Health worker migration: what can be done?
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A shortage of health workers is one of the most serious challenges that health systems face in many areas of the world. Whereas the reasons for this shortage vary across regions, health worker migration is assuming an increasingly important role in the developing world. This issue has received great attention in recent years. Different perspectives have been adopted while looking both at the reasons and at the consequences of health worker migration; and different options have been proposed to address its negative impacts. The aim of this study is to provide an in-depth presentation and discussion of health worker migration in general and in particular to present and discuss two policy options that have attracted increased interest in recent times: circular migration and policies for ethical recruitment of health workers. In addition, the study presents a short comparison of these two policies. The study looks at existing experiences of circular migration in Ghana and the Netherlands; and explores the experiences of England, who was one of the first countries to introduce a code of conduct for the ethical recruitment of health workers. The methodology adopted to address these objectives is a review of literature. Theories of migration are also used in order to shed light on the potential driving forces of health worker migration, which will also determine which policy options are more likely to work. The policy triangle framework, proposed by Walt and Gibson for policy analysis in the health sector, is also used. We found that both policies have their own advantages and disadvantages, and are unlikely to solve the problem of health worker migration in isolation. In addition, their success might be influenced by the contexts in which they are applied. A balanced solution requires that the interests of both health workers, as well as the interests of populations in sending and receiving countries are taken into due consideration, and thus will need the application of different strategies with the participation of all stakeholders. We believe the study will contribute knowledge which can inform policy makers working towards achieving a balanced solution to the health worker migration.
Master in International Social Welfare and Health Policy