Causes, consequences, and policy responses to the migration of health workers: key findings from India
Causes, consequences, and policy responses to the migration of health workers: key findings from India
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DOI：
10.1186/s12960-017-0199-y
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发表时间：
2017-04-05
影响因子：
4.5
通讯作者：
Bourgeault, Ivy Lynn
中科院分区：
文献类型：
--
作者：
Walton-Roberts, Margaret;Runnels, Vivien;Bourgeault, Ivy Lynn
背景：这项研究试图更好地了解熟练卫生专业人员移徙的驱动因素、其后果以及各国为减轻其负面影响而采取的各种战略。这项研究是在四个国家--牙买加、印度、菲律宾和南非--进行的，这些国家历来是卫生工作者移民到其他国家的“源头”。方法：通过对印度全科医生和专科医生、护士、助产士、牙医、药剂师、营养师和其他专职健康治疗师的调查收集数据。我们还对代表政府各部委、专业协会、地区卫生当局、卫生保健机构和教育机构的主要利益攸关方进行了结构性采访。定量数据采用描述性统计和回归模型进行分析。结果：在印度某些地区和某些专业领域，卫生工作者的短缺是明显的，但由于缺乏证据和卫生信息，这种短缺的程度和性质很难确定。这种短缺与国际移民之间的关系尚不清楚。卫生工作者移徙的政策对策也同样纳入旨在卫生人力管理的更广泛的进程，但总的来说，没有明确的政策议程来管理卫生工作者移徙。印度的决策者对限制移民的必要性或可取性提出了相互矛盾的选择。结论：卫生工作人员移民对印度卫生保健系统的影响不容易从其他复杂因素中区分出来。研究表明，必须结合国内的培训、招聘和留用政策来审视印度熟练卫生工作者的短缺，而不是将其视为卫生工作者国际移徙的直接后果。
Background: This study sought to better understand the drivers of skilled health professional migration, its consequences, and the various strategies countries have employed to mitigate its negative impacts. The study was conducted in four countries-Jamaica, India, the Philippines, and South Africa-that have historically been "sources" of health workers migrating to other countries. The aim of this paper is to present the findings from the Indian portion of the study.Methods: Data were collected using surveys of Indian generalist and specialist physicians, nurses, midwives, dentists, pharmacists, dieticians, and other allied health therapists. We also conducted structured interviews with key stakeholders representing government ministries, professional associations, regional health authorities, health care facilities, and educational institutions. Quantitative data were analyzed using descriptive statistics and regression models. Qualitative data were analyzed thematically.Results: Shortages of health workers are evident in certain parts of India and in certain specialty areas, but the degree and nature of such shortages are difficult to determine due to the lack of evidence and health information. The relationship of such shortages to international migration is not clear. Policy responses to health worker migration are also similarly embedded in wider processes aimed at health workforce management, but overall, there is no clear policy agenda to manage health worker migration. Decision-makers in India present conflicting options about the need or desirability of curtailing migration.Conclusions: Consequences of health work migration on the Indian health care system are not easily discernable from other compounding factors. Research suggests that shortages of skilled health workers in India must be examined in relation to domestic policies on training, recruitment, and retention rather than viewed as a direct consequence of the international migration of health workers.