1.8.2007 | Von:
James Stewart
Darlene Clark
Paul F. Clark


Healthcare systems around the world are in crisis [1]. In both developed and developing countries systems are struggling to meet the needs of citizens.
Durch die Abwerbung von Fachkräften wird weniger wohlhabenden Staaten die Möglichkeit entzogen, eine angemessene medizinische Versorgung ihrer Bürgerinnen und Bürger zu gewährleisten. (© AP)

One of the most critical challenges these systems face is a shortage of healthcare professionals. In developed countries, national healthcare systems periodically experience shortages of nurses or physicians. Usually these shortages are simply a function of demand growing faster than supply. This is most often corrected by introducing greater incentives into the labour market. By contrast, developing countries have long experienced chronic shortages of healthcare professionals.

These shortages are usually rooted in a lack of resources that prevents the training or retraining of sufficient numbers of nurses, physicians, or other healthcare professionals. However, in recent years, a number of demographic and societal changes have combined to create significant and long-term shortages in both developed and developing countries. There is an almost universal shortage of registered nurses (RNs), caused by increased demand in the face of a declining supply. Many countries also face significant shortages of medical doctors (MDs).

The recruitment of healthcare workers from less developed countries has emerged as one of the main responses of developed countries to the shortage of healthcare professionals. The latter are increasingly being recruited for temporary or permanent positions abroad. Though some of this movement occurs between developed countries, most is from developing to developed countries. The globalisation of the labour market for healthcare professionals has major implications for individual practitioners, for healthcare systems, and for governments. Some of these implications are positive, including the opportunities for nurses and physicians to improve their professional and personal lives and for developed countries to address the shortages of RNs and MDs they face. There are also significant negative consequences, primarily the drain this represents on the ability of less affluent countries to provide adequate healthcare for their citizens [2].

This policy brief begins by describing the extent of worldwide labour shortages in the healthcare sector as well as some general trends in the migration of healthcare workers. It then continues with a brief discussion of the factors which cause and influence this movement. The following section addresses the costs and benefits of the migration of healthcare workers, in both the sending and receiving countries. Finally, the brief presents some policy options which could be implemented by sending and receiving countries in order to mitigate the negative consequences of migration in this sector while balancing the rights and the needs of the main actors involved: healthcare professionals, developed countries and developing countries.


Some of the material included in this brief first appeared in Clark, P.F., Stewart, J.B. and Clark, D.A. (2006): "The Globalization of the Labour Market for Healthcare Professionals." International Labour Review 145 (1-2): 37-64.
See Clark, Stewart and Clark (2006).



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