Lila Sax dos Santos Gomes, Ferry Efendi, Nuzulul Kusuma Putri, Mery Bolivar-Vargas, Rami Saadeh, Pedro A. Villarreal, Thit Thit Aye, Manuela De Allegri, Julia Lohmann
{"title":"国际卫生工作者的移徙和招聘对来源国卫生系统的影响:哥伦比亚、印度尼西亚和约旦利益相关者的观点。","authors":"Lila Sax dos Santos Gomes, Ferry Efendi, Nuzulul Kusuma Putri, Mery Bolivar-Vargas, Rami Saadeh, Pedro A. Villarreal, Thit Thit Aye, Manuela De Allegri, Julia Lohmann","doi":"10.1002/hpm.3776","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>To address domestic shortages, high-income countries are increasingly recruiting health workers from low- and middle-income countries. This practice is much debated. Proponents underline benefits of return migration and remittances. Critics point in particular to the risk of <i>brain drain</i>. Empirical evidence supporting either position is yet rare. This study contributes to filling this gap in knowledge by reporting high-level stakeholders' perspectives on health system impacts of international migration in general, and active recruitment of health workers in specific, in Colombia, Indonesia, and Jordan.</p>\n </section>\n \n <section>\n \n <h3> Method</h3>\n \n <p>We used a multiple case study methodology, based on qualitative methods integrated with information available in the published literature.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>All respondents decried a lack of robust and detailed data as a serious challenge in ascertaining their perspectives on impacts of health worker migration. Stakeholders described current emigration levels as not substantially aggravating existing health workforce availability challenges. This is due to the fact that all three countries are faced with health worker unemployment grounded in unwillingness to work in rural areas and/or overproduction of certain cadres. Respondents, however, pleaded against targeting very experienced and specialised individuals. While observing little harm of health worker migration at present, stakeholders also noted few benefits such as <i>brain gain</i>, describing how various barriers to skill enhancement, return, and reintegration into the health system hamper in practice what may be possible in theory.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Improved availability of data on health worker migration, including their potential return and reintegration into their country of origin's health system, is urgently necessary to understand and continuously monitor costs and benefits in dynamic national and international health labour markets. Our results imply that potential benefits of migration do not come into being automatically, but need in-country supportive policy and programming, such as favourable reintegration policies or programs targeting engagement of the diaspora.</p>\n </section>\n </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3776","citationCount":"0","resultStr":"{\"title\":\"The impact of international health worker migration and recruitment on health systems in source countries: Stakeholder perspectives from Colombia, Indonesia, and Jordan\",\"authors\":\"Lila Sax dos Santos Gomes, Ferry Efendi, Nuzulul Kusuma Putri, Mery Bolivar-Vargas, Rami Saadeh, Pedro A. Villarreal, Thit Thit Aye, Manuela De Allegri, Julia Lohmann\",\"doi\":\"10.1002/hpm.3776\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>To address domestic shortages, high-income countries are increasingly recruiting health workers from low- and middle-income countries. This practice is much debated. Proponents underline benefits of return migration and remittances. Critics point in particular to the risk of <i>brain drain</i>. Empirical evidence supporting either position is yet rare. This study contributes to filling this gap in knowledge by reporting high-level stakeholders' perspectives on health system impacts of international migration in general, and active recruitment of health workers in specific, in Colombia, Indonesia, and Jordan.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Method</h3>\\n \\n <p>We used a multiple case study methodology, based on qualitative methods integrated with information available in the published literature.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>All respondents decried a lack of robust and detailed data as a serious challenge in ascertaining their perspectives on impacts of health worker migration. Stakeholders described current emigration levels as not substantially aggravating existing health workforce availability challenges. This is due to the fact that all three countries are faced with health worker unemployment grounded in unwillingness to work in rural areas and/or overproduction of certain cadres. Respondents, however, pleaded against targeting very experienced and specialised individuals. While observing little harm of health worker migration at present, stakeholders also noted few benefits such as <i>brain gain</i>, describing how various barriers to skill enhancement, return, and reintegration into the health system hamper in practice what may be possible in theory.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Improved availability of data on health worker migration, including their potential return and reintegration into their country of origin's health system, is urgently necessary to understand and continuously monitor costs and benefits in dynamic national and international health labour markets. 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The impact of international health worker migration and recruitment on health systems in source countries: Stakeholder perspectives from Colombia, Indonesia, and Jordan
Introduction
To address domestic shortages, high-income countries are increasingly recruiting health workers from low- and middle-income countries. This practice is much debated. Proponents underline benefits of return migration and remittances. Critics point in particular to the risk of brain drain. Empirical evidence supporting either position is yet rare. This study contributes to filling this gap in knowledge by reporting high-level stakeholders' perspectives on health system impacts of international migration in general, and active recruitment of health workers in specific, in Colombia, Indonesia, and Jordan.
Method
We used a multiple case study methodology, based on qualitative methods integrated with information available in the published literature.
Results
All respondents decried a lack of robust and detailed data as a serious challenge in ascertaining their perspectives on impacts of health worker migration. Stakeholders described current emigration levels as not substantially aggravating existing health workforce availability challenges. This is due to the fact that all three countries are faced with health worker unemployment grounded in unwillingness to work in rural areas and/or overproduction of certain cadres. Respondents, however, pleaded against targeting very experienced and specialised individuals. While observing little harm of health worker migration at present, stakeholders also noted few benefits such as brain gain, describing how various barriers to skill enhancement, return, and reintegration into the health system hamper in practice what may be possible in theory.
Conclusion
Improved availability of data on health worker migration, including their potential return and reintegration into their country of origin's health system, is urgently necessary to understand and continuously monitor costs and benefits in dynamic national and international health labour markets. Our results imply that potential benefits of migration do not come into being automatically, but need in-country supportive policy and programming, such as favourable reintegration policies or programs targeting engagement of the diaspora.
期刊介绍:
Policy making and implementation, planning and management are widely recognized as central to effective health systems and services and to better health. Globalization, and the economic circumstances facing groups of countries worldwide, meanwhile present a great challenge for health planning and management. The aim of this quarterly journal is to offer a forum for publications which direct attention to major issues in health policy, planning and management. The intention is to maintain a balance between theory and practice, from a variety of disciplines, fields and perspectives. The Journal is explicitly international and multidisciplinary in scope and appeal: articles about policy, planning and management in countries at various stages of political, social, cultural and economic development are welcomed, as are those directed at the different levels (national, regional, local) of the health sector. Manuscripts are invited from a spectrum of different disciplines e.g., (the social sciences, management and medicine) as long as they advance our knowledge and understanding of the health sector. The Journal is therefore global, and eclectic.