Description
In recent years there have been renewed concerns worldwide about the tremendous drain of resources that can occur when skilled health professionals migrate, particularly from developing to developed countries. Although such movement often has many advantages for the individuals concerned and their families, from the point of view of donor countries, it can have far-reaching consequences both for their economies and the development of their health services.
In the Commonwealth, migration of health professionals is a major problem for some member countries, particularly small states. In 1999, the Commonwealth Secretariat commissioned consultants to carry out literature reviews and to collect data from Ministries of Health in each of the four Commonwealth regions (Africa, Asia, the Caribbean and the Pacific), as a basis for recommending policies and strategic approaches to Commonwealth governments. This publication is based on a synthesis of the reports of these consultants.
Contents
Preface
Acknowledgements
Acronyms and Abbreviations
Executive Summary
CHAPTER 1: Introduction
1.1 Historical Context
1.2 Societal Factors Underlying Migration
1.3 Health Sector Factors Underlying Migration
1.4 Personal Factors Underlying Migration
1.5 Conclusions of the WHO Study
1.6 Changes in the Socio-economic Environment
1.7 HIV/AIDS
1.8 The Current Publication
CHAPTER 2: The Nature and Extent of Movement of Trained Health Professions
2.1 Introduction
2.2 Estimates of Health Personnel
2.3 The Nature and Extent of Migration
2.4 Countries or Sectors to which Personnel are Lost
2.5 Effects of Loss of Health Professional
CHAPTER 3: Issues and Problems Relevant to Recruitment, Deployment, Utilization and Retention
3.1 Introduction
3.2 Policy/Planning
3.3 Education/Training
3.4 Management/Utilization
CHAPTER 4: Factors that Contribute to Migration
4.1 Introduction
4.2 “Push” Factors
4.3 “Pull” Factors
CHAPTER 5: Strategic Approaches That Have Been Used by Countries to Reduce Outward Migration and to Mitigate its Effects
5.1 Introduction
5.2 Incentives and Disincentives
5.3 Changes in the Education and Training of Workers
5.4 Bilateral and Inter-country Agreements
5.5 Mitigation of Losses
CHAPTER 6 Conclusions and Recommendations
6.1 Introduction
6.2 Key Issues and Recommended Strategies for Governments
6.3 Approach to Implementation
6.4 Recommendations for Particular Commonwealth Regions
6.5 Need for Further Work
References and Notes
Annexes
Annex 1: Commonwealth Steering Committee on Nursing and Midwifery Guidance. “Guidance on Workforce Issues – the Global Crisis in the Recruitment and Retention of Nurses and Midwives”
Annex 2: Suggested Indicator Data on Migration of Health Professionals
Annex 3: African Region: Summary of Main Factors Influencing Migration and Recommendations on Policy Directions
Annex 4: Caribbean Region: Recommendations at both Policy and Strategic Level
Annex 5: Pacific Region: Discussion and Recommendations