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MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN Chief Executive Officer

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AN OVERVIEW OF FILIPINO LABOR MIGRATION Intended as a Temporary Measure Benefits  Stabilize Balance of Payments  Serve as Alternative Employment Strategy Issues/Problems  Dependence on International Labor Migration to Address Domestic Labor Market

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Page 1: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

MIGRATION AND EMPLOYMENT OF

FILIPINO NURSES

Commission on Graduates of Foreign Nursing Schools

A Presentation ByBarbara L. Nichols, DHL, MS, RN, FAAN

Chief Executive Officer

Page 2: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

OVERVIEW OF EMPLOYEMENT

Philippine Labor Force 82 Million Population

34.2 Million in Labor Force Unemployment Rate – 13% Annually About 800,000 One out of Five Underemployed

Page 3: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

AN OVERVIEW OF FILIPINO LABOR MIGRATION

Intended as a Temporary Measure Benefits

Stabilize Balance of Payments Serve as Alternative Employment Strategy

Issues/Problems Dependence on International Labor

Migration to Address Domestic Labor Market

Page 4: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

GOVERNMENT AGENCIES THAT FACILITATE AND/OR REGULATE

FILIPINO MIGRATION

Civil Service Commission Commission on Filipinos Overseas Philippine Overseas Employment Agency Professional Regulation Commission Technical Education and Skills Development

Authority

Page 5: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

PHILIPPINE HEALTH CARE SYSTEMINFLUENCES CURRENT STATE

Multifarious Issues and Problems Multiple Push Factors Devolution of Government Health Services in 1990 Private Sector Involvement

Increases 1600 Hospitals/60% Private

Smaller Than Governmental Facilities Limits Access to Marginalized and Underserved

Groups

Page 6: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

FILIPINO NURSE MIGRATION

The Philippines Major Source Country of Health Worker

Migration of Nurses Destinations of Choice

-- Saudi Arabia and the United States -- United Kingdom, Netherlands, Ireland

Page 7: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

PROFILE OF NURSES WHO MIGRATE

Predominantly Female Average Age – 32 years Leave Because Low Salary in the Philippines

Lack of Professional Opportunities Health Reasons Economic Necessity

Page 8: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

POSITIVE IMPACT OF HEALTH WORKER MIGRATION

One Billion Dollars Contributed to Economy, Annually, via Remittance

Addresses Oversupply of Health Workers

Exposure to Different Culture, Work Ethics, Career Advancement

Page 9: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

NEGATIVE IMPACT OF HEALTH WORKER MIGRATION

Human Capital Loss Negative Impact on Families

Loss of Family Values Social Costs

Increase in Fraudulent Documents Increase in Illegal Recruiters Insufficient Numbers to Maintain Philippine

Health Care System

Page 10: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

POLICY IMPLICATIONS

National Strategic Initiatives Create a National Commission on

Health Human Resource Development

Enactment of a National Health Service Act

Institute Reforms in Health Financing and Medical and Nursing Education

Page 11: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

Nursing Education in the Philippines

Commission on Graduates of Foreign Nursing Schools

CGFNS Department of Global Research & Test Administration

Page 12: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

Nursing Education in the Philippines

History TimelinePrior to 1964 Nursing curriculum offered Medical, Surgical,

Obstetrics, Pediatrics and Psychiatric Nursing specialties as separate courses

Studies showed that nursing curriculum was not relevant to the health environment

– Curriculum was too clinical and hospital based– 70% of citizens could not afford healthcare

Page 13: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

Nursing Education in the Philippines

History Timeline1965 -1984 Health conditions of citizens deteriorated Nursing curriculum revised to provide a better fit Coursework was integrated and catered to the

Philippine population Two types of programs were offered: Diploma and

Degree

Page 14: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

Nursing Education in the Philippines

History Timeline1989-Present Only one type of nursing program: Bachelor of

Science in Nursing Nursing education programs are in institutions of

higher learning After completion of courses, student must complete

fieldwork

Page 15: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

Nursing Education in the Philippines

Current Nursing Programs Nursing education program is generally 4 years in

length

Curriculum includes courses in humanities, social sciences, mathematics and natural sciences

Nursing content includes four major areas of nursing as well as community health, nursing research and nursing administration

Page 16: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

Nursing Education in the Philippines

Fieldwork• 5-10 cases of assisted and actual deliveries• 5-10 cases assisting in minor & major surgery• 4 weeks exposure to a psychiatric hospital• 12 weeks experience in community health• 4 weeks experience in a communicable disease

ward or hospital• 4 weeks clinical experience in a tertiary hospital

Page 17: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

Nursing Education in the Philippines

Current Licensure Once fieldwork is completed, graduate must pass the

nursing licensure examination administered by the Professional Regulation Commission (PRC) in order to practice as a registered nurse

As of 2000, registered nurse license is valid until revoked or suspended

Page 18: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

Top Countries of EducationVisaScreen Program (2003-2004)

51.3

16.912.8

4.6 2.3 1.70

10203040506070

Philippines Canada India UnitedStates

SouthKorea

NigeriaPerc

enta

ge o

f App

licat

ions

Rec

eive

d

Page 19: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

Philippine Educated Applicants (Certification Program)

1978 - 2004

86

71 73.6 78.1

65.8

53.9

0102030405060708090

100

1978-1982 1983-1987 1988-1992 1993-1997 1998-2002 2003-2004Year

Perc

enta

ge o

f Tes

t Tak

ers

Page 20: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

Top Countries of EducationCertification Program (1993-2004)

0

5

10

15

20

25

30

Perc

enta

ge o

f Tes

t Tak

ers

1993-19971998-20022003-2004

Page 21: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

English Requirement Pass Rates 1998 – 2004

0

5000

10000

15000

20000

25000

Num

ber o

f App

lican

ts

TOEFL TWE TSE IELTS MELAB MEORL TOEIC

Passed Exam Total Number of Applicants

Page 22: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

Average Age of CP Applicants 1978-2004

24.727.9 27

3227.8

24.3

05

10152025303540

1978-1982 1983-1987 1988-1992 1993-1997 1998-2002 2003-2004

Year

Mea

n ag

e

Page 23: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

Gender and Marital StatusCP Program, 1978-2004

0102030405060708090

100

1978-1982 1983-1987 1988-1992 1993-1997 1998-2002 2003-2004

Year

Perc

enta

ge FemaleMaleMarried

Page 24: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

Top Nursing Schools1978 – 2004

Pines City Educational Center The Central Philippine University San Pedro College The United Doctors Medical Center University of Santa Tomas The University of Pangasinan

Page 25: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

St. Tomas University

Page 26: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

Pangasinan

Cebu

Iloilo

Benguet

Manila

Top Five Provinces of Philippine Educated Applicants

1978 - 2004

Page 27: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

Map of The Philippines

BenguetPangasinan

Iloilo

Page 28: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

Downtown Manila

Page 29: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

Island of Palawan

Page 30: MIGRATION AND EMPLOYMENT OF FILIPINO NURSES Commission on Graduates of Foreign Nursing Schools A Presentation By Barbara L. Nichols, DHL, MS, RN, FAAN

Downtown Manila