Building capacity for equitable healthcare workforce policy, learning from migrant healthcare workers: A qualitative study with Romanian physicians working in Germany during COVID-19

IF 1.9 4区 医学 Q3 HEALTH POLICY & SERVICES
Ellen Kuhlmann, Marius-Ionuț Ungureanu, Nancy Thilo, Leonie Mac Fehr, Nicoleta-Carmen Cosma, Monica Georgina Brînzac, Alexandra Dopfer-Jablonka
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Abstract

Background

Attention to the healthcare workforce has increased, yet comprehensive information on migrant healthcare workers is missing. This study focuses on migrant healthcare workers' experiences and mobility patterns in the middle of a global health crisis, aiming to explore the capacity for circular migration and support effective and equitable healthcare workforce policy.

Methods

Romanian physicians working in Germany during the COVID-19 pandemic served as an empirical case study. We applied a qualitative explorative approach; interviews (n = 21) were collected from mid of September to early November 2022 and content analysis was performed.

Results and Discussion

Migrant physicians showed strong resilience during the COVID-19 crisis and rarely complained. Commitment to high professional standards and career development were major pull factors towards Germany, while perceptions of limited career choices, nepotism and corruption in Romania caused strong push mechanisms. We identified two major mobility patterns that may support circular migration policies: well-integrated physicians with a wish to give something back to their home country, and mobile cosmopolitan physicians who flexibly balance career opportunities and personal/family interests. Health policy must establish systematic monitoring of the migrant healthcare workforce including actor-centred approaches, support integration in destination countries as well as health system development in sending countries, and invest in evidence-based circular migration policy.

从移民医护人员身上学习,建设公平的医护人员政策能力:在 COVID-19 期间对在德国工作的罗马尼亚医生进行的定性研究。
背景:对医护人员的关注与日俱增,但却缺少有关外来医护人员的全面信息。本研究重点关注全球卫生危机中移民医护人员的经历和流动模式,旨在探索循环移民的能力,支持有效、公平的医护人员政策:方法:以 COVID-19 大流行期间在德国工作的罗马尼亚医生为实证案例研究对象。我们采用了定性探索法;从 2022 年 9 月中旬至 11 月初收集了访谈内容(n = 21),并进行了内容分析:在 COVID-19 危机期间,移民医生表现出了很强的适应能力,很少抱怨。对高专业标准和职业发展的承诺是移民德国的主要拉动因素,而对罗马尼亚有限的职业选择、裙带关系和腐败的看法则是强大的推动机制。我们发现了两种可能支持循环移民政策的主要流动模式:希望回报祖国的融入型医生和灵活平衡职业机会与个人/家庭利益的流动型世界主义医生。卫生政策必须对移民医护人员进行系统监测,包括以行动者为中心的方法,支持移民目的国的融合以及移民输出国的卫生系统发展,并投资于以证据为基础的循环移民政策。
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来源期刊
CiteScore
4.50
自引率
3.70%
发文量
197
期刊介绍: Policy making and implementation, planning and management are widely recognized as central to effective health systems and services and to better health. Globalization, and the economic circumstances facing groups of countries worldwide, meanwhile present a great challenge for health planning and management. The aim of this quarterly journal is to offer a forum for publications which direct attention to major issues in health policy, planning and management. The intention is to maintain a balance between theory and practice, from a variety of disciplines, fields and perspectives. The Journal is explicitly international and multidisciplinary in scope and appeal: articles about policy, planning and management in countries at various stages of political, social, cultural and economic development are welcomed, as are those directed at the different levels (national, regional, local) of the health sector. Manuscripts are invited from a spectrum of different disciplines e.g., (the social sciences, management and medicine) as long as they advance our knowledge and understanding of the health sector. The Journal is therefore global, and eclectic.
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