Migration Of Healthcare Professionals Research Articles

Exploring the factors affecting undergraduate nursing students' migration intention: A qualitative study

BackgroundThe escalating global nursing shortage, fueled by the migration of healthcare professionals from resource-constrained nations to those with greater economic prosperity, presents a formidable challenge to healthcare systems worldwide. Nepal, grappling with a significant brain drain of its nursing workforce, serves as a poignant illustration of this phenomenon. The departure of skilled nurses not only jeopardizes the country's healthcare quality but also underscores the urgent need to address the underlying educational and systemic deficiencies contributing to this trend. AimThe study aims to explore the early formation of migration intentions among undergraduate nursing students in Nepal and identify key factors influencing their decision to pursue opportunities abroad. DesignA descriptive qualitative research design. SettingsThe study was conducted at two urban nursing colleges in Nepal. ParticipantsSeventeen nursing students in their final year of undergraduate studies. MethodsData were collected via semi-structured interviews and analyzed using thematic analysis. ResultsThe thematic analysis unearthed four principal themes: (1) Aspirations Beyond Borders: Structural and Systemic Catalysts; (2) Navigating Personal Ambitions; (3) Socio-Political Currents Influencing Career Pathways; (4) Economic Incentives and Realities: Weighing the Prospects. ConclusionThe study's findings highlight the need for systemic changes to retain nursing professionals in Nepal. There is a significant gap between policy initiatives aimed at improving the status of nursing and the persistent challenges nursing students face. This gap fosters disillusionment and drives migration intentions. The research underscores the urgent need to address systemic deficiencies, empower nurses, and ensure equitable recognition. These actions are crucial to cultivating a sustainable nursing workforce dedicated to advancing health equity.

Migration of Medical Doctors from Nepal: Analyzing Trends and Policy Implications

One way migration of health care professionals especially from low-income countries like Nepal has become a concerning issue where the already fragile health system of the country faces challenges of losing skilled health care professionals to high-income countries. This trend analysis provides insights into the dynamics of Nepal's healthcare workforce migration, it offers a tailored understanding of factors influencing migration patterns, and its impact on the general population of the country and globally. It helps formulate targeted policies for workforce retention, resource planning, and addressing the country's healthcare needs and comparison with the global context. Analyzing the migration trends of medical professionals enhances medical literature by offering a comprehensive understanding of the factors affecting healthcare systems, public health, economics, education, and policy development. This knowledge plays a vital role in shaping future policies in the field of medicine in Nepal.

ELMÉLETEK ÉS MEGKÖZELÍTÉSEK AZ EGÉSZSÉGÜGYI SZAKEMBEREK MIGRÁCIÓJÁNAK FÖLDRAJZI VIZSGÁLATÁBAN

The migration of health care professionals is a global phenomenon and is discussed exten­ sively in the scientific literature. However, the approaches and theoretical backgrounds of the analyses are extremely diverse. The starting points and points of view of the research affect the results, thus analysing them can provide valuable insights regarding research gaps, future research directions and the limitations of the published studies. In this paper, the approaches and theoretical underpinnings of the international literature on the migration of health profes­ sionals are examined. For data collection, a systematic literature review has been conducted, using the Scopus bibliographic database. The analysis focused on what kind of theories appear in the records of the sample, particularly migration theories, and how these theories are applied. In addition, the publication dynamics of the records in the sample, the geographical scales and places highlighted in these articles, and the data sources and methods used in them have also been investigated.

Return Migration of Health Care Professionals and the Transformation of Medical Practices: Bulgaria and Romania in Focus

This paper analyses the category of returning health professionals in the field of maternal and child health in Bulgaria and Romania. It looks at the motivations, trajectories and experiences of return migrants on one hand, and on the effects their return migration has on the ways they themselves practice medicine at an individual level and the efforts and steps they take for bringing in transformations at a systemic level. The concept of “medical habitus” is used to grasp the reflexive move that medical professionals are compelled to make when shifting between different medical systems. The result of this shift is transfer of knowledge and transformative effects on the medical system that is framed as “professional remittances”.

Factors Influencing Brain Drain Among Health Workers in Ghana

Purpose: The advent of the covid-19 pandemic exacerbated the need for more professional health workers to serve as front-line workers in hospitals in Ghana and other developing countries. This study aimed to ascertain the factors influencing health workers' brain drain in Ghana.
 Methodology: The study was a survey with an accessible population of 15510 people in different categories of health workers. Sampling was through stratification for a sample size of 400 respondents across the Greater Accra Region of Ghana. Structured questionnaires were used for the data collection and analyzed using the Statistical Package for Social Sciences (SPSS) as a statistical tool to generate descriptive statistics that included the mean, standard deviation and ranks based on which inferences were drawn.
 Findings: The study found that government inaction on the conditions of service of health workers such as low remuneration, inadequate opportunities for staff development, poor equipment replacement policies, political interferences in their workplaces, high standards of living and inadequate housing and personal reasons amount to the reasons why Ghana is losing the majority of her finest health workers to the developed nations. The study concluded that the migration of healthcare professionals from developing to developed nations has negative effects on the delivery of healthcare in Ghana especially coming out of a deadly pandemic.
 Recommendation: The study recommends that government deals with the motivation and hygiene factors as well as the push and pull economic factors that drive many health workers to seek "greener pastures" outside the country hence the trend could continue in the coming years.

Migration of Healthcare Professionals: Exploring Self-Perception about Midwifery Professional Life and Continued Education

Migration of Healthcare Professionals: Exploring Self-Perception about Midwifery Professional Life and Continued Education

The migration of health care professionals from Hungary - global flows and local responses

International online peer-reviewed open-access journal offers a possibility for the international community of professionals working in the fields of regional and rural development or tourism to exchange their ideas and research results or practical achievements as it publishes results of both theoretical and applied research in these fields.

Survey of Japanese Medical Schools on Involvement of English-speaking Simulated Patients to Improve Students’ Patient Communication Skills

Phenomenon With increasing mobility of people across borders and medical tourism, more countries are called to make their healthcare environment ready to accept foreign patients. Patient communication skills in English are indispensable for healthcare professionals in non-English-speaking countries. This is not only in caring for foreign patients within the country but also contributing to the global health by practicing outside of the country. Although Japanese-speaking simulated patients have been involved in medical education in Japan since the 1970s and with Objective Structured Clinical Examinations formally implemented in 2005, very few medical schools have been working with English-speaking simulated patients (ESSPs). Approach A nationwide survey was conducted to investigate the involvement of ESSPs at medical schools in Japan. A questionnaire with closed and open-ended questions was mailed to the deans of 80 medical schools to determine the current ESSP involvement and the problems educators were facing in regard to working with or not working with ESSPs. The survey was conducted from November 2015 through March 2016. Data were analyzed to find problems regarding ESSPs so that their involvement could be enhanced toward developing medical students’ patient communication skills. Findings Responses from 60 medical schools (75% response rate) were received and analyzed. Among them, 22 schools were working with ESSPs, and 23 schools were willing to introduce them into their programs. The background of ESSPs varied with international students or faculty often filling the role. Many ESSPs received less than two hours of training. ESSP programs were required in the preclinical years, and more often elective in the clinical years. Medical schools mentioned the difficulty of recruiting and training ESSPs and finding the funding to pay for their remuneration and travel expenses. Insights ESSPs were increasingly used in Japanese medical schools but they were haphazardly recruited from within the school or from the local community, not trained fully, and inconsistent performers. Nevertheless, an encounter with a non-Japanese English-speaking simulated patient was regarded effective in developing medical students’ patient communication skills in English (language skills and cultural sensitivity). Ways must be found to assure the availability, quality, and sustainability of trained ESSPs so that more authentic practices and high-stakes skills exams can be introduced to ensure patient safety in the globalized world. As countries become more multicultural and international migration of healthcare professionals expands, ESSPs can be a valuable source for training and assessing international medical students and trainees’ English-language patient interviewing skills. Regional hubs of ESSPs and the use of telehealth in collaboration with educators around the world could enhance the use of ESSPs worldwide.

Migration of Healthcare Professionals in Post-Brexit Britain

What is the experience of migrant healthcare workers? How might this change following Brexit?
 This editorial explores the vital contributions of the migrant healthcare workers as the Architects of the NHS and recommends that it is critical to acknowledge their contribution and enhance their experience in post-Brexit Britain, for the survival of NHS as an exemplar healthcare service.

Strengthening capacity for cancer research in conflict settings: key informant insights from the Middle East

BackgroundManagement of cancer in the Middle East and North Africa (MENA) region is accompanied by multiple challenges including heterogeneous access to early detection and treatment options and limited implementation of national cancer control plans. Furthermore, protracted armed conflicts across the region have had dramatic effects, including disruption of healthcare systems and the migration of healthcare professionals. Strengthening capacity for cancer research has been identified as a key intervention to correct data poverty, inform policy, manage limited resources and improve health outcomes.ObjectiveThe main objective of this study is to gain insights into the landscape, barriers and enablers of cancer training, research and care in the MENA region.MethodWe utilised purposive sampling to interview 16 key informants from a diverse academic, medical and research background originating from countries affected by conflicts, such as Lebanon, and from active conflict zones including Iraq and Syria.ResultsThe themes that emerged from the interviews focused on the barriers to cancer care, barriers to cancer research and training, strengths and importance of cancer research and training recommendations. The detrimental effect of conflict on cancer provision and research was a cross-cutting sub-theme disrupting cancer care provision and research due to unsafe environments, fragmented facilities, absence of drugs and migration of personnel. When asked about perceived optimal training format for cancer research, most informants recommended a post-graduate, face-to-face training focusing on cancer research methods and concepts.ConclusionThis study offers a unique insight into the barriers affecting cancer research and capacity-strengthening priorities from oncologists and researchers working in conflict-affected areas of the MENA region. These data will form the base for future capacity-strengthening initiatives addressing specific regional challenges.

The moral challenges of health care providers brain drain phenomenon

The migration of health-care professionals has often produced morally charged discussions among ethicists, politicians, and policy makers in the migrant-sending and migrant-receiving countries because of its devastating effects on the health of those left behind in the countries of origin.This movement of skilled professionals – their decision to leaving their countries of origin in search of better work environments – has created a phenomenon that has been described as brain drain. Although the migration of health workers continue to bring prosperity to millions of people around the world, they have also evoked hopelessness in many more people. Thus, questions of global justice manifest themselves when it comes to the matters of brain drain and the just distribution of health and healthcare professionals.

Global responsibility vs. individual dreams: addressing ethical dilemmas created by the migration of healthcare practitioners

ABSTRACT Background The migration of health care professionals from developing to developed countries is a trend. This migration benefits the destination countries but is quite often devastating to healthcare systems within the home countries. Skilled practitioners from developing countries forego opportunities in their homelands to migrate to developed countries. This leaves a vacuum of talent, weakening the health systems in the ‘home’ countries. Methods This piece analyzes the consequence of such migration through the lens of the four principles of Universal Declaration of Bioethics and Human rights (UDBHR): equality, justice and equity, solidarity and cooperation, and sharing of benefits. Results In the light of moral imagination and moral reflection, we can understand one another as global citizens. Policymakers must develop guides to restore balance and ensure equitable healthcare worldwide. Incorporating ethics education in medical schools and hospitals, implementing temporary migration visas, and helping home countries offer attractive compensation can address this concern. Conclusions Health is a universal human right; the well-being of all must be addressed without overly limiting the rights of practitioners to build the lives they imagine. On the other hand, practitioners should consider themselves global citizens and consider their ethical obligations when considering their migration.

Dementia care in the Danube Region. A multi-national expert survey.

BackgroundDementia is a particularly severe societal challenge in several countries of the Danube Region due to higher-than-average increment in population longevity, disproportionate increase of the old-age dependency ratio, and selective outward migration of health care professionals. A survey was conducted among dementia experts to obtain a deeper understanding of the dementia care structures and services in this geographical area, and to identify the educational needs of health care professionals, and the availability of assistive technology.Subjects and methodsA standardized questionnaire was sent out to 15 leading dementia experts/clinicians in 10 Danube Region countries inquiring about professional groups involved in dementia care, availability and reimbursement of services, inclusion of dementia in professional education and training, acceptability of Internet-based education, and availability of assistive technology. The authors are the survey respondents.ResultsThe majority of individuals with dementia receive care in the community rather than in institutions. The roles of medical specialties are disparate. General practitioners usually identify dementia symptoms while specialists contribute most to clinical diagnosis and treatment. Health care professionals, particularly those who work closely with patients and carers, have limited access to dementia-specific education and training. The greatest need for dementia-specific education is seen for general practitioners and nurses. An Internet-based education and skill-building program is considered to be equivalent to traditional face-to-face but offer advantages in terms of convenience of access. Assistive technology is available in countries of the Danube Region but is significantly underused.ConclusionDementia care in the Danube Region can be improved by an educational and skill-building program for health care professionals who work in the frontline of dementia care. Such a program should also attempt to enhance interdisciplinary and intersectorial collaboration, to intensify the interaction between primary care and specialists, and to promote the implementation of assistive technology.

From interculturalism to inter-recognition: towards an ethico-onto-epistemological approach in migration research

ABSTRACTMigration policies and social science research tend to describe and stratify migrants according to bureaucratic and legal categories, which prevent the understanding of the complexity of migration as a process of recognition. Having in mind the migration of healthcare professionals to a semi-peripheral country like Portugal, this paper critically debates ‘multi-inter-cultural discourses’ and the asymmetric power relations it envisions. The case study under analysis reveals the production of different types of migrants’ disqualification (‘overstayers and irregulars’, ‘non-native’, ‘overqualified’, ‘underemployed’ and ‘non-human beings’) and the invisibilities that it promotes (socio-institutional, discursive, educational, professional, alterity). This article is influenced by the recognition framework as a critical approach and the decolonial proposal of an ‘Ecology of Recognitions’ [Santos, B.S. 2014. Epistemologies of the South: Justice against epistemicide. London: Paradigm Publishers]. In my view, this dialogic and comprehensive expression represents a turning point concerning the replacement of ‘culture’ as the core domain to embrace the socio-political construction of ‘difference’. A new framework for the ‘ethico-onto-epistemology’ of migration studies is therefore suggested: an inter-recognition approach. This could be an added value for the understanding of the wastage of human diversity as a process of loss of human dignity.

Proceed with caution: Potential challenges and risks of developing healthcare tourism in Indonesia

ABSTRACTThe Indonesian government is set to take part in the region’s growing healthcare tourism industry. However, Indonesia would need to do much more than just develop world-class hospitals at major tourist destinations to provide a thriving healthcare tourism industry that could attract patients from abroad. Moreover, the amount of resources needed to ensure the success of a healthcare tourism industry attracting foreign patients also raises the question of potential resource allocation diversion, as the country still has a long list of public health issues to address. There is also the potential of intensifying the migration of healthcare professionals from the public to the private sector or from rural to urban areas. Policymakers in Indonesia, and other resource-constrained countries, contemplating the development of healthcare tourism have an ethical obligation to weigh the evidence on potential positive and negative impacts before moving forward.

‘Not everyone can be a Gandhi’: South Asian-trained doctors immigrating to Canada, c. 1961–1971

Objectives. This paper will explore the social history of the transnational migration of foreign-trained doctors to western countries in the post-WWII era, by examining, as a case study, South Asian-trained doctors who were first licensed in the Canadian province of Nova Scotia between 1961 and 1971. Design. This article draws on both quantitative and qualitative primary sources. First, we analyzed the 1966 and 1971 copies of the Canadian Medical Directories (CMD), the annual compendium of all licensed practitioners in the country (over 20,000 practitioners). These CMD entries were supplemented by the annual returns of ‘intended occupation’ (those designated as ‘physician’ or ‘surgeon’) of landed immigrants to Canada, as compiled by the federal Department of Manpower and Immigration. Secondly, we analyzed testimony of 26 oral histories and narrative accounts of foreign-trained doctors being compiled as part of an ongoing multiyear program of research on the immigration of foreign-trained doctors to Canada. We have interviewed 14 doctors who, at one point in their career, practiced in Nova Scotia, 8 of whom were South Asian-trained medical practitioners. These oral interviews provide personal reflections on the process of professional and social acculturation that occurred as these foreign doctors settled in Canada. Results. The results of this paper indicate that the social history of the immigration of South Asian-trained doctors to Canada in the 1960s must be seen within a larger and more complicated pattern of the international migration of health care professionals. Indeed, the demand for foreign-trained doctors in Britain was in part a reflection of the out-migration of British-born doctors who were leaving the National Health Service for Canada, the USA, and Australia. And the demand in Canada for doctors was itself a reaction to the drift of a certain number of Canadian-trained doctors for advanced training in the USA. Conclusions. In this way, this article sheds important historical perspectives on the globalization of health human resources and the complicated, multiple migrations that continue to animate international health human resources today.

From Sustainable Development to Personalised Healthcare. The Role of Institutions in the Sustainable Development of the Healthcare Systems

Abstract The current issues concerning healthcare institutions are generated by: aging of the population; the increase in prevalence of non-communicable diseases, even in low/medium income countries; the continuous increase of indirect costs generated by chronic diseases; the necessity of new- patient-specific oriented therapies; the need of translation of fundamental research into practice; need of applicability of prevention strategies; an important segment of the working population becomes inactive; migration of healthcare professionals. An essential condition for the sustainable development of any community is the health and the maintenance of the health of its population, and it is essential that the institutions involved in the process adapt to the constant change of the society: the medical academia not only develops health professionals, but conducts research, helps implementing healthcare programmes, develops future strategies, and influences the political systems; the hospitals need to adapt to growing populations; the communities should be involved in out-patient healthcare and prevention of diseases; governmental institutions adapt to the concept of sustainable development in various ways: funding fundamental research, applying nation-wide programmes for prevention and care, help of disadvantaged population, funding medical universities.

Brain Drain: Migration of Healthcare Professionals in a Globalized World

ABSTRACT Social, economic and technological developments due to globalization have led to a surge in international demand for skilled workforce. Developed economies have made concerted efforts in not only attracting but also in retaining such human capital. Healthcare sector has been no exception. With limited career opportunities within their own country and a host of pull factors in developed countries, India and other developing countries have seen an exodus of medical and other professionals, what is known as ‘Brain Drain’. Shortages thus resulting from migration of health workers have even mitigated the effects of increased domestic healthcare spending. The health workers hold strategic importance in a nation's health systems and disease control initiatives. The resulting imbalances could have a detrimental effect on the social as well as economic fabric of such sending countries. This study is an effort in understanding the factors encouraging human capital flight and thus seeking short-term and long-term measures in dealing with it. This research brings forth strategies to deal with brain drain by forming mutually beneficial relationships with the diasporas. This reciprocity will lead to circulation of skills between source and receiving countries. Formulating suitable policies would ensure correcting the human resource imbalances within countries on a sustainable basis. How to cite this article Mahindra G, Dangi HK. Brain Drain: Migration of Healthcare Professionals in a Globalized World. Int J Res Foundation Hosp Healthc Adm 2014;2(2):63-72.

Trade in health services and mode 4 in Asian Countries: Challenges and opportunities

Trade in health services is becoming a rapidly growing trend due to the ease of using information and communication technology. Health services are traded under the General Agreement on Trade in Services (GATS) through four modes. Migration of health professionals, the 4 th mode, showed a growing trend due to increasing demand factors, such as demographic changes, aging population, and rising healthcare costs in high-income countries, and encouraging supply factors, such as export development, increasing foreign exchange earnings, and increasing employee knowledge and skills. Countries must obtain the benefit from migration of healthcare professionals also as it can be a challenge. This paper reviews the opportunities and challenges resulting from migration of healthcare professionals in Asian countries. Studies showed that countries importing and exporting health services do not face identical opportunities and challenges. Migration to higher-income countries provides better working and living conditions for healthcare professionals and acts as a revenue source for exporter countries. However, the lack of explicit policies in this area will lead to depletion of professionals in the home country and loss of national wealth that was spent on educating these migrating professionals.

Preparing for export? Medical and nursing student migration intentions post-qualification in South Africa

BackgroundThe migration of health professionals can have a profound impact on health systems around the globe. The International Organization for Migration's (IOM) Mobility of Health Professionals Research Project (MoHProf) aimed to improve knowledge about the migration of healthcare professionals and understand migration intentions and factors influencing the migration of medical and nursing students.ObjectivesThe study aimed to determine the proportion of nursing and medical students who were intending to emigrate, their attitudes and beliefs about, and the factors influencing their decision to emigrate.MethodThis study was conducted at three medical schools and one nursing school in South Africa (n = 298) amongst 260 medical and 38 nursing students. One hundred and twenty-five students were in the final year of their studies and 143 were in their prefinal year. Thirty students did not indicate the year of their studies. Every student present on the day of data collection completed a questionnaire comprising psychometric and survey-based questions. Descriptive and inferential statistics were used to analyse the data.ResultsMore than a third (37%) of the respondents intended to work or specialise abroad. The majority of medical (58.9%) and nursing (66.6%) students intended to leave SA within five years of completing their medical or nursing studies. The perception of poor working conditions within the health sector, such as long work hours, high patient loads, inadequate resources and occupational hazards, influenced medical students to consider emigrating from South Africa.ConclusionThe high number of medical and nursing students intending to emigrate requires a reassessment of effectiveness of retention strategies for doctors and nurses in the South African healthcare system and actions to improve working conditions in the public healthcare sector.