REGIONAL COMMITTEE 18.3 Sixty-first Session SEARO, New Delhi 8-11 September 2008
Provisional Agenda item
SEA/RC61/19 (Rev.1) 26 July 2008
FOLLOW-UP ACTION ON SELECTED RESOLUTIONS/DECISIONS OF THE LAST THREE YEARS: INTERNATIONAL MIGRATION OF HEALTH PERSONNEL: A CHALLENGE FOR HEALTH SYSTEMS IN DEVELOPING COUNTRIES “International migration of the health workforce” is a challenge for Member countries of the WHO South-East Asia (SEA) Region as it impedes the momentum of strengthening health systems. In response to the Regional Committee resolution SEA/RC60/R9 and to sustain the health workforce in the health system it is important to explore ways to deal with unabated migration of the health workforce. Internal migration (rural to urban areas and from public sector to private sector) and external migration of the health workforce are challenges to the health system, especially in developing countries. Improved working conditions, better compensation packages, professional and psychosocial support and career opportunities are needed to retain the health workforce in the health system. However, all of these need to be translated into action. At the same time, it is noted that some Member countries of the SEA Region benefit from international migration of the health workforce as recipient countries. Thus, there is a strong need for regional coordination mechanisms to monitor migrations. Against this background, Member countries proposed to WHO to organize a meeting for Member countries of the Region to share their experiences with a view to mitigate the negative impact of international migration of health personnel. It is acknowledged that migration of health personnel can have a positive impact on the transfer of knowledge and technology. The issue of health professionals not working in the profession should also be taken into account. In response to this growing health workforce problem, the Regional Office is developing tools to assess and explore the trend or pattern of migration and categories of the health workforce that migrate from and to the SEA Region. It is also developing a database for the health workforce in the SEA Region that will contribute towards developing evidence-based policies and strategies for health workforce retention and
for setting up forums for discussion and exploration to develop a regional code of practice for the ethical recruitment of health workers. The latter will enable governmentto-government exchange of the health workforce without incapacitating the health system in the country of origin. The Regional Office is also collaborating with Global Alliance for Health Workforce, World Trade Organization, Asia Pacific Action Alliance for Human Resources for Health (AAAH), International Organization for Migration and Organization for Economic Cooperation and Development for technical and policy dialogue. This working paper was submitted to the Meeting of the Advisory Committee (ACM), held in WHO/SEARO, New Delhi from 30 June to 3 July 2008, for review and discussion. The ACM made the following recommendations:
Action by Member States (1) (2) (3) Assess the health workforce migration pattern, and identify the “push” and “pull” factors specific to a country; Conduct research with regard to migration trends, numbers, types and movements; and Institute mechanisms for motivation of the health workforce and develop appropriate incentive systems to retain them.
Action by WHO/SEARO (1) (2) (3) (4) (5) Develop tools to monitor the health workforce migration into and out of the SEA Region; Develop the health workforce database in the Region and also develop policy dialogue, information-sharing and collaboration with partners; Organize a forum for health workforce migration and regulatory mechanisms; Convene a regional consultation to share experiences on health workforce migration; and Facilitate the study of health workforce movement within Member countries in the Region.
The working paper is now submitted to the Sixty-first Session of the Regional Committee for its consideration.
SEA/RC61/19 (Rev.1)
Follow-up action taken by Member countries of the SEA Region 1. International migration of health workforce is a challenge for countries as it impedes the momentum of strengthening the health systems to fulfil national and international health goals including the millennium development goals. Being fully aware of the “push and pull” factors that influence health workforce to migrate to greener pastures and balancing the right of people to choose where they wish to work and the daunting task of sustaining health workforce in the health system, the Regional Office is taking the following actions: • •
Developing tools to assess the situation to explore the trend or pattern of migration, categories of health workforce that migrate from and to the SEA Region. Developing a regional database for health workforce in the SEA Region that will include quantitative data on health workforce that migrates in and out of the Region by selected categories. It will contribute towards the crafting of policies and strategies for HWF retention. Planning to set-up forums for discussion and exploration of developing regional code of practice for ethical recruitment of health workers that will enable government-to- government exchange of health workforce without incapacitating the health system in the country of origin. Collaboration with Global Alliance for Health Workforce, World Trade Organization, International Organization for Migration, Asia Pacific Action Alliance for Human Resources for Health (AAAH), Organization for Economic Cooperation and Development for technical and policy dialogue.
•
•
2. Countries of the SEA Region are aware of the growing concerns on international migration of health workforce, the unplanned or excessive exits that cause significant losses of workers and compromise the system’s corpus of performance, knowledge of the health system and organizational culture. Thus, systematic management of migration of health workers by striking a balance the freedom of individuals to choose where they wish to work and the need to stem excessive movement from poorer to richer countries is advocated. The priority agenda for health workforce management in Member countries is to develop regulations and interventions to prevent excessive international migration of health workforce that deprives the population of basic and adequate health services especially in cases where the need is critical.