Hiding in Plain Sight: Gendered Dimensions of Health Worker Migration from ‘Source’ Country Perspectives

Abstract

Background: Gender roles affect health worker migration and their migration experiences, but policy responses have rarely considered the gender dimensions of health worker migration. This invisibility and lack of attention can lead to social, health and labour market inequities. Methods: A Canadian-led research team with co-investigators in the Philippines, South Africa, and India studied the international migration of health workers from these ‘source’ countries through documentary, interview and survey data with workers and country-based stakeholder interviews. Our particular focus was to examine the causes, consequences and policy responses to health worker migration. Here we undertake an explicit gender-based analysis highlighting the gender-related influences and implications that emerged from the literature, policy documents and empirical data. Results: Our data from nurses, physicians, and other health workers reveal that gender mediates health workers’ access and participation in health worker training, employment, and migration, and the impact of health worker migration is gendered, depending on country context. Female migrant health workers were “preferred” for “innate” personal characteristics and cultural reasons. Female nurse migration in particular is greatly influenced and linked to personal relationships and social networks including friends in the diaspora. Remittances by female nurses to family back home may play a large role in the decision to migrate. Migration may improve social status of women nurses, but it also exposes them to deskilling, sexism and racialization. Regardless of these apparent differences in migration decision-making and experiences for women and men health workers, gender is rarely considered either as an important contextual influence or analytic category in the policy responses.Conclusion: An explicit gender-based analysis on health worker migration offers useful insights for health workers considering migration and those that ultimately migrate, the workplaces and families they leave behind, and social and health policy of their countries.