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Brain Drain in the Philippines

Brain Drain in the Philippines. Connie Gundayao Health Students’ Action - Philippines. 50% of the population has no health care access. 5 out of 10 Filipinos die without getting any medical attention. Only 60% of the population has full access to essential drugs.

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Brain Drain in the Philippines

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  1. Brain Drain in the Philippines Connie Gundayao Health Students’ Action - Philippines

  2. 50% of the population has no health care access. 5 out of 10 Filipinos die without getting any medical attention. Only 60% of the population has full access to essential drugs. (AHW 2004, CHD 2004, NIH 2005) At A Glance: Philippine Health Situation

  3. At A Glance: Philippine Health Situation • 10 mothers die daily due to pregnancy- and childbirth-related causes. • The average hospital bill is three times the average monthly income. • 23.4 M Filipinos still do not have access to toilets. CBHP experience would double this figure. (AHW 2004, CHD 2004, NIH 2005)

  4. Hemorrhage of Health Human Resources Philippines is the no. 1 exporter of nurses worldwide • 85% of Filipino nurses work abroad in some 50 countries (approx. 163,756 nurses in 2003) • From 1999-2003: Licensed 27,342 nurses yet over 56,000 went abroad. • Increasing number of nursing schools: 170 (1990s)  251 (2003)  470 (2006) HEAD, 2007

  5. Hemorrhage of Health Human Resources Phenomenon of doctors becoming nurses to go abroad More than 9,000 doctors have already left as nurses from 2002 to 2005. 80% of public health physicians have taken up or are enrolled in nursing. 90% of Municipal Health Officers (MHOs) are taking up nursing and expected to leave the country. HEAD, 2007

  6. Obstetricians and anesthesiologists are rapidly depleting, followed by pediatricians and surgeons. • At least 37 Philippine nursing schools offer abbreviated 2-year courses for doctors to become nurses. • More than 60% of nursing schools are geared mainly for “second coursers” • Pharmacists are the next target for employment abroad HEAD, 2007

  7. TESDA has trained over 50,000 caregivers in the last 5 years and over 24,000 have been deployed abroad. • An estimated 15,000 health professionals leave the country annually for employment abroad. • Decreased enrollment in medical schools of 10%-55% in the last 2 years. • Hospitals closing down for lack of doctors/nurses: 200 completely closed, 800 partially closed (2003-2005) HEAD, 2007

  8. Lorenzo, NIH, 2003

  9. Lorenzo, NIH, 2003

  10. Markets Traditional Markets: Middle East, North America New Markets: Europe especially UK, Netherlands, High Income Asia Emerging Markets: Japan and Nurse Education abroad Lorenzo, NIH, 2003

  11. Overseas Filipino Workers (OFWs) Remittances Source: Central Bank of the Philippines, 2005-06

  12. Other consequences • Decline in the interest of young Filipinos to study medicine – evidenced by a drop of 53% in NMAT examinees with Yr. 2000 as baseline • Decline in the applicants for medical residency positions to become specialists with an average of 50% • Nurse to patient ratios in provincial and district hospitals now 1:40-1:60 • Loss of highly skilled nurses in all hospitals across the country Galvez-Tan, 2003

  13. Reasons Why Health Professionals 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, peace and order situation in the Philippines, “Labor Export Policy” of the government, western orientation and high cost of health science education

  14. Reasons why Health Professionals Leave the Country Pull Factors (Receiving Countries) • 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 Lorenzo, NIH, 2003

  15. Reasons Why Doctors Migrate as Nurse Medics PUSH FACTORS • very low compensation and salaries, • feeling of hopelessness about the Philippine current situation, • political instability and graft and corruption, • poor working conditions and • the threat of malpractice law PULL FACTORS (Receiving countries) • more socio-politico- economic security abroad, • attractive salaries and compensation packages (High salaries, benefits, compensation) • more job opportunities and career growth. Lorenzo, NIH, 2003

  16. The Unhealthy Philippine Health Care System “A health care system that cannot maintain its own health human resource is not healthy at all.” HEAD, 2007

  17. Proposed Courses of Action • Policy Level • Review/scrap “labor export policy” • Regulate the outflow of health professionals • Increase health budget, improve the salaries & working conditions of health workers/professionals • Reorientation of health science education • Advocacy & Mobilization • Awareness-raising among health science students/ Exposure to social realities • “WTO out of health” campaign

  18. Other Proposed Reforms • National Health Service Act (2-year service in the Philippines) • Compensation from receiving countries • Bilateral agreements with Receiving Countries

  19. Challenges • Sustained and concerted efforts at the country and global level • Involvement of the health professionals into the campaign

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