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PubMed1994

[The brain drain: theoretical framework and hypotheses].

"This article studies the 'brain drain' issue from the sociological perspective. It analyzes the various reasons why students from developing countries go to North American and European universities and why they decide either to return or not to return to their own country after graduation. The author...concludes that, although there are political, socioeconomic and academic factors, one's decision to return or not to return to one's country depends mainly on individual aspirations (personal and cultural development) and collective aspirations (perceived possibilities of playing a constructive role, political or otherwise, in one's native country)." (SUMMARY IN ENG)

Demography↗
PubMedDate not supplied

Health workforce imbalances in times of globalization: brain drain or professional mobility?

The health workforce is of strategic importance to the performance of national health systems as well as of international disease control initiatives. The brain drain from rural to urban areas, and from developing to industrialized countries is a long-standing phenomenon in the health professions but has in recent years taken extreme proportions, particularly in Africa. Adopting the wider perspective of health workforce balances, this paper presents an analysis of the underlying mechanisms of health professional migration and possible strategies to reduce its negative impact on health services. The opening up of international borders for goods and labour, a key strategy in the current liberal global economy, is accompanied by a linguistic shift from 'human capital flight' and 'brain drain' to 'professional mobility' or 'brain circulation'. In reality, this mobility is very asymmetrical, to the detriment of less developed countries, which lose not only much-needed human resources, but also considerable investments in education and fiscal income. It is argued that low professional satisfaction and the decreasing social valuation of the health professionals are important determinants of the decreasing attraction of the health professions, which underlies both the push from the exporting countries, as well as the pull from the recipient countries. Solutions should therefore be based on this wider perspective, interrelating health workforce imbalances between, but also within developing and developed countries.

Delivery of Health Care↗
PubMed1992

Reverse brain drain in South Korea: state-led model.

Korea's reverse brain drain (RBD) has been an organized government effort, rather than a spontaneous social phenomenon, in that various policies and the political support of President Park, Chung-Hee were instrumental in laying the groundwork for its success. Particular features of Korea's RBD policies are the creation of a conducive domestic environment (i.e., government-sponsored strategic R & D institution-building, legal, and administrative reforms), and importantly, the empowerment of returnees (via, i.e., exceptionally good maternal benefits, guarantees of research autonomy). President Park played the cardinal role in empowering repatriates at the expense of his own civil bureaucracy, and his capacity for such patronage derived from Korea's bureaucratic-authoritarian political system. Returning scientists and engineers directly benefitted from this political system as well as Park's personal guardianship. For Park, empowerment of returning "brains" was necessary to accomplish his national industrialization plan, thereby enhancing his political legitimacy in domestic politics. An alliance with the R & D cadre was functionally necessary to successfully consolidate strong presidential power, and politically nonthreatening due to the particular form of "pact of domination" in Korea's power structure. RBD in Korea will continue in the near future given Korea's drive for high technology, and the remarkable expansion of local industrial and educational sectors. Korea's future RBD, however, needs to pay closer attention to the following 4 problems: research autonomy; equality issues; skill-based repatriation of technicians and engineers rather than Ph.Ds; and subsidies to small and medium industry for RBD.

Asia↗
PubMed1997

Refugee flow or brain-drain? The humanitarian policy and post-Tiananmen mainland Chinese immigration to Canada.

"The humanitarian policy that the Canadian government implemented in response to the 1989 Tiananmen Square crackdown changed a migration system primarily based on personal networks into a brain drain. Post-Tiananmen mainland Chinese immigrants (MCIs) were better educated than those arriving in Canada previously. Among the post-Tiananmen MCIs, those who landed under the policy were better educated than those landing in other categories. The analysis suggests that post-Tiananmen MCIs represented a brain-drain rather than a refugee flow, that the humanitarian policy implicitly contained ideological and human capital concerns in addition to humanitarian concerns, and that Canada benefited from the policy by obtaining human capital as well as satisfying its humanitarian obligations and ideological aspirations."

Americas↗
PubMed1990

[The brain drain, internal migration, and management of human resources in China].

"A major impediment to Third World development, the brain drain in the People's Republic of China originates from a variety of factors which, to a notable extent, differ from more traditional causes identified in most other developing countries. In addition to political management of human resources, the organization itself of the educational system and the regularisation of internal migration are basic causes of China's massive brain emigration. Through various relations maintained by the Chinese Government with its expatriate communities, and in order to promote (and finance) the economic and technological process engaged in the early 1980s, a number of measures and incentives to integrate more rationally the resident professionals and to promote the return of expatriate brains have been adopted.... Uncertainties today impede any clear assessment of the...viability of China's official policy of recognition and integration of national professionals." (SUMMARY IN ENG)

Asia↗
PubMed2004

Roundtable. Strategies to discourage brain drain.

Building health research expertise in developing countries often requires personnel to receive training beyond national borders. For research funding agencies that sponsor this type of training, a major goal is to ensure that trainees return to their country of origin: attaining this objective requires the use of proactive strategies. The strategies described were developed under the extramural acquired immunodeficiency syndrome (AIDS) International Training and Research Program (AITRP) funded by the Fogarty International Center (FIC) at the National Institutes of Health, United States. This programme supports universities in the United States that provide research training to scientists from developing countries to enable them to address the global epidemic of human immunodeficiency virus (HIV)/AIDS and the related tuberculosis (TB) epidemic. This paper describes the strategies employed to discourage brain drain by the principle investigators (PIs) of five of the longest-funded AITRPs (funded for 15 years). Long-term trainees in these programmes spent from 11 to 96 months (an average of 26 months) studying. Using scientific, political and economic strategies that address brain drain issues, PIs working in AITRPs have attained an average rate of return home for their trainees of 80%.

Biomedical Research↗
PubMed2004

"Brain drain" of health professionals: from rhetoric to responsible action.

The question of the "brain drain" of health professionals has re-emerged since last exposed in 1970s. This paper is based on exploratory studies in Ghana, South Africa and the UK, a literature review and subsequent tracking of contemporary events. It reviews what is currently known about professional migration in the health sector and its impact on health services in poorer countries. The relevant responsibilities at the global level and source and recipient country levels are then reviewed. It is concluded that that the situation is more complex than portrayed by some of the rhetoric and that meaningful dialogue and consideration of responsibilities is needed. In addition, better information is needed to monitor migration flows; source countries need to improve staff attraction and retention strategies; and recipient countries need to ensure that they do not become a permanent drain on health professionals from the developing countries.

Emigration and Immigration↗
PubMedDate not supplied

The brain drain.

The adult human brain weights around three pounds. Yet it is capable of feats that dwarf those of the most sophisticated computers. The sad fact is, those brains are largely wasted in modern organizations. Instead of tapping the full capacity of the human brains that could make our organizations more efficient and effective, we allow them to lapse into an inexcusably large amount of wasted activity. What is needed by the health care field, in a time that demands more with less, is more sensible use not only of its manpower but also of its brainpower.

Health Facilities↗
PubMed1997

Can a brain drain be good for growth in the source economy?

"This paper analyzes the interaction between income distribution, human capital accumulation and migration. It shows that when migration is not a certainty, a brain drain may increase average productivity and equality in the source economy even though average productivity is a positive function of past average levels of human capital in an economy. It is also shown how the temporary possibility of emigration may permanently increase the average level of productivity of an economy."

Demography↗
PubMed1997

A brain gain with a brain drain.

"We study human capital depletion and formation in an economy open to out-migration, as opposed to an economy which is closed. Under the assumption of asymmetric information, the enlarged opportunities and the associated different structure of incentives can give rise to a brain gain in conjunction with a brain drain. Migration by high-skill members of its workforce notwithstanding, the home country can end up with a higher average level of human capital per worker."

Demography↗
PubMed1991

A theoretical analysis of the beneficial effects of the brain-drain phenomenon.

"The primary objective of this paper is to examine the impact of migration, and ultimately remittances on economic development in an LDC [less-developed country] within the context of a two-sector development model. For this purpose we construct a two-period development model wherein the country loses professional workers in the first period, but receives foreign-exchange remittances in the second period. Then we derive the conditions under which the 'brain drain' phenomenon may promote social welfare gains over the two periods horizon." The results indicate that "emigration of skilled labor causes the real rate of return to capital to fall and the real wage to labor in the home country to rise. Emigration of skilled labor unambiguously causes a real income loss in less developed labor-exporting countries in the first period, but may cause a real income gain to the LDC in the long run. We also find that the per capita income in an LDC may rise as a consequence of emigration in the short-run, but in the long run capita income unambiguously rises." (SUMMARY IN FRE)

Demography↗
PubMed2004

"Brain drain" or ethical recruitment?

Recruitment by wealthy countries of health personnel from developing countries is threatening the viability of crucial health programs in poor countries, especially in sub-Saharan Africa. Australia has participated in this "brain drain", although the extent and impact of this on different countries has not been adequately assessed. Australia depends on overseas-trained doctors to fill vacancies in public hospitals and private practice, particularly in rural and outer suburban areas where locally trained professionals are reluctant to work. Australia should adopt national strategies to minimise harm and maximise benefits of skills migration; concerted international action will also be required.

Australia↗
PubMed2006

The cost of health professionals' brain drain in Kenya.

BACKGROUND: Past attempts to estimate the cost of migration were limited to education costs only and did not include the lost returns from investment. The objectives of this study were: (i) to estimate the financial cost of emigration of Kenyan doctors to the United Kingdom (UK) and the United States of America (USA); (ii) to estimate the financial cost of emigration of nurses to seven OECD countries (Canada, Denmark, Finland, Ireland, Portugal, UK, USA); and (iii) to describe other losses from brain drain. METHODS: The costs of primary, secondary, medical and nursing schools were estimated in 2005. The cost information used in this study was obtained from one non-profit primary and secondary school and one public university in Kenya. The cost estimates represent unsubsidized cost. The loss incurred by Kenya through emigration was obtained by compounding the cost of educating a medical doctor and a nurse over the period between the average age of emigration (30 years) and the age of retirement (62 years) in recipient countries. RESULTS: The total cost of educating a single medical doctor from primary school to university is 65,997 US dollars; and for every doctor who emigrates, a country loses about 517,931 US dollars worth of returns from investment. The total cost of educating one nurse from primary school to college of health sciences is 43,180 US dollars; and for every nurse that emigrates, a country loses about 338,868 US dollars worth of returns from investment. CONCLUSION: Developed countries continue to deprive Kenya of millions of dollars worth of investments embodied in her human resources for health. If the current trend of poaching of scarce human resources for health (and other professionals) from Kenya is not curtailed, the chances of achieving the Millennium Development Goals would remain bleak. Such continued plunder of investments embodied in human resources contributes to further underdevelopment of Kenya and to keeping a majority of her people in the vicious circle of ill-health and poverty. Therefore, both developed and developing countries need to urgently develop and implement strategies for addressing the health human resource crisis.

Adolescent↗
PubMedDate not supplied

Taming the brain drain: a challenge for public health systems in Southern Africa.

In southern Africa, rapid out-migration of health professionals is compounding the problems of health systems already faced with budget constraints and the impacts of HIV/AIDS. These negative effects are unlikely to be offset by remittances from abroad. The same dynamics that affect the international migration of health professionals operate within nations, for instance as they move from public to private systems. "Push," "pull," and "stick" factors contribute to the migration. Some Canadian provinces have emerged as key destinations. The authors outline a program of research on how Canada and the international community might address the negative impacts of the brain drain. Policy options have been identified, but implementation may be complicated by provisions of GATS, fundamental economic disparities, and domestic political priorities.

Africa↗
PubMed2004

Plumbing the brain drain.

Opportunity is the driving force of migration. Unsatisfied demands for higher education and skills, which have been created by the knowledge-based global economy, have generated unprecedented opportunities in knowledge-intensive service industries. These multi-trillion dollar industries include information, communication, finance, business, education and health. The leading industrialized nations are also the focal points of knowledge-intensive service industries and as such constitute centres of research and development activity that proactively draw in talented individuals worldwide through selective immigration policies, employment opportunities and targeted recruitment. Higher education is another major conduit of talent from less-developed countries to the centres of the knowledge-based global economy. Together career and educational opportunities drive "brain drain and recirculation". The departure of a large proportion of the most competent and innovative individuals from developing nations slows the achievement of the critical mass needed to generate the enabling context in which knowledge creation occurs. To favourably modify the asymmetric movement and distribution of global talent, developing countries must implement bold and creative strategies that are backed by national policies to: provide world-class educational opportunities, construct knowledge-based research and development industries, and sustainably finance the required investment for these strategies. Brazil, China and India have moved in this direction, offering world-class education in areas crucial to national development, such as biotechnology and information technology, paralleled by investments in research and development. As a result, only a small proportion of the most highly educated individuals migrate from these countries, and research and development opportunities employ national talent and even attract immigrants.

Developed Countries↗