Objective. To (1) provide a contextual analysis of the Caribbean region with respect to forces shaping the current and emerging nursing workforce picture in the region; (2) discuss country-specific case(s) within the Caribbean; and (3) describe the Managed Migration Program as a potential framework for addressing regional and global nurse migration issues. Principal Findings. The Caribbean is in the midst of a crisis of shortages of nurses with an average vacancy rate of 42 percent. Low pay, poor career prospects, and lack of education opportunities are among the reasons nurses resign. Many of these nurses look outside the region for job opportunities in the United Kingdom, Canada, the United States, and other countries. Compounding the situation is the lack of resources to train nurses to fill the vacancies. The Managed Migration Program of the Caribbean is a multilateral, cross-sector, multi-interventional, long-term strategy for developing and maintaining an adequate supply of nurses for the region. Conclusions. The Managed Migration Program of the Caribbean has made progress in establishing regional support for addressing the nursing shortage crisis and developing a number of interesting initiatives such as training for export and temporary migration. Recommendations to move the Managed Migration Program of the Caribbean forward focus on advocacy, integration of the program into regional policy decisions, and integration of the program with regional health programming.Key Words. Nursing, workforce, migration, Caribbean
OVERVIEWThe migration of individuals for labor-related purposes has been one of the strongest common themes in the Caribbean since the 1400s. Over the ensuing five centuries, whether through forced labor and indentured servitude or r Health Research and Educational Trust
Countries of the Caribbean face critical challenges in nurse migration and health services delivery. They are experiencing two types of migration-country-to-country migration within the Caribbean and migration from the Caribbean to developed countries, including the United States, Canada, and the United Kingdom. Aggressive international recruitment practices in the Caribbean resulted in a dramatic loss of nurses in the region and had an adverse impact on health-services delivery. A Managed Migration Program is being developed with two guiding principles-observing the rights of individual nurses to choose where they want to work and live while balancing individual rights with a country's obligation to provide quality health services to its citizens. It is a multi-country, multi-agency, multi-interventional strategy to increase intake, production, and retention of nurses. Various efforts designed to balance nursing supply and demand are underway, with the goal of providing universal, effective, and quality health care in the Caribbean.
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