Aid for health, economic growth, and the emigration of medical workers

Abstract

Debates on the extent to which developing countries suffer from a brain drain often focus on the emigration of locally scarce health personnel. In this paper, we empirically examine how two potential determinants - aid for health and local income levels - affect the emigration rates of doctors and nurses from developing countries. Employing a standard gravity model of international migration, we show that aid for health has a negative effect on the emigration of both nurses and doctors. The quantitative impact is moderate but non-negligible: doubling the amount of foreign assistance received by developing countries in the health sector lowers the emigration rates of health personnel by around 10%. Our findings suggest that donors influence the emigration decisions of doctors and nurses through improvements in health infrastructure and health care services. Higher income per capita is also associated with lower emigration from developing countries for doctors and nurses alike. Given that nurses typically belong to the poorer segments of populations in the countries of origin, we can conclude that even at low initial income levels, on balance, economic growth provides an incentive to stay rather than enabling would-be migrants to finance migration costs and encouraging them to leave.