Keeping their health workers: Comparing “source country” approaches to self sufficiency

The migration of highly skilled health workers from developing to developed nations has increased dramatically in the last five to ten years in response to a range of social, economic and political forces.  The consequences of this shift in health human resources are of critical importance to health outcomes and the overall sustainability of health systems in many of these ‘source’ countries. These consequences have become much more salient in the ongoing debate about the reliance of some high income countries, including Canada, the U.S., the U.K., and Australia, on health workers who migrate from lower income countries.  Little systematic research has examined these consequences, particularly from an in-depth comparative perspective.  This paper will present preliminary data largely from an analysis of public domain documents comparing the migration of highly skilled health workers from, and the range of consequences this entails for, countries that represent some of the key ‘source’ countries.  We focus in particular on the migration of physicians and nurses from the Philippines, India, South Africa, Poland and the Caribbean region as these countries represent some of the key source countries to Canada, the U.S., the U.K., and Australia.  The specific research questions we will explore in our comparative study include:
·           What is the range of circumstances in these five countries/regions that have led to the large-scale migration of their highly skilled health workers?
·           What are the different types of transnational relationships that affect the migration of health workers in these source countries?
·           What, according to those ‘on the ground’, are the most critical consequences of the migration of highly skilled health workers that should be examined? 
·           What is the range of program and policy responses that have been considered, proposed and implemented to address these critical consequences, and what have been some of the outcomes?