BackgroundThis study sought to better understand the drivers of skilled health professional migration, its consequences, and the various strategies countries have employed to mitigate its negative impacts. The study was conducted in four countries—Jamaica, India, the Philippines, and South Africa—that have historically been “sources” of health workers migrating to other countries. The aim of this paper is to present the findings from the Indian portion of the study.MethodsData were collected using surveys of Indian generalist and specialist physicians, nurses, midwives, dentists, pharmacists, dieticians, and other allied health therapists. We also conducted structured interviews with key stakeholders representing government ministries, professional associations, regional health authorities, health care facilities, and educational institutions. Quantitative data were analyzed using descriptive statistics and regression models. Qualitative data were analyzed thematically.ResultsShortages of health workers are evident in certain parts of India and in certain specialty areas, but the degree and nature of such shortages are difficult to determine due to the lack of evidence and health information. The relationship of such shortages to international migration is not clear. Policy responses to health worker migration are also similarly embedded in wider processes aimed at health workforce management, but overall, there is no clear policy agenda to manage health worker migration. Decision-makers in India present conflicting options about the need or desirability of curtailing migration.ConclusionsConsequences of health work migration on the Indian health care system are not easily discernable from other compounding factors. Research suggests that shortages of skilled health workers in India must be examined in relation to domestic policies on training, recruitment, and retention rather than viewed as a direct consequence of the international migration of health workers.

This paper examines the impact of COVID-19 pandemic on migration. The rapid spread of the pandemic caught countries across the world off guard, resulting in widespread lockdowns that clamped down on mobility, commercial activities and social interactions. In India, the pandemic precipitated a severe 'crisis of mobility', with migrant labourers in many major cities seeking to return to their hometowns. Their desperate attempts to return home by any means available rendered the lockdown ineffective in several areas, prompting clashes with authorities, last-minute policy relief and, eventually, the arrangement of transport measures. This paper aims to shed light on the vulnerability of India's internal migrants in terms of their mobility, gender and mental health. In addition, it critically analyses the limitations of public policy in addressing migrants and suggests recommendations for the way ahead.

The article explores the dynamics of Indian fertility at the district level using a child-woman index developed from the four Indian censuses, 1961 to 1991. It employs statistical and geostatistical techniques to assess fertility change across districts and periods. Fertility decline is evident in every region, but sizable regional differentials exist. A cluster analysis of fertility profiles indicates that a clear spatial pattern of fertility in India has emerged and the pattern intensified because of the process of fertility decline. Copyright 2001 by The Population Council, Inc..

India is the second largest country in the world, with 72 million elderly persons above 60 years of age as of 2001, compared to China's 127 million. One of the objectives of this paper is to assess the emerging scenario of elderly for the first half of the 21st century. According to projections, the elderly in the age group 60 and above is expected to increase from 71 million in 2001 to 179 million in 2031, and further to 301 million in 2051; in the case of those 70 years and older, they are projected to increase from 27 million in 2001 to 132 million in 2051. Among the elderly persons 80 and above, they are likely to improve their numbers from 5.4 million in 2021 to 32.0 million in 2051. The increasing number and proportion of elderly will have a direct impact on the demand for health services and pension and social security payments. Mobilizing resources for geriatric care and providing sufficient maintenance for the elderly will emerge as a major responsibility for heath-care providers and pension economists.

This research is first of its kind for Kerala, being the first migration study that covers the entire state and encompasses both measurement as well as analysis of the various types and facets of migration. Migration has been the single-most dynamic factor in the otherwise dreary development scenario of Kerala in the last quarter of the twentieth century. Kerala is approaching the end of the millennium with a little cheer in many people's homes, a major contributing factor for which has been migration. Migration has contributed more to poverty alleviation in Kerala than any other factor, including agrarian reforms, trade union activities and social welfare legislation.The study shows that nearly 1.5 million Keralites now live outside India. They send home more than Rs.4,000 million a year by way of remittances. Three-quarters of a million former emigrants have come back. They live mostly on savings, work experience, and skills brought with them from abroad. More than a million families depend on internal migrants'earnings for subsistence, children's education and other economic requirements. Whereas the educationally backward Muslims from the Thrissur-Malappuram region provide the backbone of emigration, it is the educationally forward Ezhawas, Nairs and Syrian Christians from the former Travancore-Cochin State who form the core of internal migration. The paper also analyses the determinants and consequences of internal and external migration. It offers suggestions for policy formulation for the optimum utilization of remittances sent home by the emigrants and the expertise brought back by the return migrants.Migration in Kerala began with demographic expansion, but it won't end with demographic contraction. Kerala has still time to develop itself into an internally self-sustaining economy. The prevailing cultural milieu of Kerala in which its people believe that anything can be achieved through agitation and any rule can be circumvented with proper political connections, must change and be replaced by a liberalised open economy with strict and definite rules of the game. JEL Classification: J21, J235

Migration has been the single most dynamic factor in the otherwise dreary development scenario of Kerala during the last quarter of the last century. It has contributed more to poverty alleviation and reduction in unemployment in Kerala than any other factor. As a result of migration, the proportion of the population below the poverty line has declined by 12 per cent. The number of unemployed persons estimated to be only about 13 lakhs in 1998 compared with 37 lakhs reported by the Kerala Employment Exchanges has declined by over 30 per cent.Migration has caused nearly a million married women in Kerala to live away from their husbands. Most of these so-called Gulf wives experienced extreme loneliness to begin with, and were burdened with added family responsibilities to which they had not been accustomed when their husbands were with them. But over a period, and with a helping hand from abroad over the ISD, most came out of their early gloom. Their gain in autonomy, status, management skills and experience in dealing with the world outside their homes were developed the hard way and would remain with them for the rest of their lives for the benefit of their families and society. In the long run, the transformation of these million women will have contributed more to the development of Kerala society than all the temporary euphoria created by remittances and modern gadgetry.Kerala is dependent on migration for employment, subsistence, housing, household amenities, institution building, and many other developmental activities. The danger is that migration could cease, as shown by the Kuwait war of 1993, and repercussions could be disastrous for the State.Understanding migration trends and instituting policies to maintain the flow of migration is more important today than at any time in the past.

No abstract

Using a conceptual framework focusing on factors that enhance or reduce fertility relative to desired family size (see Bongaarts 2001), we study fertility variation across time (1992–2006) and space (states) in India. Our empirical analyses use data from three waves of the Indian National Family Health Surveys. We find that this framework can account for a substantial portion of the variation in the TFR across the states and over time. Our estimates focus attention on the critical components of contemporary Indian fertility, especially desired family size, unwanted fertility, son preference, and fertility postponement.