Health workforce migration and retention

Many nations, already struggling to educate and train a sufficient number of appropriate types of health workers, simultaneously experience a loss of existing health workers to other countries which they see as offering more attractive working and living conditions.

At the same time, other countries face the paradox of having an adequate number of health workers while confronting severe difficulties in keeping those workers in the places they are most needed, particularly in remote and rural areas.

In either case, the challenges are to manage international migration of health workers, to attract and motivate health workers to remain in their workplaces, and to encourage them to work effectively and productively.

WHO is responding to this challenges by:

• Developing tools, guidelines and policy options;
• Supporting countries by providing technical cooperation;
• Supporting research by building the evidence base which informs policy and decision making;
• Supporting the development of partnerships.

MANAGING HEALTH WORKFORCE MIGRATION - TOWARDS A GLOBAL CODE OF PRACTICE

Health worker migration has been increasing worldwide over the past decades, especially from lower income countries whose health systems are already very fragile. To address this situation, the World Health Assembly adopted resolution WHA57.19 which called for the development of a Code of Practice on the International Recruitment of Health Personnel.

A multi-stakeholder process to articulate the content of the Code has been initiated. The consultative process of drafting of the Code will be led by WHO through its mechanisms for global policy making.

GUIDELINES FOR THE RETENTION OF HEALTH WORKERS

The WHO resolutions on migration (WHA57.19) and rapid scaling up of health workers (WHA59.23) request Member States to put in place mechanisms which aim to improve the retention of health workers. Very recently, the Kampala Declaration, called on governments to "assure adequate incentives and an enabling and safe working environment for effective retention and equitable distribution of the health workforce".

It is against this background that WHO has embarked upon a process to develop evidence-based recommendations which will advise countries on addressing the critical issues of retention and equitable distribution of health workers.

The eventual WHO guidelines will be informed by research and analyses of evidence on existing interventions, by a series of country case studies and by consultations with experts and stakeholders regarding the effectiveness of strategies to improve retention.

EVENTS

• WHO-OECD hosted dialogue on migration and other health workforce issues in a global economy, 20-21 October 2008, Geneva, Switzerland. More information on this event will be posted shortly.
• Second Global Forum on Migration and Development, 27-30 October 2008, Manila, Philippines

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