Abstract
Migration of formal and informal health-care workers is a global phenomenon – and, as this article demonstrates, one that is produced by government policies and practices. Nurses and lesser-trained caregivers migrate from many lower-income countries to richer ones (including from the Philippines to the United States, from South Africa to England, from Central Asia to Turkey). Using the Austrian experience to illustrate how policies and lack of enforcement of labor laws lead to migration and mistreatment of health-care professionals and informal caregivers, this article recommends how to alleviate health-care staff shortages in Africa and elsewhere through policymaking in Europe and North America. Recognition of the political dimensions of health-care migration is the first step toward addressing ethical questions and damaging shortages of caregivers.
Similar content being viewed by others
References
Mills, E.J. et al (2008) Should active recruitment of health workers from sub-Saharan Africa be viewed as a crime? Lancet 23 (371): 675–688.
Snyder, J. (2009) Is health worker migration a case of poaching? American Journal of Bioethics 9 (3): 3–7.
Kaelin, L. (2011) A question of justice: Assessing nurse migration from a philosophical perspective. Developing World Bioethics 11 (1): 30–39.
Kingma, M. (2001) Nursing migration: Global treasure hunt or disaster-in-the-making? Nursing Inquiry 8 (4): 205–212.
Kline, D.S. (2003) Push and pull factors in international nurse migration. Journal of Nursing Scholarship 35 (2): 107–111.
Hooper, C.R. (2008) Adding insult to injury: The healthcare brain drain. Journal of Medical Ethics 34 (9): 684–687.
World Health Statistics. (2007) WHO statistical information system, http://www.who.int/whosis/whostat2007_5healthsystems_hrh.pdf, accessed 18 April 2011.
Aiken, L.H., Buchan, J., Sochalski, J., Nichols, B. and Powell, M. (2004) Trends in international nurse migration. Health Affairs 23 (3): 69–77.
Dal Poz, M.R., Gupta, N., Quain, E. and Soucat, A.L.B. (eds.) (2009) Handbook on Monitoring and Evaluation of Human Resources for Health, World Health Organisation, p. 54, http://whqlibdoc.who.int/publications/2009/9789241547703_eng.pdf, accessed 18 April 2011.
Ball, R.E. (2004) Divergent development, racialised rights: Globalised labour markets and the trade of nurses – The case of the Philippines. Women's Studies International Forum 27 (2): 119–133.
Perrin, M.E., Hagopian, A., Sales, A. and Huang, B. (2007) Nurse migration and its implications for Philippine hospitals. International Nursing Review 54 (3): 219–226.
Brush, B.L. and Sochalski, J. (2007) International nurse migration: Lessons from the Philippines. Policy Politics and Nursing Practice 8 (1): 37–46.
Clemens, M.A. and Pettersson, G. (2008) New data on African health professionals abroad. Human Resources for Health 6: 1, doi:10.1186/1478-4491-6-1.
Connell, J., Zurn, P., Stilwell, B., Awases, M. and Braichet, J.M. (2007) Sub-Saharan Africa: Beyond the health worker migration crisis? Social Science and Medicine 64: 1876–1891.
POEA – Philippine Overseas Employment Administration. (2009) 2007 overseas employment statistics, http://www.poea.gov.ph/stats/stats2007.pdf, accessed 30 October 2009.
Kaelin, L. (forthcoming) Strong Family, Weak State. Hegel's Political Philosophy and the Filipino Family-State Relation. Quezon City, Philippines: Ateneo de Manila University Press.
Yinger, N.V. (2011) Feminization of migration, population reference bureau, 2006, http://www.prb.org/Articles/2006/TheFeminizationofMigration.aspx, accessed 18 April 2011.
Parreñas, R.S. (2003) Servants of Globalization. Women, Migration, and Domestic Work. Quezon City, Philippines: Ateneo de Manila University Press.
Sassen, S. (1999) Guests and Aliens. New York: The New Press, pp. 133ff.
Choy, C.C. (2003) Empire of Care: Nursing and Migration in Filipino American History. Durham/London: Duke University Press, p. 25.
Redfoot, D.L. and Houser, A.N. (2005) ‘We Shall Travel On’: Quality of Care, Economic Development, and the International Migration of Long-term Care Workers. Washington: AARP Public Policy Institute, p. 25.
Lenhart, M. and Österle, A. (2007) Migration von Pflegekräften: Österreichische und europäische Trends und Perspektiven. Österreichische Pflegezeitschrift 12 (12): 8–11.
Erlanger, S., Cooke, K., Roessler, H.-C. and Finn, P. (2001) Germany, Austria. Migration News 10 (8), http://migration.ucdavis.edu/mn/more.php?id=2471_0_4_0, accessed 18 April 2011.
Vavrečková, J. (2010) Migration of Czech workers poses risk of brain drain. Eironline 2006, http://www.eurofound.europa.eu/eiro/2005/12/feature/cz0512102f.htm, accessed 13 September 2010.
Bachinger, A. (2011) Der irreguläre Pflegearbeitsmarkt. Dissertation Wien, 2009, p. 119, http://othes.univie.ac.at/8038/1/2009-09-29_9206762.pdf, accessed 13 July 2011.
Gauthier, A.H. (2007) The impact of family policies on fertility in industrialized countries: A review of the literature. Population Research and Policy Review 26 (3): 323–346.
Orter, J. (2008) Not am Bett. Falter (3), 16 January, http://www.falter.at/web/print/detail.php?id=619, accessed 18 April 2011.
For the legal provisions of the Hausbetreuungsgesetz [Home Assistance Law ] see: http://www.bmask.gv.at/cms/site/attachments/5/8/1/CH0650/CMS1272017449498/hausbetreuungsgesetz.pdf, accessed 18 April 2011.
Lahodynsky, O. (2011) Wie Leibeigene. Profil 42 (1), 3 January.
Author information
Authors and Affiliations
Additional information
Using the Austrian experience to illustrate how policies and lack of enforcement of labor laws lead to migration and mistreatment of health care professionals and informal care givers, this paper recommends how to alleviate health care staff shortages in Africa and elsewhere through policymaking in Europe and North America.
Rights and permissions
About this article
Cite this article
Kaelin, L. Care drain: The political making of health worker migration. J Public Health Pol 32, 489–498 (2011). https://doi.org/10.1057/jphp.2011.43
Published:
Issue Date:
DOI: https://doi.org/10.1057/jphp.2011.43