Depriving the Deprived: Examining Brain Drains of Health Professionals from Low- and Middle-Income Countries (LMICs) to Wealthy Nations with an Equity Lens

2025 · doi:10.22541/au.174522534.41721038/v1
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This preprint examines the global “brain drain” of health professionals from low- and middle-income countries (LMICs), especially in Sub-Saharan Africa, to OECD wealthy nations, arguing this dynamic worsens health inequities in LMICs that already have the largest shortages. Using a high-level equity lens, the authors describe how OECD member states recruit health professionals from LMICs to fill system gaps, and they note that prior strategies focusing on “push factors” have not produced noticeable impact. The paper’s main contribution is proposing a framework of shared responsibility, where recruiting countries invest in LMIC health-professional education and production and provide in-service training for mentors and trainers to strengthen medical school quality, potentially increasing the number of professionals serving both regions. This paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

With an estimated population of 7.8 billion, health professionals (HPs) are grossly inadequate globally and far below WHO’s benchmark of 1 physician, 4 nurses, and midwives per 1000 population. Despite their shortage, HPs are not equitably distributed, with low- and middle-income countries (LMICs) especially those in Sub-Saharan Africa having the greatest shortages. The Organization for Economic Co-operation and Development (OECD) member states exploit the socioeconomic vulnerability of LMICs to massively recruit HPs from these countries to fill the gaps in their systems. The prolonged hemorrhage of HPs from LMICs to OECD member states continues to complicate health equity in LMICs, which have some of the highest wealth gap among their populations; and has raised concerns about social justice and breach of ethics. The brain drain phenomenon in LMICs has been in existence for decades and several strategies focusing on push factors that drive HPs away from LMICs to OECD countries have been implemented without noticeable impact. This article proposes strategies to promote shared responsibilities, fairness, and social justice and circumvent potential ethical concerns in the migration of HPs from LMICs to OECD member countries. To achieve this, we propose a framework where OECD member states recruiting HPs from LMICs invest in the education and production of HPs from LMICs and offer in-service training for medical trainers and mentors in their countries to strengthen quality education in the LMICs’ medical schools. This initiative could potentially increase the population of HPs that can serve the needs of both the LMICs and the OECD beneficiaries. We further suggest a role for the World Health Organization, the International Labor Organization and other international public health institutions to collaborate in exploring innovative strategies like the OECD-LMICs partnership proposed in this article to ensure justice, fairness and equity in reversing the exodus of HPs from LMICs.
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Abstract

With an estimated population of 7.8 billion, health professionals (HPs) are grossly inadequate globally and far below WHO’s benchmark of 1 physician, 4 nurses, and midwives per 1000 population. Despite their shortage, HPs are not equitably distributed, with low- and middle-income countries (LMICs) especially those in Sub-Saharan Africa having the greatest shortages. The Organization for Economic Co-operation and Development (OECD) member states exploit the socioeconomic vulnerability of LMICs to massively recruit HPs from these countries to fill the gaps in their systems. The prolonged hemorrhage of HPs from LMICs to OECD member states continues to complicate health equity in LMICs, which have some of the highest wealth gap among their populations; and has raised concerns about social justice and breach of ethics. The brain drain phenomenon in LMICs has been in existence for decades and several strategies focusing on push factors that drive HPs away from LMICs to OECD countries have been implemented without noticeable impact. This article proposes strategies to promote shared responsibilities, fairness, and social justice and circumvent potential ethical concerns in the migration of HPs from LMICs to OECD member countries. To achieve this, we propose a framework where OECD member states recruiting HPs from LMICs invest in the education and production of HPs from LMICs and offer in-service training for medical trainers and mentors in their countries to strengthen quality education in the LMICs’ medical schools. This initiative could potentially increase the population of HPs that can serve the needs of both the LMICs and the OECD beneficiaries. We further suggest a role for the World Health Organization, the International Labor Organization and other international public health institutions to collaborate in exploring innovative strategies like the OECD-LMICs partnership proposed in this article to ensure justice, fairness and equity in reversing the exodus of HPs from LMICs. Supplementary Material File (depriving the deprived_20-4-2025.docx) - Download - 42.96 KB Information & Authors Information Version history Copyright This work is licensed under a Non Exclusive No Reuse License.

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Authors Metrics & Citations Metrics Article Usage 199views 97downloads Citations Download citation Ibrahim Jahun, Sonia Udod, Illia Roskoshnyi, et al. Depriving the Deprived: Examining Brain Drains of Health Professionals from Low- and Middle-Income Countries (LMICs) to Wealthy Nations with an Equity Lens. Authorea. 21 April 2025. DOI: https://doi.org/10.22541/au.174522534.41721038/v1 DOI: https://doi.org/10.22541/au.174522534.41721038/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu.

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