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University of Alberta: Linda Ogilvie, RN, PhD Judy Mill, RN, PhD Barbara Astle, RN, PhD Candidate

Credentialing of Internationally Educated Health Professionals and the Nursing Exodus from sub-Saharan Africa. University of Alberta: Linda Ogilvie, RN, PhD Judy Mill, RN, PhD Barbara Astle, RN, PhD Candidate Anne Fanning, MD, FRCPS. University of Ghana: Mary Opare, RN, MN.

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University of Alberta: Linda Ogilvie, RN, PhD Judy Mill, RN, PhD Barbara Astle, RN, PhD Candidate

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  1. Credentialing of Internationally Educated Health Professionalsand the Nursing Exodus from sub-Saharan Africa University of Alberta: Linda Ogilvie, RN, PhD Judy Mill, RN, PhD Barbara Astle, RN, PhD Candidate Anne Fanning, MD, FRCPS University of Ghana: Mary Opare, RN, MN

  2. Africa is estimated to have 1.3% of the global health workforce and 25% of the disease burden (WHO, 2004)

  3. Competing Rights • Right to: • health • leave one’s country to seek a better life • work and to just and favourable conditions of work • an adequate standard of living • education • nondiscrimination and equality

  4. Table 1: Comparison of Life Expectancy, Under Five Mortality (<5MR), and Maternal Mortality Ratio (MMR) for Canada, Ghana, Malawi, South Africa, and Zimbabwe (WHO, 2005) Note: MMR from 2000; other statistics from 2003

  5. Table 2: Physician, Nurse and Midwife Availability in Malawi, Zimbabwe, Ghana, and South Africa per Population around 1998 (WHO, 2002)

  6. Brain Drain? • Brain Gain? • Brain Circulation?

  7. Migration of Health Professionals from sub-Saharan Africa • Pattern • Poor data • Extent (physicians) • Extent (nurses)

  8. Table 3: UK Licensure of Nurses from South Africa, Zimbabwe, Ghana, and Malawi from 1998-99 to 2002-03 Adapted from Bach (2003) from UK Nursing and Midwifery Council data

  9. Push-Pull Factors in International Health Professional Migration • Common in general migration literature • HIV/AIDS • Worldwide shortage, particularly of nurses

  10. Policy Response to International Health Professional Migration • Attention to stick and stay factors within countries • High-income countries meet own needs through education and retention • Ethical recruitment practices • Financial restitution • Skill recirculation

  11. Skill Recirculation or Brain Circulation? • Initiatives from the diaspora • International partnerships • Reorientation of international aid priorities • Integration of health systems

  12. Coming Full Circle • Barriers to credentialing of internationally educated health professionals are not useful as a strategy to reduce health inequities worldwide and need to be addressed only within the context of protection of the public within the receiving country

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