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A steady flow of health personnel, including nurses, doctors, physiotherapists, pharmacists and researchers, migrates from developing countries to North America, Japan and Europe. Researchers from Belgium’s Institute for Tropical Medicine examine the underlying causes of this ‘brain drain’ and discuss strategies to reduce its negative impact. International migration flows from the most deprived regions within developing countries to middle income nations and from there to high income countries. As a result, many health systems in Africa are suffering enormously. Positive and negative effects include:
Both ‘push’ and ‘pull’ factors contribute to this migration pattern. Push factors that discourage health workers in low income countries directly include inadequate working conditions, lack of continuing education and professional development. Indirect factors are political instability, civil strife, insecurity, poor housing, inadequate social services and educational facilities for children. In the higher income countries, the increasing demand for health care is fuelled by demographic trends, advances in medical practice and technology, and increasing public expectations. This demand is, however, not matched by increases in the domestic health workforce inflow and retention. Recruitment of professionals from developing countries constitutes a major pull factor. The researchers discuss the merits of various strategies to stem the brain drain. In poorer ‘exporting’ countries, these could include:
But developed countries should also bear considerable responsibility for correcting health workforce imbalances. They could compensate less-developed countries for the health workers they attract. Administration costs of such a scheme would, however, be high and this does not tackle the root causes of migration. More importantly, wealthier countries must enhance the attractiveness and retention capacity of the health professions within their own health systems. Strategies include:
Ethically, individual freedom of movement and the personal right to pursue self-fulfilment and better living conditions are called upon by some to justify the brain drain. Their arguments are accompanied by the linguistic shift from ‘brain drain’ to ‘professional mobility’. In reality and for the foreseeable future, the current strategies result in skimming off the precious human capital of low-income countries. This type of professional mobility remains a brain drain that suits the rich countries but further reduces the chances of socioeconomic development in the South. Source(s): Funded by: Belgian Directorate General for Development Cooperation; Medicus Mundi Internationalis id21 Research Highlight: 28 April 2004
Further Information: Contact the contributor: bmarchal@itg.be Institute of Tropical Medicine, Antwerp Other related links:
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