Beyond Borders

By Jennifer Trainor, Key Correspondent for the Irish Forum for Global Health

The migration or mobility of people is not a new concept. In the age of globalization, it has never been easier for individuals, particularly our global youth, to network and seek out new opportunities in other countries. The healthcare workers of today, having a desired and transferable skill set, are at an advantage. There is a health worker shortage and they are needed everywhere. Health workers are taking advantage of that demand.

 The topic of health worker mobility has been a highlighted issue at the Fourth Global Forum on Human Resources for Health. Maximizing Benefits from Health Worker Mobility discussed the overall evidence in patterns, trends, and successful collaborative initiatives regarding mobility among health workers. The panel had representation from the World Health Organization (WHO), Australia, Ireland, Sudan, and South Africa. A key point presented was the importance of empirical data when discussing trends in health worker mobility. For example, Ibadat Dhillon, from the WHO, showed the complex nature of health worker mobility. Beyond the movement of workers from lower income to higher income countries, Mr. Dhillon presented the current trend of global south workers migrating to other global south countries and the increase of movement of workers from the global north to the global south. Overall, the panel was unanimous on one major point: mobility among health workers is real and is not showing any signs of stopping. The fundamental issue is how it is addressed. As Stacey Ann Pillay, of Africa Health Placement, noted:

[Health workers] are starting to be seen as people, and as people who are active agents who participate. We are not being sucked up by a country, but we actively participate in the process of where we work and where we live. […] Whether we like it or not, health workers are on the move.

The World Health Organization (WHO) established the Global Code of Practice on the International Recruitment of Heath Personnel, also known as “The Code”, in 2010. It encouraged countries to voluntarily follow principles on the ethical recruitment of health workers. Countries can also voluntarily complete national reports on current trends and patterns in health worker migration. It served as a platform for continuous dialogue and cooperation between countries (WHO, 2017). Dr. Elsheikh Badr, from the Sudan Medical Specialization Board, presented strategies to address health personnel migration that were initiated from the WHO code. The Code guidelines encouraged Sudan to increase mobility evidence, promote bilateral migration agreements between countries and universities, and harness the knowledge acquired by Sudanese working abroad, all while focusing on national health worker retention strategies. Dr. Ayat Abu-Agla, of the Health Workforce Observatory (Sudan) and Trinity College Dublin’s Centre for Global Health, observed:

Migration is a serious issue. It’s a reality that we have to deal with. It shapes the political, social, and cultural health systems that we live in.

Health worker mobility is a complex issue. It is evident that we cannot stop mobility, nor do I think we should. Health workers migrate for a variety of different reasons: perhaps it is the prospect of better working conditions, further training opportunities, a full-time contract offer, a salary increase, or simply the chance to travel. I believe in the exchange of information, technology, and skills, but we also need to support countries with fragile health systems. Evidence in trends and patterns of migration is key, and countries must keep the dialogue going. Initiatives, such as the Code, will hopefully maintain ethical mobility, but also encourage countries to keep working on their retention strategies.

November 17th, 2017

Jennifer Trainor is a registered nurse from Montreal, Canada, with experience in neonatal and obstetrical nursing. She is currently pursuing a PhD in nursing and global health at Trinity College Dublin, Ireland, with a focus in maternal and child health. In her spare time, Jennifer enjoys SCUBA diving and horseback riding.