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New initiative seeks practical solutions to tackle health worker migration

by the World Health Organization

On May 15 in Geneva the Health Worker Migration Policy Initiative held its first meeting today at the headquarters of the World Health Organization (WHO). The initiative, led by Mary Robinson, President of Realizing Rights: the Ethical Globalization Initiative, and Dr. Francis Omaswa, Executive Director of the Global Health Workforce Alliance (GHWA), is aimed at finding practical solutions to the worsening problem of health worker migration from developing to developed countries.

WHO Director-General Dr. Margaret Chan said, "International migration of health personnel is a key challenge for health systems in developing countries." The new initiative has a Technical Working Group housed at WHO.

The Health Worker Migration Policy Initiative is made up of two groups that will work closely together over the coming months to develop recommendations. The Migration Technical Working Group, which is being coordinated by WHO, brings together the International Organization for Migration, the International Labour Organization, professional associations, experts and academics.

The Health Worker Global Policy Advisory Council, under the leadership of Mary Robinson and Francis Omaswa and with Realizing Rights serving as its Secretariat, is made up of senior figures from developed and developing countries, who will develop a roadmap and a framework for a global code of practice for health worker migration and seek high-level political backing for its recommendations.

A recent study[1] has shown that the number of foreign-trained doctors has tripled in several OECD countries over the past three decades. The number of foreign-trained doctors from countries with chronic shortages of health workers is relatively small (less than 10 percent of the workforce) in developed countries. However, for some African countries, the migration of a few dozen doctors can mean losing more than 30 percent of their workforce, even as basic health needs remain unmet.

Other health professions are also affected by this phenomenon. The study showed that in Swaziland, 60 to 80 nurses migrate to the United Kingdom each year, while fewer than 90 graduate from Swazi schools. GHWA partner and member Save the Children UK estimates that the United Kingdom saved £65 million in training costs between 1998 and 2005 by recruiting Ghanaian health workers.

Mary Robinson summarized the need for urgent action: "We cannot stand alone as individual countries continue to address their own increased needs for health workers without looking beyond their shores to the situation these migrating workers have left behind in their homelands. We cannot continue to shake our heads and bemoan the devastating brain drain from some of the neediest countries on the planet without forcing ourselves to search for --- and actively promote --- practical solutions that protect both the right of individuals to seek employment through migration and the right to health for all people."

One of the initiative's first priorities will be to support WHO in drafting a framework for an International Code of Practice on Health Worker Migration, as called for by a resolution of the World Health Assembly in 2004. This framework will promote ethical recruitment, the protection of migrant health workers' rights and remedies for addressing the economic and social impact of health worker migration in developing countries. The Code of Practice will be the first of its kind on a global scale for migration.

The initiative will also promote good practices and strategies to enable countries to increase supply and retain their health workers more effectively. The new tools and policy recommendations developed by the initiative will support better management of migration through North-South collaboration.

Dr. Francis Omaswa emphasized the importance of addressing both the 'push' and 'pull' factors simultaneously. "Health workers are a valued and scarce resource. Demand is increasing worldwide, but not enough are being trained --- in the developed or the developing world. Developing countries must prioritize health and health workers, with better working conditions and incentives so its workforce can stay and be more efficient, while developed countries must train more of their youth and try to be self-sufficient."

The Health Worker Migration Policy Initiative is due to make initial policy recommendations by the end of 2008. Its operations are co-funded and coordinated by Realizing Rights, the Global Health Workforce Alliance, and the MacArthur Foundation.

WHO addresses health care worker migration issues
People's perceptions when they observe wildlife on Barro Colorado Island

Diabetes nutrition

STRI research on drought sensitivity and tropical forest plant distribution published in Nature

Do Irish dolphins have a brogue of their own?