Developing evidence-based ethical policies on the migration of health workers : conceptual and practical challenges
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Date
2003-10-28Author
Buchan, James
Stilwell, Barbara
Diallo, Khassoum
Zurn, Pascal
Dal Poz, Mario R.
Adams, Orvill
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Buchan, J., Stilwell, B., Diallo, K., Zurn, P., Dal Poz, M. & Adams, O. (2003) Developing evidence-based ethical policies on the migration of health workers : conceptual and practical challenges, Human Resources for Health, vol. 1, , pp. 1478-4491,
Abstract
It is estimated that in 2000 almost 175 million people, or 2.9% of the world's population, were living
outside their country of birth, compared to 100 million, or 1.8% of the total population, in 1995.
As the global labour market strengthens, it is increasingly highly skilled professionals who are
migrating. Medical practitioners and nurses represent a small proportion of highly skilled workers
who migrate, but the loss of health human resources for developing countries can mean that the
capacity of the health system to deliver health care equitably is compromised. However, data to
support claims on both the extent and the impact of migration in developing countries is patchy
and often anecdotal, based on limited databases with highly inconsistent categories of education
and skills.
The aim of this paper is to examine some key issues related to the international migration of health
workers in order to better understand its impact and to find entry points to developing policy
options with which migration can be managed.
The paper is divided into six sections. In the first, the different types of migration are reviewed.
Some global trends are depicted in the second section. Scarcity of data on health worker migration
is one major challenge and this is addressed in section three, which reviews and discusses different
data sources. The consequences of health worker migration and the financial flows associated with
it are presented in section four and five, respectively. To illustrate the main issues addressed in the
previous sections, a case study based mainly on the United Kingdom is presented in section six.
This section includes a discussion on policies and ends by addressing the policy options from a
broader perspective.