Hussain Ishrat, Haruna-Cooper Lois, Isiramen Sharon, van der Mark Nina, Khan Mishal, Rashid Mohammed Ahmed
Faculty of Medical Sciences, University College London, London, United Kingdom.
Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
PLOS Glob Public Health. 2024 Jul 16;4(7):e0003481. doi: 10.1371/journal.pgph.0003481. eCollection 2024.
Rising global migration levels have led to growing diaspora populations. There has been interest in the role of diaspora healthcare professionals (HCPs) from low- and middle-income countries (LMICs) in development aid to their origin countries, although there has been comparatively less focus on their educational activities. This study examined the stated educational priorities of LMIC medical diaspora organisations, with a particular focus on the tension between promoting professional opportunities afforded by medical migration and contributing to healthcare workforce shortages due to migration away from LMICs.We gathered a textual archive from webpages and public documents of 89 LMIC medical diaspora organisations in high income countries, predominantly the US and UK. We employed Foucauldian critical discourse analysis to examine presented rationales around educational policies and practices, with a focus on encouragement towards, and discouragement from, medical migration. Two discourses dominated this archive. The first was of preservation and framed the educational work of these organisations as a means of providing unity and social networks to diaspora HCPs, with a focus on maintaining their cultural identity and heritage, and medical connections with their origin countries. The second was of aspiration and framed their educational work as providing support to diaspora HCPs to advance their careers and maximise training opportunities, often through directly enabling and supporting migration to high income countries. There was a discursive absence around brain drain with no policies or practices that overtly sought to deter against, or offset the negative effects of, medical migration. Notwithstanding the valuable contributions that LMIC medical diaspora organisations make in global health, the discursive framings that shape their educational work are linked primarily to protecting and progressing diaspora HCPs rather than on LMIC workforce challenges. Further research is needed to examine potential impacts of these positions on HCP migratory behaviours.
全球移民水平的上升导致侨民人口不断增加。人们对来自低收入和中等收入国家（LMIC）的侨民医疗专业人员（HCP）在对其原籍国的发展援助中所起的作用颇感兴趣，不过相对而言，对他们的教育活动关注较少。本研究调查了LMIC医学侨民组织宣称的教育重点，特别关注促进医疗移民带来的职业机会与因移民离开LMIC而导致医疗劳动力短缺之间的矛盾。我们从高收入国家（主要是美国和英国）的89个LMIC医学侨民组织的网页和公共文件中收集了文本档案。我们运用福柯式批判性话语分析来审视围绕教育政策和实践所呈现的基本原理，重点关注对医疗移民的鼓励和劝阻。两种话语主导了这个档案。第一种是保护型话语，将这些组织的教育工作界定为为侨民HCP提供团结和社交网络的一种方式，重点是维护他们的文化身份和遗产，以及与原籍国的医疗联系。第二种是抱负型话语，将他们的教育工作界定为为侨民HCP提供支持，以促进其职业发展并最大化培训机会，通常是通过直接促成和支持向高收入国家的移民来实现。在人才外流方面存在话语缺失，没有任何政策或实践公开试图阻止或抵消医疗移民的负面影响。尽管LMIC医学侨民组织在全球卫生方面做出了宝贵贡献，但塑造其教育工作的话语框架主要与保护和推动侨民HCP相关，而非LMIC的劳动力挑战。需要进一步研究来考察这些立场对HCP移民行为的潜在影响。
