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Glob Health Action. 2014 Feb 13;7:23611. doi: 10.3402/gha.v7.23611. eCollection 2014.

The workforce for health in a globalized context--global shortages and international migration.

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Department of International Health, School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands;
Ethiopian Public Health Association (EPHA), Addis Ababa, Ethiopia; Alliance for Brain-Gain and Innovative Development (ABIDE), Addis Ababa, Ethiopia; African Federation of Public Health Associations (AFPHAs), Addis Ababa, Ethiopia.
Independent Consultant, Global Health, Zurich, Switzerland.


The 'crisis in human resources' in the health sector has been described as one of the most pressing global health issues of our time. The World Health Organization (WHO) estimates that the world faces a global shortage of almost 4.3 million doctors, midwives, nurses, and other healthcare professionals. A global undersupply of these threatens the quality and sustainability of health systems worldwide. This undersupply is concurrent with globalization and the resulting liberalization of markets, which allow health workers to offer their services in countries other than those of their origin. The opportunities of health workers to seek employment abroad has led to a complex migration pattern, characterized by a flow of health professionals from low- to high-income countries. This global migration pattern has sparked a broad international debate about the consequences for health systems worldwide, including questions about sustainability, justice, and global social accountabilities. This article provides a review of this phenomenon and gives an overview of the current scope of health workforce migration patterns. It further focuses on the scientific discourse regarding health workforce migration and its effects on both high- and low-income countries in an interdependent world. The article also reviews the internal and external factors that fuel health worker migration and illustrates how health workforce migration is a classic global health issue of our time. Accordingly, it elaborates on the international community's approach to solving the workforce crisis, focusing in particular on the WHO Code of Practice, established in 2010.


WHO Code of Practice; global health; globalization; health workforce migration

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