Skip to main content
Log in

Care drain: The political making of health worker migration

  • Original Article
  • Published:
Journal of Public Health Policy Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

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.

    Google Scholar 

  • Snyder, J. (2009) Is health worker migration a case of poaching? American Journal of Bioethics 9 (3): 3–7.

    Article  Google Scholar 

  • Kaelin, L. (2011) A question of justice: Assessing nurse migration from a philosophical perspective. Developing World Bioethics 11 (1): 30–39.

    Article  Google Scholar 

  • Kingma, M. (2001) Nursing migration: Global treasure hunt or disaster-in-the-making? Nursing Inquiry 8 (4): 205–212.

    Article  Google Scholar 

  • Kline, D.S. (2003) Push and pull factors in international nurse migration. Journal of Nursing Scholarship 35 (2): 107–111.

    Article  Google Scholar 

  • Hooper, C.R. (2008) Adding insult to injury: The healthcare brain drain. Journal of Medical Ethics 34 (9): 684–687.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Brush, B.L. and Sochalski, J. (2007) International nurse migration: Lessons from the Philippines. Policy Politics and Nursing Practice 8 (1): 37–46.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Google Scholar 

  • Sassen, S. (1999) Guests and Aliens. New York: The New Press, pp. 133ff.

    Google Scholar 

  • Choy, C.C. (2003) Empire of Care: Nursing and Migration in Filipino American History. Durham/London: Duke University Press, p. 25.

    Book  Google Scholar 

  • 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.

    Google Scholar 

  • Lenhart, M. and Österle, A. (2007) Migration von Pflegekräften: Österreichische und europäische Trends und Perspektiven. Österreichische Pflegezeitschrift 12 (12): 8–11.

    Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

Download references

Author information

Authors and Affiliations

Authors

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

Reprints 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

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1057/jphp.2011.43

Keywords

Navigation