Brain Drain: Healthcare Workers

June 16, 2015

This resource uses a map and newspaper articles to provide a broad overview of the contemporary 'brain drain' of healthcare workers. Its goal is to further understanding of the general dynamics of contemporary migrations of healthcare workers and to stimulate thinking about the implications of this movement for countries who send as well as countries who receive these workers, as well as for the migrants themselves.

Introduction

A typical stereotype, that migrants are unskilled and poorly trained, is defied by the importance of the global migration of highly skilled workers, such as doctors and nurses. The emigration of highly skilled individuals, often a flow from developing countries to developed countries, is a phenomenon popularly known as the 'brain drain.'

Globally, this movement of healthcare workers away from places with critical shortages exacerbates existing inequalities between world regions and nation-states. For sending states, this migration is not only the loss of skilled workers, but also a loss of financial investment. The training of healthcare workers is expensive, and when healthcare workers leave their home country, the investment of time and money in training leaves too. However, like other types of migrants, many healthcare workers maintain ties with their home countries by sending financial remittances. Some countries, like the Philippines, even encourage the migration of healthcare workers, because remittances have become an important part of the national economy. Another potential, if rare, benefit for sending countries is the return of migrants to their home country with more education and work experience from their time abroad.

In the receiving countries, the critical need for healthcare workers does not necessarily mean that healthcare migrants receive superior treatment. Indeed, quite the opposite may be true: studies undertaken in a wide variety of receiving states attest to racial discrimination experienced by migrant healthcare workers, despite their social location in the labor market. Moreover, migrant healthcare workers can often be subject to different degrees of deskilling (where their skills are not acknowledged and they are given jobs for which they are overqualified) because educational credentials may not be recognized in receiving states.

Sources

The following sources provide a perspective on the global dimensions of the migration of healthcare workers, as well as more specific stories about its impacts on sending and receiving states.

  1. A map produced by the World Health Organization showing countries with and without critical shortages of health service providers.
    World Health Organization. 2006. 

    countries with a critical shortage of health service providers


     
  2. A broadcast by National Public Radio including pictures and links to an audio clip which describe the impact of critical shortages of healthcare workers in Kenya. 
    Wilson, Brenda. 2005. Developing Countries See Health Care 'Brain Drain'. Morning Edition, National Public Radio.

     
  3. An article from BBC detailing the experiences of racism faced by migrant nurses in the United Kingdom.
    BBC NEWS. 2003. UK 'racist' to overseas nurses.

Discussion Questions

  1. The map reveals that Africa suffers the most from critical shortages of health service providers. How is Kenya trying to combat the impacts of 'brain drain'? What are the implications of this strategy? What are other possible reasons, besides migration, that may account for the shortage of healthcare workers?
  2. The map is based on data collected at the scale of the nation-state. What are the implications of focusing on the nation-state as the primary unit of analysis? What does this focus obscure (for example, differences between rural and urban areas as highlighted in the NPR article)?
  3. Consider the voices of the health service workers and how they are represented in the two articles. While nurses may be legally recruited from abroad, they still face exploitation, discrimination, and deskilling. What are the challenges faced by migrating health service workers? Consider racial and gender-related dimensions.

Suggested Readings

Coombes, Rebecca. 2005. Developed world is robbing African countries of health staff. BMJ: British Medical Journal 330, no. 7497:923-923.

Hugo, Graeme. 2007. Population geography. Progress in Human Geography 31, no. 1:77-88.

Pond, Bob, and Barbara McPake. 2006. The health migration crisis: the role of four Organisation for Economic Cooperation and Development countries. Lancet 367, no. 9520:1448-1455.

Ray, Kristin M., B. L. Lowell, and Sarah Spencer. 2006. International Health Worker Mobility: Causes, Consequences, and Best Practices. International Migration 44, no. 2:181-203.