Health worker migration and mobility is more and more often facilitated by bilateral (country-to-country) agreements, involving public as well as private players. Many such agreements exist already, but the details of them are quite in-transparent and there is much unclarity about who negotiates such agreements. Wemos’ policy researcher global health Corinne Hinlopen and Remco van de Pas from Maastricht University wrote an analysis commissioned by the Friedrich Ebert Stiftung (FES), of the existing status quo of such Skills Partnerships and formulated recommendations to improve their design and governance.
With an expected global shortage of 18 million health workers by 2030, global competition for health workers can only increase. Global Skills Partnerships (GSPs) can contribute to strengthen the global health workforce by funding training for health workers across the globe, and preparing them for the labour markets of all participating countries. Numerous skills partnerships have already shown beneficial effects in countries of origin, countries of destination as well as on individual health workers.
Earlier projects were often rooted in development cooperation and funded through government-to-government schemes. By contrast, today’s GSPs are designed as public-private partnerships aiming to “invest in skills development and facilitate mutual recognition of skills, qualifications and competence” and to generate a solid return on investment. The question is whether these returns are reinvested in decent employment, sustainable education and health systems development in the country of origin. Evidence to that effect is scarce to date.
With GSPs rapidly gaining popularity, it is essential that the interests of source countries, destination countries and migrant health workers are safeguarded: economic rewards (salary, remittances), professional gains (building knowledge and skills, career advancement), health labour market benefits (meeting demand in high-income countries), institutional strengthening for training and health institutions in low- and middle-income countries.
International policy guidelines, governance mechanisms, and normative and ethical policy frameworks can help design and govern health labour development and mobility partnerships. However, these are mostly non-binding in nature, so additional legally binding labour migration agreements would be required to ensure the rights of migrant workers, integrate a health systems development perspective and mitigate the negative impacts of excessive health worker mobility. Unless tightly designed, governed, financed and monitored by all government stakeholders, employers’ and workers’ organizations, public institutions and civil society, we fear that GSPs – in their current iteration – are unlikely to contribute to sustainable health systems development worldwide or reduce global health inequities.