[center]Article 9: Nurse Migration from a Source Country Perspective: Philippine Country Case Study.

The study aims to describe the nurse migration pattern in the Philippines and their benefits and costs for both the sending and receiving countries.
The unemployment rate in the Philippines is high, even for those in the health care sector. To ease domestic unemployment, poverty and financial instability, the Filipino workers have always taken the opportunity to move across national borders
in pursuit of new opportunities and better career prospects. As a result, the rate of emigration has markedly increased in the recent years. Currently, the Philippines is the world’s leading exporter of nurse labor. One of the nations who tend to manage to lose their nurse workforce and has approved program of producing nurses for export. Wherein the Philippines also experiencing serious provider maldistribution and countrywide health disparities
According to the study, ‘push' and 'pull' factors motivate Filipino registered nurses (RNs) to leave for employment in foreign countries. These factors include economic, job-related, personal/family-related, socio-political and economic environment.
The individual migrants and their families are the primary winners of the migration. The migrants also contribute to our government through their remittances and in the reduction of domestic unemployment. However, depopulation of professionals, trained and skilled nurses and career shifting of doctors are much faster than it can replace them, thereby jeopardizing the Philippines health care system. Another concern is the loss of senior nurses requires a continual investment in the training of staff replacements and negatively affects the provision of quality health care in the Philippines. One of the health worker said, “We are the one in need of better service yet we are the losers; those countries with better facilities enjoy better care from health professionals”.
As a result of nurse and nurse medic migration, policy makers are debating on the strategies that will ensure international nurse migrations are both beneficial for the sending and receiving countries. Many of the policy options involve bilateral agreement which is important for managing the migration in such a way that both sending and receiving countries derive benefit from the exchange. Bilateral agreements include: improving working conditions in both source and destination countries, instituting multilateral agreements to manage the flow more effectively, and developing compensation arrangements between source and destination countries. Attached also to the study are series of policy options/proposals in which the outcome of this process is still unfolding.
I agree that if the Philippines were able to produce and retain enough nurses to serve its own population with quality health care, there would be a widespread support for additional quality nurse production and migration. I also agree that attending the source country needs will also benefit the global health work force and ensure a quality health cares service for all I believe that if the Philippine government will give nurses, the benefits that they need, a compensated salary and a fair treatment. I don’t think they will leave the country because I believe that there’s no place like home.

Questions:

1. How does the current Bilateral Agreements mitigate the costs to the health system of nurse migration in the Philippines?
2. While there is endless debate about the "push and pull factors" that trigger international migration and what should the government do about it?
3. Should the government regulate or set limits on nurse migration and nurse recruitment?
4. Does the strategies and policies identified enough to manage migration?

The Nurse Migration Problem has never been an exclusively Philippine problem. Canada also experiences the same problem, with their local nurses migrating to the United States. In Little’s case study (2007), she iterated this finding: ”the current and projected shortage of nurses in Canada is a product of health care cost containment policies that failed to take into account long-term consequences for nurse workforce adequacy. An aging nurse workforce, exacerbated by layoffs of younger nurses with less seniority and increasing demand for nurses contribute to a projection of nurse shortage that is too great to be solved ethically through international nurse recruitment. National policies to increase domestic nurse production and retention are recommended in addition to international collaboration among developed countries to move toward greater national nurse workforce self sufficiency.” [1] However, although there is mitigation in health care costs in Canada, one of our principal “nurse importers”, there is, in my opinion, no cause to believe that there is such a thing as a felt “cost mitigation” in the Philippines, working conditions, especially in public hospitals have never been better, flow of nurses to the importing country is regulated only by the importing country, and we only experience the monetary compensation from being sent with more dollars. There are no real tangible and valuable contributions, only empty promises.
I believe that the push and pull effect should be countered by the government with its own push and pull effect. A study by Aiken (2007), on the US nurse labor market came to a conclusion that the US’ increased reliance on our immigration will severely affect their health care system and our health care system and that it will not solve their shortage problem. [2] There is no winner in this agreement; both the nurse importer and the nurse exporter shall reap the drastic consequences of this problem. To that effect Aiken (2007) suggested the need of the US to move toward greater self-sufficiency in its Nursing force. It will, in the long-run improve on the nurse shortage in the US; to that effect I also recommend the government to start doing the same. It will, in my opinion, also improve our economy and give our sinking health care a much needed boost. Stringently regulate nurse migration and recruitment; we have become a country of nurses, and nobody seems to notice that it’s doing nothing to our already sinking economy other than making the situation worse with unemployment. We have legislation for everything in this country, the only real problem is implementation. If we only implement laws the way they should be implemented than I believe we can finally destroy the myth that going commando abroad as a nurse is the solution to Philippine poverty.

1 - Lisa Little (2007), Nurse Migration: A Canadian Case Study, lifted from the Health Services Research Journal, accessed June 22, 2009 retrieved from www.pubmedcentral.nih.gov
2 - Linda H Aiken (2007), U.S. Nurse Labor Market Dynamics Are Key to Global Nurse Sufficiency, lifted from the Health Services Research Journal, accessed June 22, 2009 retrieved from www.pubmedcentral.nih.gov

Comment:

Quote:

Policies are not enough

! The government should make it happen. The very reason why lot of Filipinos are moving across national boarders is that “ the Philippines as our mother country, can not provide what the people needs”, this is in line with the duties of our local government. There are limited opportunities here compared to other countries. Countries overseas are very much willing to adopt professional from the Philippines because of the unique abilities of the Filipinos in caring for their clients. Aside from that, Filipinos are known to be experienced in the field of nursing. As a result, we are loosing professionals to stay and serve the country.

We often hear government officials praising OFWs for their great contribution to our economy and summoning them as the country’s new heroes.

Many nurses who train in the Philippines plan to move abroad as soon as they qualify, with the intention of remitting income to their extended families. As we can see, a number of government agencies facilitate the deployment of these health professionals.

In my opinion, as these nurses migrate from other country, the Philippines will loose its greatest source of educated workers. In short, the Philippines will experience brain-drain, as defined by Wikipedia, is a large emigration of individuals with technical skills or knowledge that is usually regarded as an economic cost, since emigrants usually take with them the fraction of value of their training.

The Philippines’ loss of these health professionals will be the gain of other countries like USA, UK, Saudi Arabia among others.

Reference:
Brain Drain from http://en.wikipedia.org/wiki/Brain_drain

It was stated in the article that:

Quote:

More remote geographic regions report chronic shortages of nurses, doctors, and other health care workers (NSO 2005).

In support of this statement, DOLE created a solution for its shortage. It says,
The Department of Labor and Employment (DOLE) is launching the Nurses Assigned in Rural Areas (NARS) program in Western Mindanao. DOLE said that the program aims to help newly graduated nurses to acquire the required work experience they needed to land a permanent job. Under the program, the neophyte nurses will receive P8,000 monthly salary from DOLE while the local government units are encouraged to -provide counterpart fund of P2,000 for each nurse that will serve in their localities.

Reference
DOLE to train, pay volunteer new nurses to the barrios, (2009, February 20). www.zambotimes.com