International nurse migration: impact on low- and middle-income source countries and policy responses

Abstract

Nursing shortages around the world and the increased rates of nurse migration have profound effects on the source countries, especially if health systems in those countries are underfunded and health needs of the population are not being met. Globalization, increased demand for nurses and the strong “push” and “pull” factors drive nurse migration. This study examines the impact of international nurse migration on the low- and middle-income source countries in a comprehensive manner and presents an overview and evaluation of the policy responses adopted to mitigate the negative effects and to promote more equitable and sustainable practices in nurse migration. The UN’s Sustainable Development Goals and Primary Health Care are used as conceptual frameworks. This study is a narrative literature review with an inductive methodological approach used to analyze the fourteen articles included in this review. The findings show the existence of both negative and positive impacts of nurse migration on the source low- and middle-income countries, although the positive impacts are still subject to debate by researchers. Policy responses ranging from international, national, and bilateral agreements and Codes of Practice have had varied levels of effectiveness and adherence. The biggest challenge is the limited adherence and the voluntary nature of these measures. The long-term effects of the source country responses that focus on retention and mutual benefit are yet to be seen. In the discussion chapter pitfalls of taking a linear view on such a complex and multi-dimensional issue as international nurse migration is mentioned, as managing it requires awareness and involvement from all recipient and destination countries, no matter the income level. Managed migration should be directed by both sides at strengthening the health care system and the nursing sector of the source country