The Pull, Push, and Problem of Health Worker Migration.

Like the institution that supports it, Mayo Clinic Proceedings, founded and centered in a relatively small town in southeastern Minnesota, has long had a mission with a global intent and reach. Begun in 1926 as a journal primarily geared for the Mayo Clinic staff physicians, Mayo Clinic Proceedings rapidly gained an international readership and a pool of submitting authors.1Lanier W.L. Celebrating Mayo Clinic Proceedings' 90th anniversary: a story of longevity and progression of mission.Mayo Clin Proc. 2016; 91: 3-9Abstract Full Text Full Text PDF PubMed Scopus (7) Google Scholar For example, in 2022, 56% of submitted content and 18% of accepted content were international in origin (defined as from countries other than the United States) and originated from some 60 countries (excluding the United States); and in 2023 year to date, 61% of submitted content and 22% of accepted content were international in origin and emanated from 41 countries. To highlight and foster its global readership and to feature topics and issues of international interest, Mayo Clinic Proceedings is introducing a new section, News from International Editors, with its inaugural contribution, “Skilled Health Workforce Emigration: Its Consequences, Ethics, and Potential Solutions,” by Joshi et al2Joshi R. Yakubu K. Keshri V.R. Jha V. Skilled health workforce emigration: its consequences, ethics, and potential solutions.Mayo Clin Proc. 2023; 98: 960-965Google Scholar published in this issue. This article comes from the research group led by Professor Vivekanand Jha, Executive Director, The George Institute for Global Health, India; Chair of Global Kidney Health, Faculty of Medicine, Imperial College of London; Conjoint Professor of Medicine, University of New South Wales, Sydney, Australia; the Past President of the International Society of Nephrology; and an International Associate Editor, Mayo Clinic Proceedings. Based on recent studies in a systematic analysis for the Global Burden of Disease Study,3GBD 2019 Human Resources for Health CollaboratorsMeasuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019.Lancet. 2022; 399: 2129-2154Abstract Full Text Full Text PDF PubMed Scopus (42) Google Scholar Joshi et al point out that more than 43 million health workers are additionally required worldwide to achieve universal health coverage as envisioned by the World Health Organization. Achieving this increase in health workers—as appropriate for different nations worldwide—is greatly challenged by the fact that health workers in low- and middle-income countries (LMICs) emigrate to high-income countries (HICs) to seek further training and to pursue professional opportunities, eventually settling there. Joshi et al discuss the extent of such emigration: the “pull factors” from HICs and the “push factors” from LMICs and the attendant financial effects and burden on health care coverage imposed on the source country; issues and problems that surround the emigration of health workers to host countries; and how the recent COVID-19 pandemic influenced health workforce emigration. Joshi et al broadly discuss approaches to skilled health worker migration after first referencing the World Health Organization Global Code of Practice on the International Recruitment of Health Personnel that was introduced in 2010. The authors conclude their article with specific recommendations for HICs that would mitigate their dependency on international medical graduates and with specific recommendations for LMICs that would aid in the development and preservation of their requisite health workforce. Mayo Clinic Proceedings warmly applauds Joshi et al for this timely and outstanding discussion of this pressing issue and in inaugurating this new section. To advance its international initiative, Mayo Clinic Proceedings is expanding its Editorial Board with international experts and is soliciting from its readership perspectives and other articles on topics of international interest. Skilled Health Workforce Emigration: Its Consequences, Ethics, and Potential SolutionsMayo Clinic ProceedingsVol. 98Issue 7PreviewTrained and equitably distributed health workers are the foundation for effective and sustainable health systems. The World Health Organization (WHO) developed the Global Strategy on Human Resources for Health: Workforce 2030 with an aim to accelerate progress towards universal health coverage and the United Nations Sustainable Development Goals.1 To meet the targets for universal health coverage, the world needs at least 43 million additional health workers.2 The most acute health workforce shortages are in sub-Saharan Africa, South Asia, North Africa, and the Middle East. Full-Text PDF Open Access