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Workshop on Human Resources For Health And Migration:
Mobility, Training and the Global Supply of Health Workers
16-17 May 2007
NEW: Briefing on Mobility, Training and the Global Supply of Health Workers, including workshop findings
The migration of trained health professionals from poorer developing countries to wealthier developed countries is still generally seen as negative for countries of origin and prejudicial for their social and ultimately economic development. This interpretation drives policy and while this workshop did not deliberately seek a revisionist approach, it aimed to re-examine what often appear to be easy assumptions.
 The principal purpose of the DRC workshop was to consider the movement of health professionals from several points of view:
- The data upon which interpretations are based.
- The causes of the movement, both the demand and the supply side.
- The question of scale in the causes and consequences of the movement.
- The alternative scenarios or likely future directions of the movement.
- The potential for "management" of the movement.
Beyond ‘The Brain Drain’ - Numbers and Issues
The two presentations in this session reviewed major quantitative work on, firstly, the movement of health workers out of Africa and , secondly, the stocks of overseas doctors and nurses in OECD countries.
The Demand Side: Future Need in Developing Countries for Health Workers in Public and Private Sectors. Is The Goal of Self-Sufficiency Desirable or Practical?
This session looked at the drivers of mobility of health workers from the demand side by reviewing the regulations around the migration of overseas nurses and growth and future direction of migrant employment in the care sector.
The Supply Side: Training for Work Abroad & Training for Work at Home
Two presentations looked at the experiences of two very diverse regions. First the Philippines’s example was presented and the effect of the proliferation of private nursing schools catering to trainees wishing to migrate to the U.S. was examined. Then the development of mid-levels cadres as a way of tackling the health paradox in Africa was discussed.
Best Practice in Developing Countries to Retain Health Staff
Reviewed trends and opportunities in HRH training, retention and distribution, looked at the example of the Malawi Emergency Human Resources Programme.
Roundtable 1: Policy
International Management of Flows: Can and Should Movement of Health Professionals be Managed and if so How?
Representatives from ILO, IOM and DFID described international initiatives designed to tackle the loss of skilled professionals from developing countries. A roundtable discussion covered issues including how to optimise contributions of the diaspora, the influence of public sector reform and economic stability, and the relative impact of international and internal distribution of health workers.
Issues of Scale: Small Countries in Context
John Connell and Elizabeth Thomas Hope discussed the situation on small pacific islands and the Carribean respectively.
Outsourcing of Health Care and the Development of Regional Centres of Care
Devesh Kapur looked at the risks to the provision of healthcare to the poor as a result of the growth of medical tourism and Ron Skeldon described the growth of Bumrumgrad hospital in Thailand.
Losing out Twice? Skill Wastage in Destination Countries
This presentation reviewed research looking at the experiences of migrant and refugee doctors and dentists in the UK and the difficulties some face in negotiating the hurdles of re-qualifying exams and recruitment.
Micro-Level Research Studies - Bangladesh, Ghana
Two country studies from work carried out by Migration DRC partners in Ghana and Bangladesh were presented here. First the case for an expansion of nursing training capacity in Bangladesh was made. This was followed by a review of migration from Ghana to the UK of doctors and nurses both from the point of view of qualified and trainee professionals.
Round Table 2: Research: Future Directions for Research
 This discussion brought out a number of the key research questions that had been flagged throughout the workshop including the role of the private sector, further information about the role of remittances, the distribution of health workers, aspects of return of health workers and its effect on health provision and looking beyond doctors and nurses to other cadres of workers. However the discussion also ranged over the diverse influence of context such as governance, the size of a country and labour needs. There was also some discussion of the political aspects of the migration debate which highlighted that the response of researchers must be strong and credible.
Useful Links
Africa Health Strategy 2007-2015
Global Health Workforce Alliance
Global Pharmacy Workforce and Migration report
Globalization, Skilled Migration and Poverty Alleviation: Brain Drains in Context, DRC working paper T15
Human Resources for Health Journal
Skilled Migration: Healthcare Policy Options, DRC briefing no.6
World Health Report 2006 - Working Together for Health
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