Pardee-CFLP-Remittances-TF-Report

8. Filling the Gap in Health Staffing in Post-ConflictStates: A Modest but Innovative ProposalFrank Feeley, Susan Foster, Kara Galer, and Martin McKeeHigh rates of “brain drain” from many developing countries are one reason fora shortfall in the supply of health professionals in these countries. Emigrationof health professionals can be particularly severe in countries that have experienceda humanitarian crisis. Severe shortages of health professionals in fragilestates, especially those emerging from conflict, will not be relieved in the shortrun by expanding the numbers in training.Our hypothesis is that:a) there is a substantial number of medical and nursing graduates working inhigh-income countries who have considered returning to their home countries;b) have been discouraged from doing so because of concern about loss of futurepension entitlement; andContinuing to pay pension contributionsc) may be encouraged to return using development funding might be oneby using development funds to way to encourage the return of experiencedcontinue contributions to their health professionals to post-conflict states—current public pension plans. a “remittance” of skills necessary to rebuildthe health system.For countries that have experiencedconflict or humanitarian crisis, the emigrant’s ties to the health systemin the country of refuge may be weaker, making the “pension incentive” potentiallymore effective in leveraging the return of desperately needed healthprofessionals.Continuing to pay pension contributions using development funding might beone way to encourage the return of experienced health professionals to postconflictstates—a “remittance” of skills necessary to rebuild the health system.A Critical Shortage Where Health Care is CriticalThe need for more medical workers in many low-income countries is clear. TheWorld Health Organization (WHO) and others have documented the increasingscale of the shortage (Kinfu et al. 2009; Stilwell et al. 2004); in Sub-SaharanAfrica alone one estimate suggests 240,000 more doctors and 551,000 morenurses would be needed by 2015 to achieve the Millennium Development GoalsRemittance Flows to Post-Conflict States: Perspectives on Human Security and Development 127