Geneva Health Forum Archive

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Understanding Health Care Worker Migration

Author(s): C. C. K. Kenner1, N. M. Sugrue2
Affiliation(s): 2School of Nursing, Northeastern University, Boston, 2Women and Gender in Global Perspectives, University of Illinois at Urbana-Champaign, Champaign, United States
Keywords: Migration, non-migration, health care workers, push-pull factors

The migration of health care workers is a global concern; in abundance are conferences, initiatives, and research focusing on these workers, with most of the work and attention centering on those workers who migrate. Most often, the interest in these workers relates to the ethics and consequences of migration as well as to money, remittances, jobs, work environments, opportunities, and quality of life issues; all of which, no doubt, factor into the decision to migrate. However, no comprehensive model of the decision to migrate, or not to migrate, has been developed, and this is a significant theoretical gap in the literature that must be addressed. At the same time, there also is an empirical gap found in most of the work related to migrant health care workers, and that gap is the lack of comparative studies and analyses among health care workers who leave and those who stay.


In response to both the theoretical and empirical gaps, we have initiated a mixed method study focusing on the push- pull factors both for health care workers who decide to migrate and for those health care workers who decide not to migrate. Through oral histories by the health care workers as well as the collection of social, educational, demographic, and economic data on health care workers and their families, we have created a model of health care migration (and non-migration) that includes micro and macro conditions.


The model of health care work migration that is developed from our data is more complex and intricate than what is found in the existing literature. The results of the preliminary study indicate that the decision to migrate is not a mirror image of the decision not to migrate. Health care workers take not only personal economic considerations into account when deciding to migrate, but they also weigh the macro level social and political conditions, the expected professional and personal opportunities, and conduct a personal relative risk assessment. Moreover, their own personal experiences with travel and knowing others who have migrated, both successfully and not successfully matter. The model we present demonstrates how these, and other factors come into play and how they interact with each other as health care workers decide to migrate or not. The decision to migrate is about much more than economics and wages. In addition to developing a more comprehensive model of health care migration, this study will provide a foundation both for: engaging in new discussions related to health care labor migration, and structuring appropriate public policy responses related to health care labor migration.

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