Health workers on the move: the need for global policy

Abstract

Issue WHO's Global Code of Practice on the International Recruitment of Health Personnel was adopted in 2010 by WHO Member States to 1: monitor and address unethical international recruitment practices; 2: to strengthen national health workforces. Unethical recruitment and lack of investments in resilient health workforces was leading to increased health inequalities worldwide. The WHO Code provided non-binding behavioral principles to address these. Description The WHO Code came with a monitoring and review mechanism. Member States were to report on Code implementation every three years and every five years the Code's relevance and effectiveness is reviewed. In the 2018/19 reporting round, non-state actors, too, submitted reports to WHO. Wemos carried out a qualitative analysis of these (14) reports and presented the findings to the Expert Advisory Group (EAG) tasked to review the Code in 2019/20. Results Non-state actor reports provide important additional information to Member States' reports on Code implementation. The 14 submissions included cases of unfair treatment of migrant health workers and indicated some improvement in health workforce planning and forecasting. Moreover, they pointed to a lack of efforts (or results thereof) by governments to invest in more resilient health workforces, fueling health worker mobility globally. Lessons These findings are consistent with observations from civil society, trade unions, health professional associations and employers' organizations, as evidenced during the roundtable discussions with the EAG in June 2019. They noted that increased global mobility, not just by health workers, is a given and actually further accelerated by a growing number of inter-country migration agreements, undermining equitable access to a health worker across the globe. They urged for supra-national policies and practices in order to achieve Universal Health Coverage for all by 2030. Key messages With increased global mobility of individuals, an equitable distribution of health workers worldwide surpasses the policy scope of national governments and requires supra-national measures. The involvement of civil society in the monitoring of mobility trends and equity effects of health workforce policies is essential for shared prosperity as envisioned in the SDG Agenda.

Workforce migration and brain drain – A nationwide cross-sectional survey of early career psychiatrists in Nigeria

“…There have been attempts at the international and local levels to mitigate the impact of health worker migration. The World Health Organisation developed a global code of practice in 2010 for the international recruitment of health personnel (Hinlopen et al, 2020 ; Toyin-Thomas et al, 2023 ). The aim was to provide an ethical framework for health worker recruitment and strengthen national health workforces to reduce the reliance of richer countries on health workers from poorer nations; however, implementation has been poor (Hinlopen et al, 2020 ; Toyin-Thomas et al, 2023 ).…”

“…The World Health Organisation developed a global code of practice in 2010 for the international recruitment of health personnel (Hinlopen et al, 2020 ; Toyin-Thomas et al, 2023 ). The aim was to provide an ethical framework for health worker recruitment and strengthen national health workforces to reduce the reliance of richer countries on health workers from poorer nations; however, implementation has been poor (Hinlopen et al, 2020 ; Toyin-Thomas et al, 2023 ). In Nigeria, there was a recent controversial attempt by the National Assembly to restrict the migration of doctors after graduation (Adejoro, 2023 ).…”