Out-Migration/Brain Drain

This report is aimed at policy makers both in developing country governments and in international agencies. It was a key input to the second meeting of the High Level Forum on the Health Millennium Development Goals held in Abuja in December 2004. It was written to raise awareness of a looming crisis in human resources for health confronting most countries in sub-Saharan Africa, and to help serve as a catalyst for action to avert this crisis.

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. This desk review was conducted on the education, regulation, scopes of practice, specialization, nomenclature, retention and cost-effectiveness of substitute health workers in terms of their utilization.

This report presents findings of a study on the migration of health professionals in Cameroon, Ghana, Senegal, South Africa, Uganda and Zimbabwe. The report provides detailed information about migration patterns and numbers, reasons for migration, effects on the quality of health care and the policies being undertaken in the respective countries to reduce outward migration. [from executive summary]

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. 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. [from abstract]

International recognition that the growing shortage of health workers poses a major threat to fighting diseases such as HIV/AIDS and tuberculosis has prompted a flurry of measures to stem the exodus of health professionals from developing countries. The initiatives — such as ethical recruitment codes to try to limit damage inflicted by the brain drain, and exchange and training programmes and projects to tap the resources of what has become known as the diaspora of migrant health workers — remain fragmented but at least mark a start in the search for solutions to the crisis. [autho

The departure of a large proportion of the most competent and innovative individuals from developing nations slows the achievement of the critical mass needed to generate the enabling context in which knowledge creation occurs. To favourably modify the movement and distribution of global talent, developing countries must implement bold and creative strategies that are backed by national policies.