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

1. International Migration of Nurses
In the Philippines
Globalization and Social
Change TAKAHASHI, Kimiaki
Prof.
Rico BURAGA
Graduate School of International Development, Nagoya
University

2. 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.

3. 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

4. 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

5. 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.

6. 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

7. 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

8. Figure 2. Trend of Deployment of Health Workers Abroad, 1992-2003
20000
18000
DENTISTS
16000
DIETITIANS AND PUBLIC
14000 HEALTH NUTRITIONISTS
12000 DOCTORS MEDICAL
Population
10000 MIDWIVES PROFESSIONAL
8000
NURSES PROFESSIONAL
6000
OPTOMETRISTS AND
4000 OPTICIANS
PHARMACISTS
2000
PHYSIOTHERAPISTS AND
0 OCCUPATIONAL
THERAPISTS
TECHNICIANS MEDICAL X-
92
93
94
95
96
97
98
99
00
01
02
03
19
19
19
19
19
19
20
20
19
19
20
20
RAY
Source: Philippine Overseas Employment Administration. URL: www.poea.gov.ph

9. 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

10. Table 3a. Deployment of Filipino Nurses by Major Country of Destination,
Philippines 1992- 2003
Yea United United Arab
Saudi Arabia United States Libya
r Kingdom 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. The Phenomenon of Doctors Become Nurse
PUSH FACTORS
Medics
•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

17. 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

18. 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

19. Impact of Nurse Migration
Effect On Family
Positive:
Increase family Income
Better quality of life for family
Negative:
Loss of family values
Social cost

20. 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

21. 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)

22. 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

23. 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

24. 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.

25. POLICY RECOMMENDATIONS

26. 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

27. thank you very much…!