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Do Visas Kill? Health Effects of African Health Professional Emigration

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  • Michael Clemens

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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
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    File URL: http://www.cgdev.org/content/publications/detail/13123
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    Cited by:

    1. 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.
    2. 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.
    3. John Gibson & David McKenzie, 2011. "Eight Questions about Brain Drain," Journal of Economic Perspectives, American Economic Association, vol. 25(3), pages 107-128, Summer.
    4. 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.
    5. 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.
    6. Michael Clemens, 2010. "A Labor Mobility Agenda for Development," Working Papers 201, Center for Global Development.
    7. Frédéric Docquier & Hillel Rapoport, 2012. "Globalization, Brain Drain, and Development," Journal of Economic Literature, American Economic Association, vol. 50(3), pages 681-730, September.
    8. 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.
    9. de Haas, Hein, 2009. "Mobility and Human Development," MPRA Paper 19176, University Library of Munich, Germany.
    10. 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, vol. 229(6), pages 679-705, December.
    11. Bakewell, Oliver, 2009. "South-South Migration and Human Development: Reflections on African Experiences," MPRA Paper 19185, University Library of Munich, Germany.
    12. Michael A. Clemens, 2009. "Skill Flow: A Fundamental Reconsideration of Skilled-Worker Mobility and Development," Human Development Research Papers (2009 to present) HDRP-2009-08, Human Development Report Office (HDRO), United Nations Development Programme (UNDP), revised Apr 2009.
    13. 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-.
    14. Michael Clemens, 2014. "A Case against Taxes and Quotas on High-Skill Emigration - Working Paper 363," Working Papers 363, Center for Global Development.
    15. Ronald Skeldon, 2008. "International Migration as a Tool in Development Policy: A Passing Phase?," Population and Development Review, The Population Council, Inc., vol. 34(1), pages 1-18.
    16. Elisabetta LODIGIANI, 2009. "Diaspora Externalities as a Cornerstone of the New Brain Drain Literature," Discussion Papers (IRES - Institut de Recherches Economiques et Sociales) 2009036, Université catholique de Louvain, Institut de Recherches Economiques et Sociales (IRES).
    17. Dacuycuy, Lawrence B., 2009. "Best practices in fostering migration opportunities : do they work?," ILO Working Papers 994318673402676, International Labour Organization.
    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.
    19. repec:ilo:ilowps:431867 is not listed on IDEAS

    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

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