The need for partnerships in migration for medical workers
Authors: Caroline Theoharides
Journal: The Lancet Neurology (2024)

In an Editorial,1The Lancet NeurologyImproving neurological services in and out of Africa.Lancet Neurol. 2024; 23: 1Summary Full Text Full Text PDF Google Scholar The Lancet Neurology discussed the scarcity of neurological specialists in low-income countries, particularly in Africa, due to few training opportunities and to international migration. I agree that global partnerships are key for ensuring the viability of the health workforce across countries, but would like to highlight some relevant evidence in this respect. Economists, like myself, have long questioned the merits of the brain drain versus brain gain debate. On the one hand, recruiting medical workers might lead to shortages in countries of origin. On the other hand, high economic returns abroad for specific skills might lead individuals to invest more in education; given that migration remains a low probability event, such investment can increase the number of skilled workers in the origin country. The migration of nurses from the Philippines could inform the design of policy regarding medical workers, with a few caveats. In collaboration with Paolo Abarcar,2Abarcar P Theoharides C Medical worker migration and origin-country human capital: evidence from US visa policy.Rev Econ Stat. 2024; 106: 20-35Crossref Scopus (0) Google Scholar our research found that an increase in visas to the USA for nurses in 2000 led to substantially higher nursing school enrolment and graduation in the Philippines. For each new nurse that migrated, approximately nine newly licensed nurses remained in the Philippines. Similarly, when visa availability was reduced 7 years later, a sharp reduction in nursing graduates followed. Without opportunities to migrate, many individuals chose other fields of study instead of nursing. Such brain gain was possible in the Philippines due to the ability of the tertiary education system to respond quickly. The supply of nursing schools rapidly increased, largely through the creation of nursing programmes at existing private universities. Despite these gains, many licensed nurses chose not to work in hospitals, due to low wages and unsafe working conditions.3Philippine Institute for Labor StudiesStudy on the Filipino health workforce: a sequential exploratory analysis of the decent work indicators in the health sector.https://ils.dole.gov.ph/downloads/file/706-study-on-the-filipino-health-workforce-a-sequential-exploratory-analysis-of-the-decent-work-indicators-in-the-health-sectorDate: 2021Date accessed: March 12, 2024Google Scholar Other graduates never passed the licensure exam. These facts point to the need for better partnerships between departments of labour, ministries of health and education, and immigration agencies in both origin countries and destination countries. The Editorial notes the need for more research on the migration of health personnel, especially in Africa. I urge partnerships of policy makers, medical researchers, physicians, and economists to make this research—and thus the alleviation of dire medical shortages—a reality. I declare no competing interests. I thank Amherst College for financial support.