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International Migration of Nurses
                              In the Philippines



                 Globalization and Social
                 Change TAKAHASHI, Kimiaki
                    Prof.




                   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

                  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
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
     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
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
  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
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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International migration of nurses 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.
  • 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…!