Health professionals' migration in emerging market economies: patterns, causes and possible solutions.
Nair M., Webster P.
BACKGROUND: About a third of the countries affected by shortage of human resources for health are the emerging market economies (EMEs). The greatest shortage in absolute terms was found to be in India and Indonesia leading to health system crisis. This review identifies the patterns of migration of health workers, causes and possible solutions in these EMEs. METHODS: A qualitative synthesis approach based on the 'critical review' and 'realist review' approaches to the literature review was used. RESULTS: The patterns of migration of health professionals' in the EMEs have led to two types of discrepancies between health needs and healthcare workers: (i) within country (rural-urban, public-private or government healthcare sector-private sector) and (ii) across countries (south to north). Factors that influence migration include lack of employment opportunities, appropriate work environment and wages in EMEs, growing demand in high-income countries due to demographic transition, favourable country policies for financial remittances by migrant workers and medical education system of EMEs. A range of successful national and international initiatives to address health workforce migration were identified. CONCLUSIONS: Measures to control migration should be country specific and designed in accordance with the push and pull factors existing in the EMEs.