Developing evidence-based ethical policies on the migration of health workers: conceptual and practical challenges

It is estimated that in 2000 almost 175 million people, or 2.9% of the world's population, were living outside their country of birth, compared to 100 million, or 1.8% of the total population, in 1995. As the global labour market strengthens, it is increasingly highly skilled professionals who are migrating. Medical practitioners and nurses represent a small proportion of highly skilled workers who migrate, but the loss of health human resources for developing countries can mean that the capacity of the health system to deliver health care equitably is compromised. However, data to support claims on both the extent and the impact of migration in developing countries is patchy and often anecdotal, based on limited databases with highly inconsistent categories of education and skills. The aim of this paper is to examine some key issues related to the international migration of health workers in order to better understand its impact and to find entry points to developing policy options with which migration can be managed. The paper is divided into six sections. In the first, the different types of migration are reviewed. Some global trends are depicted in the second section. Scarcity of data on health worker migration is one major challenge and this is addressed in section three, which reviews and discusses different data sources. The consequences of health worker migration and the financial flows associated with it are presented in section four and five, respectively. To illustrate the main issues addressed in the previous sections, a case study based mainly on the United Kingdom is presented in section six. This section includes a discussion on policies and ends by addressing the policy options from a broader perspective

Compounding practices in Queensland: experiences and perceptions of pharmacists and pharmacy students

Background: Changes in the roles of the contemporary pharmacist has seen a decline in the number and variety of extemporaneously compounded dosage forms. Pharmacy curricula refl ect this change with a reduction in the emphasis on extemporaneous compounding practice. Aim: To elicit information about extemporaneously compounded dosage forms and perceptions of compounding practice from pharmacists and pharmacy students. Method: Self-administered surveys were mailed to 1063 pharmacists and offered online to 896 pharmacy undergraduates across the 4 years of a Bachelor of Pharmacy program in Queensland. Results: 382 (36%) pharmacists and 455 (51%) students completed the survey. Most pharmacists (96%) reported compounding a product in the 12 months prior to the survey, particularly semi-solids (89%) and liquids (64%) for external use. Most pharmacies (> 96%) owned basic compounding equipment, such as a slab and spatula, mortar and pestle, and cylindrical/conical measures. Half of the pharmacies used mechanical rather than electronic balances. Students expressed greater confi dence in their ability to use basic compounding equipment and to perform basic compounding tasks as they progressed through the 4-year degree course. Pharmacists' views on students' ability to compound basic products at the end of their degree were generally similar to the proportion of fi nal-year students who reported they could confi dently complete the task. Conclusion: Despite a decline in extemporaneously compounded products in community pharmacy, pharmacy graduates need to be competent in compounding techniques

Factors Affecting Whether Environmental Migration is Temporary or Permanent: Evidence from Bangladesh

This study examines whether environmental migrants in Bangladesh move permanently or temporarily. The analyses are based on data collected in 2010 and 2011, and cover four themes, namely migrant characteristics, environmental change related factors, conflict and adaptation strategies, and social networks. The estimates obtained from binary logit models show that most sets of variables have statistically significant impacts on the temporary migration versus permanent migration decision. Females are more inclined to migrate temporarily, a finding which is consistent with prior studies that argued that female migration is one temporary household survival strategy in the face of an environmental crisis. The probability of intending to move temporarily is significantly affected by the prior occupational experience: Migrants who were previously engaged in agriculture or fishing are more inclined to migrate permanently. Those households who reported that they had lost assets due to environmental hazards are shown to have a higher probability of becoming permanent migrants. In contrast, loss of livestock and crop failure are associated with a greater likelihood of temporary migration. The empirical results reveal the groups that can be targeted in destination regions in settlement policy, and equally the groups whose return home can be facilitated once any immediate danger has passed