International health organisations and recruitment of health workers.

摘要

A telling phrase in David Southall and colleagues' Comment is: "By offering better salaries and working conditions... international organisations prevent government-trained doctors and nurses from contributing to their NHS."International organisations are not preventing health workers from being employed in public systems, but are providing what public health systems often neglect-good working conditions, on-time salaries, and recognition. From research on retention, we know that financial and non-financial factors affect health workers' choices about where they work and whether they stay.In countries with weak health systems, non-state sectors might provide the bulk of health services. We cannot assume, therefore, that health workers employed by non-state sectors do not contribute to public health. Government health workers frustrated by poor working conditions might transfer to employers that provide salaries, equipment, and facilities, enabling them to perform well. Would they otherwise migrate externally and be lost as a resource to their countries?