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2006 Health in Foreign Policy Forum Migration and the Global Shortage of Health Care Professionals
With an expected nurse shortage of 800,000 and physicians shortage of 200,000 by 2020, U.S. hospitals are increasingly looking abroad to resolve staffing needs. Currently 22 percent of physicians and 12 percent of nurses in the United States are foreign born, but these figures are likely to rise. The paradox is that thousands of qualified medical and nursing school applicants are turned away each year in this country. U.S. shortages directly affect the health workforce shortages in both rich and poor countries around the world. Countries such as Canada, the United Kingdom, and Australia are losing nurses to the United States, and are deeply concerned that active recruitment by U.S. hospitals will further exacerbate their shortages. Approximately 30 percent of the U.S. health workforce comes from other developed nations. These same countries also recruit internationally to resolve their shortages. The United Kingdom, for example, now imports more nurses from abroad than it trains at home. But because these developed countries have smaller workforces than the United States, the absolute recruitment numbers remain low. Seventy percent of foreign nurses and physicians in the United States come from developing countries, most of them English-speaking nations of Africa, the Caribbean, and Southeast Asia. This scaling up of international recruitment in the United States comes against a backdrop of massive health worker shortages in these regions. While the World Health Organization recommends a minimum of 500 nurses and 20 physicians per 100,000 people, many sub-Saharan African countries, for example, have fewer than 50 nurses and 5 physicians per 100,000. For the Caribbean and Sub-Saharan African countries, the problem of health worker migration is a serious threat to health systems already reeling from the HIV/AIDS epidemic. Unfortunately, few international aid efforts are addressing this issue, despite a large U.S. investment in programs to prevent and treat HIV/AIDS. Without a long-term strategy for building the workforce that delivers care in these countries, the impact of HIV/AIDS programs will be severely impaired. India, China, and the Philippines represent a different situation. They are able, at least in theory, to produce more health workers than they can currently employ. Some representatives from these countries believe that as long as the migratory flow is steady and can be anticipated, there are many positive effects of migration, including remittances back to the country, as well as expanded educational and work opportunities abroad, followed in some cases by the return of emigrants to their home country. While the complexities of health workforce shortages and international recruitment make a single solution impossible, there is an urgent need to bring together domestic health and foreign policy experts to explore complementary policies that can be tailored to specific regional situations. These two sectors rarely coordinate, but in this case, the absence of dialogue means that U.S. domestic practices threaten to undermine our foreign aid objectives. The Forum will initiate dialogue around a shared goal: building health workforce capacity in this country and abroad. Bellagio Conference: International Nurse Migration 2005 Health in Foreign Policy Forum Archives ___________________________________ |
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