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Causes, consequences, and policy responses to the migration of health workers: key findings from India

View Article: PubMed Central - PubMed

ABSTRACT

Background: This study sought to better understand the drivers of skilled health professional migration, its consequences, and the various strategies countries have employed to mitigate its negative impacts. The study was conducted in four countries—Jamaica, India, the Philippines, and South Africa—that have historically been “sources” of health workers migrating to other countries. The aim of this paper is to present the findings from the Indian portion of the study.

Methods: Data were collected using surveys of Indian generalist and specialist physicians, nurses, midwives, dentists, pharmacists, dieticians, and other allied health therapists. We also conducted structured interviews with key stakeholders representing government ministries, professional associations, regional health authorities, health care facilities, and educational institutions. Quantitative data were analyzed using descriptive statistics and regression models. Qualitative data were analyzed thematically.

Results: Shortages of health workers are evident in certain parts of India and in certain specialty areas, but the degree and nature of such shortages are difficult to determine due to the lack of evidence and health information. The relationship of such shortages to international migration is not clear. Policy responses to health worker migration are also similarly embedded in wider processes aimed at health workforce management, but overall, there is no clear policy agenda to manage health worker migration. Decision-makers in India present conflicting options about the need or desirability of curtailing migration.

Conclusions: Consequences of health work migration on the Indian health care system are not easily discernable from other compounding factors. Research suggests that shortages of skilled health workers in India must be examined in relation to domestic policies on training, recruitment, and retention rather than viewed as a direct consequence of the international migration of health workers.

No MeSH data available.


Frequency seeking migration information from personal contacts (Source Health Professional Migration Survey, n = 1719)
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Fig4: Frequency seeking migration information from personal contacts (Source Health Professional Migration Survey, n = 1719)

Mentions: Evidence from the health worker survey indicates that the majority of health professionals surveyed were not intending to migrate in the next 2 years (of those who responded 75% answered “very unlikely,” 7.5% “very likely”), and the majority had not previously applied for any kind of foreign work permit, residence, or license (see Fig. 2). With regard to information about migration, there was also a fairly strong tendency to never seek out information from recruiters, professional associations, and personal connects, with recruiters the least likely source of information consulted (see Figs. 3 and 4). Approximately 42% of nurses considered migration “a great deal” or “somewhat” compared to 24% of dentists and 32% of doctors. Of all the professions, nurses were the least likely to answer “none at all” about their level of consideration of migration possibilities (27.4% followed by dieticians and other therapists, dentists, and doctors at 36.8%) (see Fig. 5).Fig. 2


Causes, consequences, and policy responses to the migration of health workers: key findings from India
Frequency seeking migration information from personal contacts (Source Health Professional Migration Survey, n = 1719)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5382411&req=5

Fig4: Frequency seeking migration information from personal contacts (Source Health Professional Migration Survey, n = 1719)
Mentions: Evidence from the health worker survey indicates that the majority of health professionals surveyed were not intending to migrate in the next 2 years (of those who responded 75% answered “very unlikely,” 7.5% “very likely”), and the majority had not previously applied for any kind of foreign work permit, residence, or license (see Fig. 2). With regard to information about migration, there was also a fairly strong tendency to never seek out information from recruiters, professional associations, and personal connects, with recruiters the least likely source of information consulted (see Figs. 3 and 4). Approximately 42% of nurses considered migration “a great deal” or “somewhat” compared to 24% of dentists and 32% of doctors. Of all the professions, nurses were the least likely to answer “none at all” about their level of consideration of migration possibilities (27.4% followed by dieticians and other therapists, dentists, and doctors at 36.8%) (see Fig. 5).Fig. 2

View Article: PubMed Central - PubMed

ABSTRACT

Background: This study sought to better understand the drivers of skilled health professional migration, its consequences, and the various strategies countries have employed to mitigate its negative impacts. The study was conducted in four countries—Jamaica, India, the Philippines, and South Africa—that have historically been “sources” of health workers migrating to other countries. The aim of this paper is to present the findings from the Indian portion of the study.

Methods: Data were collected using surveys of Indian generalist and specialist physicians, nurses, midwives, dentists, pharmacists, dieticians, and other allied health therapists. We also conducted structured interviews with key stakeholders representing government ministries, professional associations, regional health authorities, health care facilities, and educational institutions. Quantitative data were analyzed using descriptive statistics and regression models. Qualitative data were analyzed thematically.

Results: Shortages of health workers are evident in certain parts of India and in certain specialty areas, but the degree and nature of such shortages are difficult to determine due to the lack of evidence and health information. The relationship of such shortages to international migration is not clear. Policy responses to health worker migration are also similarly embedded in wider processes aimed at health workforce management, but overall, there is no clear policy agenda to manage health worker migration. Decision-makers in India present conflicting options about the need or desirability of curtailing migration.

Conclusions: Consequences of health work migration on the Indian health care system are not easily discernable from other compounding factors. Research suggests that shortages of skilled health workers in India must be examined in relation to domestic policies on training, recruitment, and retention rather than viewed as a direct consequence of the international migration of health workers.

No MeSH data available.