Sharing knowhow and joining forces towards Health for All

Thematic Guide: International migration and recruitment of health personnel


Our thematic guide to internet resources leads you beyond the limits of the Medicus Mundi International Network. For MMI Network resources, please refer to our HRH main page. And have a look at our "Human Resources for Health" guide, too. Any important resources missing? Please let us know.

The MMI working group on HRH


WHO Code of Practice

The WHO Global Code of Practice on the International Recruitment of Health Personnel was adopted by the 63rd World Health Assembly on 21 May 2010. The Code, which is voluntary in nature, sets forth ten articles advising both source and destination countries on how to regulate the recruitment of health personnel in a way that mitigates damage to low-income countries struggling to meet the basic health needs of their populations in a setting of serious workforce deficits.


Thematic leaders and particular initiatives


Key resources

Reports and fact sheets

 Resources collections



Selected reports, statements, debates: general







Before 2013

  • Stopping before the finishing line? (In)action on the Code of Practice on the international recruitment of health workers.
    Rangarirai Machemedze et al. in: equinet newsletter (2012)
  • Negotiating global health at the World Health Organization: The case of the Global Code of Practice on the International Recruitment of Health Personnel
    Remco van de Pas in: get involved (2012)
  • Stemming the Brain Drain — A WHO Global Code of Practice on International Recruitment of Health Personnel
    Allyn L. Taylor, Lenias Hwenda, Bjørn-Inge Larsen, Nils Daulaire in: NEJM (2011)
  • The WHO Global Code of Practice on the International Recruitment of Health Personnel: The Evolution of Global Health Diplomacy
    Allyn L. Taylor and Ibadat S. Dhillon in: GHG (2011)
  • Debate: The financial cost of doctors emigrating from sub-Saharan Africa: human capital analysis. Edward J Mills et al. in: BMJ (2011) -  No, British Medical Journal, the emigration of African doctors did not cost Africa $2 Billion. Michael Clemens, CGDev,
  • Debate: Health worker migration - disease or symptom? Why America steals doctors from poorer countries. Jonathan Wolff in: Guardian (2011) - People are not property: Please stop saying that countries “steal” doctors from Africa. Michael Clemens on: Blattman's blog (2011) and in the Global Health Magazine (2011)
  • Reflections on the ethics of recruiting foreign-trained human resources for
    Runnels et al. in: HRH (2011, focus on Canada)
  • The Future of Health Worker Migration
    Binod Khadira, Background paper to World Migration Report (2010)
  • Innovations in cooperation: A guidebook on bilateral agreements to address health worker migration
    Dillon et al., HWMI (2010)
  • Health worker migration: Perspectives from an African health worker
    Francis Omaswa, ACHEST (2009)
  • The looming crisis in the health workforce
    OECD Health Policy Studies (2008)
  • Return Migration of Nurses
    Mary Haour-Knipe and Anita Davies, ICNM (2008)
  • The International Migration of Health Workers: A Human Rights Analysis
    Judith Bueno de Mesquita and Matt Gordon, medact (2005)

Country and regional reports: see below, specific section
More reports: see HRH global resource centre


Selected reports, factsheets and presentations: Country and regional level

  • Europe (2012) Action towards achieving a sustainable health workforce and
    strengthening health systems
    The roadmap of the WHO Regional Committee for Europe for implementing the WHO Global Code of Practice in the European Region:
  • Europe (2012) Countries discuss challenges in achieving sustainable health workforce. Report on technical briefing during the WHO Europe Regional Commitee meeting.
  • Europe (2012) Implementing the WHO Global Code of Practice on International Recruitment of Health Personnel in the European Region
    Draft policy brief for discussion at a technical briefing during the WHO Europe Regional Commitee meeting. Remco van de Pas and Linda Mans, Wemos, contributed a chapter on "Progress to date: actions by civil society"
    WHO EURO document as pdf
  • Moçambique (2012) Brain drain and health workforce distortions in Mozambique
    "Internal migration is an important contributor to capital flight from the public sector, accounting for more cases of physician loss than external migration in Mozambique. Given the urgent need to strengthen public sector health systems, frank reflection by donors and NGOs is needed to assess how hiring practices may undermine the very systems they seek to strengthen." - The report nevertheless includes data on external migration. Authors: Kenneth Sherr, Antonio Mussa, Baltazar Chilundo, Sarah Gimbel, James Pfeiffer, Amy Hagopian, Stephen Gloyd (in: PLoS one)
  • Poland (2012) Emigration preferences and plans among medical students in Poland
    "The majority of Polish students see the emigration as a serious alternative to the continuation of their professional training. However, the actual scale of brain drain of young Polish doctors due to emigration will be more limited than previously feared."

    Authors: Krzysztof Krajewski-Siuda, Adam Szromek, Piotr Romaniuk, Christian A Gericke, Andrzej Szpak and Krzysztof Kaczmarek

  • USA (2012) US distribution of physicians from lower income countries
    "128,729 international medical graduateswere identified from 53 lower income countries, constituting 15 percent of the US active physician workforce. The countries with the greatest loss of physicians to the United States per 100,000 population were the Philippines, Syria, Jordan, and Haiti." Authors: E. Fuller Torrey and Barbara Boyle Torrey

  • Switzerland (2012) Do not resolve the Swiss health personal crisis at the expense of the poorest
    Together with a broad coalition the Network Medicus Mundi Switzerland launched a manifesto that addresses the worldwide need for properly trained healthcare professionals and urges Swiss stakeholders to implement the WHO Code of practice on the international recruitment of health personnel.
  • Africa (2011) Implementing the WHO Global code of Practice on the International Recruitment of health Personnel in Africa
  • Europe and globally (2011-12) National profiles of migration of health professionals
    A collection published by Mobility of Health Professionals (MoHProf). Countries covered: Australia, Austria, Bulgaria, Canada, France, Germany, India, Ireland, Lithuania, Netherlands, Philippines, Poland, Portugal, Romania, Russia, Sweden, Ukraine, United Kingdom, USA, with summary report
    National reports:
    Summary report:
  • USA (2011) Health worker shortages and global justice
    "Seven recommendations to the US government to address the global health worker shortage, including building its own workforce with a focus on self-sufficiency and task shifting, collaborating with the international community, and reforming its global health assistance programs to help developing countries educate and retain their own workers." Paula O’Brien and Lawrence O. Gostin, Milbank Memorial Fund
  • South Africa (2011) Where did all the doctors go?
    "Our country has a dire shortage of healthcare professionals, not just in some but in all disciplines. Too many South African doctors have left the public sector and South Africa, and there are too few left to serve the country. But a glimmer of hope for a turnaround strategy is starting to shine through." Author: Mary Hudson
  • Japan (2011) The current shortage and future surplus of doctors: a projection of the future growth of the Japanese medical workforce
    "Japan's ruling party after the 2009 election, promised in their manifesto to increase the medical student quota to 1.5 times what it was in 2007, in order to raise the number of medical doctors to more than 3.0 per 1000 persons. The purpose of this research is to project the future growth of the Japanese medical doctor workforce from 2008 to 2050 and to forecast whether the proposed additional increase in the student quota will cause a doctor surplus." Authors: Hideaki Takata et al.
  • Kenya (2011) Building trade union solidarity and action for workers on the move
    "It is hoped that the findings and recommendations of this report will contribute to strengthening the health workforce, reduce migration pressures, however ensuring that if and when migration occurs, it will result to a beneficial experience for all.
  • Europe (2011) Health professional mobility and health systems: evidence from 17 European countries
    "This volume gives a comprehensive analysis of mobility patterns, the impacts of migration on health systems and its relevance for policy-making and policy responses across Europe. It will enhance our knowledge not only on health workforce mobility but also on workforce development."
    PROMeTHEUS study report:
    Related EuroObserver report:
  • Europe (2011) Addressing the Global Health Workforce Crisis: Challenges for France, Germany, Italy, Spain and the UK
    "The report, which compares the foreign and domestic policies on health workers in five European countries, looks at the causes of health shortages in both source and destination countries and explores what needs to be done to fulfil the requirements of the WHO Code of Practice and to strengthen health systems in developing countries."
  • The Netherlands (2010) Chances for Change – Dutch measures to improve the global distribution of health personnel 
    "This publication by Wemos presents measures, composed by the Dutch Alliance for Human Resources for Health, to be taken by Dutch actors to improve the distribution of health staff across countries. This publication is to inspire Dutch stakeholders involved in training, recruitment, retention, and employment of health personnel to collaborate and undertake tailor-made actions, which jointly constitute a substantial Dutch contribution to global health." 
  • Canada (2010) Brain gain, drain and waste.
    The experiences of internationally educated health professionals in Canada. Authors: Ivy Lynn Bourgeault et al.
  • Switzerland (2010) Foreign Health Personnel in Switzerland
    The report by the Swiss Health Observatory is available in German and French. Authors: Hélène Jaccard Ruedin, Marcel Widmer.
  • Switzerland (2010) Qualitative analysis of the foreign health personnel in Switzerland and its recruitment
    The report by the Swiss Conference of the Health Ministers of the State Governments is available in German and French. Authors: Kathrin Huber, Ewa Mariéthoz.
  • South Africa (2010) Employment of Foreign Health Professionals in the South African Health Sector.
    Policy Document by SA Department of Health
  • Asia-Pacific Region (2010) Migration of health workers in the Asia-Pacific region
    Author: John Connell, Human Resources for Health Knowledge Hub
  • UK (2009) British Medical Association statement on the international migration of health workers
  • Italy (2008) Mismatches in the formal sector, expansion of the informal sector: immigration of health professionals to Italy
    "This health working paper authored by Jonathan Chaloff analyses forces shaping immigration of foreign health workers to Italy. An ageing population, an oversupply of doctors and a dearth of nurses have created the need to import health workers from abroad- in particular nurses - to care for the elderly. Barriers however persist to their integration in the formal health system, and as a result immigrant health workers practice largely in the private and informal sector. International migration, however, will not suffice to redress Italy's health workforce imbalances." (OECD Health Working Paper No. 34)
  • Canada (2008) International Mobility of Health Professionals and Health Workforce Management in Canada: Myths and Realities
    "This report examines the role played by immigrant health workers in the Canadian health workforce but also the interactions between migration policies and education and health workforce management policies." (OECD Health Working Paper No. 40)
  • UK (2008) Migration of Health Workers: The UK Perspective to 2006
    OECD Health Working Paper No. 38
  • Europe (2008) How can the migration of health service professionals be managed so as to reduce any negative effects on supply?
    James Buchan, policy brief written for the WHO European Ministerial Conference on
    Health Systems, 25–27 June 2008
  • Europe (2007) Health worker migration in Europe. Policy issues and options
    Author: James Buchan, hlsp
  • Eastern and Southern Africa (2007) The costs and benefits of health worker migration from East and Southern Africa: A literature review
    Author: Rudi Robinson, The North-South Institute
  • Europe (2006) Health worker migration flows in Europe: Overview and case studies in selected CEE countries – Romania, Czech Republic, Serbia and Croatia
    Author: Christiane Wiskow, ILO
  • Philippines (2006) Migration of health workers: Country case study "International migration has become an important feature of globalized labour markets in health care. A number of industrialized countries have opened their doors to highly skilled health professionals, a great number of which come from the Philippines. This study, commissioned by the International Labour Organization (ILO), aims to provide in-depth information on the migration of Filipino health workers and the repercussions this has on individual migrants, their families, their professions and the nation as a whole."

More country reports: see HRH global resource centre

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