Introduction to Labor and Health Economics: Mobility of Medical Doctors in the Mediterranean Region

Shortage Of Medical Doctors, Migration & Global Health Systems

The above issues are discussed in this part with first, the introduction of shortage of medical doctors. This is followed by a focus on some factors that could lead to shortage before discussing migration and then by the on-going related policies.

Such components are likely to allow for an overall understanding of the links between shortage, migration and education besides the overall policies governing education, migration and health.

This problem has been identified and excessively discussed with the publication of the WHO report (2006) with the analysis of the patterns, issues and trends related to the workforce operating in the health systems. Among the background papers in this report, there is the one by Dal Poz, Kinfu, Drager and Kunjumen (2006) that dealt with counting health workers through data with showing the global results. The most promising publication on labor markets for the health workforce is the recent book edited by Soucat, Scheffler and Ghebreyesus (2013). While the book focuses on Africa, it provides important insights about the analysis of the health systems.

Ranson, Chopra, Atkins, Dal-Poz and Bennett (2010) argue that since human resources account for approximately 70% of recurrent expenditure in most health systems, inadequate human resource training, regulation, distribution and management can have enormous implications. To the authors, poor developing economies suffer from shortage of health-care providers and from the poor distribution of providers within the same country. These concern disparities in the distribution of health workers between regions, between rural and urban areas, and between public and private sectors. In Algeria with 8% of the population in Algiers, 24% of specialist physicians are located in this city. Similarities are found in other countries (Argentina, Egypt, Uganda and Tanzania). The working time, the level of efficiencies between private and public sectors are also discussed as expressions of implicit discriminations. But, to the authors this is a more general trend that is exaggerated in poor developing countries.

Ranson, Chopra, Atkins, Dal-Poz and Bennett (2010) have discussed the priorities for research on human resources for health in low and Middle income countries. The authors have used interviews of different stakeholders to find out about the major problems facing health workers and the type of research priorities needed. Twenty-one research questions are identified with some have never received attention in the reviewed literature. They include incentives for retention and attraction of health human resources to underserviced areas, the impacts of multiple employments and the use of optimal incentives to enhance quality of health care. A clear consensus about the type of policy problems faced by different countries and the nature of evidence needed to tackle them. Coordinated action to support and implement research into the highest priority questions identified here could have a major impact on health worker policies and, ultimately, on the health of the poor.