WORLD BANK
RESEARCH PROGRAM
on
MEDICAL BRAIN DRAIN
Çaglar Özden
Senior Economist
Development Research Group
Brain Drain
Skilled Migration
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 Migration - Africa
Share of Migrants by Education Attainment: 2000
100%
80%
60%
40%
20%
0%
Africa Ghana Cote Togo Benin Burkina Nigeria Niger Sierra Guinea
d'Ivoire
Faso
Leone
secondary
tertiary
Skilled Migration - Africa
Share of Labor Force by Education Attainment: 2000
30%
25%
20%
15%
10%
5%
0%
Africa Ghana Cote Togo Benin Burkina Nigeria Niger Sierra Guinea
d'Ivoire
Faso
Leone
secondary
tertiary
Physician Migration Dataset
What do we actually know??
Migration
Soccer Players vs Doctors
Total Number by Origin
1000
750
500
250
0
Rest of Africa Nigeria Cameroon Ghana Senegal South Africa Ivory Coast
Migration
Soccer Players vs Doctors
Total Number By Origin
10,000
8,000
6,000
4,000
2,000
0
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
Others Nigeria Sudan Ghana Ethiopia Zimbabwe Kenya
Migration
Soccer Players vs Doctors
Total Number By Destination
1000
750
500
250
0
Rest of Europe France
Belgium
England
Netherlands
Turkey
Portugal
Migration
Soccer Players vs Doctors
Total Number by Destination
10,000
8,000
6,000
4,000
2,000
0
1991
1993
Rest
1995
UK
1997
USA
1999
2001
Australia Canada France
2003
Migration
Soccer Players vs Doctors
Migration Rate
50%
40%
30%
20%
10%
0%
Ethiopia
Ghana
Liberia
Malawi
Somalia
Zimbabwe
Migration
Soccer Player vs Doctors
What are the differences between
Soccer players and Doctors?
Migration
Soccer Players vs Doctors
What are the differences between
Soccer players and Doctors?
Salaries?
Social Externalities?
Lifestyle?
Talent?
Looks?
Migration
Soccer Players vs Doctors
Senegal vs.
France
2002
World Cup
Migration
Soccer 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
56
40
18
3
30-39
40-49
50-59
60-69
Gender Dimension
Gender distribution
100
80
60
40
20
0
Female
Male
Role of Networks??
Siblings abroad
62
21
13
No sibling
1
2
13
14
3
4+
Social Status
Education level of Father
51
19
20
22
3
No
education
Primary
school
Secondary
school
bachelor's
degree
professional
degree
Remittances
Remittances- Average: $6,800
24
18
14
12
4
>$1
$1-$5
$5-$9
$ Thousands
$9-$15
$15+
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!