and methods: A cross-sectional study was conducted. The study was conducted using a survey consisting of 29 questions and involving a total of 102 respondents, and three interviews were conducted for research purposes. Results: The participants attend retraining to ensure a better future for their children abroad (38.1 %), to find a good, steady and better paid job (23.5 %) and to obtain a dignified pension (63.7 %). As the main reason for emigration, respondents cite corruption and injustice (65.7 %), non-arrangement of the state (59.8 %), while seeing the biggest problem in leaving the family (20.6 %). At the end of 2019 Croatia was abandoned by 1,438 nurses, mainly due to poor working conditions and dissatisfaction with the material conditions of work in Croatia. This trend included other health professionals. Conclusion: The main factor for the emigration of health professionals is the political organization of the state, which is manifested by corruption and injustice, clientelism, political affiliation, and replaces man's knowledge, ability, skill, value and dignity. Keywords: motivation, departure, health professionals, abroad

Exploration of Estimated Emigration Trends of Polish Health Professionals.

Background: Due to the significant staff shortages, emigration of health professionals is one of the key challenges for many healthcare systems. Objective: The aim of this article is to explore the estimated trends and directions of emigration among Polish health professionals. Methods: The emigration phenomenon of Polish health professionals is still under-researched and the number of studies in this field is limited. Thus, the authors have triangulated data using two methods: a data analysis of five national registers maintained by chambers of professionals (doctors, nurses, midwives, physiotherapists, pharmacists, and laboratory diagnosticians), and data analysis from the Regulated Profession Database in The EU Single Market. Results: According to the data from national registers, between 7–9% of practicing doctors and nurses have applied for certificates, which confirm their right to practice their profession in other European countries (most often the United Kingdom, Germany, Sweden, Spain, and Ireland). The relatively high number of such certificates applied for by physiotherapists is also worrying. Emigration among pharmacists and laboratory diagnosticians is rather marginal. Conclusions: Urgent implementation of an effective mechanism for monitoring emigration trends is necessary. Furthermore, it is not possible to retain qualified professionals without systemic improvement of working conditions within the Polish healthcare system.

Identifying the role of the sending state in the emigration of health professionals: a review of the empirical literature

There is a growing research interest in how sending states manage the emigration of health professionals. While the ‘push’ and ‘pull’ factors depict sending states as passive actors in this process, emergent studies are revealing them to be active actors with an articulated policy agenda. Using a variety of examples from the empirical literature, this paper identifies the multiple roles that sending states play in the emigration of doctors and nurses. The current findings contribute to the international migration literature in three ways. Firstly, this paper emphasizes that sending states are active actors in the health professional migration. Secondly, it shows that sending states adopt one of the three strategies: (1) introduce restrictive measures to delay the mobility of health professionals; (2) respond to market demands by producing and promoting emigration; and (3) implement a combination of these two strategies. Lastly, this paper highlights how sending states institutionalize gendered emigration through a bilateral cooperation in nurse migration. Missing from the extant literature are studies on competing beliefs, motivations, and technical information informing the strategies of sending states. This paper concludes by presenting a research agenda to further examine how and why sending states are active actors in the health professional migration.

English

Emigration and immigration/returning (simply put as migration) of highly-skilled professionals are of increasing concern in developing countries of the world. Emigration of core health professionals from Nigeria have been claimed to be increasing towards the developed North, while immigration/returning of health professionals into the country was believed to be increasing as well, over time. Ironically, virtually no empirical study has been carried out to prove these assertions. The study therefore examined the directions and destinations of health professionals from and into selected institutions in the southwestern Nigeria between 1986 and 2010. On this premise, two tertiary (UCH, Ibadan and OAUTHC, Ile-Ife) and one secondary (AMTH, Ibadan) health institutions were purposively selected, while a systematic random sampling was employed in selecting 348 respondents out of 3,089. The trajectories were mapped over space and time and other data analysed. The findings showed emigration was increasing while immigration/returning of health professionals declined over time. Also, the direction was majorly towards developed North and the destination being the United Kingdom (33.0%), followed by the United States of America (27.6%), Canada (12.0%). Immigrants were majorly from Europe (69.0%), while returnees were from the United Kingdom and United States (33.3% each). The study concludes that the rate of emigration of health professionals is alarming, particularly of the doctors, which if not checked, could affect the health system of the country.    Key words: Spatio-temporal, Emigration, Immigration/returning, Health Professionals, Health Institutions, Nigeria.  &nbsp

South Africa's protracted struggle for equal distribution and equitable access - still not there.

The purpose of this contribution is to analyse and explain the South African HRH case, its historical evolution, and post-apartheid reform initiatives aimed at addressing deficiencies and shortfalls. HRH in South Africa not only mirrors the nature and diversity of challenges globally, but also the strategies pursued by countries to address these challenges. Although South Africa has strongly developed health professions, large numbers of professional and mid-level workers, and also well-established training institutions, it is experiencing serious workforce shortages and access constraints. This results from the unequal distribution of health workers between the well-resourced private sector over the poorly-resourced public sector, as well as from distributional disparities between urban and rural areas. During colonial and apartheid times, disparities were aggravated by policies of racial segregation and exclusion, remnants of which are today still visible in health-professional backlogs, unequal provincial HRH distribution, and differential access to health services for specific race and class groups.Since 1994, South Africa’s transition to democracy deeply transformed the health system, health professions and HRH establishments. The introduction of free-health policies, the district health system and the prioritisation of PHC ensured more equal distribution of the workforce, as well as greater access to services for deprived groups. However, the HIV/AIDS epidemic brought about huge demands for care and massive patient loads in the public-sector. The emigration of health professionals to developed countries and to the private sector also undermines the strength and effectiveness of the public health sector. For the poor, access to care thus remains constrained and in perpetual shortfall.The post-1994 government has introduced several HRH-specific strategies to recruit, distribute, motivate and retain health professionals to strengthen the public sector and to expand access and coverage. Of great significance among these is the NHI Plan that aims to bridge the structural divide and to redistribute material and human resources more equally. Its success largely hinges on HRH and the balanced deployment of the national workforce.Low- and middle-income countries have much to learn from South African HRH experiences. In turn, South Africa has much to learn from other countries, as this case study shows.

Interventions to reduce emigration of health care professionals from low- and middle-income countries.

The emigration of skilled professionals from low- and middle-income countries (LMICs) to high-income countries (HICs) is a general phenomenon but poses particular challenges in health care, where it contributes to human resource shortages in the health systems of poorer countries. However, little is known about the effects of strategies to help regulate this movement. To assess the effects of policy interventions to regulate emigration of health professionals from LMICs. We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register (searched 15 March 2011), the Cochrane Register of Controlled Trials (CENTRAL) (searched 2 March 2011), MEDLINE (searched 5 March 2011), EMBASE (searched 2 March 2011), CINAHL (searched 5 March 2011), LILACS (searched 7 March 2011), WHOLIS (searched 20 March 2011), SocINDEX (searched 11 March 2011), EconLit (searched 8 March 2011), Science and Social Science Citation Index (searched 8 March 2011), NLM Gateway (searched 31 March 2011) and ERIC (searched March 3 2011). We reviewed reference lists of included studies and selected reviews on the topic, contacted authors of included studies and experts on the field, and reviewed relevant websites. Randomised controlled trials (RCT), non-randomised controlled trials (NRCT), controlled before-and-after studies (CBA) and interrupted time series (ITS) studies assessing any intervention inthe source, the recipient or both countries that could have an impact on the number of professionals that emigrate from a LMIC. Health professionals, such as physicians, dentists, nurses or midwives, should be nationals of a LMIC whose graduate training was in a LMIC. One review author extracted data onto a standard form and a second review author checked data. Two review authors assessed risk of bias. Only one study was included. This time series study assessed the migration of Philippine nurses to the United States of America (USA) from 1954 to 1990. We re-analysed it as an interrupted time series study. The intervention was a modification of migratory law in the US, called the 'Act of October 1965', which decreased the restrictions on Eastern hemisphere immigrants to the USA. The analysis showed a significant immediate increase of 807.6 (95% confidence interval (CI) 480.9 to 1134.3) in the number of nurses migrating to the USA annually after the intervention. This represents a relative increase of5000% over the underlying pre-intervention trend. There were no significant differences in the slopes of the underlying trends for the number of nurses migrating between the pre- and postintervention periods. There is an important gap in knowledge about the effectiveness of policy interventions in either HICs or LMICs that could regulate positively the movement of health professionals from LMICs. The only evidence found was from an intervention in a HIC that increased the movement of health professionals from a LMIC.New initiatives to improve records on the migration of health professionals from LMICs should be implemented, as a prerequisite to conducting more rigorous research in the field. This research should focus on whether the range of interventions outlined in the literature could be effective in retaining health professionals in LMICs. Such interventions include financial rewards, career development and continuing education, improving hospital infrastructure, resource availability, better hospital management and improved recognition of health professionals.

Cambio y Revolución: el surgimiento del Sistema Nacional Único de Salud en Cuba, 1959-1970

This article studies the impact on the Cuban public health system of the political, economical and social changes that occurred after the 1959 Revolution, and the main transformations that occurred in the Cuban public health system during the 1960s, such as the creation of a new public health ministry, the nationalization of the pharmaceutical industry, the massive emigration of health professionals, a reform of medical studies, the creation of a Medical Rural Service, the incorporation of socialist principles in public health and the development of primary health care. As this article intends to demonstrate, these measures guided Cuban public health reform towards the construction of a state monopolized National Health System in 1970.