Patients and healthcare workers engage in international mobility/migration as one means to overcome inequality in health services and professional opportunities. This chapter examines international migration in the context of health in terms of worker and patient mobility using four themes. First, the inverse care law is used to explain how access to health services and workers is shaped by the level of urban and economic development. Second, healthcare worker mobility and its nascent management at the global scale are explored. Third, medical tourism is considered as a form of increasing patient mobility. Fourth, international patient mobility and its management are addressed by considering the patient charters and international trade in health service agreements. A conclusion is then offered to highlight how the migration of patients and health workers are tendencies of globalizing healthcare systems marked by increased public-private marketization. The international mobility of workers cumulatively affects the ability of health systems to equitably and adequately deliver healthcare, and poses important challenges for those promoting health for all. The circulation of both of these human inputs must be understood as a central element of an increasingly global health services landscape.
Margaret Walton-Roberts, Jonathan Crush and Abel Chikanda
Diasporas are increasingly viewed as key development resources by sending and receiving states as well as international organizations such as the World Bank, the International Organization for Migration (IOM) and the Global Forum on Migration and Development. In many cases, financial remittances from migrant diasporas have surpassed official development aid and other forms of investment entering the Global South. Many migrant origin nations have turned to their diaspora communities in order to boost national development agendas. This chapter offers three critical research directions regarding the socio-spatial dimensions of diaspora engagement using policy, place and people as broad framings. In terms of policy, the authors caution against the policy orthodoxy employed by states examining their diaspora’s role in development. In terms of place, they draw attention to how diasporas are viewed as homogeneous extensions of the homeland, and when sensitivity to regional and other differences is embraced, it often becomes the basis for the material and discursive securitization of diaspora groups. Turning to people, the authors examine for whom the diaspora-development agenda is working, and reference the tendency for remittances to concentrate wealth in certain regions and for certain groups, with the potential to further embed forms of economic and spatial inequality. Building on these critical research framings the authors offer four cross-cutting issues that they argue are increasingly important to the analysis of diasporic formation, organization and influence: diasporas and the new economy; diasporas and information and communication technology; identity, gender and intersectionality; and lastly marginalization.