WORLD BANK RESEARCH PROGRAM

onMEDICAL BRAIN DRAIN

Çaglar Özden

Senior EconomistDevelopment Research Group Development Research Group

Brain Drain

The Benefits Remittances Diaspora effects Incentives for higher

levels of education Brain Circulation

The Costs The Cost of Education Loss of Positive

Spillovers – benefits to people other than the migrant Productivity spillovers Services to population

– education and healthcare

Innovation and creativity

Institution building

Skilled MigrationSkilled Migration

Skilled Migration - AfricaSkilled Migration - Africa

Share of Migrants by Education Attainment: 2000

0%

20%

40%

60%

80%

100%

Africa Ghana Coted'Ivoire

Togo Benin BurkinaFaso

Nigeria Niger SierraLeone

Guinea

secondary tertiary

Skilled Migration - AfricaSkilled Migration - Africa

Share of Labor Force by Education Attainment: 2000

0%

5%

10%

15%

20%

25%

30%

Africa Ghana Coted'Ivoire

Togo Benin BurkinaFaso

Nigeria Niger SierraLeone

Guinea

secondary tertiary

Physician Migration Dataset

What do we actually know??

MigrationSoccer Players vs Doctors

Total Number by Origin

0

250

500

750

1000

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

Rest of Africa Nigeria Cameroon Ghana Senegal South Africa Ivory Coast

MigrationSoccer Players vs Doctors

Total Number By Origin

0

2,000

4,000

6,000

8,000

10,000

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004

Others Nigeria Sudan Ghana Ethiopia Zimbabwe Kenya

MigrationSoccer Players vs Doctors

Total Number By Destination

0

250

500

750

1000

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

Rest of Europe France Belgium Portugal

England Turkey Netherlands

MigrationSoccer Players vs Doctors

Total Number by Destination

0

2,000

4,000

6,000

8,000

10,000

1991 1993 1995 1997 1999 2001 2003

Rest UK USA Australia Canada France

MigrationSoccer Players vs Doctors

Migration Rate

0%

10%

20%

30%

40%

50%

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

Ethiopia Ghana Liberia Malawi Somalia Zimbabwe

MigrationSoccer Player vs Doctors

What are the differences between Soccer players and Doctors?

MigrationSoccer Players vs Doctors

What are the differences between Soccer players and Doctors?

Salaries?

Social Externalities?

Lifestyle?

Talent?

Looks?

MigrationSoccer Players vs Doctors

Senegal vs. France

2002World Cup

MigrationSoccer Players vs Doctors

What are the differences between Soccer players and Doctors?

Opportunity Cost of Production/Replacement

Migration

Migration of Doctors is not the ‘disease’

It is the

‘symptom’

Migration

Skilled people leave because of

- Professional opportunities- Income gain

- Political Instability- Under-appreciation

Migration

Who Leaves?

Preliminary Data from Ghana

It is not a recent issue!

Age Range

40

56

18

3

30-39 40-49 50-59 60-69

Gender Dimension

Gender distribution

0

20

40

60

80

100

Female Male

Role of Networks??

Siblings abroad

62

1321

13 14

No sibling 1 2 3 4+

Social Status

Education level of Father

19 20 22

51

3

No education

Primary school

Secondary school

bachelor's degree

professional degree

Remittances

Remittances- Average: $6,800

4

24

18

1412

>$1 $1-$5 $5-$9 $9-$15 $15+

$ Thousands

Migration

What should we do?

Treat the symptom or cure the disease?

Migration

What should we do?

Treat the symptom or cure the disease?

Take away Passports Punish the recruiters

Pay Higher salaries back at home Make migrants pay for their education

Make migrants feel guilty

Migration

…or is High Level of

Skilled Migration

a result of wrong

education and health policies?

Migration

What is equitable, economically efficient and pro-development?

Two–tiered education system? One for the Global Market, one for the local

market where the first finances the latter? Migrant tax – coordinated w/ Destination

countries? Recruitment Tax? Brain Circulation?

Migration

No Easy Answers!!

Ask The British!!

UK is the country with the Highest level of skilled

migration today!