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Taking more than a fair share? The migration of health professionals from poor to rich countries.

Dovlo D - PLoS Med. (2005)

View Article: PubMed Central - PubMed

Affiliation: dovlod@yahoo.com

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The international migration of health workers, especially of physicians and nurses but also increasingly of other health workers, has become a major global health concern... Recent meetings, such as the World Health Assembly of 2004 and the High-Level Forum on the Millennium Development Goals in December 2004, as well as a number of publications have highlighted the severe shortage of health personnel in poorer parts of the world and the rise in demand for health workers in rich countries... Thus, barely affordable initiatives towards capacity-building result instead in further losses of capacity... Policy-makers in sub-Saharan Africa must feel helpless when they are completely unable to match either the remuneration or the working conditions found in recipient countries... The authors reviewed these data for all physicians in the US who received their training in sub-Saharan Africa... What they found was that more than 23% of America's 771,491 physicians received their medical training outside the country, mostly (64%) in low-income or lower-middle-income countries... Thus, policies and actions that reduce medical and nursing school intake in poor countries while facilitating entry visas into rich countries for physicians and nurses from these same poor countries may be responsible for the deaths of thousands of African children and women... Effective international agreements on managing recruitment seem only to work when both source and recipient countries are developing countries... For example, South Africa has been successful at banning recruitment from within Africa, but richer countries opt for voluntary “codes of conduct” that are often quite ineffective... The migration of physicians and other trained health professionals undermines the ability of developing countries to meet agreed Millennium Development Goals and creates untenable health conditions for the poorer sections of their populations... Developing countries on their own cannot achieve effective moderation of migration and secure the integrity of health services without the cooperation and collaboration of the countries that receive their health workers... An international regimen is needed to manage and moderate the migration of health workers in order to minimize the deleterious effects this has on underdeveloped countries... Countries have different experiences, and each country must develop strategies that reflect the needs of their particular situation... However, the appropriate international environment for managing human resources is necessary if the strategies of developing countries are to achieve meaningful results.

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Global Variation in the Density of Health WorkersIn a report by the Joint Learning Initiative, 186 countries were designated as having low, medium, and high worker density clusters (below 2.5, between 2.5 and 5.0, and above 5.0 workers per 1,000 population, respectively), with the low- and high-density clusters further subdivided according to high and low under-five mortality [9]. Among low-density countries, 45 are in the low-density/high-mortality cluster; these are predominantly sub-Saharan countries experiencing rising death rates and weak health systems. (Illustration: Giovanni Maki, adapted from [9])
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pmed-0020109-g001: Global Variation in the Density of Health WorkersIn a report by the Joint Learning Initiative, 186 countries were designated as having low, medium, and high worker density clusters (below 2.5, between 2.5 and 5.0, and above 5.0 workers per 1,000 population, respectively), with the low- and high-density clusters further subdivided according to high and low under-five mortality [9]. Among low-density countries, 45 are in the low-density/high-mortality cluster; these are predominantly sub-Saharan countries experiencing rising death rates and weak health systems. (Illustration: Giovanni Maki, adapted from [9])

Mentions: Though some migration occurs between rich countries (and also between poor countries), most of the migration of health professionals is occurring from countries with physician densities of about 17 per 100,000 population to countries with densities of 300 per 100,000 population (see p. 16 of [3]). This is a good example of the “inverse care law”—that countries that need the most health care resources are getting the least (Figure 1). Why does this migration occur when there appears to be a glut of physicians in the recipient countries? One of the reasons is that pay levels are up to 24 times higher in recipient countries than they are in source countries [4].


Taking more than a fair share? The migration of health professionals from poor to rich countries.

Dovlo D - PLoS Med. (2005)

Global Variation in the Density of Health WorkersIn a report by the Joint Learning Initiative, 186 countries were designated as having low, medium, and high worker density clusters (below 2.5, between 2.5 and 5.0, and above 5.0 workers per 1,000 population, respectively), with the low- and high-density clusters further subdivided according to high and low under-five mortality [9]. Among low-density countries, 45 are in the low-density/high-mortality cluster; these are predominantly sub-Saharan countries experiencing rising death rates and weak health systems. (Illustration: Giovanni Maki, adapted from [9])
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC1140940&req=5

pmed-0020109-g001: Global Variation in the Density of Health WorkersIn a report by the Joint Learning Initiative, 186 countries were designated as having low, medium, and high worker density clusters (below 2.5, between 2.5 and 5.0, and above 5.0 workers per 1,000 population, respectively), with the low- and high-density clusters further subdivided according to high and low under-five mortality [9]. Among low-density countries, 45 are in the low-density/high-mortality cluster; these are predominantly sub-Saharan countries experiencing rising death rates and weak health systems. (Illustration: Giovanni Maki, adapted from [9])
Mentions: Though some migration occurs between rich countries (and also between poor countries), most of the migration of health professionals is occurring from countries with physician densities of about 17 per 100,000 population to countries with densities of 300 per 100,000 population (see p. 16 of [3]). This is a good example of the “inverse care law”—that countries that need the most health care resources are getting the least (Figure 1). Why does this migration occur when there appears to be a glut of physicians in the recipient countries? One of the reasons is that pay levels are up to 24 times higher in recipient countries than they are in source countries [4].

View Article: PubMed Central - PubMed

Affiliation: dovlod@yahoo.com

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

The international migration of health workers, especially of physicians and nurses but also increasingly of other health workers, has become a major global health concern... Recent meetings, such as the World Health Assembly of 2004 and the High-Level Forum on the Millennium Development Goals in December 2004, as well as a number of publications have highlighted the severe shortage of health personnel in poorer parts of the world and the rise in demand for health workers in rich countries... Thus, barely affordable initiatives towards capacity-building result instead in further losses of capacity... Policy-makers in sub-Saharan Africa must feel helpless when they are completely unable to match either the remuneration or the working conditions found in recipient countries... The authors reviewed these data for all physicians in the US who received their training in sub-Saharan Africa... What they found was that more than 23% of America's 771,491 physicians received their medical training outside the country, mostly (64%) in low-income or lower-middle-income countries... Thus, policies and actions that reduce medical and nursing school intake in poor countries while facilitating entry visas into rich countries for physicians and nurses from these same poor countries may be responsible for the deaths of thousands of African children and women... Effective international agreements on managing recruitment seem only to work when both source and recipient countries are developing countries... For example, South Africa has been successful at banning recruitment from within Africa, but richer countries opt for voluntary “codes of conduct” that are often quite ineffective... The migration of physicians and other trained health professionals undermines the ability of developing countries to meet agreed Millennium Development Goals and creates untenable health conditions for the poorer sections of their populations... Developing countries on their own cannot achieve effective moderation of migration and secure the integrity of health services without the cooperation and collaboration of the countries that receive their health workers... An international regimen is needed to manage and moderate the migration of health workers in order to minimize the deleterious effects this has on underdeveloped countries... Countries have different experiences, and each country must develop strategies that reflect the needs of their particular situation... However, the appropriate international environment for managing human resources is necessary if the strategies of developing countries are to achieve meaningful results.

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