LINkING MIGRATION, FOOD SECuRITY AND DEVELOPMENT

58 Pages·2012·2.04 MB·English

t S a M p
he outhern Frican igration rograMMe
L M ,
inking igration
F S
ood ecurity
d
and eveLopMent
M p S n . 60
igration oLicy erieS o
L M ,
inking igration
F S
ood ecurity and
d
eveLopMent
J c
onathan ruSh
SerieS editor:
proF. Jonathan cruSh
S a M p (SaMp)
outhern Frican igration rograMMe
2012
acknowLedgeMentS
SAMP wishes to thank the IDRC and OSISA for their financial support. This
report is a joint publication with the African Food Security Urban Network
(AFSUN) and also appears in the AFSUN Urban Food Security Series as No. 9.
The AFSUN research reported here was funded by CIDA under the UPCD Tier
One Program. The author wishes to thank Bruce Frayne, Wade Pendleton and
Cassandra Eberhardt for their assistance.
Published by the Southern African Research Centre, Queen’s University, Canada
© Southern African Migration Programme (SAMP) 2012
ISBN 978-1-920596-02-6
First published 2012
Production by Bronwen Müller, Cape Town
All rights reserved. No part of this publication may be reproduced or transmitted,
in any form or by any means, without prior permission from the publishers.
Printed by Megadigital, Cape Town
contentS page
executive SuMMary 1
introduction 6
internaL Migration and urban Food Security 8
urbanization and circuLation 8
Food Security and Stretched houSehoLdS 14
South-South Migration and Food Security 17
changing Migration StreaMS 17
croSS-border Migration and urban Food Security 26
MigrantS and Food Security 28
Migration and Food tranSFerS 34
concLuSion 41
endnoteS 43
Migration poLicy SerieS 49
LiSt oF tabLeS
tabLe 1: Southern aFrican urban popuLation, 1950-2050 8
tabLe 2: Southern aFrican urbaniSation, 1950-2050 10
tabLe 3: South aFrican MunicipaLitieS experiencing greateSt 10
in-Migration, 2001-6
tabLe 4: proportion oF Migrant and non-Migrant houSehoLdS 14
tabLe 5: occupationS oF Labour MigrantS in South aFrica, 2006 21
tabLe 6: reFugee appLicationS in South aFrica by country oF 24
origin, 1994-2004
tabLe 7: reFugee appLicationS and deciSionS in South aFrica, 2009 25
tabLe 8: SourceS oF incoMe oF Migrant houSehoLdS 26
tabLe 9: MonthLy expenSeS oF Migrant-Sending houSehoLdS 27
tabLe 10: SourceS oF houSehoLd incoMe 30
tabLe 11: houSehoLd dietary diverSity 33
tabLe 12: Food tranSFerS by city 38
tabLe 13: Frequency oF tranSFerS by area oF origin 39
(%, paSt 12 MonthS)
tabLe 14: typeS oF Food tranSFerred 40
tabLe 15: typeS oF tranSFer aS houSehoLd Migrant-StatuS 41
LiSt oF FigureS
Figure 1: Southern aFrican urban popuLation, 1950-2050 9
Figure 2: internaL Migration in zaMbia, 1996-2006 12
Figure 3: LegaL entrieS to South aFrica FroM reSt oF aFrica, 1990-2010 18
Figure 4: LegaL entrieS FroM ziMbabwe to South aFrica, 1980-2010 19
Figure 5: MaLe eMpLoyMent in South aFrican MineS and FeMaLe 20
eMpLoyMent in LeSotho garMent FactorieS, 1990-2006
Figure 6: deportationS FroM South aFrica, 1990-2008 22
Figure 7: SourceS oF houSehoLd incoMe 31
Figure 8: incoMe terciLeS 31
Figure 9: Food Security oF Migrant and non-Migrant houSehoLdS 32
Figure 10: SourceS oF Food For Migrant and non-Migrant houSehoLdS 34
Figure 11: totaL Food tranSFerS to urban houSehoLdS 36
Figure 12: Frequency oF Food tranSFerS to urban houSehoLdS by area 37
oF origin
Figure 13: Frequency oF Food tranSFerS to urban houSehoLdS by area 39
oF origin (% oF houSehoLdS)
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eExXeEcCuUtTiIvVeE SSuUMMMMaArRyY k
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Hwo issues have recently risen to the top of the international
ealth workers are one of the categories of skilled profession-
development agenda: (a) Food Security; and (b) Migration
als most affected by globalization. Over the past decade, k
and Development. Each has its own global agency champions,
there has emerged a substantial body of research that tracks
international gatherings, national line ministries and body of k
patterns of international migration of health personnel,
research. Global and regional discussions about the relationship between
assesses causes and consequences, and debates policy responses at global
migration and development cover a broad range of policy issues including k
and national scales. Within this literature, the case of South Africa is
remittance flows, the brain drain, the role of diasporas and return migra-
attracting growing interest. For almost 15 years South Africa has been k
tion. Strikingly absent from these discussions is any systematic discus-
the target of a ‘global raiding’ of skilled professionals by several devel-
soiponed o cf otuhne trreielast. iHonoswh ipto b deetwale wenit hpo tphuel actoionnse mquigernacteios no fa nthde f oreosdu lsteacnutr iotuy.t - k
If the global migration and development debate sidelines food security,
flow of health professionals is a core policy issue for the national gov-
the current international food security agenda has a similar disregard for k
ernment.
migration. The primary focus of the agenda is food insecurity and under-
This paper aims to to examine policy debates and issues concerning
k
nutrition and how enhanced agricultural production by small farmers can
the migration of skilled health professionals from the country and to
resolve these endemic problems. There is a tendency to ignore the real-
furnish new insights on the recruitment patterns of skilled health per- k
ity that migration is a critical food security strategy for rural households
sonnel. The objectives of the paper are twofold:
up and down the African continent. If migration is a neglected aspect k
(cid:81) (cid:43)(cid:67)(cid:1)(cid:68)(cid:70)(cid:67)(cid:74)(cid:61)(cid:56)(cid:57)(cid:1)(cid:53)(cid:66)(cid:1)(cid:53)(cid:73)(cid:56)(cid:61)(cid:72)(cid:1)(cid:67)(cid:58)(cid:1)(cid:72)(cid:60)(cid:57)(cid:1)(cid:67)(cid:70)(cid:59)(cid:53)(cid:66)(cid:61)(cid:78)(cid:53)(cid:72)(cid:61)(cid:67)(cid:66)(cid:1)(cid:53)(cid:66)(cid:56)(cid:1)(cid:68)(cid:53)(cid:72)(cid:72)(cid:57)(cid:70)(cid:66)(cid:71)(cid:1)(cid:67)(cid:58)(cid:1)(cid:70)(cid:57)(cid:55)(cid:70)(cid:73)(cid:61)(cid:72)(cid:8)
of discussions about rural food insecurity, it is almost totally absent from
ment of skilled professionals from South Africa in the health
k
considerations of the causes and impact of food security amongst urban
sector. The paper draws upon a detailed analysis of recruitment
populations. In practice, therefore, there is a massive institutional and
advertising appearing in the South African Medical Journal for k
substantive disconnect between these two development agendas.
the period 2000-2004 and a series of interviews conducted with
Currepnritv caoten creecprtuuiatliinsagt eionntse ropfr itshees .food security crisis in Africa provide k
an inadequate basis for working at the interface between migration and
(cid:81) (cid:25)(cid:53)(cid:71)(cid:57)(cid:56)(cid:1)(cid:73)(cid:68)(cid:67)(cid:66)(cid:1)(cid:72)(cid:60)(cid:57)(cid:1)(cid:53)(cid:54)(cid:67)(cid:74)(cid:57)(cid:1)(cid:53)(cid:66)(cid:53)(cid:64)(cid:77)(cid:71)(cid:61)(cid:71)(cid:1)(cid:53)(cid:66)(cid:56)(cid:1)(cid:53)(cid:56)(cid:56)(cid:61)(cid:72)(cid:61)(cid:67)(cid:66)(cid:53)(cid:64)(cid:1)(cid:61)(cid:66)(cid:72)(cid:57)(cid:70)(cid:74)(cid:61)(cid:57)(cid:75)(cid:71)(cid:1)(cid:75)(cid:61)(cid:72)(cid:60)
food security. First, there is the assumption that food security is primar- k
key stakeholders in the South African health sector, the paper
ily a rural problem that will be resolved through technical innovation
offers a series of recommendations for addressing the problem of
k
amongst smallholders (in the guise of a new Green Revolution). What
skilled health migration. These recommendations are grounded
seems to be forgotten in this romantic view of the African rural house-
in both South African experience and an interrogation of inter- k
hold is that its food security is not simply, or even mainly, a function of
national debates and ‘good policy’ practice for regulating recruit-
what it does or does not produce itself. Up and down the continent rural k
ment.
households purchase some or most of their food and they do so with
The paper is organized into five sections. Section Two positions
k
cash that they receive from household members who have migrated to
debates about the migration of skilled health professionals within a
earn income in other places within the country and across borders. The
wider literature that discusses the international mobility of talent. k
evidence for Southern Africa is that these rural households do not invest
Section Three reviews research on the global circulation of health pro-
rfeemssiiottnaanlcs,e sfo icnu asignrigc uinlt upraer tbicuut lianr ubapsoinc ndeecbeastseist ireesl,a itninclgu dtoin tgh feo eoxdp peurire-nce k
chase. Rural food security, in other words, may be improved but will not
of countries in the developing world. Section Four moves the focus from
be resolved by current approaches to food insecurity. k
international to South African issues and provides new empirical mate-
A second assumption is that food security in urban areas is about pro-
rial drawn from the survey of recruitment patterns and key interviews k
moting urban agriculture. The obsession with urban agriculture may be
undertaken with health sector recruiters operating in South Africa.
well-intentioned but it derives from misplaced idea that increased food
Section Five addresses the questions of changing policy interventions in k
production is the key to urban food security. The primary determinant of
South Africa towards the outflow of skilled health professionals and the
food insecurity in African cities is not production shortfalls but the lack k
recruitment of foreign health professionals to work in South Africa. The
of access to food and that means the absence of a regular and reliable
k
income with which to purchase it. Even within the poorest areas of the
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MIGRATIONPOLICYSERIESNO. 45 k Linking Migration, Food Security and deveLopMent
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EXECUTIVE SUMMARY city, access varies considerably from household to household with wage
employment, other income generating activity, the size and structure of
k
Health workers are one of the categories of skilled profession- the household, the educational level of the household members, access to
als most affected by globalization. Over the past decade, k social grants and being embedded in social networks.
there has emerged a substantial body of research that tracks There are some recent signs of recognition of the reality that migra-
patterns of international migration of health personnel, k tion and remittances play an important role in the food security strategies
assesses causes and consequences, and debates policy responses at global of rural households. A recent issue of the journal Food Policy, for exam-
k
and national scales. Within this literature, the case of South Africa is ple, suggests that “the sending of a migrant means the loss or reduced
attracting growing interest. For almost 15 years South Africa has been k presence of one or more members of the household. On the consump-
the target of a ‘global raiding’ of skilled professionals by several devel- tion side this clearly means fewer mouths to feed and to support in other
oped countries. How to deal with the consequences of the resultant out- k ways. On the production side, migration means the loss of labor and, in
flow of health professionals is a core policy issue for the national gov- fact, the negative consequences of migration on nutrition are likely to
k
ernment. come through this labor loss.” The major positive impact of migration
This paper aims to to examine policy debates and issues concerning is the remittances sent home by the migrant which can have direct and
k
the migration of skilled health professionals from the country and to indirect effects on production and consumption. This is an important
furnish new insights on the recruitment patterns of skilled health per- k issue, but so is the relationship between migration and the food security
sonnel. The objectives of the paper are twofold: of the urban household.
(cid:81) (cid:43)(cid:67)(cid:1)(cid:68)(cid:70)(cid:67)(cid:74)(cid:61)(cid:56)(cid:57)(cid:1)(cid:53)(cid:66)(cid:1)(cid:53)(cid:73)(cid:56)(cid:61)(cid:72)(cid:1)(cid:67)(cid:58)(cid:1)(cid:72)(cid:60)(cid:57)(cid:1)(cid:67)(cid:70)(cid:59)(cid:53)(cid:66)(cid:61)(cid:78)(cid:53)(cid:72)(cid:61)(cid:67)(cid:66)(cid:1)(cid:53)(cid:66)(cid:56)(cid:1)(cid:68)(cid:53)(cid:72)(cid:72)(cid:57)(cid:70)(cid:66)(cid:71)(cid:1)(cid:67)(cid:58)(cid:1)(cid:70)(cid:57)(cid:55)(cid:70)(cid:73)(cid:61)(cid:72)(cid:8) k Food security needs to be “mainstreamed” into the migration and
ment of skilled professionals from South Africa in the health development agenda and migration needs to be “mainstreamed” into
k
sector. The paper draws upon a detailed analysis of recruitment the food security agenda. Without such an effort, both agendas will pro-
advertising appearing in the South African Medical Journal for k ceed in ignorance of the other to the detriment of both. The result will
the period 2000-2004 and a series of interviews conducted with be a singular failure to understand, and manage, the crucial reciprocal
private recruiting enterprises. k relationship between migration and food security. This report sets out to
(cid:81) (cid:25)(cid:53)(cid:71)(cid:57)(cid:56)(cid:1)(cid:73)(cid:68)(cid:67)(cid:66)(cid:1)(cid:72)(cid:60)(cid:57)(cid:1)(cid:53)(cid:54)(cid:67)(cid:74)(cid:57)(cid:1)(cid:53)(cid:66)(cid:53)(cid:64)(cid:77)(cid:71)(cid:61)(cid:71)(cid:1)(cid:53)(cid:66)(cid:56)(cid:1)(cid:53)(cid:56)(cid:56)(cid:61)(cid:72)(cid:61)(cid:67)(cid:66)(cid:53)(cid:64)(cid:1)(cid:61)(cid:66)(cid:72)(cid:57)(cid:70)(cid:74)(cid:61)(cid:57)(cid:75)(cid:71)(cid:1)(cid:75)(cid:61)(cid:72)(cid:60) promote a conversation between the food security and migration agen-
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key stakeholders in the South African health sector, the paper das in the African context in the light of what we know and what we
offers a series of recommendations for addressing the problem of need to know about their connections. This report focuses primarily on
k
skilled health migration. These recommendations are grounded the connections in an urban context. Four main issues are singled out
in both South African experience and an interrogation of inter- k for attention: (a) the relationship between internal migration and urban
national debates and ‘good policy’ practice for regulating recruit- food security; (b) the relationship between international migration and
ment. k urban food security; (c) the difference in food security between migrant
The paper is organized into five sections. Section Two positions and non-migrant urban households; and (d) the role of rural-urban food
k
debates about the migration of skilled health professionals within a transfers in urban food security.
wider literature that discusses the international mobility of talent. k The simplest way to examine the relationship between cross-border
Section Three reviews research on the global circulation of health pro- migration and food security is to ascertain (a) how international migrants
fessionals, focusing in particular upon debates relating to the experience k address their own food and nutrition needs in the destination country
of countries in the developing world. Section Four moves the focus from and (b) what happens to the income that they earn while away from
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international to South African issues and provides new empirical mate- home. The two questions are related to one another for the amount of
rial drawn from the survey of recruitment patterns and key interviews k money available to send home is to some degree contingent on the food-
undertaken with health sector recruiters operating in South Africa. related expenditures of the migrant in the destination country. Migrants
Section Five addresses the questions of changing policy interventions in k rarely live alone and their income may often have to support members of
South Africa towards the outflow of skilled health professionals and the “makeshift” households (not all of whose members can find work) as well
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recruitment of foreign health professionals to work in South Africa. The as second households.
Migration within and to the Southern African region has changed
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foofo cdo iunn tthriee sp irnev tihoeu sd yeevaerl.o ping world. Section Four moves the focus from
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iSno tuhteh tAypfreisc ao ft ogowoadrds st hthate mouigtrflaonwts osfe nskdi lhleodm hee. aTlthhe rper owfeasss liiotntlael se vain-d the
dreecnrcuei tomf elunxt uorfy f ogoreoidgsn bheeinalgt hse pnrto. fIenssstioeanda,l sc ltoot hwionrgk (irne cSeoivuetdh bAyf r4i1c%a. Tofh e k
households) and food (received by 29%) were the items most frequently
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MIGRATIONPOLICYSERIESNO. 45 k Linking Migration, Food Security and deveLopMent
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EXECUTIVE SUMMARY brought or sent. In the case of Mozambique, 60% of households received
food and in Zimbabwe, 45%.
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Health workers are one of the categories of skilled profession- The next question is whether migrants are more food insecure than
als most affected by globalization. Over the past decade, k longer term residents of the poorer areas of Southern African cities.
there has emerged a substantial body of research that tracks AFSUN conducted a survey in 11 SADC countries in 9 countries in
patterns of international migration of health personnel, k 2008 which helps to answer this question. Because access to income is
assesses causes and consequences, and debates policy responses at global a critical determinant of food security in urban areas, it is important to
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and national scales. Within this literature, the case of South Africa is know if non-migrant households are more or less likely to access regular
attracting growing interest. For almost 15 years South Africa has been k and reliable sources of income, both formal and informal. Across the
the target of a ‘global raiding’ of skilled professionals by several devel- sample as a whole, unemployment rates were high with nearly half of
oped countries. How to deal with the consequences of the resultant out- k both migrant and non-migrant households receiving no income from
flow of health professionals is a core policy issue for the national gov- regular wage work. This suggests that migrants do not find it harder to
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ernment. obtain wage employment than permanent residents in the city. Migrant
This paper aims to to examine policy debates and issues concerning households do find it easier to derive income from casual work while
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the migration of skilled health professionals from the country and to non-migrant households were more involved in running informal and for-
furnish new insights on the recruitment patterns of skilled health per- k mal businesses (20% versus 14%). Very few households in either category
sonnel. The objectives of the paper are twofold: earn any income from the sale of home-grown agricultural produce.
(cid:81) (cid:43)(cid:67)(cid:1)(cid:68)(cid:70)(cid:67)(cid:74)(cid:61)(cid:56)(cid:57)(cid:1)(cid:53)(cid:66)(cid:1)(cid:53)(cid:73)(cid:56)(cid:61)(cid:72)(cid:1)(cid:67)(cid:58)(cid:1)(cid:72)(cid:60)(cid:57)(cid:1)(cid:67)(cid:70)(cid:59)(cid:53)(cid:66)(cid:61)(cid:78)(cid:53)(cid:72)(cid:61)(cid:67)(cid:66)(cid:1)(cid:53)(cid:66)(cid:56)(cid:1)(cid:68)(cid:53)(cid:72)(cid:72)(cid:57)(cid:70)(cid:66)(cid:71)(cid:1)(cid:67)(cid:58)(cid:1)(cid:70)(cid:57)(cid:55)(cid:70)(cid:73)(cid:61)(cid:72)(cid:8) k The similarities in the access of migrant and non-migrant households
ment of skilled professionals from South Africa in the health to the labour market and to various income-generating activities suggests
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sector. The paper draws upon a detailed analysis of recruitment that they might have similar income levels and, in turn, levels of food
advertising appearing in the South African Medical Journal for k security. In fact, there was one distinct difference in the income profile
the period 2000-2004 and a series of interviews conducted with of migrant and non-migrant households. About a third of the households
private recruiting enterprises. k in each group fell into the lowest income tercile. However, 36% of non-
(cid:81) (cid:25)(cid:53)(cid:71)(cid:57)(cid:56)(cid:1)(cid:73)(cid:68)(cid:67)(cid:66)(cid:1)(cid:72)(cid:60)(cid:57)(cid:1)(cid:53)(cid:54)(cid:67)(cid:74)(cid:57)(cid:1)(cid:53)(cid:66)(cid:53)(cid:64)(cid:77)(cid:71)(cid:61)(cid:71)(cid:1)(cid:53)(cid:66)(cid:56)(cid:1)(cid:53)(cid:56)(cid:56)(cid:61)(cid:72)(cid:61)(cid:67)(cid:66)(cid:53)(cid:64)(cid:1)(cid:61)(cid:66)(cid:72)(cid:57)(cid:70)(cid:74)(cid:61)(cid:57)(cid:75)(cid:71)(cid:1)(cid:75)(cid:61)(cid:72)(cid:60) migrant households were in the upper income tercile, compared to only
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key stakeholders in the South African health sector, the paper 29% of migrant households. The situation was reversed with the middle
offers a series of recommendations for addressing the problem of income tercile. In other words, migrant status is not a completely reliable
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skilled health migration. These recommendations are grounded predictor of whether a household will be income poor. However, non-
in both South African experience and an interrogation of inter- k migrant households are likely to have a better chance of having better
national debates and ‘good policy’ practice for regulating recruit- incomes, primarily because some are able to access better-paying jobs.
ment. k The Household Food Insecurity Scale (HFIAS) measures household
The paper is organized into five sections. Section Two positions access to food on a 0 (most secure) to 27 (most insecure) point scale.
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debates about the migration of skilled health professionals within a In terms of the relationship between the HFIAS and migration, migrant
wider literature that discusses the international mobility of talent. k households had a mean score of 10.5 and non-migrant households a
Section Three reviews research on the global circulation of health pro- score of 8.9. This suggests that non-migrant households have a better
fessionals, focusing in particular upon debates relating to the experience k chance of being food secure than migrant households. The Household
of countries in the developing world. Section Four moves the focus from Food Insecurity Access Prevalence (HFIAP) Indicator. found that only
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international to South African issues and provides new empirical mate- 16% of migrant households were “food secure” compared with 26% of
rial drawn from the survey of recruitment patterns and key interviews k non-migrant households. Although levels of food insecurity are disturb-
undertaken with health sector recruiters operating in South Africa. ingly high for both types of household, migrant households stand a great-
Section Five addresses the questions of changing policy interventions in k er chance of being food insecure.
South Africa towards the outflow of skilled health professionals and the Another question is whether there are any differences between
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recruitment of foreign health professionals to work in South Africa. The migrant and non-migrant households in where they obtain their food in
the city. Migrant households were more likely than non-migrant house-
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1 k 4
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MMIiGgRrAaTtIiOoNn PPOoLlIiCcYy SSEeRrIiEeSS NnOo.. 4650
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EXECUThIVolEdsS toU pMaMtroAnRisYe supermarkets. The opposite was true with regard to k
the informal food economy. This may have to do with the fact that non-
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Hmigrant houesaelhthol dwso wrkoeurlsd a bree omnoer eo ff athmei licaart ewgiothri easl toefr nskaitlilveed fporoodf essosuiorcne-s
compared waitlsh mreocsetn atf fienc-tmedig rbayn gtslo, bina lpizaarttiiocnul.a Or, vwehr ot hweo pualdst bdee cmaodree, k
likely to knotwhe areb ohuats aenmde rregceodg an issueb ssutapnetrimala rbkoedty o ouft lreetsse. aArc hse cthoantd t draifcfkers-
ence is the epxattetnertn tso o wf hinicther hnoatuisoenhaoll dmsi greralyt ioonn ootfh heer ahltohu speehrosoldnsn feolr, food, k
eaistsheessre tsh craouusgehs sahnadr icnogn mseeqaulse nocr efso, oadn tdr adnesbfaetres.s Tpohliisc wy arse smpoonres ecso amt mgloonb al
k
aamndo nnga tmioingraaln stc athleasn. Wnointh-mini gtrhains tl ihteoruasteuhreo,l dtsh,e s ucgagsee sotifn Sgo tuhteh eAxifsrtiecna cies of
sattrtornacgteirn sgo gcriaolw ninetgw ionrtkesr easmt. oFnogrs at lmmiogsrta n1t5s .y Teahrisr dSloy,u ntho nA-mfriicgara hnat sh boeuesne- k
hthoeld tsa wrgeerte omf oa r‘eg lloikbeally rtaoid girnogw’ no fs sokmilele odf ptrhoefiers osiwonn afloso bdy tsheavne rmali gdreavnetl -
hoopuedse choouldnst.ries. How to deal with the consequences of the resultant out- k
flowT hoef hmeaajlotrhit py rooff epsosioorn haolsu isse ha oclodrse i np oSloicuyt hisesrune Afofrr itchaen ncaittiieosn eailt hgeorv -
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ceornnmsisetn etn. tirely of migrants or a mix of migrants and non-migrants. Rapid
urbaTnhizisa tpioapne, ri nacimresa steod t oci recxualmatiinoen paonldic gyr odwebinagte cs raonssd- bisosrudeesr cmonigcreartnioinn g
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hthaev em ailgl rmateioannt o tfh sakti ltlheed nhuemalbthe rp orof fmesisgiroannatlss afnrodm m tihgrea ncot uhnoturyse ahnodld tso in
tfhuern ciisthy nheaws girnoswignh tesx opnon tehnet iraelclyr.u Titmhies nist lpikaettlye rtnos coofn stkiniluleed f ohre aseltvhe rpaelr - k
msoonrnee dl.e cTahdee so absje ucrtbivaensi zoaft itohne cpoanpteirn uarees .t Wwoef ocladn:n ot simply assume that
all p(cid:81)oor (cid:43)u(cid:67)rb(cid:1)(cid:68)a(cid:70)n(cid:67) (cid:74)h(cid:61)o(cid:56)u(cid:57)s(cid:1)e(cid:53)h(cid:66)o(cid:1)(cid:53)ld(cid:73)s(cid:56) (cid:61)a(cid:72)r(cid:1)(cid:67)e (cid:58)a(cid:1)(cid:72)l(cid:60)ik(cid:57)e(cid:1).(cid:67) W(cid:70)(cid:59)(cid:53)h(cid:66)il(cid:61)e(cid:78)(cid:53) l(cid:72)e(cid:61)v(cid:67)e(cid:66)l(cid:1)s(cid:53) (cid:66)of(cid:56) f(cid:1)o(cid:68)o(cid:53)(cid:72)d(cid:72) (cid:57)in(cid:70)(cid:66)se(cid:71)(cid:1)c(cid:67)u(cid:58)r(cid:1)(cid:70)it(cid:57)y(cid:55) (cid:70)a(cid:73)r(cid:61)e(cid:72) (cid:8) k
unaccepmtaebnlyt hofig shk iallmedo npgrsotf easlsl ioofn tahlse mfro, mm iSgroauntth h Aoufrsiecha oilnd st hdeo hheaavleth a
k
greater cshecatnocre. Tofh be epinapg efro oddra iwnss eucpuorne wa idthet aalill eodf aitns aaltytseisn doaf nret chreuaitlmthe anntd
nutritionaadlv perrotibsilnemg sa.p Tpehaisr ifnagc ti nn etehdes Stoou bteh rAecforigcnains eMd ebdyi cpaoll iJcoyu-mrnaakl efrosr k
and actetdh eu ppoenri.o d 2000-2004 and a series of interviews conducted with
private recruiting enterprises. k
(cid:81) (cid:25)(cid:53)(cid:71)(cid:57)(cid:56)(cid:1)(cid:73)(cid:68)(cid:67)(cid:66)(cid:1)(cid:72)(cid:60)(cid:57)(cid:1)(cid:53)(cid:54)(cid:67)(cid:74)(cid:57)(cid:1)(cid:53)(cid:66)(cid:53)(cid:64)(cid:77)(cid:71)(cid:61)(cid:71)(cid:1)(cid:53)(cid:66)(cid:56)(cid:1)(cid:53)(cid:56)(cid:56)(cid:61)(cid:72)(cid:61)(cid:67)(cid:66)(cid:53)(cid:64)(cid:1)(cid:61)(cid:66)(cid:72)(cid:57)(cid:70)(cid:74)(cid:61)(cid:57)(cid:75)(cid:71)(cid:1)(cid:75)(cid:61)(cid:72)(cid:60)
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key stakeholders in the South African health sector, the paper
offers a series of recommendations for addressing the problem of
k
skilled health migration. These recommendations are grounded
in both South African experience and an interrogation of inter- k
national debates and ‘good policy’ practice for regulating recruit-
k
ment.
The paper is organized into five sections. Section Two positions
k
debates about the migration of skilled health professionals within a
wider literature that discusses the international mobility of talent. k
Section Three reviews research on the global circulation of health pro-
fessionals, focusing in particular upon debates relating to the experience k
of countries in the developing world. Section Four moves the focus from
k
international to South African issues and provides new empirical mate-
rial drawn from the survey of recruitment patterns and key interviews k
undertaken with health sector recruiters operating in South Africa.
Section Five addresses the questions of changing policy interventions in k
South Africa towards the outflow of skilled health professionals and the
k
recruitment of foreign health professionals to work in South Africa. The
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15 k
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