Strengthening Health Systems in North and Central America: What Role for Migration?
In this study the authors explore the intersecting dynamics of evolving demographic trends, shifting epidemiological profiles, and worker migration in five countries in the Americas in order to develop policy recommendations for health workforce development, specifically for nursing personnel. The countries highlighted in this study are El Salvador, Guatemala, Honduras, Mexico, and the United States.
The report begins by providing general background information on the health care sector in each country. Section II explores the phenomenon of nurse migration and highlights the contributions of internationally educated nurses (IENs) to the U.S. health care system. Nursing human resource issues specific to each country and their links to general educational issues that affect nursing are briefly discussed. Section III reviews the major health care issues in each country, discussing how changing demographics and epidemiological profiles increase the demand for services and how nursing services can meet this new demand.
Using migration to meet health care demand is complex. Nonetheless, the authors advocate exploring and investing in the possibility because of the potential benefits to health care systems, economies, and patient outcomes. Recommendations include investments in educational systems, ways to facilitate the credentialing of nurses across borders, developing visas based on improving language concordance between nurses and patients disproportionately affected by health disparities, integrating transitional educational programs as part of the credentialing process for internationally educated nurses, and ways to capitalize on “hidden nurses” of Hispanic heritage who are currently living in the United States.
I. Sector Overview
A. El Salvador
E. The United States
II. An Overview of Regional Nursing Workforce Issues
A. Trends in International Nurse Migration
B. Trends in US Nursing Workforce Demand
C. Hidden Nurses
D. Standardization of Training
E. Looking Forward
III. Why Health Care Matters
A. Aging Populations
B. Epidemiological Changes in the Health Profile of the Americas
C. The Cost-Effectiveness of Nursing Services
D. Regional Shortages of Nursing Personnel
E. Production of Nurses in the Region
F. Barriers to the Production and Migration of Nurses in the Region
G. Anticipating Demand from Medical Tourists and Expatriate Communities
A. Policy Recommendations
B. Suggestions for Future Research
V. Concluding Remarks