Assets, Livelihoods, and Social Policy by The World Bank

Author:The World Bank
Language: eng
Format: epub
ISBN: 9780821369951
Publisher: The International Bank for Reconstruction and Development / The World Bank

It is in the context of this final point that the major issues raised by international nurse recruitment come into focus. If one way to examine the distribution of risks, costs, and benefits across the global nursing chain is by putting in to the foreground costs to hospitals, profits to recruitment agencies, and increased pay to migrant nurses in individual cases of nurse migration, another calculation at the national-societal and global levels is not only possible but essential. From this viewpoint, the major benefits accrue to the health system of the host country, while the major costs are borne by the health care system of the country on the other end of the global care chain. These costs include not only the cost of educating and training the nurse involved, but also the health deficit caused by the migration of the nurse and the effect that a depleted health service has on the social and economic development of the country of origin.

It cannot be denied that the remittances sent by individual migrant workers provide some benefits to the country of origin and its individual households, or that there are recent examples of attempts to mobilize these remittances for general social benefit. Indeed, research suggests that migrant workers “make a major contribution to the economies of their home countries, which far surpasses the initial financial investment of educating the nurses” (Buchan, Kingma, and Lorenzo 2005, 16). However, more research is needed before it can confidently be declared that international nurse remittances balance the total economic and social loss involved in nurse emigration. It is in this context of the spread of costs and benefits across the global nursing chain at the individual, employer, government, and societal levels that policy proposals calling for more effective governance of international nurse migration must be formulated.

Of course, this raises the question of what the overall aims of policy should be; how the competing interests of state, commercial, professional, labor, and households can be balanced; and whether these interests can be reconciled. This is complicated by the country’s position within the global care chain, whether at the lower or upper end. How does one achieve a balance between the conflicting interests and needs involved? How can the asset-accumulation strategies of individual nurses and their families in low-income countries weigh against the need for nursing staff to fill vacancies in middle- and high-income countries? The need for nurses to take care of older people in developed countries has to be weighed against the need for nurses in developing countries to help care for people with HIV/AIDS. This goes to the heart of the problem as to how far international migration should be regulated in the interests of public health, welfare, and social development.

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