Migration and the Globalisation of Health Care
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Migration and the Globalisation of Health Care

The Health Worker Exodus?

John Connell

The international migration of health workers has been described by Nelson Mandela as the ‘poaching’ of desperately needed skills from under-privileged regions. This book examines the controversial recent history of skilled migration, and explores the economic and cultural rationale behind this rise of a complex global market in qualified migrants and its multifaceted outcomes.
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Chapter 9: Policy Implications

John Connell


Well-established structures of migration exist in many developing countries, influencing both skilled and unskilled workers. SHWs have moved to take advantage of superior wages and salaries, training and research opportunities and working conditions for themselves, and to better the lifestyles of their children and extended families, through education, social change and remittances. Without significant changes, migration is likely to continue, where such aspirations remain, and kin are increasingly overseas. Policies that redress issues of supply and demand have proved difficult for most countries. Not only has the rationale for migration been more or less similar for 30 years and in a multitude of countries, but many policies for slowing and reducing the negative effects of migration are similarly longstanding (Mejia et al. 1979; Gish 1971), indicating the problems attached to developing and implementing retention policies. Moreover, governments in source countries have infrequently sought to discourage international migration, and have been less likely to do so in the present century. While the rationale for migration ultimately relates to entrenched issues of global uneven development and national financial support, most migrants assert that they do not want to migrate. Policy initiatives are therefore plausible. At a relatively high level of abstraction it is implicit that in order to achieve the United Nations Millennium Development Goals by 2015, with their particular focus on health issues, a situation that already seems unlikely for SSA (WHO 2006a), better access to health care interventions and thus to SHWs is necessary. That requires more effective recruitment, retention...

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