Has the Code Been Successful? An integrative review of the impact of the WHO Global Code of Practice on the International Recruitment of Health Personnel

Abstract

International migration of health human resources (HHR) from low- and middle-income (LMIC) countries to high-income countries has been addressed on several international platforms since the late 1990s. World Health Organization (WHO) adopted the WHO Global Code of Practice on the International Recruitment of Health Personnel in 2010 to mitigate the adverse effects of HHR migration, but like other codes of practice aiming to provide ethical guidelines for international recruitment, the impact of the code is not clear so far. This study is an integrative review of past studies assessing the impact and adherence of the code in WHO state members and regions. This review follows the Whittemore & Knafl 2005 guidelines for conducting the review. A total of eleven studies were included in the review. The study results suggest that the code has not yet realized its full potential, especially in the countries that are more in need of health human resources. The direct impact of the code was found to be limited in areas such as key legislation in migration or bi-lateral agreements between source and destination countries or any financial mechanism to compensate source countries for the loss of HHR. However, as intended the code has been able to promote a global discussion and awareness of the issue related to migration and catalyse a few developmental changes. The study is limited by geographical regions as it does not represent all geographical regions such as regions of the Americas or western Pacific regions. This study provides a future direction to evaluate the code’s impact on LMICs and amendments to be made in the code to make it more effective.