Migration
The costs and benefits of health worker migration from East and Southern Africa
Brain drain or brain gain?: balancing the costs and benefits of health worker migration
Authors:
R. Robinson; North South Institute; Health Systems Trust; East, Central and Southern African Health Community
Publisher:
EQUINET: Network for Equity in Health in Southern Africa, 2007
This EQUINET discussion paper reviews the literature on health worker migration from East and Southern African (ESA) countries to developed nations. It finds that most research ignores the benefits, both financial and knowledge-related, which countries enjoy when their health professionals emigrate. Instead, it focuses almost entirely on costs. Many researchers identify the medical brain drain as a serious problem because it impacts negatively on health systems, not only in terms of loss of skilled labour but also because governments which subsidise the education of health workers lose their investment when those workers emigrate. However, the paper argues that their research lacks hard quantitative data, making sound analysis of costs almost impossible.
The paper concludes that the overall policy objective should be to manage the migration of health professionals from ESA countries in such a way that it minimises the costs while allowing those countries to enjoy the benefits. It recommends mandatory cost-benefit analysis (CBA) of the migration of health professionals from all sub-Saharan African countries. This in turn will require a comprehensive database on the economic, social and demographic aspects of health worker migration to be developed at country, regional and/or sub-regional level.
