The impact of healthcare worker migration in source countries: Colombia, Indonesia, and Jordan

Abstract Background To address domestic shortages, high-income countries are increasingly recruiting healthcare workers from low- and middle-income countries. This practice is much debated, yet empirical evidence is rare. This study fills this knowledge gap by reporting high-level stakeholders’ perspectives on health system impacts of international migration and active recruitment of HCWs in Colombia, Indonesia, and Jordan. Methods We used a multiple case study methodology, based on qualitative methods integrated with information available in the published literature. Results All respondents decried a lack of robust and detailed data as a serious challenge in ascertaining their perspectives on impacts of healthcare workersmigration. Stakeholders described current emigration levels as not substantially aggravating existing healthcare workforce availability challenges. This is due to the fact that all three countries are faced with healthcare worker unemployment grounded in unwillingness to work in rural areas and/or overproduction of certain cadres. Respondents, however, pleaded against targeting very experienced and specialised individuals. While observing little harm of healthcare worker migration at present, stakeholders also noted few benefits such as brain gain, describing how various barriers to skill enhancement, return, and reintegration into the health system hamper in practice what may be possible in theory. Conclusions Improved availability of data on healthcare workers migration, including their potential return and reintegration into their country of origin’s health system, is urgently necessary to understand and monitor costs and benefits in dynamic national and international health labour markets. Our results imply that potential benefits of migration do not come into being automatically, but need in-country supportive policy, such as favourable reintegration policies or programs targeting engagement of the diaspora.