Source Country Perspectives on the Migration of Health Personnel: Causes Consequences and Responses S U M M E R 2 0 1 3 Health Worker Migration Symposium, Ottawa INSIDE THIS ISSUE: Project Overview 2 Co-PIs 2 India 3 Jamaica 4 Philippines 4 South Africa 5 IPA 6 Scoping Reviews 6 HWM Website 7 SAVE THE DATE Sept. 16th, 2013 We cordially invite all of you connected with the destination and source country projects to join us for a one-day Symposium in Ottawa: Monday 16 Sept. 2013 9:00am 5:00pm Symposium on Destination and Source Country Perspectives on Health Worker Migration Room 12102 Desmarais Building 55 Laurier Avenue East University of Ottawa Ottawa, ON, Canada The Symposium combines the findings from two research projects which you have been involved with in some shape or form. The morning will be devoted to Destination Country perspectives. Presenters will share their data on the trends and impacts of health worker migration to the key destination countries of Canada, Australia, the UK and the USA. In the afternoon, researchers from the Source Country project will share their findings on health worker migration from key source countries of India, the Philippines, South Africa and Jamaica. Mid-day will involve a series of poster presentations. Where to stay: Desmarais Building Several project members will be staying at Les Suites Ottawa (130 Besserer Street, Ottawa). Other hotels in close walking proximity to the Symposium location are Novotel (33 Nicholas St. ) and The Westin (11 Colonel By Dr. ). RSVP for the Symposium: Please inform Lisa Childs at lchilds@uottawa.ca by Friday September 6th if you will be attending the meeting. We hope to see you all there!
The aim of this project is to undertake a multi-method comparative analysis of the causes, consequences and responses of some of the key source countries to the migration of their health workers. We have focused in particular on the migration of highly skilled health professionals working in management, planning, care delivery, and education from the Philippines, India, South Africa, and Jamaica. Through key informant interviews and health professional surveys, the following questions will be explored: Source Country Project Overview 1. What is the present picture of and recent historic trends in the migration of highly skilled health personnel in each of our major source countries, of HHR flows? 2. What, according to those on the ground are the most critical consequences of the migration of health workers Health that Worker should Migration be examined Website and how could these consequences be measured for comparative policy analyses? P A G E 2 3. What is the range of program and policy responses that have been considered, proposed and implemented to address these causes and consequences of health worker migration from low- to high-income countries, and what have been some of the outcomes to these responses? Co-Principal Investigators Ivy Bourgeault, PhD, Professor, Interdisciplinary School of Health Sciences, University of Ottawa, (613) 562-5800 ext.8614 ivy.bourgeault@uottawa.ca Ronald Labonté, PhD, Professor, Faculty of Medicine, University of Ottawa, (613) 562-5800 ext.2288 rlabonte@uottawa.ca Gail Tomblin Murphy, RN, PhD, Professor, School of Nursing, Faculty of Health Professions and Community Health, Dalhousie University, (902) 494-2228 gail.tomblin.murphy@dal.ca
Atul Sood is a co-lead for the India Case Study. He is covering the Punjab Region. Atul works at the Institute for Development and Communication (IDC) in Chandigarh, India. India Research Team P A G E 3 Dr. Irudaya Rajan is also a co-lead for the India Case study within the Kerala Region. He is a professor at the Centre for Development Studies in Trivandrum, India. Margaret Walton Roberts is a co-lead for the India Case Study. She works at Wilfrid Laurier University, Waterloo, Ontario, Canada. Dr. Philomina Thomas is a co-lead for the India Case Study. She works at the All India Institutes of Medical Science in New Delhi, India India Key Informant Interviews Key informant interviews in India have been carried out by three research hubs. Dr. Philomina Thomas of the College of Nursing at the All India Institutes of Medical Sciences in New Delhi has conducted some 15 interviews in New Delhi. Professor Irudaya Rajan, based at the Centre for Development Studies, has conducted nearly 40 interviews in and around the Kerala region. Professor Atul Sood of the Institute for Development and Communication is conducting the remainder of the interviews. India Health Personnel Surveys Professor Rajan, Professor Sood and their teams are currently conducting the randomly selected face-to-face health personnel surveys. Their aim is to collect as many as 1,600 surveys, focusing on four types of target respondents: doctors, nurses, pharmacists and physiotherapists who were active members of professional associations in 2012.
P A G E 4 Jamaica Case Study Health services in the public sector in Jamaica are provided at primary, secondary and tertiary levels. The public sector, administered by the Ministry of Health, is the foundation of Jamaica's health care system, supplemented by a private sector that is not highly regulated. There are 23 government-run hospitals, and a teaching hospital at the University of West Indies. The Jamaican component of this project is being undertaken by the Ministry of Health's Strategic Human Resource Management Unit, under the leadership of Mr. Benjamin Waysome and Mrs. Joan Guy-Walker and coordinated by Ms. Rowena Palmer. The health professional groups being included in the Jamaica component are doctors, nurses, midwives, and dental auxiliaries. The key informant interviews have been completed and the survey of health professionals will be completed soon. Dr. Erlinda (Caster) Palaganas is the national lead for the Philippines Case Study. She is a professor at the College of Social Sciences (Institute of Management), University of the Philippines in Baguio. Philippines Research Team Dr. Denise Spitzer is the Canadian lead for the Philippines Case Study. She is based at the Institute of Women's Studies and the Institute of Population Health at the University of Ottawa Philippines Key Informant Interviews Prof. Erlinda (Caster) Palaganas is a coinvestigator on the project and national lead for the Philippines case study. She is based at the University of the Philippines - Baguio campus and works with Dr. Jaime Tan and Dr. Kenneth Ronquillo. A large research team has been created to undertake both the key informant interviews and the health personnel surveys. Due to her expertise on migrant Filipina health care workers, Dr. Denise Spitzer of University of Ottawa has also joined the team as Canadian co-lead for this country study. The team has been able to conduct approximately 25 key informant interviews. Data analysis is under way. Four types of target respondents have been sought for the health personnel survey: doctors, nurses, midwives, and allied professionals, including speech pathologists, and occupational and physical therapists. Five hundred sample respondents were to be selected at random from each of the four lists, for a total of 2,000 sample respondents. Two modes of data collection are being employed. The first involves completing a survey instrument online. The second mode, which has been completed, involved household surveys. This second mode was employed to capture individuals who studied or trained to be in the health professions but perhaps did not become as successful as those who are active members of the professional associations to be covered in the online survey. Based on the most recent population census, after Metro Manila, the province of Cebu ranked as the province with the highest number of its population with degrees in the field of health. Both sites were therefore targeted for the household survey.
Dr. Jonathon Crush is a co-lead for the South Africa Case Study. He working on the health personnel surveys within the D e p a r t m e n t o f Environmental and Geographical Science at the University of Cape Town, South Africa. South Africa Research Team Dr. David Sanders is also a co-lead for the South Africa Case Study. He is working on key informant interviews based at the University of the Western Cape, South Africa. P A G E 5 Dr. Yoswa Dambisya is a co-lead for the South Africa Case Study. He is a professor at the University of Limpopo, South Africa and is working on key informant interviews in that region. South Africa Health Personnel Surveys Four types of target respondents were recruited for the health personnel survey in South Africa: doctors, nurses, pharmacists, and dentists. Individuals were selected at random from each of the four lists, for a total of 2,000 sample respondents. All individuals participating had to be active members of professional associations and completed a selfadministered online survey. Prof. Crush and his assistant were able to use the services of Medpages, which carries lists of members of professional health associations categorized by specific profession. The research team is now beginning data analysis. South Africa Key Informant Interviews Key informant interviews are being carried out through two research hubs in South Africa. One is located at the University of the Western Cape s School of Public Health in Cape Town. This hub is headed by Prof. David Sanders and Prof. Thubelihle Mathole. The second hub sits at the University of Limpopo, headed by Prof. Yoswa Dambisya. The research teams are busy conducting the remaining key informant interviews with a range of stakeholder representatives, including but not limited to professional educators, regulators, national government agency officials (e.g., dealing with immigration and health human resources), local government authorities, recruitment agencies, and representatives from professional associations and councils. It is anticipated that 20 to 30 key informants will have been interviewed.
International Policy Analysis Dr. Nicola Yeates is a Professor of Social Policy in the Department of Social Policy and Criminology at the Open University, Milton Keynes, in the UK. She has published widely on issues of gender and migration in relation to health, social care and social protection policy across diverse country settings and spheres of crossborder governance. Dr. Yeates is conducting interviews with key international agencies interested in and influential in the migration of highly skilled health professionals. This component of the project will enable the discovery of policy responses con sidered, proposed, and implemented to address the causes and consequences of h e alth work er migr at ion and to identify some of the outcomes to these responses. Eleven interviews have been conducted thus far. MDGs are a focus for many international policy organizations. Scoping Reviews Country Reports Dr. Vivien Runnels and Birama Apho Ly have recently joined the Source Country Project team at the University of Ottawa. Apho, a PhD student in Population Health, is in the process of completing a scoping review of the French language literature on the migration of health workers. One of the posters projected for the September meeting will show his findings. Vivien, who has worked in the past with Dr. Packer and Dr. Labonté on migration and health human resources, is continuing the scoping reviews of the literature commenced by Brenda Dogbey. To help of all country teams, Vivien will ensure that country reports for South Africa, India, Philippines and Jamaica will be ready in time for the September meeting in Ottawa.
The Health Worker Migration Website was launched in May 2009. The purpose of this website is to bring together the perspectives of health policy researchers and decision-makers who have an interest in the migration of health professionals from either a destination country or source country perspective. The website contains: Health Worker Migration Website News/video clips that address issues related to health worker migration from across the globe, Important links related to health worker migration information from across the globe Access to numerous resources for researchers as well as highlighted work from team members. Click the link to visit the website: www.healthworkermigration.com This website P A G E 7 brings together perspectives of health policy researchers and decisionmakers who have an Updates to the site! Health Worker Migration Library: The Library is now Live, access the Library by clicking here! Profiles: Meet the team! Profiles of researchers and collaborators have been updated. Contact us if you wish to have any changes made to your profile. Publications: Publications have been added and updated. Let us know if there any other publications you would like to see featured. Videos: Additional videos on topics related to migration of health personnel have been added. Suggestions: Please email contacttus@healthworkermigration.com interest in the migration of health professionals from either a destination or source country perspective." Compilation by various contributors. Institute of Population Health, University of Ottawa, Ontario, Canada