Human resources for health in southeast Asia: shortages, distributional challenges, and international trade in health services.

  • Kanchanachitra C
  • Lindelow M
  • Johnston T
 et al. 
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In this paper, we address the issues of shortage and maldistribution of health personnel in southeast Asia in the context of the international trade in health services. Although there is no shortage of health workers in the region overall, when analysed separately, five low-income countries have some deficit. All countries in southeast Asia face problems of maldistribution of health workers, and rural areas are often understaffed. Despite a high capacity for medical and nursing training in both public and private facilities, there is weak coordination between production of health workers and capacity for employment. Regional experiences and policy responses to address these challenges can be used to inform future policy in the region and elsewhere. A distinctive feature of southeast Asia is its engagement in international trade in health services. Singapore and Malaysia import health workers to meet domestic demand and to provide services to international patients. Thailand attracts many foreign patients for health services. This situation has resulted in the so-called brain drain of highly specialised staff from public medical schools to the private hospitals. The Philippines and Indonesia are the main exporters of doctors and nurses in the region. Agreements about mutual recognition of professional qualifications for three groups of health workers under the Association of Southeast Asian Nations Framework Agreement on Services could result in increased movement within the region in the future. To ensure that vital human resources for health are available to meet the needs of the populations that they serve, migration management and retention strategies need to be integrated into ongoing efforts to strengthen health systems in southeast Asia. There is also a need for improved dialogue between the health and trade sectors on how to balance economic opportunities associated with trade in health services with domestic health needs and equity issues.

Author-supplied keywords

  • Asia, Southeastern
  • Commerce
  • Emigration and Immigration
  • Emigration and Immigration: statistics & numerical
  • Emigration and Immigration: trends
  • Health Manpower
  • Health Manpower: statistics & numerical data
  • Health Personnel
  • Health Personnel: education
  • Health Personnel: statistics & numerical data
  • Health Resources
  • Health Resources: organization & administration
  • Health Resources: standards
  • Health Resources: statistics & numerical data
  • Health Resources: supply & distribution
  • Health Resources: trends
  • Humans
  • Medical Tourism
  • Medical Tourism: statistics & numerical data
  • Medical Tourism: trends
  • Medically Underserved Area
  • Midwifery
  • Midwifery: statistics & numerical data
  • Nurses
  • Nurses: statistics & numerical data
  • Physicians
  • Physicians: statistics & numerical data
  • Public Policy
  • Public Policy: trends

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  • Churnrurtai Kanchanachitra

  • Magnus Lindelow

  • Timothy Johnston

  • Piya Hanvoravongchai

  • Fely Marilyn Lorenzo

  • Nguyen Lan Huong

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