scholarly journals Hiding in Plain Sight: Gendered Dimensions of Health Worker Migration from ‘Source’ Country Perspectives

2020 ◽  
Author(s):  
Ivy Lynn Bourgeault ◽  
Vivien Runnels ◽  
Jelena Atanackovic ◽  
Denise Spitzer ◽  
Margaret Walton Roberts
Keyword(s):  
Health Worker ◽  
Health Workers ◽  
Personal Characteristics ◽  
Migrant Health ◽  
The Philippines ◽  
Migration Decision ◽  
Policy Responses ◽  
Gender Based ◽  
The Impact ◽  
Health Worker Migration

Abstract Background: Gender roles affect health worker migration and their migration experiences, but policy responses have rarely considered the gender dimensions of health worker migration. This invisibility and lack of attention can lead to social, health and labour market inequities. Methods: A Canadian-led research team with co-investigators in the Philippines, South Africa, and India studied the international migration of health workers from these ‘source’ countries through documentary, interview and survey data with workers and country-based stakeholder interviews. Our particular focus was to examine the causes, consequences and policy responses to health worker migration. Here we undertake an explicit gender-based analysis highlighting the gender-related influences and implications that emerged from the literature, policy documents and empirical data. Results: Our data from nurses, physicians, and other health workers reveal that gender mediates health workers’ access and participation in health worker training, employment, and migration, and the impact of health worker migration is gendered, depending on country context. Female migrant health workers were “preferred” for “innate” personal characteristics and cultural reasons. Female nurse migration in particular is greatly influenced and linked to personal relationships and social networks including friends in the diaspora. Remittances by female nurses to family back home may play a large role in the decision to migrate. Migration may improve social status of women nurses, but it also exposes them to deskilling, sexism and racialization. Regardless of these apparent differences in migration decision-making and experiences for women and men health workers, gender is rarely considered either as an important contextual influence or analytic category in the policy responses.Conclusion: An explicit gender-based analysis on health worker migration offers useful insights for health workers considering migration and those that ultimately migrate, the workplaces and families they leave behind, and social and health policy of their countries.

scholarly journals Hiding in Plain Sight: The Absence of Consideration of the Gendered Dimensions in ‘Source’ Country Perspectives of Health Worker Migration

2020 ◽  
Author(s):  
Ivy Lynn Bourgeault ◽  
Vivien Runnels ◽  
Jelena Atanackovic ◽  
Denise Spitzer ◽  
Margaret Walton Roberts
Keyword(s):  
South Africa ◽  
Health Worker ◽  
Survey Data ◽  
Health Workers ◽  
The Philippines ◽  
Migration Decision ◽  
Source Country ◽  
Policy Responses ◽  
Gender Based ◽  
Health Worker Migration

Abstract Background: Gender roles and relations affect both the drivers and experiences of health worker migration, yet policy responses rarely consider these gender dimensions. This lack of explicit attention from source country perspectives can lead to inadequate policy responses. Methods: A Canadian-led research team with co-investigators in the Philippines, South Africa, and India examined the causes, consequences and policy responses to the international migration of health workers from these ‘source’ countries through documentary, interview and survey data with workers and country-based stakeholders. Here we undertake an explicit gender-based analysis highlighting the gender-related influences and implications that emerged from the published literature and policy documents from the decade 2005 to 2015; in-depth interviews with 117 stakeholders; and surveys conducted with 3,580 health workers. Results: The literature on health worker migration from South Africa, India and the Philippines reveal that gender can mediate access and participation in health worker training, employment, and migration. Our analysis of survey data from nurses, physicians and other health workers in South Africa, India and the Philippines and interviews with policy stakeholders, however, reveals a curious absence of how gender might mediate health worker migration. Stakeholders in South Africa described female health workers as “preferred” for “innate” personal characteristics and cultural reasons, and in India that men are directed away from nursing roles particularly because they are considered only for women. That inadequate remuneration was identified as a key migration driver amongst survey respondents in India and the Philippines, where nurses predominated in our sample, may be linked to the impact of underlying gender-based pay inequity. The literature suggests that migration may improve social status of women nurses, but it may also expose them to deskilling, as a result of intersecting racism and sexism in their destination country. Regardless of these underlying influences in migration decision-making, gender is rarely considered either as an important contextual influence or analytic category in the policy responses.Conclusion: An explicit gender-based analysis on health worker migration could offer useful insights for health and social policy responses and emphasize the importance of equity considerations to their decisions in these countries.

scholarly journals Hiding in plain sight: the absence of consideration of the gendered dimensions in ‘source’ country perspectives on health worker migration

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Ivy Lynn Bourgeault ◽  
Vivien Runnels ◽  
Jelena Atanackovic ◽  
Denise Spitzer ◽  
Margaret Walton-Roberts
Keyword(s):  
South Africa ◽  
Health Worker ◽  
Health Workers ◽  
The Philippines ◽  
Source Country ◽  
Policy Responses ◽  
Documentary Analysis ◽  
Gender Based ◽  
Source Countries ◽  
Health Worker Migration

Abstract Background Gender roles and relations affect both the drivers and experiences of health worker migration, yet policy responses rarely consider these gender dimensions. This lack of explicit attention from source country perspectives can lead to inadequate policy responses. Methods A Canadian-led research team partnered with co-investigators in the Philippines, South Africa, and India to examine the causes, consequences and policy responses to the international migration of health workers from these ‘source’ countries. Multiple-methods combined an initial documentary analysis, interviews and surveys with health workers and country-based stakeholders. We undertook an explicit gender-based analysis highlighting the gender-related influences and implications that emerged from the published literature and policy documents from the decade 2005 to 2015; in-depth interviews with 117 stakeholders; and surveys conducted with 3580 health workers. Results The documentary analysis of health worker emigration from South Africa, India and the Philippines reveal that gender can mediate access to and participation in health worker training, employment, and ultimately migration. Our analysis of survey data from nurses, physicians and other health workers in South Africa, India and the Philippines and interviews with policy stakeholders, however, reveals a curious absence of how gender might mediate health worker migration. Stereotypical views were evident amongst stakeholders; for example, in South Africa female health workers were described as “preferred” for “innate” personal characteristics and cultural reasons, and in India men are directed away from nursing roles particularly because they are considered only for women. The finding that inadequate remuneration was as a key migration driver amongst survey respondents in India and the Philippines, where nurses predominated in our sample, was not necessarily linked to underlying gender-based pay inequity. The documentary data suggest that migration may improve social status of female nurses, but it may also expose them to deskilling, as a result of the intersecting racism and sexism experienced in destination countries. Regardless of these underlying influences in migration decision-making, gender is rarely considered either as an important contextual influence or analytic category in the policy responses. Conclusion An explicit gender-based analysis of health worker emigration, which may help to emphasize important equity considerations, could offer useful insights for the health and social policy responses adopted by source countries.

scholarly journals Connecting communities to primary care: a qualitative study on the roles, motivations and lived experiences of community health workers in the Philippines

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Eunice Mallari ◽  
Gideon Lasco ◽  
Don Jervis Sayman ◽  
Arianna Maever L. Amit ◽  
Dina Balabanova ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Community Health ◽  
Community Health Workers ◽  
Financial Incentives ◽  
Lived Experiences ◽  
Health Workers ◽  
The Philippines ◽  
Community Members ◽  
Cross Sectional ◽  
The Impact

Abstract Background Community health workers (CHWs) are an important cadre of the primary health care (PHC) workforce in many low- and middle-income countries (LMICs). The Philippines was an early adopter of the CHW model for the delivery of PHC, launching the Barangay (village) Health Worker (BHW) programme in the early 1980s, yet little is known about the factors that motivate and sustain BHWs’ largely voluntary involvement. This study aims to address this gap by examining the lived experiences and roles of BHWs in urban and rural sites in the Philippines. Methods This cross-sectional qualitative study draws on 23 semi-structured interviews held with BHWs from barangays in Valenzuela City (urban) and Quezon province (rural). A mixed inductive/ deductive approach was taken to generate themes, which were interpreted according to a theoretical framework of community mobilisation to understand how characteristics of the social context in which the BHW programme operates act as facilitators or barriers for community members to volunteer as BHWs. Results Interviewees identified a range of motivating factors to seek and sustain their BHW roles, including a variety of financial and non-financial incentives, gaining technical knowledge and skill, improving the health and wellbeing of community members, and increasing one’s social position. Furthermore, ensuring BHWs have adequate support and resources (e.g. allowances, medicine stocks) to execute their duties, and can contribute to decisions on their role in delivering community health services could increase both community participation and the overall impact of the BHW programme. Conclusions These findings underscore the importance of the symbolic, material and relational factors that influence community members to participate in CHW programmes. The lessons drawn could help to improve the impact and sustainability of similar programmes in other parts of the Philippines and that are currently being developed or strengthened in other LMICs.

Exposing Nursing Students To the Marketing Methods of Pharmaceutical Companies

2008 ◽  
Vol 15 (3) ◽  
pp. 396-410 ◽  
Author(s):  
Murat Civaner ◽  
Ozlem Sarikaya ◽  
Sevim Ulupinar Alici ◽  
Gulcin Bozkurt
Keyword(s):  
Nursing Students ◽  
Pharmaceutical Company ◽  
Health Worker ◽  
Prescription Drugs ◽  
Health Workers ◽  
Negative Impact ◽  
Strong Association ◽  
Pharmaceutical Companies ◽  
Marketing Methods ◽  
The Impact

There is a strong association between reliance on the promotional activities of pharmaceutical companies and a generally less appropriate use of prescription drugs. Pharmaceutical companies direct some of their promotion towards health workers who do not have the authority to prescribe medicines, such as nurses in certain countries. The aim of this study was to determine the impact that exposure to the marketing methods of pharmaceutical companies has on judgments made by nursing students about health worker—pharmaceutical company relationships. A cross-sectional survey was carried out with 442 nursing students in Istanbul, Turkey. The exposure of students to the marketing methods of pharmaceutical companies, whether it be indirectly through observation or directly by first-hand experience, increases the probability that students will adopt rationales that underlie affirmative judgments of health worker—pharmaceutical company relationships. Based on the pervasiveness and ability of drug promotion to influence the perceptions of students, it is imperative that attempts be made to reduce its negative impact.

A tale of three cities: water disaster policy responses in Bangkok, Kuala Lumpur and Metro Manila

Water Policy ◽  
2015 ◽  
Vol 17 (S1) ◽  
pp. 89-113 ◽  
Author(s):  
Keizrul Abdullah ◽  
Apichart Anukularmphai ◽  
Tadashige Kawasaki ◽  
Dolora Nepomuceno
Keyword(s):  
East Asia ◽  
Fold Increase ◽  
The Philippines ◽  
South East Asia ◽  
Kuala Lumpur ◽  
Local Conditions ◽  
Policy Responses ◽  
Metro Manila ◽  
The Impact ◽  
Water Disaster

Floods and typhoons are two of the greatest water disasters affecting South East Asia, causing misery and death to people, damaging properties, infrastructure and crops, and causing disruption to commerce and industry. In many cases the impact can be widespread, affecting not only individual households but also large parts of a country including agriculture areas, towns and cities, and sometimes even beyond national borders. The rapid pace of development has resulted in a disproportionate increase in runoff and a many-fold increase in river discharges leading to more frequent and more intense flooding. This situation is expected to be further aggravated due to the impact of global warming and climate change. To cope with such challenges, countries in South East Asia are developing their policy responses tailored to suit their local conditions and environment. This paper looks at the water disaster situation and the policy responses in three cities in South East Asia: Bangkok, Kuala Lumpur and Metro Manila, the capital cities of the Kingdom of Thailand, the Federation of Malaysia and the Republic of the Philippines, respectively. Although all three countries are in the same climatic zone, due to their geographical locations, water disasters impact differently on them and the remedial measures also differ.

scholarly journals The impact of health worker absenteeism on patient health care seeking behavior, testing and treatment: A longitudinal analysis in Uganda

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256437
Author(s):  
Han Zhang ◽  
Günther Fink ◽  
Jessica Cohen
Keyword(s):  
Public Sector ◽  
Health Worker ◽  
Low Income ◽  
Health Workers ◽  
Care Seeking ◽  
Health Clinics ◽  
Worker Absenteeism ◽  
Care Seeking Behavior ◽  
Seeking Behavior ◽  
The Impact

Introduction Absenteeism of frontline health workers in public sector facilities is widespread in low-income countries. There is little quantitative evidence on how health worker absenteeism influences patient treatment seeking behavior, though low public sector utilization and heavy reliance on the informal sector are well documented in low-income settings. Methods Using a unique panel dataset covering health facilities and households over a 10-month period in Uganda, we investigate the extent to which health worker absenteeism (defined as zero health workers present at a health facility) impacts patient care seeking behavior, testing, and treatment. Results We find high rates of health worker absenteeism at public sector health facilities, with most of the absenteeism occurring at lower level public health clinics. On average, no health worker was present in 42% of all days monitored in lowest level public health clinics, whereas this number was less than 5% in high level public hospitals and private facilities. In our preferred empirical model with household fixed effects, we find that health worker absenteeism reduces the odds that a patient seeks care in the public sector (OR = 0.65, 95% CI = 0.44–0.95) and receives malaria testing (OR = 0.73, 95% CI = 0.53–0.99) and increases the odds of paying out-of-pocket for treatment (OR = 1.41, 95% CI = 1.10–1.80). The estimated differences in care-seeking are larger for children under-five than for the overall study population. Conclusions The impact of health worker absenteeism on the quality of care received as well as the financial burden faced by households in sub-Saharan Africa is substantial.

scholarly journals Motivational factors that can improve the efficiency and quality of health care / Motivacioni faktori koji mogu poboljšati efi kasnost i kvalitet zdravstvene njege

2015 ◽  
Vol 2 (2) ◽  
pp. 19 ◽  
Author(s):  
Njegoslava Kaurin
Keyword(s):  
Health Care ◽  
Health Workers ◽  
Personal Characteristics ◽  
Potential Threat ◽  
Internal Factors ◽  
Poor Countries ◽  
Health Institutions ◽  
Motivating Factor ◽  
The Impact

Motivation is the impact of charges, directs and maintains the desired behavior. On the motivation of individuals affected by his personal characteristics, such as the needs, attitudes, interests, features of the work and characteristics of the organization he works for. The internal factors of motivation will be in a situation where the decision to go into nursing adopted much earlier (childhood) will be sufficient to remain in the profession even when they present a strong external factors that reduce motivation. Reduced number of nurses with the increased workload represents the greatest potential threat to the collapse of health care.In the DZ Šamac we examined the factors that motivate nurses to quality work and point to the need for leaders in health care dealing with the complex issues of motivation of employees.The main motivating factor is the material compensation. This is expected for poor countries such as ours, and the reasons are piled up in the socio-economic problems in the country and the fact that they are receiving health workers unchanged for years or even reduced. Nurses / technicians with quality associates and modern equipment necessary to adequately evaluating the environment. Ignoring these factors, together with the permanent lack of staff and increase the daily workload seems to be among healthcare professionals it is increasingly discontent. Managment in health institutions should be interested to motivate people to ensure that they reach their maximum potential, they know the needs of employees and encourage them through the provision of various incentives which may be material, economic and psychological.

scholarly journals Health worker migration from South Africa: causes, consequences and policy responses

2015 ◽  
Vol 13 (1) ◽  
Author(s):  
Ronald Labonté ◽  
David Sanders ◽  
Thubelihle Mathole ◽  
Jonathan Crush ◽  
Abel Chikanda ◽  
...  
Keyword(s):  
South Africa ◽  
Health Worker ◽  
Policy Responses ◽  
Health Worker Migration
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