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International Migration of Nurses in the Philippines

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					             International Migration of Nurses
                                In the Philippines



                  Globalization and Social Change
                     Prof. TAKAHASHI, Kimiaki




                   Rico BURAGA
Graduate School of International Development, Nagoya University
Purpose
 To describe the push and pull factors of nurse migration in the
 Philippines.



Organizing Construct
 Review of literature on Filipino nurse migration, and
 examination of effects on sending country health sector.
                     Topic Outline
I. INTRODUCTION
  A. Current Economic Condition
  B. Philippine Migration
II. NURSE MIGRATION SITUATION
III. DEMOGRAPHIC PROFILE OF NURSE MIGRANTS
IV. REASONS FOR MIGRATION
  A. Push Factors
  B. Pull Factors

V. PHENOMENON OF DOCTORS BECOME NURSE MEDICS

VI. REASONS FOR RETURNING

VII. IMPACT OF NURSE MIGRATION

VII. CONCLUSION

IX. POLICY RECOMMENDATIONS

X. REFFERENCES
INTRODUCTION
Background on Current Economic Situation

  • Rapidly growing population projected population: 89,468,677
    (July 2006 est.)

  •Unemployment rates around 8.1% (2006 est.)

  •Job opportunities have not increased correspondingly with
   population increase

  •Every year about 600,000 young people begin looking for
   work in a various economic sectors
 Background on Philippine Migration


 More than 10 million overseas Filipinos worldwide, about
  11% of the total population of the Philippines

The amount total annual remittance represents 13.5% of
the country's GDP

 Remittance by OFWs back to the Philippines is a major
  factor in the country's economy, amounting to more than
  US$10 billion in 2005.
                                  Figure 1. Trend in Deployment of Filipino Nurses Abroad, 1992-
                                                              2003



                                                                                             13536
   Number of Filipino Nurses




                                                                                                     11911


                                                                                                       8968
                                                     7584                             7683
                                         6744 6699
                                  5747                                         5413
                                                              4734 4242 4591




                                Yr   Yr   Yr   Yr   Yr   Yr   Yr   Yr   Yr   Yr   Yr   Yr
                               1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003
Source: Philippine Overseas Employment Administration. URL: www.poea.gov.ph
               Table 1. Number of Filipino Nurses Deployed Abroad Per
                                   Year, 1992-2003
                                    1992                                      5747
                                    1993                                      6744
                                    1994                                      6699
                                    1995                                      7584
                                    1996                                      4734
                                    1997                                      4242
                                    1998                                      4591
                                    1999                                      5413
                                    2000                                      7683
                                    2001                                      13536
                                    2002                                      11911
                                    2003                                      8968
                                   Total                                      87852
Source: Philippine Overseas Employment Administration. URL: www.poea.gov.ph
                              Figure 2. Trend of Deployment of Health Workers Abroad, 1992-2003

                    20000

                    18000
                                                                                                     DENTISTS
                    16000
                                                                                                     DIETITIANS AND PUBLIC
                    14000                                                                            HEALTH NUTRITIONISTS

                                                                                                     DOCTORS MEDICAL
       Population




                    12000

                    10000                                                                            MIDWIVES PROFESSIONAL

                     8000
                                                                                                     NURSES PROFESSIONAL

                     6000
                                                                                                     OPTOMETRISTS AND
                     4000                                                                            OPTICIANS

                                                                                                     PHARMACISTS
                     2000
                                                                                                     PHYSIOTHERAPISTS AND
                        0                                                                            OCCUPATIONAL
                                                                                                     THERAPISTS
                        92

                              93

                                    94

                                          95

                                                96

                                                       97

                                                              98

                                                                     99

                                                                              00

                                                                                    01

                                                                                          02

                                                                                                03
                                                                                                     TECHNICIANS MEDICAL X-
                       19

                             19

                                   19

                                         19

                                               19

                                                     19

                                                            19

                                                                   19

                                                                          20

                                                                                   20

                                                                                         20

                                                                                               20


Source: Philippine Overseas Employment Administration. URL: www.poea.gov.ph
                                                                                                     RAY
Total Number of Nurses in the Country

• Total Registered Nurses (1960-2003) = 333, 581

• Estimated Deaths = 1, 375.20

• Estimated Current Stock of Nurses = 332, 206

SUPPLY AND DEMAND:

• Supply      = 332, 206

• Demand      = 193, 223

• Oversupply = 138, 983
    Table 3a. Deployment of Filipino Nurses by Major Country of Destination,
                            Philippines 1992- 2003
                                                                                                          United Arab
     Year        Saudi Arabia               United States            United Kingdom           Libya
                                                                                                             Emirates
                Num            %           Num            %           Num       %      Num        %      Num     %
     1992       3279        57.06%         1767        30.75%            0    0.00%    269      4.68%    271    4.72%
     1993       4202        62.31%         1987        29.46%            0    0.00%    721      10.69%    47    0.70%
     1994       3332        49.74%         2853        42.59%            0    0.00%     15      0.22%    270    4.03%
     1995       3249        42.84%         3690        48.66%            1    0.01%    380      5.01%     94    1.24%
     1996       3071        64.87%          270         5.70%            0    0.00%    809      17.09%   137    2.89%
     1997       3794        89.44%           11         0.26%            0    0.00%    175      4.13%    209    4.93%
     1998       4098        89.26%           5          0.11%           63    1.37%     89      1.94%    279    6.08%
     1999       4031        74.47%           53         0.98%          367    6.78%     18      0.33%    378    6.98%
     2000       4386        57.09%           91         1.18%          295    3.84%     17      0.22%    305    3.97%
     2001       5045        37.27%          304         2.25%         5383    39.77%    9       0.07%    243    1.80%
     2002       5704        47.89%          320         2.69%         3105    26.07%   414      3.48%    405    3.40%
     2003       5740        64.01%          196         2.19%         1544    17.22%    52      0.58%    226    2.52%
     Total     49931        56.84%        11547        13.14%        10758    12.25%   2968     3.38%    2864   3.26%
Source: Philippine Overseas Employment Administration. URL: www.poea.gov.ph
    Table 3b. Deployment of Filipino Nurses by Major Country of Destination,
                            Philippines 1992- 2003
    Year               Ireland                Singapore                       Kuwait          Qatar           Brunei
                 Num            %            Num           %          Num          %     Num      %      Num       %
     1992          0          0.00%            0         0.00%          320      5.57%    0      0.00%    0      0.00%

     1993          0          0.00%            0         0.00%          139      2.06%    0      0.00%    6      0.09%

     1994          0          0.00%            0         0.00%          455      6.79%    6      0.09%    5      0.07%

     1995          0          0.00%           79         1.04%          59       0.78%   10      0.13%    7      0.09%

     1996          0          0.00%           264        5.58%          269      5.68%    6      0.13%    5      0.11%

     1997          0          0.00%           228        5.37%          25       0.59%   14      0.33%   32       0.75%

     1998          0          0.00%           224        4.88%          143      3.11%   21      0.46%    2      0.04%

     1999          0          0.00%           154        2.85%          53       0.98%   12      0.22%    1      0.02%

     2000         126         1.64%           292        3.80%          133      1.73%    7      0.09%    0      0.00%

     2001        1529        11.30%           413        3.05%          182      1.34%   143     1.06%    1      0.01%

     2002         915         7.68%           337        2.83%          108      0.91%   213     1.79%    9      0.08%

     2003         207         2.31%           326        3.64%          51       0.57%   242     2.70%    2      0.02%

    Total       2777         3.16%          2317        2.64%         1937       2.20%   674     0.77%   70      0.08%
Source: Philippine Overseas Employment Administration. URL: www.poea.gov.ph
         Country of Destinations

Traditional Markets: Middle East, North America

New Markets: Europe especially UK, Netherlands, High
 Income Asia

 Emerging Markets: Japan and Nurse Education abroad
Demographic Profile of Filipino Nurse
            Migrants
Predominantly female

Young - 20’s -30’s

From Middle Class Family

 Mostly with basic professional education ;some with
  masters’ degrees

 Specialized in Critical Care nursing, OR and ER, and
  rendered 1-10 years of service before migration
 Reasons Why Filipino Nurses Leave the
               Country

Push Factors

• Economic: low salary at home, no overtime and hazard pay,
  low coverage of health insurance

•Job-related: work overload or stressful working environment,
 slow promotion

• Socio-political and economic environment: limited
  opportunities for employment, decreased health budget
  Reasons Why Filipino Nurses Leave the
                Country
Pull Factors

Economic: higher income, better benefits and compensation package


Job-related: Lower nurse to patient ratio, more options in working hours


Individual/Family-related: Chance to upgrade nursing skills, acquisition of
 immigrant visa and opportunity for family to migrate, opportunity to travel
 and learn other cultures, influence from peers and relatives


 Socio-political and Economic environment: Advanced technology, better
  peace and order situation
The Phenomenon of Doctors Become Nurse
               Medics
   PUSH FACTORS
•very low compensation and salaries
•feeling of hopelessness about the Philippine economic
 situation
•political instability
•poor working conditions
•the threat of malpractice law

   PULL FACTORS
•more socio-politico- economic security abroad
•more job opportunities and career growth
• high salaries, benefits, compensation
Reasons Why Filipino Nurses Return:
Personal Reasons
  To get married
  To raise children in homeland
  To take a vacation
  Homesickness and depression
  To retire
  To get family
Professional Reasons
  To share expertise learned abroad
Reasons Why Filipino Nurses Return
 Financial Reasons
   -Nurse has saved enough money
   -To set up a business at home

 Job-related Reasons
   -To buy a house or a car

 Social Reasons
   -Contract has expired
   -Plans to retire back home
          Impact of Nurse Migration
Effect On Family

  Positive:

      Increase family Income
      Better quality of life for family


  Negative:

      Loss of family values

      Social cost
               Impact of Nurse Migration
Effect On Health Care System

   •Positive
     Transfer of technology

   Negative

     Loss of senior, competent staff

     Compromised health care due to inadequate pool of skilled workers

     The HR becomes more expensive

     Some hospitals have closed down because there are not enough
         nurses and no applicants for various residency programs

     Increased patients to nurse ratio
               Impact of Nurse Migration
Effect on the Nursing as a Profession

  Positive
    Encourages Filipinos to take up health courses

    Exposure to different culture, work ethics, technology transfer if they
    return
    Career advancement because of better technology in host countries
    Top students go into nursing


  Negative
    repercussions of other professionals moving into nursing (incompetent
        and unproductive nurses)
           Social Net Benefits

Winners

Nurse migrants and their families- (increased
household income)

Economy – remittances, raise hours worked in self-
employment and lead to relatively capital-intensive
enterprises by migrants’ households
            Social Net Benefits
Losers
 Health Care System
   Loss of skilled trained health staff
   Rendered health system fragile
 Extended Families
   Family members will be far apart (may lead to
   psychological or social problems)

 Philippine Nursing
   Ability to renew and further nursing development is
   hampered
CONCLUSION




    - Nurses migrate to seek better wages and working
    conditions abroad.

    - Migration is predicted to continue until hosting countries
    address the underlying causes of nurse shortages and the
    Philippines address conditions that cause nurses to leave.

    - Given the current conditions, workers migration in general
    have a positive impact in Philippine economy.
POLICY RECOMMENDATIONS
REFFERENCES:

Battistella, Graziano and Anthony Paganoni, eds. 1992. Philippine Labor Migration: Impact and Policy. Quezon City: Scalabrini Migration Center.

Cariño, Benjamin V., ed. 1998. Filipinos on the Move: Trends, Dilemmas and Policy Options. Quezon City: Philippine Migration Research Network.

Donna, Kline Push and Pull Factors in International Nurse Migration. http://www.blackwell-synergy.com/links/doi/10.1111/j.1547-
5069.2003.00107.x/enhancedabs/

Dooley, K. (2002, July 13). Hospital imports nurses from the Philippines to alleviate shortage. Lexington Herald-Leader, A1.

Gonzales, Joaquin III. 1998. Philippine Labour Migration: Critical Dimensions of Public Policy. Singapore: Institute of Southeast Asian Studies.

Martin, Philip. Best Practices to Manage Migration: The Philippines. http://www.blackwell-synergy.com/doi/pdf/10.1111/j.1747-7379.2004.tb00247.x

Philippine Overseas Employment Administration. http://www.poea.gov.ph/

Philippine National Statistics Office. http://www.nso.gov.ph/

United States Central Intelligence Agency Fact Book. URL://https://www.cia.gov/cia/publications/factbook/print/rp.html

Wikipedia. http://en.wikipedia.org/

http://www.ilo.org/public/english/protection/migrant/download/imp/imp64.pdf

http://www.unesco.org/most/apmrnw11.htm

http://www.pmrw.org/

http://www.migrationinformation.org/Profiles/display.cfm?ID=364

http://www.icmc.net/pdf/phillipines_may_2006.pdf

http://www.academyhealth.org/international/nursemigration/lorenzo.ppt

http://www.osce.org/publications/eea/2006/05/19187_625_en.pdf

http://www.ilo.org/dyn/natlex/natlex_browse.details?p_lang=en&p_country=PHL&p_classification=17&p_origin=SUBJECT
thank you very much…!

				
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Description: International migration of nurses in the Philippines. A presentation to describe the push and pull factors of nurse migration in the Philippines. International Migration of Nurses in the Philippines