Migrants comprise a significant proportion of health workforces that have long been recognised as being at high risk of experiencing adverse outcomes from contracting Covid-19. However, there is a paucity of high-quality research data on the risks of such outcomes faced by migrant health workers compared with non-migrant workers. This paper explores the available data around Covid-19 deaths, health workers, and migration and develops a methodology to estimate how many migrant health workers died due to Covid-19. It presents preliminary assessments of the numbers of such workers based on statistical data from four trial countries chosen for their differences in terms of proportions of foreign-born health workers and development contexts – India, Mexico, Nigeria and the UK. We identify the age-sex standardised approach as the best-available one for this enumerative task. However, the paper identifies the lack of robust data needed to confidently quantify the relative differences in risk of death faced by migrant health workers compared with their non-migrant colleagues.
We reaffirm the World Health Organization’s advocacy of standardised measurement and reporting of Covid-19 impacts, and, on the basis of this research, extend its recommendations to improve data on the health workforce to enable disaggregation by sex, age, ethnicity, occupation, health status, migration status, country of origin and whether employed in public or private health care delivery, and to institute better data systems with greater capacity for collecting and analysing disaggregated data. Such advances would go a long way to redressing the near-invisibility of migrant health workers (and migrants more generally) in Covid-19 impact studies and to improving their working conditions.
To ensure transparency around the estimation process and provide a tool for other researchers to use, we provide the spreadsheets used to create this set of estimates. The tools require a set of inputs: population estimates, figures on health workers, figures on the foreign-born health care workforce, and figures in Covid-19 deaths. An estimate of the number of Covid-19 deaths is then given for foreign-born doctors, nurses, midwives, and the overall population of foreign-born workers in the health care sector. For each group, the spreadsheets provide a basic estimate and an age-standardised estimate.
These input figures can be taken from our Covid-19 database specially produced as part of this report, specifically, population estimates, Covid-19 reported and excess deaths, and figures on health workers taken from the National Health Workforce Accounts (NHWA) and the International Labour Organization (ILO).
It should be noted that this database includes figures from international datasets only: country-specific figures were only sourced for the four trial countries, hence some gaps will remain where there were gaps in the original worldwide sources. Appendix B of the paper contains a list of the information included in this database.
Copyright: The Open University
Estimating migrant health worker deaths during Covid-19 based on WHO reported deaths: India
Estimating migrant health worker deaths during Covid-19 based on WHO reported deaths: Mexico
Estimating migrant health worker deaths during Covid-19 based on WHO reported deaths: Nigeria
Estimating migrant health worker deaths during Covid-19 based on WHO reported deaths: UK
Estimating migrant health worker deaths during Covid-19 based on WHO excess deaths: India
Estimating migrant health worker deaths during Covid-19 based on WHO excess deaths: Mexico
Estimating migrant health worker deaths during Covid-19 based on WHO excess deaths: Nigeria
Estimating migrant health worker deaths during Covid-19 based on WHO excess deaths: UK
Our data is fully Open Access (Creative Commons licence CC BY-NC-SA). It is freely available from the UK Data Service. There you will find further information about how we collected and generated the data and the processes we used to ensure its quality. You will also have access to a comprehensive User Guide, estimation spreadsheets for Covid reported and excess deaths in India, Mexico, Nigeria and the UK, and our data (in Excel workbook, SPSS and Stata file formats).
Yeates, Nicola, Tipping, Sarah and Murphy, Victoria (2022). COVID-19 mortality among migrant health care workers. [Data Collection]. Colchester, Essex: UK Data Service.
Migrant workers have been at high risk of contracting Covid-19 and experiencing adverse outcomes from it. This paper reviews research evidence from academic and grey literatures as regards how the pandemic has impacted on migrant health workers. Five principal factors stand out as exacerbating the risks to such workers: health workforce shortages; decent work deficits, including lack of social protection; discrimination, violence and harassment; absence of social dialogue, and changing patterns of international recruitment. These factors are interlocking and have highly consequential implications not only for the rights and welfare of those workers but also for the provision of universal health care and realising rights-based, people-centered sustainable development for all countries.
This paper presents a ‘state of the art’ comprehensive review and discussion of global and national policy responses to address the risks faced by migrant health care workers during the COVID-19 pandemic (2020-2022). It shows that remarkably few of the policy responses directed at the health workforce have addressed the specific circumstances, risks and needs of migrant members of this workforce, and not all such workers benefited from the measures. Beneficial measures, notably recognition of COVID-19 as an occupational safety and health issue and as an ILO fundamental right, are accompanied by measures infringing health workers’ earlier acquired rights. Accelerated international recruitment of health workers has been facilitated by rapidly adjusted domestic regulations on qualifications and skills recognition, licenses and visas, exacerbating extant staffing shortages in countries of origin and collective rights to health of populations in those countries.
Global policy responses have been largely declaratory, focussed on mobility, skills and training capacities, ethical recruitment and government-to-government programmes to manage health worker migration. Long-term policy responses in relation to rights-based approaches to health worker migration and building sustainable health care systems have been very limited. Further research is required to assess the efficacy of the measures adopted and whether those introduced on a temporary basis have been revoked, retained and/or extended.
See also PSI Policy Brief on health worker migration:
Building Resilience Across Borders: a policy brief on health worker migration (Jane Pillinger and Nicola Yeates, 2020)
Executive Summary of Building Resilience Across Borders: a policy brief on health worker migration - English version (Jane Pillinger and Nicola Yeates, 2020)
Executive Summary of Building Resilience Across Borders: a policy brief on health worker migration - French version (Jane Pillinger and Nicola Yeates, 2020)