Seeking Greener Pastures: Healthcare Worker Migration and Brain Drain in the Philippines

Joum Malonosan
5 min readDec 3, 2021

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I. Introduction

Since the advent of globalization, the markets of the Global North and South have been intimately intertwined. The free flow of goods, ideas, and culture amongst different countries have facilitated the integration of different labor markets such as the healthcare workforce (Jani et al., 2019). Considering these trends, international migration has been a salient feature of globalized markets. Developed countries such as the United States, Canada, and United Kingdom have opened their doors to highly skilled healthcare professionals from developing countries like the Philippines (Bludau, 2021). According to Cheng (2009), there has been an “exodus” of healthcare workers from the Philippines. Statistics indicate that since 2007, 11% of the Filipino population lives abroad (Masselink and Lee, 2013). In addition, Filipino nurses, the largest healthcare labor export,compose around 3,000 to 8,000 of these individuals that leave the country followed by midwives and physicians (Abarcar, 2018).

A consequence of the international migration of healthcare workers from the Philippines is the phenomenon called brain drain.This refers to the migration of healthcare workers from developing countries like the Philippines to developed countries in search of better living conditions, higher salaries, and more stable political and economic conditions (Peters et al., 2020). According to Badr(2018), brain drain is a public health issue that warrants further research and scholarship to determine its impacts on vulnerable countries like the Philippines. Hence, it is necessary to identify the factors that compel Filipino healthcare workers to migrate and assess its effects on Philippine society.

II. Push and Pull: Factors on Healthcare Worker Migration

According to Dimaya et al. (2012) there are two core factors that influence the migration of Filipino healthcare workers: push and pullfactors. The former refers to internal conditions in the Philippines that are responsible for driving healthcare workers away from the country. On the other hand, the latter refers to external conditions that lure Filipino healthcare workers to their destination countries. These two factors steer the influx of migration between the Philippines and the developed regions of the world.

Firstly, the push factors are the domestic conditions that characterize the Philippine context. Developing countries like the Philippines confront a myriad of issues ranging from severe poverty, underdevelopment, unemployment, and political instability (Jin et al., 2015). Similarly, these inequalities are also reproduced in the healthcare system that consequently burdens Filipino healthcare workers. For example, in the study of Dimaya et al. (2012) on nurses, low salaries in both public and private institutions were the main drivers of migration. Moreover, poor working conditions, obsolete medical technologies, and the lack of opportunities in the Philippines make the environment for healthcare workers in the country hostile (Dimaya et al., 2012). These factors urge them to seek greener pastures outside the Philippines.

Meanwhile, pull factors attract Filipino healthcare workers away from the country. Due to the impoverished circumstances of the Philippines, healthcare workers look for better opportunities in affluent countries. Moreover, developed countries also face a shortage of healthcare workers, hence they need to outsource the healthcare workforce from poorer countries. In the study of Ortiga and Macabasag (2021), it has been discovered that higher salary offers, better working conditions, and latest technologies in developed countries attract Filipino healthcare workers to pursue their careers outside the nation. These appealing labor conditions lies in stark contrast to the dismal state of local healthcare systems in the Philippines.

III. Impact of Brain Drain in the Philippines

In the short-run, international migration of healthcare workers from the Philippines has some tangible benefits. The remittances of income earned abroad by migrant healthcare workers have boosted the local economy of the country (Abarcar, 2018). However, in the long-term, the excessive outflow of the healthcare labor force in the country has deleterious consequences that outweigh its short-term benefits. A concrete example is the depletion of the local healthcare workforce in the Philippines. The loss of young and highly skilled healthcare labor consequently affects the availability and quality of healthcare service. In a country like the Philippines, healthcare systems already suffer from a lack of resources and underpaid healthcare workers. The further decrease in the workforce pool can further strain the healthcare system of the Philippines (Mackey, 2012). For example, the shortage of nurses may lead to increased accidents and patient injuries, higher cross-infection rates, and adverse events after surgery in healthcare systems experiencing brain drain like the Philippines (Finch, 2013).

IV. Conclusions

Healthcare workers are an important human resource for a developing country like the Philippines. However, the occurrence of brain drain merits serious attention from scholars and policymakers in the country. To address this problem, the government must recognize the push and pull factors that drive migration. For the push factors, working conditions of healthcare workers must be improved by providing adequate compensations, bolstering health resources, and creating laws that protect their welfare in the Philippines (Dimaya et al, 2012). Concurrently, pull factors can be tackled by making comprehensive and coherent foreign policies in the field of healthcare. The Philippines must ensure that bilateral agreements with other countries uphold its own national interests. A key example is managed migration programs that guarantee the return of healthcare workers from temporary migration to maintain its human resources and mutual benefit with other countries (Dimaya et al., 2012). These are necessary conditions to secure a healthy future for the country.

References:

Abarcar, P. (2018). The international migration of healthcare professionals and the supply of educated individuals left behind. Amherst College. https://economics.nd.edu/assets/289077/theoharides_amherst_intl_migration_of_healthcare_pros.pdf

Badr, K. F. (2018). Reversing the brain drain in healthcare education in Lebanon: A success story. Universities in Arab Countries: An Urgent Need for Change, 295–299. https://doi.org/10.1007/978-3-319-73111-7_16

Bludau, H. (2021). Global Healthcare Worker migration. Oxford Research Encyclopedia of Anthropology. https://doi.org/10.1093/acrefore/9780190854584.013.231

Cheng M. H. (2009). The Philippines’ health worker exodus. Lancet (London, England), 373(9658), 111–112. https://doi.org/10.1016/s0140-6736(09)60022-2

Dimaya, R. M., McEwen, M. K., Curry, L. A., & Bradley, E. H. (2012). Managing health worker migration: a qualitative study of the Philippine response to nurse brain drain. Human resources for health, 10, 47. https://doi.org/10.1186/1478-4491-10-47

Finch, S. (2013). Philippines brain drain: Fact or fiction? Canadian Medical Association Journal, 185(12). https://doi.org/10.1503/cmaj.109-4459

Jani, V. J., Joshi, N. A., & Mehta, D. J. (2019). Globalization and health: An empirical investigation. Global Social Policy, 19(3), 207–224. https://doi.org/10.1177/1468018119827475

Jin, C., Cheng, J., Lu, Y. et al. Spatial inequity in access to healthcare facilities at a county level in a developing country: a case study of Deqing County, Zhejiang, China. Int J Equity Health 14, 67 (2015). https://doi.org/10.1186/s12939-015-0195-6

Masselink, L. E., & Daniel Lee, S.-Y. (2012). Government officials’ representation of nurses and migration in the Philippines. Health Policy and Planning, 28(1), 90–99. https://doi.org/10.1093/heapol/czs028

Ortiga, Y. Y., &Macabasag, R. L. A. (2021). Understanding International Immobility through Internal Migration: “Left behind” Nurses in the Philippines. International Migration Review, 55(2), 460–481. https://doi.org/10.1177/0197918320952042

Peters, A., Palomo, R. &Pittet, D. (2020). The great nursing brain drain and its effects on patient safety. Antimicrob Resist Infect Control 9, 57. https://doi.org/10.1186/s13756-020-00719-4

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