Inaugural Commonwealth Nurses Conference Our health: our common wealth March 2012 London UK

Transcription

1 Inaugural Commonwealth Nurses Conference Our health: our common wealth March 2012 London UK Mr DHUNRAJ FOOLCHAND An analysis of factors influencing nurse migration from Mauritius In collaboration with the 9 th CNF Europe Region Conference Supported by the Royal College of Nursing UK

2 COMMONWEALTH NURSES FEDERATION London,United Kingdom AN ANALYSIS OF THE FACTORS INFLUENCING THE MIGRATION OF NURSES FROM MAURITIUS by Dhunraj FOOLCHAND RN,Chairman Nursing Council Bsc(Hons)Nursing Master in Public Health MSc Health Services Management

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4 COUNTRY LOCATION

5 OUTLINE OF PRESENTATION Definition & overview of migration. Nurse migration. Facts and figures. Push and pull factors. The local context. Ethical issues & way forward. Conclusion.

6 DEFINITION OF MIGRATION Migration - usually refers to the geographic movement of people across a specified boundary for purpose of establishing a new or semi permanent residence. International migration- involves movement of migrants between two countries. Immigration - the act of moving into a new country. Emigration the act of moving out of home country.

7 WHY MIGRATION? Migration is increasingly seen as a mean for development and a better distribution of global wealth(iom 2003). Worker migration is a result of the interplay of economic, social, cultural, political and legal forces. Globalisation is significantly facilitating the process of worker migration. Skilled professional migrants consist mainly of engineers, I.T workers & health professionals. But the fact remains that health professionals occupy the greatest share of the market with nurses and midwives being increasingly part of the migratory system

8 THEORIES OF MIGRATION Migration is the outcome of a rational evaluation of costs and benefits of movement(todaro 1985 Neo classical theory). Migration of skilled professionals is often a response to the lack of opportunity in their home country and the availability of opportunity and deliberate promotion of immigration in the other (Saravia& Miranda 2004). Migration leads to brain drain, depletion of workforce, poor quality of service, low productivity and pressure on economy(findlay&lowell 2002). Individual is the main decision maker in isolation from the household or the community.

9 WHY NURSE MIGRATION? High vacancy and attrition rates in health sector worldwide tend to influence the level of nurse migration (ICN 2004). Nurse shortages in developed countries such as, Canada, USA, New Zealand and Australia have accelerated international nurse migration and recruitment(iom2003). Nurse migration is a social phenomenon, that occurs in a context of increasing global mobility and growing competition for scarce skills.

10 IMPACT OF NURSE MIGRATION POSITIVE Improve knowledge base that is brain gain Trans cultural nursing work force Exposure to specialities and use of latest technology Improve social and professional image NEGATIVE Brain drain and loss of human capital. Cost and time of training human power. Pressure on nurses because of staff shortages. Abusive recruitment & employment practices. Vulnerable status of migrants.

11 THE CAROUSEL MOBILITY OF NURSES Many nurses leave their source countries with the intention to migrate to several countries, until they settle in one of their choice (Kingma2001). 43% of foreign nurses surveyed in London have expressed their intention to migrate to other countries, particularly the U.S (Buchan 2005)

12 REASONS INFLUENCING NURSES TO MIGRATE Improved learning and practice opportunities. Better pay and working conditions. Improved quality of life and personal safety. (Buchan 2002;Kline 2003;Kingma 2008 & ICNM 2008)

13 PUSH AND PULL FACTORS PUSH FACTORS Low pay Poor working conditions Lack of resources to work effectively Limited career opportunities Limited educational opportunities Dangerous work environment Economic instability PULL FACTORS Higher pay Better working conditions Better resourced health system Career opportunities Provision of post basic education Safe working environment Political stability and travel opportunities. Trans cultural nursing workforce

14 THE DEMAND FOR NURSES GENERAL Ageing population Increasing population growth. Burden of chronic and non communicable diseases. SPECIFIC Ageing nursing workforce. Inadequate human resource planning and management. Growth for alternative career opportunities for women. Underinvestment on training and development.

15 THE MAURITIAN CONTEXT Mauritius identified as one country where nursing students join their training with the intention to migrate(whr 2006). Around 600 nurses have migrated mainly to UK since 1999 (MOH&QOL). More than 1300 nurses have migrated since 2000 (MNA). Acute nurse shortage felt in both private and public sector since Private clinics and Private hospital started recruiting foreign nurses from India for the first time.

16 POLICY DECISION & ACTUAL SITUATION Government came up with a retention plan in Nurses not allowed long vacation leave or leave without pay to visit countries where nurses are on high demand. Despite this, many nurses have resigned to take jobs abroad. Nurses in the age group of have continued and are more keen to leave their job.

17 FACTS AND FIGURES On average 1 nurse in 20 trained in Africa are working in OECD countries (ICNM 2008). USA the largest importer of nurses. Philippines and India are the largest providers of nurses to indusdrialised countries. Foreign nurses account 5%-10% in Australia, UK, Canada and USA. Predicted shortfall- US,275000(2010), UK,53000(2010) Ireland,10000(2008),Canada,78000(2011) Australia,40000(2010). By 2020 there will be a shortfall of 800,000 nurses in USA and 600,000 in Sub Saharan African Countries. The emigration rate of nurses are very high in Jamaica, Trinidad, Tobago, Haiti, Phillipines & India (OECD2009).

18 ETHICAL ISSUES WHO global code of practice & ICN position statement on nurse recruitment (2000) advocate: No recruitment to be made in developing countries where there is shortage. No discrimination against migrant nurses. Effective planning for a sustainable nursing workforce. The provision of support for developing countries.

19 THE WAY FORWARD Proper human resource planning and sustainable training program. Improved working conditions. Provide resourced health system and opportunities for professional growth. Regulate international nurse recruitment and enforce ethical recruitment code. Promote circular migration and foster bilateral agreement. Train for export.

20 CONCLUSION Migration of nurses will be ongoing because of international mobility due to globalisation. Nurse migration is pushed, pulled and shaped by a constellation of forces and determined by a series of choices. If nurse migration is to be reduced, the need to migrate must be addressed, rather than to curb the flow. In one way or another a better life and livelihood are at the root of decisions for a nurse to migrate.

21 END OF PRESENTATION THANK YOU VERY MUCH FOR YOUR ATTENTION