Migration of Health-Care Workers from Developing Countries: Strategic Approaches to Its Management

By Stilwell, Barbara; Diallo, Khassoum et al. | Bulletin of the World Health Organization, August 2004 | Go to article overview

Migration of Health-Care Workers from Developing Countries: Strategic Approaches to Its Management


Stilwell, Barbara, Diallo, Khassoum, Zurn, Pascal, Marko, Vujicic, Orvill, Adams, Dal Poz, Mario, Bulletin of the World Health Organization


Resume

Migration des agents de sante en provenance des pays en developpement : approches strategiques de la gestion de ce phenomene

Sur les 175 millions de personnes (2,9 % de la population mondiale) qui vivaient hors de leur pays d'origine en l'an 2000, 65 millions etaient economiquement actives. L'essor de l'emigration a des consequences notables dans de nombreux pays en developpement, qui perdent leurs ressortissants les plus instruits au profit de pays plus riches. Les medecins et le personnel infirmier representent une faible proportion des professionnels hautement qualifies qui emigrent mais, pour un pays en developpement, la perte de ressources humaines dans le secteur de la sante peut signifier que la capacite du systeme de sante a delivrer des soins de maniere equitable sera gravement compromise. Il est peu probable que l'emigration cesse, du fait des progres des moyens de communication et du developpement du marche mondial du travail dans certains domaines, dont font maintenant partie les soins infirmiers. Le present article a pour but d'examiner quelques aspects cles de l'emigration des agents de sante et d'envisager des approches strategiques de la gestion de ce phenomene.

Resumen

Migracion de personal sanitario de los paises en desarrollo: enfoques estrategicos para su gestion

De los 175 millones de personas (2,9% de la poblacion mundial) que vivian fuera de su pais natal en 2000, 65 millones formaban parte de la poblacion actica. El aumento del numero de migrantes tiene importantes consecuencias para muchos paises en desarrollo, que pierden asi a sus ciudadanos mejor formados en beneficio de los paises mas ricos. Los medicos y enfermeras representan una pequena parte de los trabajadores altamente calificados que deciden migrar, pero la perdida de recursos humanos que ello acarrea para los paises en desarrollo en el sector de la salud puede poner seriamente en peligro la capacidad del sistema sanitario para proporcionar atencion de salud de forma equitativa. No es probable que se logre poner fin a las migraciones, teniendo en cuenta los avances de las comunicaciones mundiales y la progresiva globalizacion experimentada por los mercados de trabajo en algunos sectores, entre los que se encuentra hoy la enfermeria. El objetivo de este articulo es examinar algunos temas clave relacionados con la migracion internacional de personal sanitario y analizar posibles enfoques estrategicos para gestionar las migraciones.

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Background

The movement of people from one place to another has shaped today's political, social and economic world and continues to be a major influence on society. In 2000 almost 175 million people, or 2.9% of the world's population, were living outside their country of birth for longer than one year. Of these, about 65 million are economically active (1). In absolute terms the number of people living outside their country at

any one time (the stock of migrant population) has more than doubled since 1965, but as a percentage of the world's population the growth is much smaller, rising from 2.3% in 1965 to 2.9% in 2000 (1). Nevertheless, the rise in the number of people migrating is significant for many resource-poor countries because they are losing their better-educated nationals to richer countries: around 65% of all economically active migrants who have moved to developed countries are classed as "highly skilled" (2). This classification attempts to define both the level of education and the level of the job. Highly skilled professionals are generally assumed to have completed tertiary education and to have a professional job: in terms of the health-care workforce this refers to physicians, nurses, dentists, and pharmacists.

The migration of health-care workers has closely followed general trends in international migration. The migration of health workers is not new: nurses and physicians have sought employment abroad for many reasons, including high unemployment in the health-care labour market in their home country (3). …

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