The migration of doctors and nurses from South Pacific Island Nations

Abstract
Little is known of the structure of the international migration of skilled health professionals. Accelerated migration
of doctors and nurses from the Pacific island states of Fiji, Samoa and Tonga to the Pacific periphery is part of the
globalization of health care. The findings from a recent survey of 251 doctors and nurses from the three island countries
are reported here. Key determinants of both present migration status and future migration intentions were analyzed
using econometric methods. Nurses’ and doctors’ propensities to migrate are influenced by both income and nonincome factors, including ownership of businesses and houses. Migrants also tend to have more close relatives overseas,
to have trained there, and so experienced superior working conditions. Migration propensities vary between countries,
and between nurses and doctors within countries. Tongan nurses have a higher propensity to migrate, mainly because of
greater relative earnings differentials, but are also more likely to return home. The role of kinship ties, relative income
differentials and working conditions is evident in other developing country contexts. Remittances and return migration,
alongside business investment, bring some benefits to compensate for the skill drain. National development policies
should focus on encouraging return migration, alongside retention and recruitment, but are unlikely to prevent out
migration.
r 2003 Elsevier Ltd. All rights reserved.
Keywords: Migration; Skill drain; Pacific islands; Return migration; Doctors; Nurses