Health worker migration from South Africa: causes, consequences and policy responses

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dc.contributor.authorLabonté, Ronald
dc.contributor.authorSanders, David
dc.contributor.authorMathole, Thubelihle
dc.contributor.authorCrush, Jonathan
dc.contributor.authorChikanda, Abel
dc.contributor.authorDambisya, Yoswa
dc.contributor.authorRunnels, Vivien
dc.contributor.authorPacker, Corinne
dc.contributor.authorMacKenzie, Adrian
dc.contributor.authorMurphy, Gail Tomblin
dc.contributor.authorBourgeault, Ivy Lynn
dc.date.accessioned2021-10-08T07:04:13Z
dc.date.available2021-10-08T07:04:13Z
dc.date.issued2015
dc.description.abstractBackgroundThis paper arises from a four-country study that sought to better understand the drivers of skilled health worker migration, its consequences, and the strategies countries have employed to mitigate negative impacts. The four countries—Jamaica, India, the Philippines, and South Africa—have historically been “sources” of skilled health workers (SHWs) migrating to other countries. This paper presents the findings from South Africa.MethodsThe study began with a scoping review of the literature on health worker migration from South Africa, followed by empirical data collected from skilled health workers and stakeholders. Surveys were conducted with physicians, nurses, pharmacists, and dentists. Interviews were conducted with key informants representing educators, regulators, national and local governments, private and public sector health facilities, recruitment agencies, and professional associations and councils. Survey data were analyzed using descriptive statistics and regression models. Interview data were analyzed thematically.ResultsThere has been an overall decrease in out-migration of skilled health workers from South Africa since the early 2000s largely attributed to a reduced need for foreign-trained skilled health workers in destination countries, limitations on recruitment, and tighter migration rules. Low levels of worker satisfaction persist, although the Occupation Specific Dispensation (OSD) policy (2007), which increased wages for health workers, has been described as critical in retaining South African nurses. Return migration was reportedly a common occurrence. The consequences attributed to SHW migration are mixed, but shortages appear to have declined. Most promising initiatives are those designed to reinforce the South African health system and undertaken within South Africa itself.ConclusionsIn the near past, South Africa’s health worker shortages as a result of emigration were viewed as significant and harmful. Currently, domestic policies to improve health care and the health workforce including innovations such as new skilled health worker cadres and OSD policies appear to have served to decrease SHW shortages to some extent. Decreased global demand for health workers and indications that South African SHWs primarily use migratory routes for professional development suggest that health worker shortages as a result of permanent migration no longer pertains to South Africa.
dc.identifier.apacitationLabonté, R., Sanders, D., Mathole, T., Crush, J., Chikanda, A., Dambisya, Y., ... Bourgeault, I. L. (2015). Health worker migration from South Africa: causes, consequences and policy responses. <i>Human Resources for Health</i>, 13(1), 174 - 177. http://hdl.handle.net/11427/34454en_ZA
dc.identifier.chicagocitationLabonté, Ronald, David Sanders, Thubelihle Mathole, Jonathan Crush, Abel Chikanda, Yoswa Dambisya, Vivien Runnels, et al "Health worker migration from South Africa: causes, consequences and policy responses." <i>Human Resources for Health</i> 13, 1. (2015): 174 - 177. http://hdl.handle.net/11427/34454en_ZA
dc.identifier.citationLabonté, R., Sanders, D., Mathole, T., Crush, J., Chikanda, A., Dambisya, Y., Runnels, V. & Packer, C. et al. 2015. Health worker migration from South Africa: causes, consequences and policy responses. <i>Human Resources for Health.</i> 13(1):174 - 177. http://hdl.handle.net/11427/34454en_ZA
dc.identifier.issn1478-4491
dc.identifier.ris TY - Journal Article AU - Labonté, Ronald AU - Sanders, David AU - Mathole, Thubelihle AU - Crush, Jonathan AU - Chikanda, Abel AU - Dambisya, Yoswa AU - Runnels, Vivien AU - Packer, Corinne AU - MacKenzie, Adrian AU - Murphy, Gail Tomblin AU - Bourgeault, Ivy Lynn AB - BackgroundThis paper arises from a four-country study that sought to better understand the drivers of skilled health worker migration, its consequences, and the strategies countries have employed to mitigate negative impacts. The four countries—Jamaica, India, the Philippines, and South Africa—have historically been “sources” of skilled health workers (SHWs) migrating to other countries. This paper presents the findings from South Africa.MethodsThe study began with a scoping review of the literature on health worker migration from South Africa, followed by empirical data collected from skilled health workers and stakeholders. Surveys were conducted with physicians, nurses, pharmacists, and dentists. Interviews were conducted with key informants representing educators, regulators, national and local governments, private and public sector health facilities, recruitment agencies, and professional associations and councils. Survey data were analyzed using descriptive statistics and regression models. Interview data were analyzed thematically.ResultsThere has been an overall decrease in out-migration of skilled health workers from South Africa since the early 2000s largely attributed to a reduced need for foreign-trained skilled health workers in destination countries, limitations on recruitment, and tighter migration rules. Low levels of worker satisfaction persist, although the Occupation Specific Dispensation (OSD) policy (2007), which increased wages for health workers, has been described as critical in retaining South African nurses. Return migration was reportedly a common occurrence. The consequences attributed to SHW migration are mixed, but shortages appear to have declined. Most promising initiatives are those designed to reinforce the South African health system and undertaken within South Africa itself.ConclusionsIn the near past, South Africa’s health worker shortages as a result of emigration were viewed as significant and harmful. Currently, domestic policies to improve health care and the health workforce including innovations such as new skilled health worker cadres and OSD policies appear to have served to decrease SHW shortages to some extent. Decreased global demand for health workers and indications that South African SHWs primarily use migratory routes for professional development suggest that health worker shortages as a result of permanent migration no longer pertains to South Africa. DA - 2015 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - Human Resources for Health LK - https://open.uct.ac.za PY - 2015 SM - 1478-4491 T1 - Health worker migration from South Africa: causes, consequences and policy responses TI - Health worker migration from South Africa: causes, consequences and policy responses UR - http://hdl.handle.net/11427/34454 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34454
dc.identifier.vancouvercitationLabonté R, Sanders D, Mathole T, Crush J, Chikanda A, Dambisya Y, et al. Health worker migration from South Africa: causes, consequences and policy responses. Human Resources for Health. 2015;13(1):174 - 177. http://hdl.handle.net/11427/34454.en_ZA
dc.language.isoeng
dc.publisher.departmentLaw Clinic
dc.publisher.facultyFaculty of Law
dc.sourceHuman Resources for Health
dc.source.journalissue1
dc.source.journalvolume13
dc.source.pagination174 - 177
dc.source.urihttps://dx.doi.org/10.1186/s12960-015-0093-4
dc.subject.otherAdult
dc.subject.otherAttitude of Health Personnel
dc.subject.otherDelivery of Health Care
dc.subject.otherDentists
dc.subject.otherDeveloping Countries
dc.subject.otherEmigration and Immigration
dc.subject.otherEmployment
dc.subject.otherFemale
dc.subject.otherHealth Policy
dc.subject.otherHumans
dc.subject.otherJob Satisfaction
dc.subject.otherMale
dc.subject.otherMiddle Aged
dc.subject.otherMotivation
dc.subject.otherNurses
dc.subject.otherPersonnel Turnover
dc.subject.otherPharmacists
dc.subject.otherPhysicians
dc.subject.otherSalaries and Fringe Benefits
dc.subject.otherSouth Africa
dc.subject.otherSurveys and Questionnaires
dc.titleHealth worker migration from South Africa: causes, consequences and policy responses
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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