Migration of health workers

The health sector workforce is large and diverse, and includes several highly trained groups. Health workers are of crucial importance to global health systems, which are under increasing pressure because:

  • In less developed contexts, health systems are beginning from a low base and limited health human resources are hindering improvements in mortality and morbidity.
  • In more developed contexts, the ageing of populations is creating an exponential demand for health workers which is not being met from internal training systems.

The countries in South and South-West Asia are influenced by both these trends since they have a below global average provision of health services yet they are also suffering a burgeoning outflow of health workers to OECD and other high- income countries. Three countries in this region, namely India, the Islamic Republic of Iran and Pakistan, are among the ten countries that have the largest numbers of doctors working abroad (World Bank 2011).

In India, despite having the world’s largest emigrant source of doctors, the doctor-to-population ratio in 2006 was 60:100,000 compared with 548.9:100,000 in the United States of America (Khadria 2009). The country, which is also one of the world’s major sources of emigrant nurses, had had only 79 nurses per 100,000 population in 2006 compared with 782 in the United States of America (Khadria 2009).

There is increasing global concern regarding the ‘brain drain’ of health professionals from this subregion as well as other low-income subregions (OECD and WHO 2010). WHO (2010) has developed a Global Code of Practice on the International Recruitment of Health Personnel and the acceptance and implementation of this is an important priority.