IDEAS home Printed from https://ideas.repec.org/p/cgd/wpaper/114.html
   My bibliography  Save this paper

Do Visas Kill? Health Effects of African Health Professional Emigration

Author

Listed:
  • Michael Clemens

    ()

Abstract

The emigration of highly skilled workers can in theory lower social welfare in the migrant-sending country. If such workers produce a good whose consumption conveys a positive externality—such as nurses and doctors in a very poor country—the loss can be greater, and welfare can even decline globally. Policies to impede emigration thus have the potential to raise sending-country and global welfare. This study uses a new database of health worker emigration from Africa to test whether exogenous decreases in emigration raise the number of domestic health professionals, increase the mass availability of basic primary care, or improve a range of public health outcomes. It identifies the effect through two separate natural quasi-experiments arising from the colonial division of the African continent. These produce exogenous changes in emigration comparable to those that would result from different immigration policies in principal receiving countries. The results suggest that Africa's generally low staffing levels and poor public health conditions are the result of factors entirely unrelated to international movements of health professionals. A simple model proposes that such results would be explained by segmentation of health workforce labor markets in the sending countries. The results further suggest that emigration has caused a greater production of health workers in Africa.

Suggested Citation

  • Michael Clemens, 2007. "Do Visas Kill? Health Effects of African Health Professional Emigration," Working Papers 114, Center for Global Development.
  • Handle: RePEc:cgd:wpaper:114
    as

    Download full text from publisher

    File URL: http://www.cgdev.org/content/publications/detail/13123
    Download Restriction: no

    References listed on IDEAS

    as
    1. Michel Beine & Frédéric Docquier & Maurice Schiff, 2013. "International migration, transfer of norms and home country fertility," Canadian Journal of Economics, Canadian Economics Association, vol. 46(4), pages 1406-1430, November.
    2. Frederic, DOCQUIER & B. Lindsay, LOWELL & Abdeslam, MARFOUK, 2007. "A gendered assessment of the brain drain," Discussion Papers (ECON - Département des Sciences Economiques) 2007045, Université catholique de Louvain, Département des Sciences Economiques.
    3. Stark, Oded & Helmenstein, Christian & Prskawetz, Alexia, 1997. "A brain gain with a brain drain," Economics Letters, Elsevier, vol. 55(2), pages 227-234, August.
    4. Joost de Laat & William Jack, 2008. "Adverse Selection and Career Outcomes in the Ethiopian Physician Labor Market," Cahiers de recherche 0828, CIRPEE.
    5. Javorcik, Beata S. & Özden, Çaglar & Spatareanu, Mariana & Neagu, Cristina, 2011. "Migrant networks and foreign direct investment," Journal of Development Economics, Elsevier, pages 231-241.
    6. Jack, William & Lewis, Maureen, 2009. "Health investments and economic growth : macroeconomic evidence and microeconomic foundations," Policy Research Working Paper Series 4877, The World Bank.
    7. Serneels, Pieter & Lindelow, Magnus & Garcia-Montalvo, Jose & Barr, Abigail, 2005. "For public service or money : understanding geographical imbalances in the health workforce," Policy Research Working Paper Series 3686, The World Bank.
    8. Felbermayr, Gabriel J. & Toubal, Farid, 2012. "Revisiting the Trade-Migration Nexus: Evidence from New OECD Data," World Development, Elsevier, vol. 40(5), pages 928-937.
    9. Gibson, John & McKenzie, David, 2011. "The microeconomic determinants of emigration and return migration of the best and brightest: Evidence from the Pacific," Journal of Development Economics, Elsevier, vol. 95(1), pages 18-29, May.
    10. Desai, Mihir A. & Kapur, Devesh & McHale, John & Rogers, Keith, 2009. "The fiscal impact of high-skilled emigration: Flows of Indians to the U.S," Journal of Development Economics, Elsevier, vol. 88(1), pages 32-44, January.
    11. McKenzie, David, 2007. "Paper Walls Are Easier to Tear Down: Passport Costs and Legal Barriers to Emigration," World Development, Elsevier, vol. 35(11), pages 2026-2039, November.
    12. Oded Stark, 2005. "The New Economics of the Brain Drain," World Economics, World Economics, 1 Ivory Square, Plantation Wharf, London, United Kingdom, SW11 3UE, vol. 6(2), pages 137-140, April.
    13. Antonio Spilimbergo, 2009. "Democracy and Foreign Education," American Economic Review, American Economic Association, pages 528-543.
    14. Kenneth L. Leonard & Melkiory C. Masatu & Alexandre Vialou, 2007. "Getting Doctors to Do Their Best: The Roles of Ability and Motivation in Health Care Quality," Journal of Human Resources, University of Wisconsin Press, vol. 42(3).
    15. Djankov, Simeon & Ramalho, Rita, 2009. "Employment laws in developing countries," Journal of Comparative Economics, Elsevier, vol. 37(1), pages 3-13, March.
    16. David McKenzie & Hillel Rapoport, 2011. "Can migration reduce educational attainment? Evidence from Mexico," Journal of Population Economics, Springer;European Society for Population Economics, vol. 24(4), pages 1331-1358, October.
    17. Kugler, Maurice & Rapoport, Hillel, 2007. "International labor and capital flows: Complements or substitutes?," Economics Letters, Elsevier, vol. 94(2), pages 155-162, February.
    18. Michel Beine & Fréderic Docquier & Hillel Rapoport, 2008. "Brain Drain and Human Capital Formation in Developing Countries: Winners and Losers," Economic Journal, Royal Economic Society, vol. 118(528), pages 631-652, April.
    19. Michael A. Clemens & Lant Pritchett, 2008. "Income per Natural: Measuring Development for People Rather Than Places," Population and Development Review, The Population Council, Inc., vol. 34(3), pages 395-434.
    20. Michael Clemens, 2007. "Do Visas Kill? Health Effects of African Health Professional Emigration," Working Papers 114, Center for Global Development.
    21. Rogers, Mark Llewellyn, 2008. "Directly unproductive schooling: How country characteristics affect the impact of schooling on growth," European Economic Review, Elsevier, vol. 52(2), pages 356-385, February.
    22. Solimano, Andres (ed.), 2008. "The International Mobility of Talent: Types, Causes, and Development Impact," OUP Catalogue, Oxford University Press, number 9780199532605.
    23. William R. Kerr, 2008. "Ethnic Scientific Communities and International Technology Diffusion," The Review of Economics and Statistics, MIT Press, vol. 90(3), pages 518-537, August.
    24. Robert E.B. Lucas, 2005. "International Migration and Economic Development," Books, Edward Elgar Publishing, number 3826, April.
    25. Bhagwati, Jagdish & Hamada, Koichi, 1974. "The brain drain, international integration of markets for professionals and unemployment : A theoretical analysis," Journal of Development Economics, Elsevier, vol. 1(1), pages 19-42, April.
    26. Commander, Simon & Chanda, Rupa & Kangasniemi, Mari & Winters, L. Alan, 2004. "Must Skilled Migration Be a Brain Drain? Evidence from the Indian Software Industry," IZA Discussion Papers 1422, Institute for the Study of Labor (IZA).
    27. Beine, Michel & Docquier, Frédéric & Schiff, Maurice, 2008. "Brain Drain and its Determinants: A Major Issue for Small States," IZA Discussion Papers 3398, Institute for the Study of Labor (IZA).
    28. Filmer, Deon & Hammer, Jeffrey S & Pritchett, Lant H, 2000. "Weak Links in the Chain: A Diagnosis of Health Policy in Poor Countries," World Bank Research Observer, World Bank Group, vol. 15(2), pages 199-224, August.
    29. Satish Chand & Michael A. Clemens, 2008. "Skilled emigration and skill creation: A quasi-experiment," International and Development Economics Working Papers idec08-05, International and Development Economics.
    30. Fernandes, Ana Margarida & Mattoo, Aaditya, 2009. "Professional services and development : a study of Mozambique," Policy Research Working Paper Series 4870, The World Bank.
    31. Sean P. Corcoran & William N. Evans & Robert S. Schwab, 2002. "Changing Labor Market Opportunities for Women and the Quality of Teachers 1957-1992," NBER Working Papers 9180, National Bureau of Economic Research, Inc.
    32. Osili, Una Okonkwo, 2007. "Remittances and savings from international migration: Theory and evidence using a matched sample," Journal of Development Economics, Elsevier, vol. 83(2), pages 446-465, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Michael Clemens, 2010. "A Labor Mobility Agenda for Development," Working Papers 201, Center for Global Development.
    2. de Haas, Hein, 2009. "Mobility and Human Development," MPRA Paper 19176, University Library of Munich, Germany.
    3. Yaw Nyarko, 2014. "The Returns to the Brain Drain and Brain Circulation in Sub-Saharan Africa: Some Computations Using Data from Ghana," NBER Chapters,in: African Successes, Volume II: Human Capital, pages 305-345 National Bureau of Economic Research, Inc.
    4. Lucia Rizzica, 2008. "The Impact of Skilled Migration on the Sending Country: Evidence from African Medical Brain Drain," Rivista di Politica Economica, SIPI Spa, vol. 98(6), pages 195-230, November-.
    5. Docquier Frédéric & Rapoport Hillel, 2009. "Documenting the Brain Drain of “La Crème de la Crème”: Three Case-Studies on International Migration at the Upper Tail of the Education Distribution," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, pages 679-705.
    6. Clemens, Michael A., 2009. "Skill Flow: A Fundamental Reconsideration of Skilled-Worker Mobility and Development," MPRA Paper 19186, University Library of Munich, Germany.
    7. John Gibson & David McKenzie, 2011. "Eight Questions about Brain Drain," Journal of Economic Perspectives, American Economic Association, vol. 25(3), pages 107-128, Summer.
    8. Ha, Wei & Yi, Junjian & Zhang, Junsen, 2016. "Brain drain, brain gain, and economic growth in China," China Economic Review, Elsevier, vol. 38(C), pages 322-337.
    9. Frédéric Docquier & Hillel Rapoport, 2012. "Globalization, Brain Drain, and Development," Journal of Economic Literature, American Economic Association, vol. 50(3), pages 681-730, September.
    10. John Gibson & David McKenzie, 2012. "The Economic Consequences of ‘Brain Drain’ of the Best and Brightest: Microeconomic Evidence from Five Countries," Economic Journal, Royal Economic Society, vol. 122(560), pages 339-375, May.
    11. Elisabetta Lodigiani, 2009. "Diaspora Externalities as a Cornerstone of the New Brain Drain Literature," CREA Discussion Paper Series 09-03, Center for Research in Economic Analysis, University of Luxembourg.
    12. Michael Clemens, 2014. "A Case against Taxes and Quotas on High-Skill Emigration - Working Paper 363," Working Papers 363, Center for Global Development.
    13. Dacuycuy, Lawrence B., 2009. "Best practices in fostering migration opportunities : do they work?," ILO Working Papers 994318673402676, International Labour Organization.
    14. repec:ilo:ilowps:431867 is not listed on IDEAS
    15. Pavel Yakovlev & Tanner Steinkopf, 2014. "Can Economic Freedom Cure Medical Brain Drain?," Journal of Private Enterprise, The Association of Private Enterprise Education, vol. 29(Fall 2014), pages 97-117.
    16. Hanson, Gordon H. & Xiang, Chong, 2013. "Exporting Christianity: Governance and doctrine in the globalization of US denominations," Journal of International Economics, Elsevier, vol. 91(2), pages 301-320.
    17. Bakewell, Oliver, 2009. "South-South Migration and Human Development: Reflections on African Experiences," MPRA Paper 19185, University Library of Munich, Germany.
    18. Ratha, Dilip & Mohapatra, Sanket & Scheja, Elina, 2011. "Impact of migration on economic and social development : a review of evidence and emerging issues," Policy Research Working Paper Series 5558, The World Bank.

    More about this item

    Keywords

    emigration; health professionals; visas; africa; highly skilled workers; public health;

    JEL classification:

    • F22 - International Economics - - International Factor Movements and International Business - - - International Migration
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:cgd:wpaper:114. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Publications Manager). General contact details of provider: http://edirc.repec.org/data/cgdevus.html .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.