Malawi is facing a health crisis as trained nurses leave to seek better wages abroad. More than half come to Britain to work for the NHS and private hospitals. Last year over 12,000 nurses from outside the European Union registered to work in the UK. In contrast Malawi, one of the world's poorest countries, trains around 60 nurses each year.
Human Resources
Poor countries need to tackle the health brain drain
With the United Kingdom needing 10 000 more doctors, and with more than 7000 nurses from the Philippines alone currently registered in the United Kingdom, compared with just 52 in 1999, a new report says that the countries providing the workers, as well as those that hire them, need to look for solutions. The report says that many African doctors also migrate within the continent, mostly to southern African states where salaries are often higher: for instance, $1242 a month in South Africa, compared with $50 in Sierra Leone.
strategic approaches to health care migration management
Medical practitioners and nurses represent a small proportion of the highly skilled workers who migrate, but the loss for developing countries of human resources in the health sector may mean that the capacity of the health system to deliver health care equitably is significantly compromised. It is unlikely that migration will stop given the advances in global communications and the development of global labour markets in some fields, which now include nursing. The aim of this paper is to examine some key issues related to the international migration of health workers and to discuss strategic approaches to managing migration.
The Zambian HIV/AIDS workforce study
Anticipating significant scale-up of its current HIV/AIDS services, the Zambian Central Board of Health commissioned this study of the human resource implications. The study collected data at 16 government, NGO, and private for-profit sites across Zambia that currently provide VCT, P-MTCT, and ART services. It analyses the time taken to carry out the prescribed tasks involved in each of the services, describes the present workforce involved in providing these services and the extent to which services are currently following national service delivery standards, and projects the human resource requirements and costs associated with scaling up services to planned levels.
Impact, regulation and health policy implications of physician migration
Although the Organisation for Economic Co-operation and Development (OECD) member countries generally favour long-term policies of national self-sufficiency to sustain their medical workforce, such policies usually co-exist with short-term or medium-term policies to attract foreign physicians. As this is likely to continue, there is a need to create a global framework that enforces physician migration policies that confer benefits on home and host countries. In the long-term, OECD member countries need to put in place appropriate education and training policies rather than rely on physician migration to address their future needs.
Preventing the brain drain through equitable health systems
Physicians for Human Rights report
"The nations of the world are setting ambitious health and development goals, including the World Health Organization (WHO) target of providing AIDS treatment to 3 million people by 2005 and health-related UN Millennium Development Goals. Unless greater attention by donors and governments is given to developing human resources, these goals almost certainly will not be met. Many of the countries in sub-Saharan Africa, the region that will be the focus of this report, are experiencing severe shortages of skilled health care workers. There are multiple causes, the significance of which varies by country, but one of the most important factors is brain drain. Brain drain is defined in this report as the exodus of health care workers from developing nations to the wealthier countries of the North."
Training health service staff in developing countries
The quality of health care is hugely dependent on the skills of health professionals. Clinical skills centres are neutral and protected settings in which a variety of skills and techniques can be taught. In developing countries, resource constraints and pressure to direct skilled staff away from teaching to working in health service facilities can limit the opportunities for developing and implementing an effective training curriculum.
International recruitment of health workers to the UK
The UK is currently prominent as an active recruiter of health workers, most notably doctors and nurses. This is unlikely to change in the short term. The demographics in many developed countries such as the UK- a growing, ageing population and an ageing nursing workforce- make it likely that many of these countries will be actively encouraging inflow of health workers. Stopping migration is unlikely to be a viable option -which essentially leaves two other policy stances - non intervention, or some level of intervention to attempt to manage the migration process so that it is nearer “win –win”, or at least is not exclusively “win- lose”, with the countries that can least afford to lose being the biggest losers.
Thousands quit SA health service jobs
The provincial health department [Western Cape] has lost nearly 4 000 staff in the past six years - and there are no plans to replace them. But the department does not intend to let the numbers drop further. In his budget speech in the provincial legislature, Health MEC Pierre Uys said the department was losing staff at the rate of 1 000 a year.
Using mid-level cadres as substitutes for internationally mobile health professionals in Africa
Substitute health workers are cadres who take on some of the functions and roles normally reserved for internationally recognized health professionals such as doctors, pharmacists and nurses but who usually receive shorter pre-service training and possess lower qualifications. The findings raise interest in expanding the use of substitute cadres, as the demands of expanding access to services such as antiretroviral treatment requires substantial human resources capacity.