In low- and middle-income countries, scaling essential health interventions to achieve health development targets is constrained by the lack of skilled health professionals to deliver services. We take a labor market approach to project future health workforce demand based on an economic model based on projected economic growth, demographics, and health coverage, and using health workforce data (1990–2013) for 165 countries from the WHO Global Health Observatory. The demand projections are compared with the projected growth in health worker supply and the health worker “needs” as estimated by WHO to achieve essential health coverage. The model predicts that, by 2030, global demand for health workers will rise to 80 million workers, double the current (2013) stock of health workers, while the supply of health workers is expected to reach 65 million over the same period, resulting in a worldwide net shortage of 15 million health workers. Growth in the demand for health workers will be highest among upper middle-income countries, driven by economic and population growth and aging. This results in the largest predicted shortages which may fuel global competition for skilled health workers. Middle-income countries will face workforce shortages because their demand will exceed supply. By contrast, low-income countries will face low growth in both demand and supply, which are estimated to be far below what will be needed to achieve adequate coverage of essential health services. In many low-income countries, demand may stay below projected supply, leading to the paradoxical phenomenon of unemployed (“surplus”) health workers in those countries facing acute “needs-based” shortages. Opportunities exist to bend the trajectory of the number and types of health workers that are available to meet public health goals and the growing demand for health workers.

/pdf/global-health-workforce-labor-market-projections-for-2030-5fwmrmm7ek.pdf

Global Health Workforce Labor Market Projections for 2030

With Germany facing a shortage of doctors, hospitals have been increasingly recruiting physicians from abroad. Studies in other countries have shown that migrant physicians experience various difficulties in their work, which might impact the quality of patient care, physician job satisfaction, and, accordingly, retention. The experiences of migrant doctors in Germany have not been systematically studied so far and will likely differ from experiences migrant physicians make in other contexts. A thorough understanding of challenges faced by this group, however, is needed to develop adequate support structures—as required by the WHO Global Code of Practice on the International Recruitment of Health Personnel. A qualitative study was conducted to give an overview of the multifaceted difficulties migrant physicians might face in German hospitals. Twenty semi-structured interviews with foreign-born and foreign-trained physicians were conducted in German. Participants were recruited via the State Chambers of Physicians and snowballing based on a maximum variation sampling strategy varying purposefully by source country and medical specialty. The interviews were recorded, transcribed verbatim, and analysed using qualitative content analysis. Participants described difficulties relating to healthcare institutions, own competencies, and interpersonal interactions. Participants experienced certain legal norms, the regulation of licensure and application for work, and the organization of the hospital environment as inadequate. Most struggled with their lack of setting-specific (language, cultural, clinical, and system) knowledge. Furthermore, behaviour of patients and co-workers was perceived as discriminating or inadequate for other reasons. This is the first study to describe the broad range of issues migrant physicians experience in Germany. Based on this information, institutional actors should devise support structures to ensure quality of care, physician wellbeing, and retention. For example, training opportunities should be offered where needed to support acquisition of setting-specific knowledge. Discrimination experienced by participants calls for better diversity management as a leadership task in healthcare institutions. Misinformation practices in recruitment could be managed by a voluntary code of ethical conduct. Further research is necessary to identify strategies that adequately address diverging normative positions between migrant health personnel and their patients and colleagues.

/pdf/difficulties-experienced-by-migrant-physicians-working-in-4omaw5c57q.pdf

Difficulties experienced by migrant physicians working in German hospitals: a qualitative interview study

Health professional mobility in the European Union: Exploring the equity and efficiency of free movement

Background: In lowand middle-income countries, scaling essential health interventions to achieve health development targets is constrained by the lack of skilled health professionals to deliver services. Methods: We take a labor market approach to project future health workforce demand based on an economic model based on projected economic growth, demographics, and health coverage, and using health workforce data (1990–2013) for 165 countries from the WHO Global Health Observatory. The demand projections are compared with the projected growth in health worker supply and the health worker “needs” as estimated by WHO to achieve essential health coverage. Results: The model predicts that, by 2030, global demand for health workers will rise to 80 million workers, double the current (2013) stock of health workers, while the supply of health workers is expected to reach 65 million over the same period, resulting in a worldwide net shortage of 15 million health workers. Growth in the demand for health workers will be highest among upper middle-income countries, driven by economic and population growth and aging. This results in the largest predicted shortages which may fuel global competition for skilled health workers. Middle-income countries will face workforce shortages because their demand will exceed supply. By contrast, low-income countries will face low growth in both demand and supply, which are estimated to be far below what will be needed to achieve adequate coverage of essential health services. Conclusions: In many low-income countries, demand may stay below projected supply, leading to the paradoxical phenomenon of unemployed (“surplus”) health workers in those countries facing acute “needs-based” shortages. Opportunities exist to bend the trajectory of the number and types of health workers that are available to meet public health goals and the growing demand for health workers.

/pdf/erratum-to-global-health-workforce-labor-market-projections-3mnkgq022l.pdf

Erratum to: Global Health Workforce Labor Market Projections for 2030.

Romanian migration is today one of the biggest, complex, and dynamic migration to Western Europe. This paper is a comprehensive review of the existing literature that aims at providing a full picture of this dynamic migratory process and discusses its far-reaching consequences. It first presents and characterizes the Romanian migration through the different phases during and after state socialism. The second part of the paper is dedicated to unfolding the socio-economic effects of the Romanian migration addressing the remitting behavior and its development over the past years. The issue of return migration is also addressed stressing that return is not much developed, however it has significant impacts through the emergence of returnees’ entrepreneurship. Finally we address some of the consequences of the medical doctors’ migration which is today considered one of the main migration challenges the country is facing.

International migration, return migration, and their effects. A comprehensive review on the Romanian case

T he health workforce is essential to attaining, sustaining and accelerating progress on universal health coverage. This report was intended to inform proceedings at the Third Global Forum on Human Resources for Health and the global audience in order to trigger action towards progress on universal health coverage. Workforce data and searches on human resources for health progress were analyzed from 36 countries.

Health professional mobility in a changing Europe: new dynamics, mobile individuals and diverse responses.

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Health professional mobility in a changing Europe: new dynamics, mobile individuals and diverse responses.