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Michael Clemens, PhD, Research Fellow, Center for Global Development, 1776 Massachusetts Ave. NW, Suite 301, Washington, DC 20036-1915, (202) 416 0722, mclemens@cgdev.org
Rich countries that hire medical professionals from Africa stand accused of undermining sound health systems in the countries that need them most, violating the classical physicians' injunction to do no harm. Emigration by African health staff has varied greatly across countries and over time, and this paper empirically tests the hypothesis that higher emigration rates for African doctors and nurses have led to lower staffing levels or worse outcomes on key health indicators. Two natural experiments leading to exogenous changes in emigration rates isolate the causal effect of migration on staffing and health. There is no evidence of any such relationship. This suggests little impact for staffing or public health can be expected in general from widely-supported legal restrictions on the international movement or recruitment of African health professionals. Such restrictions may in fact do unintended harm to diaspora return, technology transfer, large remittance flows, and entry into the health profession. The analysis is based on a unique new database of cumulative net bilateral migration flows of doctors and nurses for 53 African migrant-sending countries and the nine most important receiving countries, as well as a survey of thousands of émigré African health workers.
Learning Objectives:
Keywords: Migrant Workers, Health Care Workers
Presenting author's disclosure statement:
Any relevant financial relationships? No
The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA