Tajik healthcare workers on the move: causes, consequences and responses

Abstract
In 2012-2013, with the support of IOM Development Fund and in collaboration with the Ministry of Health and Social Protection of the Republic of Tajikistan, IOM conducted a study on the causes, consequences, and responses to the migration of Tajik health workers. Until this study, the topic of the mobility of Tajik health professionals abroad has received limited attention in labor migration research in Tajikistan. The research findings presented here address this gap by focusing on the push and pull factors that affect the mobility of health professionals from Tajikistan. It investigates the link between the migration of health workers and the capacity of the healthcare system in Tajikistan to handle this phenomenon and analyses the national policy response in this respect. The research methods applied include both qualitative and quantitative approaches. The findings indicate that lack of financial resources within the healthcare system in Tajikistan, low salaries, particularly in remote unattractive rural areas, and limited opportunities for professional development are the main push factors for the migration of Tajik health professionals. Higher remuneration, better working conditions, and professional development are leading pull factors attracting health professionals in the host states with main destination country being the Russian Federation. The development of the private health sector can decrease the out-migration of health professionals. In addition to extending the private medical care, providing incentives to medical workers particularly in the rural areas, and implementing new mechanism of the payment to health providers per capita within the primary healthcare system and case-based payments at the hospital level planned by the Ministry of Health and Social Protection of the Republic of Tajikistan can retain the Tajik health professionals in the country.