Migration of physicians and nurses: a world wide picture.

WHO's Multinational Study of the International Migration of Physicians and Nurses, the subject of this paper, was the first step of WHO's response to a mandate calling for a study of health manpower migration and for collaborative efforts to regulate such migration where found to be undesirable. The study, which is both diagnostic and prescriptive, is based on an extensive library of published and unpublished literature. Major reports emanating from the study were: an analytical review of the literature; a statistical report on stocks and flows of migrant physicians and nurses for each of 137 countries; and a final report which provides an in-depth analysis of the characteristics of the migrants, the dimensions, directions, possible determinants, and consequences of the migration, and the actions taken by countries to regulate migration. It also suggests options for dealing with undesirable migration. Perhaps the most important finding is that countries which produce far more physicians and nurses than they can economically afford become donors of such manpower and those that produce fewer than they can afford become recipients. Almost all other factors either derive from or are secondary to the economic factor.